Accelerating leaf area measurement using a volumetric approach.

BACKGROUND: Despite the advances in the techniques of indirect estimation of leaf area, the destructive measurement approaches have still remained as the reference and the most accurate methods. However, even utilizing the modern sensors and applications usually requires the laborious and time-consuming practice of unfolding and analyzing the single leaves, separately. In the present study, a volumetric approach was tested to determine the pile leaf area based on the ratio of leaf volume divided by thickness. For this purpose, the suspension technique was used for volumetry, which is based on the simple practice and calculations of the Archimedes' principle. RESULTS: Wheat volumetric leaf area (VLA), had a high agreement and approximately 1:1 correlation with the conventionally measured optical leaf area (OLA). Exclusion of the midrib volume from calculations, did not affect the estimation error (NRMSE < 2.61%); however, improved the slope of the linear model by about 6%, and also reduced the bias between the methods. The error of sampling for determining mean leaf thickness of the pile, was also less than 2% throughout the season. Besides, a more practical and facilitated version of pile volumetry was tested using Specific Gravity Bench (SGB), which is currently available as a laboratory equipment. As an important observation, which was also expectable according to the leaf 3D expansion (i.e., in a given 2D plane), it was evidenced that the variations in the OLA exactly follows the pattern of the changes in the leaf volume. Accordingly, it was suggested that the relative leaf areas of various experimental treatments might be compared directly based on volume, and independently of leaf thickness. Furthermore, no considerable difference was observed among the OLAs measured using various image resolutions (NRMSE < 0.212%); which indicates that even the superfast scanners with low resolutions as 200 dpi may be used for a precision optical measurement of leaf area. CONCLUSIONS: It is expected that utilizing the reliable and simple concept of volumetric leaf area, based on which the measurement time might be independent of sample size, facilitate the laborious practice of leaf area measurement; and consequently, improve the precision of field experiments.

Wheat grain width: a clue for re-exploring visual indicators of grain weight.

BACKGROUND: Mean grain weight (MGW) is among the most frequently measured parameters in wheat breeding and physiology. Although in the recent decades, various wheat grain analyses (e.g. counting, and determining the size, color, or shape features) have been facilitated, thanks to the automated image processing systems, MGW estimations have been limited to using few number of image-derived indices; i.e. mainly the linear or power models developed based on the projected area (Area). Following a preliminary observation which indicated the potential of grain width in improving the predictions, the present study was conducted to explore more efficient indices for increasing the precision of image-based MGW estimations. For this purpose, an image archive of the grains was processed, which were harvested from a 2-year field experiment carried out with 3 replicates under two irrigation conditions and included 15 cultivar mixture treatments (so the archive was consisted of 180 images including more than 72,000 grains). RESULTS: It was observed that among the more than 30 evaluated indices of grain size and shape, indicators of grain width (i.e. Minor & MinFeret) along with 8 other empirical indices had a higher correlation with MGW, compared with Area. The most precise MGW predictions were obtained using the Area × Circularity, Perimeter × Circularity, and Area/Perimeter indices. Furthermore, it was found that (i) grain width and the Area/Perimeter ratio were the common factors in the structure of the superior predictive indices; and (ii) the superior indices had the highest correlation with grain width, rather than with their mathematical components. Moreover, comparative efficiency of the superior indices almost remained stable across the 4 environmental conditions. Eventually, using the selected indices, ten simple linear models were developed and validated for MGW prediction, which indicated a relatively higher precision than the current Area-based models. The considerable effect of enhancing image resolution on the precision of the models has been also evidenced. CONCLUSIONS: It is expected that the findings of the present study, along with the simple predictive linear models developed and validated using new image-derived indices, could improve the precision of the image-based MGW estimations, and consequently facilitate wheat breeding and physiological assessments.

Idea Generation Through Hackathon Event in Emergencies and Disasters, with Emphasis on Managing Flash Flood Disaster.

OBJECTIVE: This study was intended to demonstrate the applicability of the hackathon in idea generation for managing emergencies and disasters with a particular focus on flash floods. METHODS: A 4-day hackathon event was held, having 60 students, 9 mentors and 6 judges gathered to explore different ideas, and to solve problems of Iran flooding from mid-March to April, 2019. Of these, 10 teams with 6 students were accordingly formed to brainstorm and discuss the idea, while 9 mentors offered advice and guided them to manage their ideas. Then, all teams focused on designing their business models. Finally, the hackathon teams finalized their lean canvas and presented their ideas to the judging panel and the other participants. RESULTS: A total of 10 ideas were presented, and based on the knowledge and experience of the judges, 3 ideas that were more practical and useful were selected. CONCLUSIONS: As participants in a hackathon identify and present real-world problems, while ensuring that the prototype solutions address the end-user's needs, it could be used to drive innovation, generate ideas, promote change in emergencies and disasters, and can increase our preparedness for future events. It helps us to develop tools and applications to better respond to these events.

Basic Criteria, Models, and Indicators of Intersectoral Collaboration in Health Promotion: A Scoping Review.

BACKGROUND: In this study, the basic criteria, models, and indicators of intersectoral collaboration in health promotion were investigated to facilitate the implementation of collaboration. METHODS: This scoping review was conducted using datasets of Embase, Web of Science, Scopus, and PubMed, and search engines of Google, Google Scholar, and ProQuest. RESULTS: 52 studies were included, and 32 codes in Micro, Meso, and Macro level, were obtained. Micro-level criteria had the highest frequency. Among the models used in the reviewed studies, social network analysis, Diagnosis of Sustainable Collaboration, Bergen, and logic models had the highest frequency. Among the indicators studied, the number of participants and the level of collaboration as well as its sustainability were the most frequent indicators. CONCLUSION: The findings identified the most important and widely used criteria, models, and indicators of intersectoral collaboration in health promotion which can be useful for decision-makers and planners in the domain of health promotion, in designing, implementing, and evaluating collaborative programs.

Causes of medical errors and its under-reporting amongst pediatric nurses in Iran: a qualitative study.

OBJECTIVES: To explore the causes of medical errors (ME) and under-reporting amongst pediatric nurses at an Iranian teaching hospital. DESIGN: A qualitative study, based on individual, in-depth, semi-structured interviews and content analysis approach. SETTINGS: The study was conducted at the Pediatric Department of the largest tertiary general and teaching hospital in Shiraz, southern Iran. PARTICIPANTS: The study population was all pediatrics nurses who work at Pediatric Department and they had been trained on ME, as well as methods to report them through the hospital's ME reporting system. Purposive sampling was used by selecting key informants until data saturation was achieved and no more new information was obtained. Finally, 18 pediatric nurses were interviewed. MAIN OUTCOME MEASURE(S): Pediatrics nurses' views on the causes of ME and under-reporting. RESULTS: We found five main factors causing ME and under-reporting: personal factors, workplace factors, managerial factors, work culture and error reporting system. These factors were further classified into proximal and distal factors. Proximal factors had direct relationship with ME and distal factors were contextual factors. CONCLUSION: Causes of ME and under-reporting amongst pediatric nurses are complex and intertwined. Both proximal and distal factors need to be simultaneously addressed using context-specific approaches. Further research on other groups of healthcare workers and using a quantitative approach will be beneficial to elucidate the most appropriate interventions.

Revised Risk Priority Number in Failure Mode and Effects Analysis Model from the Perspective of Healthcare System.

BACKGROUND: Methodology of Failure Mode and Effects Analysis (FMEA) is known as an important risk assessment tool and accreditation requirement by many organizations. For prioritizing failures, the index of "risk priority number (RPN)" is used, especially for its ease and subjective evaluations of occurrence, the severity and the detectability of each failure. In this study, we have tried to apply FMEA model more compatible with health-care systems by redefining RPN index to be closer to reality. METHODS: We used a quantitative and qualitative approach in this research. In the qualitative domain, focused groups discussion was used to collect data. A quantitative approach was used to calculate RPN score. RESULTS: We have studied patient's journey in surgery ward from holding area to the operating room. The highest priority failures determined based on (1) defining inclusion criteria as severity of incident (clinical effect, claim consequence, waste of time and financial loss), occurrence of incident (time - unit occurrence and degree of exposure to risk) and preventability (degree of preventability and defensive barriers) then, (2) risks priority criteria quantified by using RPN index (361 for the highest rate failure). The ability of improved RPN scores reassessed by root cause analysis showed some variations. CONCLUSIONS: We concluded that standard criteria should be developed inconsistent with clinical linguistic and special scientific fields. Therefore, cooperation and partnership of technical and clinical groups are necessary to modify these models.

Overcrowding in emergency departments: A review of strategies to decrease future challenges.

Emergency departments (EDs) are the most challenging ward with respect to patient delay. The goal of this study is to present strategies that have proven to reduce delay and overcrowding in EDs. In this review article, initial electronic database search resulted in a total of 1006 articles. Thirty articles were included after reviewing full texts. Inclusion criteria were assessments of real patient flows and implementing strategies inside the hospitals. In this study, we discussed strategies of team triage, point-of-care testing, ideal ED patient journey models, streaming, and fast track. Patients might be directed to different streaming channels depending on clinical status and required practitioners. The most comprehensive strategy is ideal ED patient journey models, in which ten interrelated substrategies are provided. ED leaders should apply strategies that provide a continuous care process without deeply depending on external services.

Evaluation of reproductive health indicators in women affected by East Azarbaijan earthquake on August 2012.

BACKGROUND: Ignoring reproductive health services during natural disasters leads to some negative consequences such as reduced access to contraceptive methods, sexual disorders, and pregnancy complications. Despite previous researches, there is still more need for research on this area of health. This study attempts to identify the indicators of reproductive health in the women affected by the East Azarbaijan earthquake on August 2012. MATERIALS AND METHODS: In this descriptive study, reproductive health information pertaining to the years before, during, and after the earthquake were collected and compared in the health centers of the three affected cities including Ahar, Heriss, and Varzaghan as well as the health and forensics centers of the East Azarbaijan province in Iran by census method. RESULTS: Findings indicated a decrease in live birth rate, general marriage fertility rate, stillbirth rate, contraceptive methods coverage, and prevalence of sexually transmitted diseases during and after the earthquake. Moreover, important indicators such as neonatal mortality rate and percentage of infants screened for breast milk, decreased during the disaster year in comparison with the years before and after. Other indicators such as preconception care, pregnancy first visit, rate of caesarian delivery, and under 1-year formula milk-fed infants' percentages increased during the year of disaster in comparison with the years before and after. CONCLUSIONS: During the earthquake, some indicators of reproductive health have been reported to decrease whereas some others have gone through negative changes. Despite the partly favorable status of services, decision-makers and health service providers should pay more attention to the needs of women during disasters.

Recognition of medical errors' reporting system dimensions in educational hospitals.

INTRODUCTION AND OBJECTIVE: Nowadays medical errors are one of the serious issues in the health-care system and carry to account of the patient's safety threat. The most important step for achieving safety promotion is identifying errors and their causes in order to recognize, correct and omit them. Concerning about repeating medical errors and harms, which were received via theses errors concluded to designing and establishing medical error reporting systems for hospitals and centers that are presenting therapeutic services. The aim of this study is the recognition of medical errors' reporting system dimensions in educational hospitals. MATERIALS AND METHODS: This research is a descriptive-analytical and qualities' study, which has been carried out in Shahid Beheshti educational therapeutic center in Isfahan during 2012. In this study, relevant information was collected through 15 face to face interviews. That each of interviews take place in about 1hr and creation of five focused discussion groups through 45 min for each section, they were composed of Metron, educational supervisor, health officer, health education, and all of the head nurses. Concluded data interviews and discussion sessions were coded, then achieved results were extracted in the presence of clear-sighted persons and after their feedback perception, they were categorized. In order to make sure of information correctness, tables were presented to the research's interviewers and final the corrections were confirmed based on their view. FINDING: The extracted information from interviews and discussion groups have been divided into nine main categories after content analyzing and subject coding and their subsets have been completely expressed. Achieved dimensions are composed of nine domains of medical error concept, error cases according to nurses' prospection, medical error reporting barriers, employees' motivational factors for error reporting, purposes of medical error reporting system, error reporting's challenges and opportunities, a desired system characteristics, and the quality of error experiences' transmission in the health-care system. CONCLUSION: Although, appropriate achievements have been assured in Shahid Beheshti Hospital, but it seems necessary that in order to immune promotion not only in this hospital, but in the other organizations, necessary infrastructures have been provided for an error reporting system performance. An appropriate medical error reporting system could be educated and prevent the occurrence of repeated errors.

Quality service delivery in cardiac rehabilitation: cross-cultural challenges in an Australian setting.

BACKGROUND: Cardiac rehabilitation is an evidence-based health service model for providing secondary prevention strategies following an acute cardiac event. In spite of the benefits of cardiac rehabilitation, there are striking cultural and ethnic disparities with regard to access to and usage of these programmes. OBJECTIVE: To investigate the challenges in providing cardiac rehabilitation to culturally diverse populations in Australia to inform culturally competent care. METHOD: This was a qualitative study using interviews with 25 health professionals from diverse professional and language backgrounds working in cardiac rehabilitation and participant observation of educational and counselling sessions in four cardiac rehabilitation programmes in metropolitan Sydney, Australia. RESULTS: Providing cardiac rehabilitation to patients from culturally and linguistically diverse backgrounds presented greater challenges than did provision to the mainstream population. These challenges resulted from the interaction of multiple and complex factors such as patients, providers, structural and organisational characteristics within the treatment setting. Communication issues, reconciling health messages with culturally specific issues such as diet, social and family structure and implementation of self-management strategies are significant challenges. CONCLUSION: Strategies are needed to overcome cross-cultural challenges and ensure effective and equitable cardiac rehabilitation service delivery.

Negotiating norms, navigating care: findings from a qualitative study to assist in decreasing health inequity in cardiac rehabilitation.

PURPOSE: People from culturally and linguistically diverse backgrounds (CaLDBs) have lower rates of participation in cardiac rehabilitation (CR). Systematically evaluating barriers and facilitators to service delivery may decrease health inequalities. This study investigated approaches for promoting cultural competence in CR. METHODS: A qualitative study of 25 health practitioners was undertaken across three CR programs using a purposive sampling strategy. Interviews and participant observation were undertaken to identify factors to promote culturally competent care. RESULTS: Three key foci were identified for implementing cultural competence approaches: (1) point of contact; (2) point of assessment; and (3) point of service. Based upon study findings and existing literature, a conceptual model of cultural competency in CR was developed. CONCLUSION: Culturally competent strategies for identifying and tailoring activities in the CR setting may be a useful approach to minimise health inequities. The findings from this study identified that, in parallel with mainstream health services, CR service delivery in Australia faces challenges related to cultural and ethnic diversity. Encouragingly, study findings revealed implementation and integration of culturally competent practices in rehabilitation settings, in spite of significant odds.

Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS).

BACKGROUND: Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). METHODS: This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research instrument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. RESULTS: Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. CONCLUSIONS: Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authorities in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable framework and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

The sociocultural contexts of attempting suicide among women in Iran.

In this study, we investigated the sociocultural contexts of suicide attempts among women in Iran. Fifty women who attempted suicide and were admitted to the two main hospitals in Isfahan in 2006 were interviewed. The main themes identified were family problems, marriage and love, social stigma, pressure of high expectations, and poverty. We observed significant sociocultural influence on attempting suicide among the Iranian women in this study. Based on our findings we conclude that the women in the study were affected by social changes and the interplay between traditional and modern values and attitudes. Understanding sociocultural aspects of suicide in Iran is critical in providing effective and culturally sensitive suicide prevention and care programs.

A review of the cultural competence view of cardiac rehabilitation.

AIMS AND OBJECTIVES: This paper describes cultural competence issues within the scientific and scholarly discourse surrounding cardiac rehabilitation (CR). BACKGROUND: CR is an important secondary prevention strategy, improving health-related outcomes and reducing the risks of subsequent cardiovascular events. Internationally, it is widely accepted as a discrete health service model and is endorsed by government and professional bodies. Over past decades, low participation rates in CR remain a concern, particularly among minority groups and culturally and linguistically diverse populations. DESIGN: Systematic review. METHODS: Search of electronic databases. CONCLUSIONS: Few studies to date have described cultural competence in CR service design and as a consequence, there are minimal data to assist CR professionals and policy makers in tailoring health service delivery models. The limited scholarly debate and discussion regarding cultural competence in the CR literature limits the development and evaluation of culturally appropriate interventions. RELEVANCE TO CLINICAL PRACTICE: There needs to be greater attention to the concept of cultural competence, both in practice and research settings, to ensure access to CR for people from culturally and linguistically diverse backgrounds.

Identification of Australians from culturally and linguistically diverse backgrounds in national health data collections.

In multicultural Australia, comprehensive and up-to-date information on ethnicity and health is essential to guide policy and service development in the health sector. Data collected for purposes other than research are a potentially important source of information. This study explored the extent to which indicators of cultural and linguistic diversity are currently included in national health and welfare service data collections, and the data standards employed. We identified and reviewed 44 relevant bodies of work: 7 national data dictionaries, 15 national data sets, 10 national health data collections and 12 national surveys. Each of the large data dictionaries (health, community services and housing assistance) contained several ethnicity-related variables. Immigrant Australians were identified (usually by country of birth, sometimes by language, and occasionally by period of residence or year of arrival) in all the major national health and community data sets, health data collections and surveys. Australian Bureau of Statistics standards and classifications relating to cultural and linguistic diversity were widely used. Researchers, health policy makers and planners should fully exploit these secondary data sources, as well as undertaking or commissioning primary research.