bluuebunny/crossref_metadata_2025 huggingface dataset:
158: ASSESSING THE QUALITY OF SEARCH STRATEGIES IN DECISION SUPPORT SYSTEM (DSS) SYSTEMATIC REVIEWS
Authors: Fathifar Zahra , Hasankandi Hossein Saeedi , Sadeghi-Ghyassi Fatemeh
Published: May 2024

Background and aims:

Search strategies play a major role in developing a systematic review. A comprehensive literature search dramatically reduces publication bias. The higher sensitive search leads to a more well-prepared systematic review. The aim of this study is evaluating the quality of search strategies in decision support system (DSS) systematic reviews.

Methods:

A comprehensive literature search using MEDLINE (via Ovid), Embase, Pubmed and Cochrane Library was conducted until September August 2016. The search was limited to systematic reviews and with no language restriction. Meta-reviews were excluded. Only results of searching for “decision support systems” or “decision support system” keywords and limited to title of documents were included in this study. Two independent authors screened the results. Disagreement was resolved by discussion. The search strategies of the included studies were assessed with a nine-question checklist prepared by Faggionet al1. Data were extracted into Excel.

Results:

A total of 47 systematic reviews (SRs) were included. There was a dramatic increase in the number of SRs in recent decade; however no significant improvement was seen in search strategies during the time. The mean score of search strategies among SRs was 4.63 (out of 9). The highest score was 7 (21.2%) and more than 53% of SRs obtained a score between 5 and 7. In 74.4% of SRs, 3–8 databases were searched which 40.4% were considered 4 databases. About 55% of SRs reported search keywords and using Boolean operators that has increased in recent years. Near to 98% of studies were not conducted in duplicate. In near to 75% of studies hand-searching was performed but instead, in 72.3% grey literature was not searched and in 65.9% the authors of studies were not contacted for further relevant information. Fortunately, in about 60% of studies the literature search was performed without language restriction.

Conclusions:

Lack of duplicate literature searching in systematic reviews was notable. Although most of SRs were searched more than four databases but it seems that in most of them the major databases were not searched and instead, local or specialized databases were considered. Low tendency to grey literature searching was remarkable. It seems that the quality of reporting search strategies in the field of DSS is poor or moderate.
18: ASSESSMENT OF EXISTENCE OF THE REQUIREMENTS OF CLINICAL RISK MANAGEMENT IN HOSPITALS
Authors: Farokhzadian Jamileh , Poorchangizi Batool , Borhani Fariba
Published: May 2024

Background and aims:

At present, modern advances in health care, serious deficiencies have been identified in the quality of care and patients' safety. One way to handle these challenges is the establishment of a clinical risk management (CRM) system. This approach would improve the quality of healthcare and help ensure the safety of patients, visitors, and employees, as well as reduce the costs associated with the healthcare system. The aim of this study was to assess the existence of the requirements of CRM in the hospitals.

Methods:

This cross-sectional study was conducted on 200 clinical staff members from three teaching hospitals affiliated with the Kerman University of Medical Sciences in southeast Iran in 2014. The proportionate simple random sampling technique was used. Two tools were used for data collection, i.e., a structured observation checklist and a questionnaire. The data were analyzed using SPSS version 20.

Results:

Among the six domains of CRM, the highest mean belonged to domain the monitoring of analysis, evaluation and risk control (3.18±0.72).; the lowest mean belonged to domain the staff's knowledge, recognition and understanding of CRM (2.93±0.66). The findings indicated that implementing and developing domains of CRM ranged from poor to moderate. Almost all of study settings were implementing most measures of CRM. Despite these initiatives, there were no incident report forms in patients' files; electronic systems, such as Patient Safety Information Systems (PSIS); or the Patient Safety Reporting System (PSRS).

Conclusion:

Despite the establishment of clinical governance and accreditation approaches, the status of CRM is not appropriate. Health care in southeast Iran is not moving enough towards high quality and safe practice. Health care should move toward quality improvement and safe practice through the effective integration of CRM in organizational process. The organizational leaders must facilitate this process by creating necessary institutional infrastructures and strategic planning, management systems, and reinforcement of teamwork and professional communication to build positive attitudes among care providers towards strategies accreditation and clinical governance.
181: INFORMATION PRESCRIPTION FOR HEART FAILURE PATIENTS; A RANDOMIZED CONTROLLED TRIAL
Authors: Gavgani Vahideh Zarea , Golmohammadi Ali , Sadeghi-Bazargani Homayoun , Majd Faranak Kazemi
Published: May 2024

Background and Aims:

Patient's health/medical literacy may affect the healthcare promotion. There are various educational models for patient. The physician prescribed information intervention seems to be effective and demanded way of patient information delivery. We presented physician prescribed, medical librarian provided information after the physician confirmation to HF patients classified in functional class III or IV. The purpose of this study was to determine whether physician prescribed information intervention would decrease the rate of hospital re-admission in heart failure patients with functional class III or IV. The secondary outcomes were the cost of re-admission and change in number and type of medication prescription (Rx).

Methods:

We performed a 12-month randomized controlled trial from December 2013 to December 2014. 120 Patients were randomly allocated into two groups of intervention (n=60) and control (n=60).The control group received routine information given by nurse or physician and the intervention group received routine information plus Information Prescription (IP) prescribed by physician and presented to patient by librarian who explain patient how to use the prescription and describe it orally. Data were collected by telephone interviews with the follow up interval of 3, 6 and 12 months after discharge. Analysis of data was performed continually. Primary outcome was re-admission and or death in HF patients.

Results:

Patients were included with mean age 71.05±11.3. Patients in the intervention group had a lower rate of hospital re-admission or death upon adjusting a Cox survival model, the patients in the intervention group compared to control group [RR: 0.57 CI: 0.4–0.81] NNT: 3.3, CI NNT: 7.7–2.13. Fewer patients died during one year in intervention group compared to the control group (7vs15) [P=0.059, RR=0.47, CI: 0.20–1.06] NNT: 7.69 CI NNT: 3.7–333 .There was no significant difference in medication changes in intervention group compared to control group [RR=5; 95%CI: 2.6–9.8] NNT: 1.87 CI NNT: –1.47––2.76. Financial study demonstrated nearly triple difference in intervention and control per patient re-admission cost.

Conclusion:

Findings of this pilot study have shown that physician prescribed information intervention is clinically effective in reduction of death and re-admission rate in HF patients classified in functional class of III or IV. However to achieve the level of certainty based on statistical significance more evidence are still needed. Physician prescribed information intervention is a low cost, safe and risk free intervention comparing to other complementary intervention specially other educational programs for chronic conditions such as HF.
188: NURSES' UNDERSTANDING OF EVIDENCE-BASED PRACTICE AND IDENTIFICATION OF BARRIERS TO UTILIZATION FROM RESEARCH: A STUDY OF NURSES' KNOWLEDGE, ATTITUDE AND PRACTICE
Authors: Kalhor Rohollah , Kiaei Mohammad Zakaria , Azmal Mohammad , moosavi Saeideh , Tabatabaee Seyed Saeed , Gholami Soheyla
Published: May 2024

Background and aims:

In medical organizations, nurses utilize evidence-based practice (EBP) in order to evaluate their skills, develop and implement policies and procedures, carry out effective clinical interventions, and prepare care plans to enhance positive outcomes for patients. The aim of this study was to investigate the nurses' understanding of EBP and its relevant barriers in the selected hospitals in Iran.

Methods:

The present study was a descriptive- analytical research that was conducted using a cross-sectional design in order to investigate the nurses' understanding of EBP and its barriers. In so doing, 260 nurses were randomly selected from 6 teaching hospitals in Qazvin, Iran. Upton Evidence-based Practice Questionnaire and Funket al.Barriers Scale were employed to measure EBP dimensions and the relevant barriers, respectively. For analyze of collected data, frequency distribution tables, ANOVA, and linear regression coefficient were used.

Results:

According to the results of the present study, the level of the nurses' understanding of EBP was totally over the average (3.91 out of 7), and the mean practice, attitude, and knowledge/skill were respectively 4.14, 3.78, and 3.74. The total mean of the barriers was 3.07. The organizational and adopter dimensions had the maximum and minimum means, respectively. There were a significant relationships between adopter and communication with practice There were also significant relationship between the adopter and organization with Knowledge/Skills (p<0.05).

Conclusion:

Administering educational programs based on needs assessment obtained from the results of the present study can lead to an improvement in the level of the nurses' knowledge about EBP. In addition, since the existing barriers influence the effective conduction of EBP, removing such barriers by creating the necessary infrastructures and supplying human, physical, and financial resources can help with the achievement of its goals.
189: PATIENT MRI UTILIZATION BEFORE AND AFTER IRANIAN HEALTH CARE REFORM IN SHIRAZ GOVERNANCE HOSPITAL
Authors: Hajizamani Shadi , Sadeghimehr Reza , Aghajanian Saeid , Amozagar Mahbobeh , Sadati Ahmad Kalateh
Published: May 2024

Background and aims:

This study aimed to compare MRI utilization in governmental hospital 6months before and after Iranian health care reform in equal 6 months for 92&93.

Methods:

This is cross sectional study and data gathered from R&D department of Shiraz University of medical sciences and for data analysis used excell2007 and calculated utilization index

Results:

The total number of MRI scans in 92 was (31613) and in93 (35175). Average of inpatient admissions in 92 was (653) and for 93 (763) while the average utilization in 92 for outpatient was (4615) and this average for 93 is (4600) and utilization Index for inpatient is (1/16) and also for outpatient is (0/98).

Conclusion:

results indicate increase for inpatient utilization after reform .it seems that inpatient health coverage by government increase the possibility of induced demand by service provider after Iranian health care reform are important reasons for this changes in utilization index. It's important to monitoring all aspects by applying appropriate rules and prevents waste of resources and expanding justice for utilization of services.
19: ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICAL SKILLS REQUIRED FOR MEDICAL INTERNS TO LEARN DURING THE 7-DAY RHEUMATOLOGY WARD PERIOD IN TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Authors: Mokhtarkhani Mohaddeseh , Kolahi Sousan , Najafi Maryam
Published: May 2024

Background and Aims:

Medical students are responsible to learn and practice in the internal wards (including rheumatology) according to the designed evidence based standard of Tabriz University of Medical Sciences. It is Important to assess how much they have learnt. The aim of this study was to assess the interns' knowledge, attitude and the skills during their 7-day rheumatology ward education period.

Methods:

The current study is a cross sectional one conducted since 2014 to 2016, among interns of the Imam Reza Teaching hospital of Tabriz University of Medical Sciences. The students were to answer to the questions “What Did You Learn during Your rheumatology Period?” and “What Issue Was More Interesting and Useful?” Their writings were classified according to the national standard guideline of educational program, which contained 24 items; 9 for knowledge, 7 for skills, 4 for attitude and 4 major issues of rheumatology. The data were transferred to the analysis software of SPSS.

Results:

The statistics indicated that the interns' knowledge was scored for clinical findings, history, psychological effects and treatment of patients as 53.84%, 3.84%, 11.54% and 76.92%, respectively. Also their skills in physical examination, diagnosis, diagnostic arrangements, and medical recordings were scored as 100%, 88.46%, 76.92% and 53.84% respectively. For the attitude assessments, 34.61% and 38.46% of the interns had learnt active listening (patient value) and ethical behaving during their 7-day ward period. According to the assumed program for the major issues of rheumatology, arthritis and back pain was learned as well in 11.53% and 26.92% of interns.

Conclusion:

The findings indicated that this strategy can be an effective way for medical students' assessment. They assess themselves while reviewing their learning and writing them down. It can also be useful for the professors. Assessments should be according to the evidence based logbook; to consider how it is being taught. Through the current strategy, the common cases of the rheumatology ward and clinic get distinguished. Thus, if any change is needed to be conducted on the content of the evidence based logbook, it can be done.
196: THE EFFECT OF FAMILY PRESENCE DURING PEDIATRIC INTENSIVE CARE UNIT BEDSIDE ON FAMILY GENERAL HEALTH: A CLINICAL TRIAL STUDY
Authors: Adineh Mohammad , Toulabi Tahereh
Published: May 2024

Background and aims:

A child's hospitalization in intensive care units causes stress and worry in other family members. This study aimed to determine the effect of family presence during pediatric ICU bedside on family general health.

Methods:

In this clinical trial study, 46 family members of the pediatrics hospitalized in the ICU in Teaching hospital affiliated with the Lorestan University of Medical Sciences in khorramabad in April to November 2014 were divided into two groups using the stratified block randomization. Family members of the intervention group were present at the bedside of their patients two hours a day for six days, but family members of the control group did not visit their patients during six day. The general health status of the family members in the two groups was evaluated immediately before and after the visit on the first, sixth and twelfth visit, by using the General Health Questionnaire (GHQ). The data was analyzed using the repeated measure tests and independent t-tests.

Results:

Results showed there was a significant difference between the groups in terms of the means of the GHQ scores of the family members before and after the intervention (P<0.05).

Conclusion:

The presence of family members at pediatrics' bedside and their cooperation in care can improve their general health.
205: THE USE OF SOCIAL MEDIA TO CREATE VIRTUAL COMMUNITIES FOR PROMOTING EVIDENCE BASED PRACTICE AMONG NATIONAL UROLOGIST
Authors: Ebrahimi Sina , Ghoreifi Alireza , Shakiba Behnam , Azaripour Arash , Deldadeh Hamid , Elahian Amir Reza , Hadi Mazaher , Emadi Parvin , Rajaee Hamed , Dehghani Mehdi , Nosraty Lily
Published: May 2024

Background and aims:

This study aimed to find how Iranian national urologist see the Telegram messaging app to create a virtual community for sharing knowledge, patient management and problem solving by using best evidence.

Methods:

Telephone interviews with 50 urologist from Iran (10 residents, 25 urologist and 15 fellow), conducted in the context of use telegram. (We launched Telegram in 2016 and it has 295 members) In the interviews the respondents were asked to give their opinions about frequency of social media use, professional usefulness, popularity, ethics and barriers, evidence based practice and impact of this social media tools on their education, practice and patient management. The interviews were subjects to thematic analysis with an inductive approach.

Results:

The result sought to determine how these professionals are using an applicable messaging app-Telegram- and use their learning through this tool in their practice. The most of respondents emphasized the importance of this tool in their medical education in relation to busy and shift working schedule. The respondents saw this tool as a smart innovation for solving problem in their practice. However, they mentioned that in the lack of evidence they could not express their opinion which lead incompetence. The important things for our respondents were to continue their professional communication through online social networking sites but shift working times make them unable to attend the scheduled educational sessions. Therefore, new tools and social network are essential in continues education.
206: TRACKING THE PATIENT'S RIGHT TO INFORMATION IN IRANIAN PATIENT RIGHT CHARTER FROM THE MEDICAL INFORMATION SCIENCE PERSPECTIVE: A QUALITATIVE STUDY
Authors: Samadi Soraya , Gavgani Vahideh Zarea
Published: May 2024

Background and aims:

From the information science perspective making the right information accessible to patients ensures the healthcare promotion and empowers the patient to contribute and involve in his/her healthcare decision making and change. This study aimed at analyzing and visualizing the Iran's Patients Right Charter from the Medical Library and Information Sciences' viewpoints.

Methods:

A mix method of qualitative and quantitative was used to push the study. Content Analyzing and Descriptive method were used to analyze and describe data. It was also benefited the documentary methods to review the related literature in citation databases and gray literatures. And descriptive analysis also was hired to show the share of each concept in total knowledge depiction of Patient's Right to Information. The Iranian patient right charters were reviewed to trace the concept of information/right to information in every Para and articles. The Library Congress Subject Heading (LCHS) was used to extract the equivalent/parallel concepts related to ontology of information in the concept of health and medicine as well as law. All the LCSH based terms were then converted to main categories and subcategories. Patient right charters were reviewed with the LCSH based categories to reveal does the patient right charter include the right to information parameters, and which concepts, Para or articles is supporting right to information?

Conclusion:

Access to the right information at the right time is advocated by ethical and legal issues of clinical governance through the patients' rights. But to execute the patient's rights to information in practice it is essential to create clinical guidelines and to develop rules for information therapy service in Iran.
33: COMPARING THE EFFECTS OF BREAST CANCER SCREENING EDUCATION BASED ON “SYSTEMATIC COMPREHENSIVE HEALTH EDUCATION AND PROMOTION” MODEL TO HEALTH VOLUNTEERS ON WOMEN'S PRACTICE
Authors: Mirzaii Khadijeh , Ashkezari Shadan Nessari , Khadivzadeh Talaat
Published: May 2024

Background and aims:

Breast cancer is the most common cancer among Iranian women .One of the challenges of educational planners in gamut of reproductive health is how to deliver effective medical and health instructions. It feels and absolute need to have a native Educational model. This study attempted to determine the effect of breast cancer screening education based on SHEP (Systematic comprehensive Health Education and Promotion) model to Healthy volunteers on women's attitude covered by Mashhad health centers.

Methods:

This was a quasi-experimental study with two group/ Trainers and Audients, done in 2 urban health centers affiliated to Mashhad district health authority, divided randomly to experimental and control centers. 6 health volunteers and 60 women with random selected from each center were the sample of the study. An 8-hour workshop conformity SHEP model was conducted over two days for health volunteers in experimental group. In both centers 10 women were allocated for each health volunteer, were taken a pre-test with a breast self-examination checklist, and a questionnaire evaluating their knowledge and attitude about breast cancer screening and intend to do mammography and clinical examination. 2-hour educational session was performed for them by health volunteers, immediately and 4 weeks after educational sessions 2 post-tests were taken. Research data were processed and analyzed, using t-test, two-way ANOVA, Mann Whitney, Friedman, Chi Square, Fisher's exact test in SPSSv20

Results:

The mean scores of knowledge, attitude and practice was not statistically different between two groups in pre-test (p>0/05).There was a significant difference in mean scores of knowledge, attitude and practice between two groups immediately and one month after the intervention and on both times was higher in experimental group (p<0/05).

Conclusion:

Results of this study emphasize the efficiency of training based on SHEP model by usage peer Trainers on women's short and long term knowledge promotion about breast cancer screening, their attitude reformation toward breast cancer screening and improvement their performance in breast self-examination and intention to mammography and clinical breast examination.
38: COMPLICATIONS OF BROWN ADIPOSE TISSUE AND ITS ASSOCIATION WITH CARCINOGENESIS; A SYSTEMATIC REVIEW (PRELIMINARY DATA)
Authors: Jourabchi-Ghadim Neda , Aynehchi Aydin , Ebrahimi-Mameghani Mehrangiz
Published: May 2024

Background and aims:

Recently, increasing Beige/Brown Adipose Tissue (BBAT) - a hyper-metabolic tissue in human body – has been a promising tool to combat metabolic diseases such as obesity, diabetes and metabolic syndrome, which are associated with some cancers. Therefore, it seems that increased BBAT could reduce cancer incidence, which it is not agreed with the results of a number of studies. By considering the findings of observational and experimental studies, we aimed to review existing evidence for the link between BBAT hyperactivity and carcinogenesis.

Methods:

A systematic review of either published or e-published literatures from 1946 up to July-2016 was carried out using PRISMA guidelines. Scientific databases and search engines including MEDLINE, EMBASE, Ovid, PubMed, Scopus, ClinicalKey and ProQuest were searched systematically using key terms including “cancer”, “neoplasm”, “malignancy”, “carcinoma”, “tumor”, “metastasis”, “oxidative stress”, “free radicals”, “oxidant”, “brown”, “beige”, “brite”, “adipose”, “adipocyte” and “fat” in combination. This search was limited on English reported original research that were thoroughly appraised and included in this review.

Results:

Somein vitroandin vivostudies met the selection criteria. The production of a significant amount of free radicals by uncoupling chain protein 1 (UCP1) in the BBAT mitochondria has frequently been investigated. This could be as the main contradiction of a hyperactive-BAT. Furthermore, the link between BBAT activity and risk of cancer has been reported in a limited number of observational studies, esp. with breast cancer. Hence, BAT hyperactivity has been reported to be accompanied by the browning process of white adipose tissue (producing beige fat) in some experimental and observational studies that could deteriorate cancer cachexia through increasing metabolism. The production of free radicals along with increasing metabolism and energy expenditure of the human body has been suggested as possible mechanisms.

Conclusion:

It is concluded that although BBAT hyperactivity could have a potential role in carcinogenesis and cancer-induced cachexia, more human studies are required to focus on BBAT involvement in carcinogenesis.
40: CONSIDER THE PHYTOCHEMICAL, ANTI-BACTERIAL, ANTI-FUNGAL, ANTI-GIARDIA AND ANTIOXIDANT COMPOUNDS OF NECTAROSCORDEUM KOELZII AND NECTAROSCORDEUM TRIPEDALE
Authors: Rashidipour Marzieh
Published: May 2024

Background and aims:

Nectaroscordeum species are belong to the Alliaceae Liliaceae family which are used as ornamental flowers because of beautiful inflorescences. Leaves of nectaroscordeum koelzii and nectaroscordeum tripedale collected from west mountainous regions of Iran in the spring and used as flavorings in the preparation of a local bread. The aim of this stydy is consider the phytochemical, anti-bacterial, anti-fungal, anti-Giardia and antioxidant compounds of nectaroscordeum koelzii and nectaroscordeum tripedale.

Methods:

Component were extracted using methanol as solvent extraction, separation and measurement of the two plants by gas chromatography (GC/MS) was done, phytochemical properties of extract, including antioxidants, anthocyanins, phenols and flavonoids were examined. anti-bacterial and anti-fungal activity of the extracts were evaluated in two ways MIC and MBC, different concentrations of the extract was used to measure anti-Giardia.

Rrsults:

Most composition of essential oils of N. koelzii include: Di-El. Limonene (35/09%), beta-pinene (20/06%) and Trans-caryophyllene (11/32%), IC50 µg/ml 263/03, phenolic compounds 0/15%, flavonoid compounds 61/44% was reported, respectively.Most composition of essential oils ofN.tripedaleinclude: 2,4-decadinal (11/11%), Hexadecanoic acid(10/29%),Heptadecane(9/55%).The MIC for antibacterial and antifungal activity of extracts from both plants was variable between 625 and 10,000 per ml. In this study, the maximum power extract for anti-Giardia was at a concentration of 20 milligrams per ml. IC50 330/58 µg/ml, phenolic compounds 0/04%, flavonoid compounds 26/88% and anthocyanin was 4*10−6.

Conclusion:

According to the results obtained, N. koelzii extract was more powerful thanN.tripedalein biological properties, so these plants can be used as a preservative in food, pharmaceutical and cosmetics.
43: DESIGNING EVIDENCE BASED RISK ASSESSMENT SYSTEM FOR CANCER SCREENING AS AN APPLICABLE APPROACH FOR THE ESTIMATING OF TREATMENT ROADMAP
Authors: Maserat Elham , Safdari Reza , Aghdaei Hamid Asadzadeh , khoshsirat Alireza , Zali Mohammad Reza
Published: May 2024

Background and aims:

Prevention of cancer and risk assessment activity is highly information – intensively task, yet health care providers don't have appropriate technologies available to access, manage and interpret varied information. Also decision making modalities for cancer screening for many conditions and different stages have become increasingly complex. Evidence based systems facilitate decision making for the delivery of cancer screening services. The aim of this article is to designing evidence based Risk assessment system for cancer screening.

Methods:

This was a developing study. The first phase was a comparative study that performed by using secondary data extracted from literature review. Three courtiers (Canada, Australia and United States) were selected from 25 countries that are member in the international Cancer Screening Network (ICSN). National guidelines of colorectal cancer screening were approved in the next step. The scond phase was estimating of survival rate of covered populations. The Naive Bayes classifier was selected as one of the data mining technique for estimating. Finally evidence based hybrid decision support system was implemented. Programming language of designed web base system is Javascript. An integrated development environment (IDE) and database of system are respectively Jetbrain webstorm and MySQL.

Results:

In this study, screening evidence base system was surveyed of six dimensions. These dimensions were general specification, functions, technologies, data resources, users, manual and standards of screening information system. We approved four risk assessment guidelines (High risk, increased, average and low risk), clinical criteria for hereditary syndromes and roadmap of genetic and pathologic analysis. Designed intelligent hybrid system is integrated with registry system. This web base system has detected risk assessment groups by approved guidelines. This system determined 595 individuals with high risk, 185 individuals with increased risk, 20 individuals with average risk and 16 individuals with low risk up to July 30, 2016. Also screening recommendation screening of system was demonstrated by risk groups. Precision of system for detecting of risk groups was 100%. Evidence based system has estimated survival rates of covered populations with precision of 95.6%.

Conclusion:

This review was presented that evidence based system has improved real-time decision making process. This system has managed vast operation of cancer screening. One of the suggestions for future research is the national integrated evidence based network for all cancers.
47: DOWNSIZING OF PUBLIC HOSPITALS IN TABRIZ AND ARDABIL CITIES
Authors: Mousazadeh Yalda , beyrami Hosein Jabbari
Published: May 2024

Background and aims:

many countries use different strategies for example downsizing in order to optimal use of resources and reduce costs. Therefore, this study was implemented to evaluate of different downsizing methods in public hospitals of Tabriz and Ardabil cities.

Methods:

This study was a descriptive study that was conducted in 2015 and 2016 in order to identify of downsizing methods in public hospitals in Tabriz and Ardabil cities. A self-made questionnaire was used to data collection. Its content validity was approved by five university professors in health economic and health services management. SPSS 20 software and descriptive statistics was used for data analysis.

Results:

A total of 13 of downsizing methods, 11 methods were used in Tabriz hospitals and 6 methods were used in Ardabil hospitals. Outsourcing and cooperation between hospitals were the most frequent methods. Cost reduction was the most important goal of downsizing. Also, performance evaluation was the most important control mechanism after downsizing.

Conclusion:

The findings showed that the downsizing method specially Outsourcing and cooperation have been used widely in public hospitals of Tabriz and Ardabil universities of medical sciences. It seems precise planning, variety and hospital circumstances are important factors in achieving the downsizing goals.
49: EFFECT OF GREEN TEA ON LIVER ENZYMES IN RAT HEPATIC FIBROSIS MODEL
Authors: Dorreyatim Seyed Sina , Bavil Fariba Mirzaee
Published: May 2024

Background and aims:

Green tea is a popular beverage in the world, especially Asia. Beneficial effects of it have studied in the prevention and treatment of diseases. There are few studies about impact of green tea on hepatic diseases, thus we decided to investigate its impact on liver fibrosis.

Methods:

Forty male wistar rats were randomly divided into five groups: control group, GTE (green tea extract) group that received GTE powder dissolved in distilled water at doses of 125 mg/kg body weight orally for four weeks, fibrosis group, that was injected carbon tetrachloride (CCl4)1ml/kg/IP (diluted in corn oil), 3 times per week for 4 weeks, GTE+CCl4 group that received GTE and CCl4 at the same time and corn oil group was administered corn oil 1 mL/kg body weight three times a week for four weeks. In the end of study, the rats were sacrificed to measure serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP).

Results:

The fibrosis group showed an increase in ALT, AST and ALP levels in comparison with the control group (P<0.01). Green tea reduced all of enzymes in fibrosis model significantly (P<0.05). GTE and corn oil had no effect on the enzymes in normal conditions.

Conclusion:

According to obtained results, GTE decrease liver enzymes in situations fibrosis. So it is suggested that the use of green tea can be useful in reduction of liver injuries.
68: FACTORS AFFECTING THE KNOWLEDGE TRANSLATION: A QUALITATIVE STUDY AMONG FACULTY MEMBERS
Authors: Kakemam Edris , Sokhanvar Mobin , Arab-Zozani Morteza , Naderi Bahar
Published: May 2024

Background and aims:

When the results of researches be used in the field and suggested ideas come into force, it can be said the purpose of research was achieved. This study was conducted to extract the factors affecting the knowledge translation from faculty member`s perspective.

Methods:

This qualitative study was done in 2016 among faculty members of Tehran University of Medical Sciences. The sample number was based on data saturation. So the semi-structured interview was conducted with 18 faculty members. The interview set between 45–60 minutes. Note taking and audio type were used to data gathering. Content analysis was done by using MAXQDA-10.

Results:

The mean interview duration was 52 minutes. The 55.5 percent of participants were men and mean age of all participates was 42.6 years. 41 original codes were obtained from the review of transcripts. In the second step those codes were placed in 11 main categories based on codes content convergence. Finally, 5 main themes were extracted from categories combination based on theirs overlap. These themes included database and information availability, social and organizational culture, social capital, personal factors, and organizational factors.

Conclusion:

Knowledge translation is necessary to utilize studies result. In this regard attention to affecting factors is important to deal properly and successful knowledge translation.
83: IS DIFFERENT OF THE NURSES AND NURSING STUDENTS' PERSPECTIVE ABOUT PROFESSIONAL VALUES?
Authors: Poorchangizi Batool , Farokhzadian Jamileh , Borhani Fariba , Abbaszadeh Abbas , Mirzaee Moghaddameh
Published: May 2024

Background and aims:

Each professional group has its basic standards which are called the professional values and are considered the guides and motivation for individual professional behavior. Commitment to values is very important issue in health care that changing rapidly. The aim of this study was to examine the professional values from perspective of nurses and nursing students.

Methods:

This study was a descriptive-analytical research. By stratified random sampling method participated 250 nurses from hospitals affiliated to University of Medical Sciences and 100 baccalaureate nursing students of a school in Kerman, Iran in 2016. Data were collected by Persian version of the Nurses Professional Values Scale-Revised (NPVS-R) Weis and Schank. This instrument consisted 26-item in the five dimensions (Caring, Activism, Trust, Professionalism and Justice) at five- point Likert-Scale format (from not important to very important). Data analyzed by SPSS version 19.

Results:

The results showed that there was no significant difference between the mean scores of professional values of nurses (102/57±11/94) and students (101/79±12/42). The most important values of nurses and students, included “maintain confidentiality of patient” (from caring dimension), “safeguard patient's right to privacy” (from caring dimension), and the least important values in both groups were related to activism and professionalism dimensions for example participating in nursing research and/or implement research findings appropriate to practice and participating in peer review.

Conclusions:

The high total score of professional values of nurses and nursing students in this study represent most orientation nurses. Recommended to educators to pay more attention to these values in theoretical and clinical training of nursing students in particular values associated with social and political issues that there are related to activism and professionalism dimensions until through the teaching these values helped to promotion the nursing profession and also emphasized to the role continuing education in learning and instill professional values to nurses, according to emerging ethical challenges.
87: KNOWLEDGE, ATTITUDE, AND PRACTICE OF EVIDENCE-BASED MEDICINE AMONG PHYSICIANS: A SYSTEMATIC REVIEW
Authors: Barzkar Farzaneh , Baradaran Hamidreza
Published: May 2024

Background and aims:

Evidence-based practice, defined as the systematically reviewing, appraising and using clinical research findings to aid the delivery of optimum clinical care to patients, has been encouraged among physicians worldwide. We conducted a systematic review of articles assessing knowledge, attitude, and practice (KAP) of graduate physicians towards evidence-based medicine (EBM) and the barriers to the implementation of EBM.

Methods:

Medline, Google Scholar, and ERIC were searched systematically with appropriate search terms up to February 2016. References of the articles detected by search were screened for any missed articles evaluating knowledge, attitude, or practice of EBM among physicians. Studies with a qualitative design and those merely evaluated implementation of clinical practice guidelines were excluded based on abstracts. The studies were assessed regarding their instruments.

Results:

Out of 46 articles finally included in our study, 15 studies evaluated the study parameters among primary care physicians and the remaining studies evaluated residents (n=12) and specialists. The most commonly used (n=23) questionnaire was the one developed by McColl et al in 1998 which evaluated self-reported awareness, attitudes, and barriers towards EBM. Regarding the tools that assess knowledge, attitude, and practice of EBM, we found that the current questionnaires may have relatively adequate strength to measure attitude, but are subjective and indirect measures of awareness rather than knowledge. Moreover, some of the less commonly used tools were more objective and practical than the ones most commonly used.

The physicians have a generally positive attitude towards EBM and most of them believe that its implementation improves patient care. However their self-reported awareness and knowledge regarding common terms used in EBM and the main databases is generally poor. Both knowledge and attitude have improved through years after the introduction of EBM and specialists generally have a more positive attitude and better knowledge towards EBM than primary care physicians.

Conclusion:

Findings from our review indicate that in spite of the increasingly more positive attitude towards EBM among physicians, their knowledge and practice remain relatively poor. Also, there is need for updated more objective tools for the assessment of EBM knowledge, attitude, and practice among physicians
9: ADAPTATION OF PREGNANCY RISK ASSESSMENT MONITORING SYSTEM (PRAMS) AND PROVIDE A MODEL ON IT
Authors: Kharaghani Roghieh , Shariati Mohammad , Keramat Afsaneh , Yunesian Masud , Moghisi Alireza
Published: May 2024

Background and aims:

A surveillance system helps to detect epidemics and the pattern of the problems incidence in the community and it is essential part of evidence based decision making process. This study aimed to adapt of PRAMS and provide a model on it.

Methods:

This study was performed in 7 steps as follows: Surveillance systems in pregnancy were reviewed and appropriate system was selected for Iran by nominal group technique. Two comparative studies were conducted to determine the similarities and differences between Iran and the selected community. PRAMS method and system were adapted based on the results of the comparative studies and experts opinions. The study tool was adapted. A field trial was conducted to assess adapted PRAMS feasibility based on TELOS (technical, economic, legal, operational, and schedule) model in the city of Shahriar, located in the west of Tehran, and to compare data collection methods. Then, based on the results and consultation with related executive managers, the final model of PRAMS was suggested for Iranian health system.

Results:

Review of the surveillance systems in pregnancy, identified six models. The results of the nominal group technique showed that, the appropriate model for Iran is PRAMS. Based on the comparative studies and expert opinions, the appropriate system and method for program was as follows: the sampling frame was composed of data in thyroid screening forms and hospital records, the sampling method was systematic, data collection methods were home and phone based surveys, and participants were women within 2 to 6 months postpartum who had a live or still birth. The study tool was adapted. Thirty-seven health volunteers collected the data in this study (technical feasibility). Any home based completed questionnaire cost 2.45 and a phone cost 1.89 USD. Many indices were achieved from the study, which were worth much more than the expenses (economic feasibility). The project was consistent with legal requirements (legal feasibility). There was no statistically significant differences in mother's participation rate between phone (90.9%) and home visit (92.8%) groups and about 90.8% of different sections of the questionnaire were completed (operational feasibility). All data collection processes took 35 days (schedule feasibility). Based on the study results, the appropriate model of surveillance system was suggested with the goals of reducing infant morbidity and mortality and promoting maternal health by influencing maternal and child health programs, and maternal behaviors during pregnancy and early infancy.

Conclusion:

The adapted PRAMS could be considered feasible in Iran and may offer a potential solution to some data deficits in maternal and child health indicators. Moreover, by monitoring pregnancy risks and outcomes, we can assess, analyses, and modify the current prenatal care program through PRAMS widespread and periodic implementation.
97: POSITIVE RELIGIOUS COPING AS A PREDICTOR FOR IMPROVEMENT OF MENTAL HEALTH AMONG UNIVERSITY STUDENTS
Authors: Taheri-Kharameh Zahra , Hazavehei Mohammad Mahdi
Published: May 2024

Background and aims:

Religious Coping is known as a main resource influencing for adjustment and managing appropriately the problems and stressors, that it seems to be an inseparable component in mental health literature in recent years. This study was carried out to investigate the religious Coping and mental health in the students of the Qom University of Medical Sciences.

Methods:

In this descriptive and analytical study, 138 students of the Qom University of Medical Sciences were selected via random sampling methods. These students completed the Brief religious Coping scale (RCOPE) and General Health Questionnaire (GHQ-12). Data were analyzed in SPSS 16 software environment utilizing descriptive statistics and the Independent t-test, ANOVA, Pearson correlation coefficient and regression analysis.

Results:

Mean and standard deviations of religious coping well-being and mental health scores were 24.63±2.07 and 12.62±6.39. 47.8 percent of students have higher mean score in positive religious coping and the portion about negative religious coping was 48.5 percent. The results of multiple liner regression showed that positive religious Coping was significantly associated with general health (β=0.37;p=0.0001) related to the mental health component as well as controlling for demographic variables. There were no significant correlations between negative positive religious and psychological distress.

Conclusion:

The findings indicated that positive religious coping was associated significantly with better general health spatially mental health of students. Another word, positive religious Coping was respectively the most important factor for religious-spiritual components which may improve mental health in students.
Lipid profile alterations in non-infectious uveitis: correlation with quantitative optical coherence tomography angiography parameters
Authors: Shen Junhui , Qin Guangming , Feng Lei
Published: May 2024

Background/aims

Lipid profiles have been changed in numerous chronic conditions. The impact of uveitis on lipid metabolism remains unclear.

Methods

This is a cross-sectional study included 416 patients with non-infectious uveitis (NIU) and 416 healthy subjects. Standard techniques were used to measure total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDLc), low-density lipoprotein-cholesterol (LDLc) levels. Quantitative optical coherence tomography angiography (OCTA) parameters were obtained from 500 eyes in each group. Correlation analysis examined the relationship between lipid profile and OCTA parameters.

Results

Patients with NIU exhibited significantly elevated TC, TG and LDLc levels compared with controls (p=0.003; p<0.001; p<0.001, respectively). Subgroup analysis revealed that HDLc was significantly lower in Behçet’s disease (p=0.024) compared with controls. Vascular density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris and optic disk were significantly decreased in NIU eyes (p<0.05, respectively) compared with controls. HDLc exhibited a significant negative correlation with VDs in the whole and parafovea SCP (r=−0.489, p=0.008; r=−0.480, p=0.0026, respectively), while LDLc showed a significant positive correlation with VDs in the whole and parafovea DCP in NIU patients (r=0.576, p=0.032; r=0.267, p=0.034, respectively).

Conclusions

The lipid profile is altered in NIU, and there are correlations between HDLc and LDLc levels and VD as measured by OCTA. Lipid profile analysis may offer valuable insights into evaluating vascular and metabolic aspects of NIU.
Use of digital technologies for staff education and training programmes on newborn resuscitation and complication management: a scoping review
Authors: Horiuchi Sayaka , Soller Tasmyn , Bykersma Chloe , Huang Shan , Smith Rachel , Vogel Joshua P
Published: May 2024

Background

Poor-quality care is linked to higher rates of neonatal mortality in low-income and middle-income countries (LMICs). Limited educational and upskilling opportunities for healthcare professionals, particularly those who work in remote areas, are key barriers to providing quality neonatal care. Novel digital technologies, including mobile applications and virtual reality, can help bridge this gap. This scoping review aims to identify, analyse and compare available digital technologies for staff education and training to improve newborn care.

Methods

We conducted a structured search of seven databases (MEDLINE (Ovid), EMBASE (Ovid), EMCARE (Ovid), Global Health (CABI), CINAHL (EBSCO), Global Index Medicus (WHO) and Cochrane Central Register of Controlled Trials on 1 June 2023. Eligible studies were those that aimed to improve healthcare providers’ competency in newborn resuscitation and management of sepsis or respiratory distress during the early postnatal period. Studies published in English from 1 January 2000 onwards were included. Data were extracted using a predefined data extraction format.

Results

The review identified 93 eligible studies, of which 35 were conducted in LMICs. E-learning platforms and mobile applications were common technologies used in LMICs for neonatal resuscitation training. Digital technologies were generally well accepted by trainees. Few studies reported on the long-term effects of these tools on healthcare providers’ education or on neonatal health outcomes. Limited studies reported on costs and other necessary resources to maintain the educational intervention.

Conclusions

Lower-cost digital methods such as mobile applications, simulation games and/or mobile mentoring that engage healthcare providers in continuous skills practice are feasible methods for improving neonatal resuscitation skills in LMICs. To further consider the use of these digital technologies in resource-limited settings, assessments of the resources to sustain the intervention and the effectiveness of the digital technologies on long-term health provider performance and neonatal health outcomes are required.