Background and Aim: With the digitalization of healthcare, hospital information systems handle vast amounts of sensitive data, making their protection crucial. This study aimed to assess the compliance of these systems in hospitals affiliated with Birjand University of Medical Sciences with the physical and technical safeguard standards of Health Insurance Portability and Accountability Act (HIPAA) in 2024. Materials and Methods: This cross-sectional descriptive study was conducted in 15 hospitals affiliated with Birjand University of Medical Sciences. The study population consisted of Information Technology (IT) unit managers, who were selected using a census method (15 individuals). The research instrument was a researcher-developed checklist consisting of 56 items based on the physical and technical standards of HIPAA. The face validity of the checklist was confirmed by five experts in Health Information Management, Medical Informatics, and Health Policy, and its reliability was verified with a Cronbach’s alpha coefficient of 0.84. Data were analyzed using SPSS software and descriptive statistics, including frequency, percentage, mean, and standard deviation. Results: A total of 15 information technology managers (14 men and 1 woman) from 15 hospitals, including 8 teaching and 7 non-teaching hospitals, participated in the study. The findings showed that the hospital information systems of Birjand University of Medical Sciences complied with the HIPAA physical and technical safeguard standards at rates of 81.7% and 86.7%, respectively. In the domain of physical safeguards, the workstation security standard demonstrated the highest level of compliance, with a mean score of 89.3%. Full compliance (100%) was observed for certain indicators, including emergency access procedures for facilities and physical access control procedures. In contrast, the lowest compliance in this domain was related to the device and media controls standard, with a mean score of 74.9%, particularly in the identification and tracking of hardware and electronic media. In the domain of technical safeguards, the overall mean compliance rate was 86.7%. Among these standards, person or entity authentication achieved the highest level of compliance, with all hospitals demonstrating full compliance (100%). In addition, access control (93.3%), audit controls (86.7%), and transmission security (85.3%) were all at desirable levels. However, the lowest compliance was observed for the integrity standard (50%), highlighting the need to strengthen technical infrastructure and implement more advanced electronic mechanisms to ensure data accuracy and integrity. Conclusion: Although the overall level of compliance in the hospitals under study is satisfactory, significant gaps remain, particularly in device and media control and data integrity. These deficiencies may lead to breaches of patient privacy and undermine public trust in the healthcare system. It is recommended that senior hospital managers and health policymakers address these deficiencies by developing and implementing clear internal guidelines, investing in appropriate supportive technologies, and conducting continuous, targeted training programs for all personnel. In addition, periodic compliance monitoring is essential to ensure continuous improvement
Background and Aim: Fair protection against financial risks is considered one of the main goals of health systems, and lack of financial protection in health is regarded as a disease in health systems. Protecting citizens from the financial consequences of illness and fair access to health services is a challenge for governments and policymakers. Therefore, this study was conducted to investigate the indicators of out-of- pocket payments (OOP), catastrophic health expenditures (CHE), and Impoverishing Health Expenditures in hospitals in Tehran. Materials and Methods: This descriptive-analytical study was conducted cross-sectionally in 2023. The research population was all the households covered by one of the country’s insurance organizations in Tehran and 298 households participated in this study. A simple random sampling method was performed in five selected general hospitals in Tehran. The World Health Organization questionnaire was used to collect data. An interview was conducted with the head of the household or an informed person of the family. The back-breaking expenses were calculated based on the household’s payment capacity and the poverty line based on the household’s food expenses. Data were analyzed using Excel and SPSS software. Results: The results showed that 39.9% of households spent less than 10% of their total household expenditures on OOP health payments. However, 62.1% and 24.2% of participants experienced CHE and impoverishing health expenditures, respectively. Additionally, 36.9% reported borrowing money from friends or family, while 17.4% borrowed from non-relatives to cover health expenses. Furthermore, 5.4% of participants were forced to sell household assets, such as furniture, carpets, or jewelry, to finance their healthcare costs. Dental services, with an average cost of 1369000 tomans (±3,626,000), and medications with an average cost of 1,210,000 tomans (±2,104,000), imposed the highest expenses on households. Statistical analyses showed that the prevalence of CHE among participants differed significantly according to age (P=0.001), employment status (P=0.004), presence of a disabled or care-dependent individual in the household (P=0.002), and education level (P=0.021). Conclusion: According to the results of the study, over 62% of households face CHE, particularly among older adults and retirees, indicating weak financial protection in the health system. This highlights the urgent need to reform health financing policies and expand targeted insurance coverage for high-risk groups. It is recommended to design special insurance packages for individuals aged 60 and above, covering chronic, specialized, and preventive services.
Background and Aim: Adolescents spend most of their time online participating in social media activities rather than seeking scientific or health information. This study aimed to investigate the effect of e-health literacy training based on self-efficacy theory on the effective use of virtual social networks among first-year Afghan high school students in Mashhad. Materials and Methods: This quasi-experimental study used multi-stage cluster sampling in a randomized manner to create intervention and control groups. A total of 104 Afghan girls and boys first-year secondary school students were randomly selected from four self-governing refugee schools in 2024. The intervention group (53 participants) attended four training sessions, while the control group (51 participants) did not receive any intervention. Data were collected before, immediately following, and three months after the educational intervention. The following questionnaires were used to collect data: a demographic information questionnaire; the standard Sherer self-efficacy questionnaire, which had a Cronbach’s alpha reliability coefficient of 0.82; the standard e-health literacy questionnaire, which had a Cronbach’s alpha reliability coefficient of 0.88; and the standard social networking questionnaire, which had a Cronbach’s alpha reliability coefficient of 0.85. The data were analyzed using SPSS software. The significance level was considere as P<0.05. Results: Of the 104 participating students, 53 were in the intervention group (28 girls and 25 boys), and 51 were in the control group (26 girls and 25 boys). The age of participants in the intervention group was 13.55±0.50 years. Fifty two point eight percent of them had fathers with primary education, and 64.2% of them had fathers who were workers. Thirty five point eight percent them had illiterate mothers. A significant difference was found between students’ e-health literacy and their fathers’ level of education (P<0.05). A significant difference was observed in the effective use of virtual social networks based on the father’s job and income, and the mother’s education level (P<0.05). A significant difference was reported between self-efficacy and their father’s education (P<0.05). In the intervention group, E-health literacy increased from 16.85±2.61 to 29.15±1.89, The effective use of virtual social networks decreased from 50.04±15.05 to 37.57±8.38, and self-efficacy increased from 50.96±4.78 to 64.47±5.19, which was statistically significant (P<0.0001). Conclusion: The findings showed that education can increase students’ e-health literacy and self-efficacy, as well as their ability to effectively use virtual social networks. It is recommended that schools provide opportunities to strengthen e-health literacy through curricula and create supportive environments to increase students’ self-efficacy in effectively using virtual social networks. It is also better to consider the active participation of parents and teachers in designing interventions
Background and Aim: Helicobacter pylori is one of the most common causes of human infection. Most infected individuals develop chronic active gastritis, which can lead to gastric ulcers, atrophic gastritis, gastric cancer, and gastric MALT lymphoma. Antibiotic resistance is a multifaceted problem and encompasses medical, social, economic, and anthropological domains. The emergence of antibiotic- resistant strains in clinical settings has raised concerns among public health authorities. The aim of this study was to determine the antibiotic resistance of Helicobacter pylori to amoxicillin, levofloxacin, metronidazole, and clarithromycin in the gastroenterology clinic of Razi Hospital, Ilam. Materials and Methods: This is a descriptive study conducted over a period of 1 year on patients suspected of having infection caused by Helicobacter pylori who were diagnosed and treated in Razi Hospital as an inpatient or outpatient. In this study, a group of 50 people suspected of having gastrointestinal infections were selected for endoscopy. The obtained categorical data were analyzed using Chi-square and Fisher’s exact tests, while continuous variables (age) were analyzed using Student’s t-test in SPSS software, with a significance level of P<0.05. Results: A total of 50 patients were studied. None of the 50 patients had taken antibiotics during the previous month. Of these, 25 (50%) were men and the rest were women. The mean age of men in this study was higher than that of women, but this difference was not statistically significant (P-value=0.097). Of the 50 samples collected, 13 were confirmed as Helicobacter pylori based on a combination of positive rapid urease test (RUT), culture, biochemical testing, and genotypic verification via PCR. The PCR test result in all 13 cases was positive. Thus, the prevalence of Helicobacter pylori among patients who had referred to the hospital with gastrointestinal symptoms was 26%. In addition, the test result did not differ statistically significant according to the patient’s gender. Antibiotic sensitivity and resistance testing showed that all 13 samples studied (100%) were resistant to metronidazole and amoxicillin. Ten out of 13 samples (76.9%) were resistant to tetracycline and levofloxacin, and 12 samples (92.3%) were resistant to clarithromycin. Conclusion: The findings of this study indicated that H.pylori resistance to metronidazole and amoxicillin is high, and resistance to clarithromycin is also significant. Therefore, the choice of treatment regimen should be guided by local resistance patterns. Due to the small number of positive isolates, the results of this study should be interpreted with caution, and larger studies are required for generalization
Background and Aim: Continuous revision and updating of educational programs are essential to fulfill the primary mission of higher education. Therefore, the present study aims to examine the perspectives of stakeholders regarding the necessary changes in the BSc curriculum of Medical Library and Information Science. Materials and Methods: This study was conducted in two phases using the Fuzzy Delphi technique and a survey method. Participants included professors, students, graduates, and relevant administrators in the field of Medical Library and Information Science. The number of participants were 41 in the first phase and 122 in the second. The data collection tool was a researcher-made checklist based on the last edition of BSc curriculum of Medical Library and Information Science in the first phase, which was developed lesson by lesson. In the second phase, a researcher-made questionnaire based on the first phase data was its data collection tool. Collected data were analyzed using fuzzy numbers, defuzzification, and descriptive statistics. Results: The findings showed that the Basic courses comprised 19 credits (9 courses), of which only 11% were deemed necessary to retain, while 78% were identified as requiring deletion or major revision. The Core Courses (mandatory) comprised 65 credits (30 courses), with 20% considered essential to retain, 43% requiring review, and 37% requiring deletion or major revision. The Non-Core/ elective Courses comprised 12 credits (6 courses), and none of the elective courses achieved the required score for retention; 50 percent required revision and the remaining 50 percent required major revision or elimination. The highest necessity for course retention from stakeholders’ viewpoints was related to Sociology of Information in basic courses, Data Structures and Programming in core courses, and Introduction to Archiving in none core courses. In the second phase, updated teaching methods, inclusion of courses on evidence-based performance, critical thinking, artificial intelligence, and practical orientation of the Research Methods course were among the key findings. Conclusion: The results highlight the necessity of curriculum revision in BSc curriculum of Medical Library and Information Science. The curriculum of Medical Library and Information Science is expected not only to keep pace with developments in digital health and emerging technologies but also to adopt an interdisciplinary and skill-based approach. This requires changes in the design, implementation, and evaluation of the curriculum.
Background and Aim: Noncommunicable diseases are one of the most important public health challenges in the 21st century. Neuromyelitis optica (NMO) is a rare autoimmune disease that affects the central nervous system and can lead to permanent disability in young people. This disease is important due to its economic impact and reduced quality of life, and it is essential to understand its economic and social factors on these subjects. Materials and Methods: This study is a cross-sectional study based on the population of Iranian NMO patients. The instrument of this study was a researcher-made questionnaire in English from Harvard University, USA, which was translated into Persian and re-translated into English (translate- retranslate technique). The samples included NMO patients registered in the Iranian National NMO Registry System at Sina Hospital in Tehran, who completed information about their employment, income, and socioeconomic status via telephone interviews. The data were analyzed by SPSS software. Results: The total number of samples was 70, with a mean age of 41.40 years with a standard deviation of 10.91 years. The majority of patients were women, with 71.4% (50 of 70) of patients being female and 28.6% (20 of 70) being male. Sixty-one-point four percent of patients (43 of 70) had lost their jobs due to NMO and 70% (49 of 70) had reduced their working hours. Also, 47.1% of patients (33 of 70) reported a decrease in their annual income. Thirty-two-point eight percent (23 of 70) had lost between 51% and 100% of their annual income due to this disease and 10% (7 of 70) of patients had no annual income. Eighteen point five percent (13 of 70) of patients no longer work outside home due to the occurrence of NMO disease. Overall, the effects of NMO on the reduction of employment, working hours and income of patients were significantly high. Conclusion: The results showed that NMO has serious effects on the employment and income status of these patients in Iran and they need more economic and social support. Considering the physical disabilities caused by this disease and the reduced ability to work, NMO patients should receive special social and economic support from government.
Background and Aim: Trichophyton rubrum is among the most frequently detected species that cause dermatophyte infections, especially chronic infections, so it requires early diagnosis and appropriate antifungal treatment. Due to the increasing resistance of different species of dermatophytes to antifungals, the use of herbal compounds with antifungal properties can be used as adjuvant therapy or even an alternative therapy. Carvacrol has a wide range of biological activities, including antifungal, antiviral, antibacterial, insecticidal, and antioxidant properties. Accordingly, we aimed to determine the antifungal effect of carvacrol on 12 strains of Trichophyton rubrum in comparison to the antifungal drug terbinafine in vitro. Materials and Methods: This investigation was conducted on Trichophyton rubrum isolates that had been previously identified morphologically and molecularly. The protocol used to perform in vitro susceptibility testing was the A38-M-CLSI standard using the Broth Microdilution method. The obtained results were analyzed using SPSS software, and the MIC50, MIC90, and GM of this compound against Trichophyton rubrum isolates were estimated compared to terbinafine. Results: The minimum inhibitory concentration (MIC) was determined using different concentrations of carvacrol (in the concentration range of 0.25 to 2 μg/mL) and terbinafine (in the concentration range of 0.0625 to 0. 5 μg/mL). The MIC50 and MIC90 values for Carvacrol were determined to be 0. 5 and 2 μg/mL, respectively. Whereas, the corresponding values for terbinafine were calculated at 0.0625 and 0. 5 μg/mL. The GM values were 0.5 for cavacrol and 0.1 for terbinafine. Similar to terbinafine, the antifungal efficacy of the studied compound displayed significant differences against Trichophyton rubrum isolates (P-value<0.05). Conclusion: Although the MIC values for carvacrol were higher than those for terbinafine in vitro, it demonstrated significant antifungal activity against Trichophyton rubrum isolates. Therefore, this natural compound seems to be a good option for adjuvant therapy along with antifungals in dermatophyte infections, although the realization of this matter requires further investigation on the combined effect of carvacrol and terbinafine, determining the toxicity of carvacrol, and also examining this compound in vivo.
Background and Aim: Observing the principles of professional ethics by university faculty members guarantees the improvement of student ethics and the moral situation of the entire university environment. A 360-degree evaluation is a method in which individuals are assessed from multiple perspectives, including peers, supervisors, subordinates, and self-assessment. Therefore, the results of this type of evaluation are more objective, reliable, and valid. This study was conducted to evaluate the professional ethics of faculty members of operating room departments of the Universities of Medical Sciences in Tehran using a 360-degree feedback model. Materials and Methods: This descriptive-analytical cross-sectional study was conducted in the universities of Medical Sciences in Tehran between 2021 and 2022. The faculty members of the operating room groups of each university were evaluated by four groups of evaluators (themselves, senior managers, colleagues, and students of the operating room group) based on researcher-made questionnaires of professional ethics. In the community of faculty members, superior managers, and peers, the size of the community was equal to the sample. In the student community, the stratified sampling method was used according to the volume to determine the required samples from the student population in each university, and the sample size of 195 students was determined. The face and content validity of the questionnaires were confirmed by a group of expert professors (11 people). To estimate the reliability of the questionnaires, Cronbach’s alpha coefficient was used, which was for the self-evaluator questionnaire (0.87), superior managers (0.92), peers (0.88), and students (0.95). Data normality was assessed using the Kolmogorov–Smirnov test. Independent t-test, Mann–Whitney U test, and Kruskal–Wallis test were used for group comparisons, while Pearson’s correlation coefficient was used to examine relationships between variables. Finally, the data analysis was performed using SPSS software. For all tests, a significance level of P<0.05 was considered. Results: The overall mean professional ethics score of faculty members from the perspective of the four evaluator groups was 4.06±0.58, indicating a desirable level of professional ethics. Self-evaluation yielded the highest mean score across all dimensions (4.79±0.17), whereas student evaluations produced the lowest mean score (3.77±0.56). Professional ethics scores were significantly associated with the gender of self-evaluators (P<0.05). So that female faculty members rated themselves better than male ones. Furthermore, a significant difference was observed between male and female students regarding their perceptions of faculty members’ adherence to professional ethics (P<0.05). So that male students rated the faculty members’ adherence to professional ethics better. Conclusion: Considering the diversity of evaluators’ perspectives, modern and practical evaluation approaches such as 360-degree feedback are valuable tools for assessing adherence to professional ethics to determine the status of professional ethics from various stakeholder perspectives. These methods can help faculty members identify areas for improvement and enhance their professional performance.
Background and Aim: Klebsiella pneumoniae is among the most important pathogens responsible for nosocomial infections worldwide. In recent years, multidrug-resistant (MDR) and extensively drug-resistant (XDR) K.pneumoniae, the causative agent of urinary tract infections (UTI), have emerged as a major global health problem. This study aimed to investigate the prevalence of MDR and XDR K.pneumoniae originating from urinary infections and to compare their antimicrobial susceptibility to fosfomycin and cefiderocol. Materials and Methods: This descriptive cross-sectional study was conducted using 208 urine samples from hospitalized individuals during 2023-24. After identifying carbapenemase-producing K.pneumoniae strains by phenotypic and genotypic (PCR) tests, MDR and XDR isolates were identified using the Kirby-Bauer method and broth microdilution test according to the CLSI-2021 guideline. The minimum inhibitory concentrations of cefiderocol and fosfomycin were determined using broth microdilution and agar dilution, respectively. Results: Of the 57 carbapenemase-producing K.pneumoniae isolates, about 84% were collected from urine samples of patients hospitalized for more than 1 week and hospitalized in the intensive care unit (P<0.05), of which the highest level of resistance was observed to aztreonam (84.21%), followed by tetracycline (57.90%). Among the carbapenemase-positive K.pneumoniae isolates, 87.72% exhibited multidrug resistance, and 57.90% demonstrated extensive drug resistance. No significant differences were observed between age groups and gender in antimicrobial resistance (P=0.06). The effects of different fosfomycin concentrations showed that the highest growth changes were observed at concentrations of 16 μg/mL and 32 μg/mL, and 90% of the MDR and XDR strains were inhibited at concentrations of 64 and 512 μg/mL, respectively, with susceptibility rates equal to or greater than 92%. In determining the minimum inhibitory concentration of cefiderocol, the susceptibility rates of K.pneumoniae isolates that were multi- and extensively resistant to it were confirmed to be 88% and 79%, respectively. Conclusion: Considering the antibacterial effect and potential of fosfomycin in laboratory conditions, which is estimated to be 1.3 times that of cefiderocol, the results of this study suggest that fosfomycin may be effective in treating urinary tract infections with high drug resistance.
Background and Aim: The occurrence of conflict of interest in the Iranian health system has a negative impact on the provision of efficient and effective health care and services to patients, the training and education of students in medical sciences. Despite the efforts made in the country’s health system to manage conflict of interest, this phenomenon is currently observed through various factors, including the inefficiency of the financial structure, lack of transparency, and the lack of an integrated health information system in Iran. Materials and Methods: The present scoping review study that aimed to identify and determine conflict of interest management strategies in the Iranian health system in comparison with selected countries and to select appropriate strategies in 2024-2025 using the Arksey and O’Malley guidelines. All relevant articles and resources from 2007 to 2024 were extracted from national and international databases by observing the entry and exit criteria and by selecting Persian and English keywords. After screening steps using Prisma flowchart, 23 studies in English and Persian language from international and national databases, were analyzed. Results: Findings from 17 international studies—most of which were conducted in the United States— along with 6 domestic articles, showed main strategies of Iranian conflict of interest which included participation, transparency, legal oversight, processes reform, restructuring and reorganization. Although, using collective campaigns for correction of process behaviors and decisions, definition of ethical ethic codes, and standardization may help implementation of these strategies. Also, the most common cause of conflict of interest in the health system is individual rather than organizational, which requires regulation, the use of legislative levers, and the transparency of financial relations in the health system. Conclusion: Accurate identification of potential examples of conflict of interests among the agents of health care system by implementing information clarification, and using modern procedures may decrease the challenges in formulating and implementing strategies of conflict of interests among Iranian health care system. Although benchmarking from successful countries will be helpful in these countries. The implementation of these recommendations may face challenges within Iranian society, including resistance from certain professional groups, a lack of financial and technical resources, and the complexity and specific conditions of the health system. Therefore, a step-by-step approach to implementing policy recommendations for managing conflicts of interest in the health system should be considered.
Background and Aim: War is an inseparable part of human history that brings many problems. Self-care plays a major role in reducing complications and mortality. The purpose of this study is to “familiarize war casualties with self-care immediately after injury.” Materials and Methods: In this study, a narrative review of library resources and searching of internal and external databases related to the purpose of the study was used. Then, articles, books, dissertations, and other scientific resources related to the subject were examined. Results: In wartime conditions, a set of clinical problems leads to the deterioration of casualties’ conditions. One of the most important factors influencing self-care during wars is having sufficient awareness and knowledge in first aid, which requires the development of integrated approaches for first aid content. Other factors include identifying and eliminating threatening factors; quickly stopping the damaging agent; immediate contact with rescuers; maintaining an open airway; general self-assessment and temporary control of external bleeding; more thorough examination to identify signs of injury and life-threatening conditions; monitoring status (consciousness, breathing, circulation) and psychological self-support; and ambulance transfer to medical centers. Conclusion: To have a successful and effective self-care program for war casualties, first aid training specific to war crises should be provided to members of the community. Control of extensive bleeding, airway protection, wound dressing, pain control, and psychological self- support should be included in self-care programs. Accordingly, basic planning by relevant authorities, especially the health system, is recommended to increase the level of awareness and knowledge of self-care among members of the community in war crises.
Background and Aim: Electronic health literacy (eHealth literacy) refers to the ability to search, comprehend, and effectively apply health-related information obtained from digital sources, thereby enabling individuals to make informed decisions regarding their health. In the context of increasing reliance on the internet and online health resources, this skill has become essential for personal and public health. The aim of this study was to evaluate the level of eHealth literacy among adults aged 18 years and older in the city of Kerman, Iran. Materials and Methods: This cross-sectional, descriptive-analytical study assessed eHealth literacy among 700 adults (≥18 years) in Kerman City. Participants were sampled from different city areas to ensure representativeness. Data were collected using the validated 8-item eHealth Literacy Scale (eHEALS) on a 5-point Likert scale (total score 8–40; higher scores indicate greater literacy). Analyses were performed in SPSS using descriptive statistics (frequency, mean, SD) and inferential tests (Mann–Whitney U and Kruskal–Wallis) to explore associations with demographic variables. Results: The mean eHealth literacy score was 26.26±6.80, reflecting a moderate level of proficiency. While over half of the participants reported being capable of searching for and utilizing online health resources, less than half possessed the skills required to critically evaluate the quality of such information. The Mann-Whitney U test revealed a significant relationship between gender and eHealth literacy (P=0.002), with women scoring significantly higher than men. Furthermore, the Kruskal–Wallis test demonstrated statistically significant associations between eHealth literacy and age (P<0.001), level of education (P=0.001), employment status (P=0.001), and economic status (P<0.001). So that, higher scores were observed among younger adults (18–40 years), individuals with university education, students, and those with a higher economic status. Conclusion: The study indicates a moderate level of eHealth literacy among the population, with significant gaps in the ability to evaluate credible sources and use health information confidently. To address these gaps, policymakers should implement infrastructure improvements and public education programs that enhance access to reliable resources, foster critical appraisal skills, and support informed health decision-making
Background and Aim: Preparing laboratory sciences students for clinical internship requires enhancing practical skills and effective review of theoretical topics taught in the early years. This study aimed to design, implement, and evaluate a summer school for laboratory skills to improve students’ preparedness before entering clinical internships. Materials and Methods: This study was conducted over two consecutive academic years (2022–2023 and 2023– 2024) at the School of Allied Medical Sciences, in collaboration with the Departments of Laboratory Sciences, Hematology and Blood Transfusion, and Medical Information Sciences. Educational needs were identified through literature review and unstructured interviews. Subsequently, six specialized hands-on workshops were designed and conducted, covering Hematology and Blood Banking, Biochemistry, Immunology and Serology, Microbiology, Parasitology, and Hormone Assays. The quality of the courses was assessed with a researcher- made questionnaire. The questionnaire was designed based on a literature review and considering the research objectives. The face and content validity of this questionnaire was qualitatively reviewed and confirmed by experienced teachers (5 members of the faculty of the Laboratory Sciences Department), and its reliability was calculated and confirmed based on Cronbach’s alpha coefficient of 0.92. The questionnaire items measured the level of student satisfaction with a 5-point Likert scale from completely disagree (1) to completely agree (5). Statistical analysis was performed using SPSS statistical software. The effect of the courses on the students’ competence after the internship was also measured with the questionnaire. Results: Based on the results of the questionnaires completed by the students, 93.3% of the participants expressed their satisfaction with the overall implementation of the summer school. Further details showed that 91.6% of the students believed that the summer school was effective in improving their practical skills. Also, 78.8% of the participants gave a positive rating to the educational environment provided for practical learning, and 93.9% expressed their satisfaction with the supervision and feedback provided by the professors. Based on the results of the questionnaires after the end of the 12-unit internship, on average, 77.7% of the students stated that participating in the summer school increased their self-confidence and ability to perform laboratory tests during the internship. Also, 66.6% of the participants evaluated the course as an effective factor in improving their readiness to enter the clinical hospital environment. More than 90% considered the workshops useful for consolidating knowledge. Conclusion: It seems that the summer school increased students’ satisfaction and preparedness for entry into the clinical environment. It is recommended that such programs be integrated into the laboratory sciences curriculum.
Background and Aim: Identifying and transferring lessons learned from past disasters can significantly improve future disaster management performance. Although the general principles of disaster management are similar across events such as earthquakes, context-specific factors, including geographical location, scale and severity of the event, timing, and local characteristics, can shape distinct challenges and, consequently, different management approaches. Therefore, conducting case-based studies that account for the unique conditions of each disaster is essential for effective learning. This study focuses on the Kuhbanan earthquake and aims to identify management challenges arising from the specific characteristics of this region. Materials and Methods: This study employed a qualitative design using a directed content analysis approach. The study population consisted of experts, decision-makers, and frontline practitioners directly involved in managing the Kuhbanan earthquake. Using purposive sampling with maximum variation, 15 participants were selected from key organizations, including the University of Medical Sciences, the Iranian Red Crescent Society, the Provincial Crisis Management Center, and non-governmental organizations active in rescue and relief operations. Data were collected through in-depth semi-structured interviews, with questions developed based on the dimensions of the STEEPV framework (Social, Technological, Economic, Environmental, Political, and Values). Interviews continued until data saturation was achieved. Data analysis was conducted using MAXQDA software. Results: Data analysis led to the identification of 42 initial codes, 14 subcategories, and six categories aligned with the STEEPV framework. In the social dimension, key challenges included deficiencies in public and professional training systems (3 codes), weak intersectoral communication and coordination (6 codes), and inadequate responsiveness to community health needs (4 codes). In the technological domain, major limitations were observed in information management (2 codes) and the capacity of technological infrastructure (2 codes). From an economic perspective, financial constraints (5 codes) and welfare-related barriers (3 codes) were identified as influential factors. In the environmental dimension, specific geographical and climatic conditions including mountain topography, fault proximity, and mining operations (4 codes), along with unsuitable physical spaces for disaster management (3 codes), posed major challenges. In the political sphere, a noticeable gap between the government and the public (2 codes) and weak performance of some executive institutions (2 codes) were evident. Cultural and values-related challenges included specific local beliefs (1 code), inappropriate behaviors among communities and relief teams (2 codes), and insufficient consideration of regional culture in rescue and relief operations (3 codes). Conclusion: This study demonstrated that despite the relatively small scale of the Kuhbanan earthquake, many structural and managerial challenges previously observed in larger disasters were repeated. This finding highlights a chronic weakness in institutional learning and process improvement within the disaster management system. The application of comprehensive analytical frameworks such as STEEPV can assist managers and planners in understanding the complexity and interconnections of different crisis dimensions, moving beyond fragmented and reactive approaches toward more informed decision-making, enhanced stakeholder coordination, and ultimately greater community resilience. It is recommended that the findings of this study be used as a roadmap for revising national disaster management policies and for designing an integrated disaster lesson-learning system.
Background and Aim: Artificial intelligence-based systems can facilitate data management and interpretation in various dental specialties and can be used as auxiliary tools in diagnosis and education. Case-based reasoning is a promising artificial intelligence method for implementing decision support systems in medical sciences. In the current research, this technique has been used to design an intelligent system for the differential diagnosis of oral diseases. Materials and Methods: This research is a developmental study and is applied in terms of results. To create a database of cases, patient data was collected by referring to the specialized polyclinic of the Faculty of Dentistry at Tehran University of Medical Sciences and through clinical interviews. The [feature-value] collection was used to display the cases. The weight of the features was determined through a specialized Delphi survey conducted at the national level and as an online study. The determined weights were stored in the case database and used as similarity evaluation parameters. Then, the similarity index was calculated for each case. Results: The intelligent system designed in this research has been developed based on web technologies. Problem-solving in the case-based reasoning method is done in a cycle and includes four main stages: recovery, reuse, review, and maintenance. The input parameters of the system include clinical indicators, paraclinical indicators, historical data, and management data affecting the diagnosis process. The system provides a prioritized list of differential diagnoses of oral diseases across six main axes as output including Ulcerative, vesicular, and bullous lesions, Red and white lesions of the oral mucosa, Pigmented lesions of the oral mucosa, Benign lesions of the oral cavity, Oral cancer, Salivary gland diseases. Conclusion: The development of the system utilizing case-based reasoning techniques and clinical data processing has the potential to assist dentists in achieving differential diagnosis across six main areas of oral diseases.
Background and Aim: The rise in chronic diseases is one of the major challenges facing healthcare systems in the 21st century. Developed countries have turned to health-related quality of life recommender systems to address this issue. This study aims to review and evaluate these systems in the context of chronic diseases. Materials and Methods: A rapid review method was used in this study. The search was performed using a combination of keywords chronic disease, recommender system, health-related quality of life, and evaluation. The most frequently reviewed systems were related to the endocrine and metabolic diseases group with 15 cases (27.3%), which included diabetes (13 cases) and obesity (2 cases). This was followed by cardiovascular diseases with 9 cases (16.4%), including heart failure (7 cases), coronary artery disease (1 case), and hypertension (1 case), as well as respiratory diseases with 7 cases (12.7%), including chronic lung disease (4 cases), asthma (2 cases), and lung transplantation (1 case). Based on the inclusion criteria, some other chronic diseases including blood diseases and immune mechanism-related disorders with 2 cases (3.6%) including AIDS and hemophilia, cancers with 2 cases (3.6%), digestive diseases with 1 case (1.8%) including hepatitis and urinary tract diseases with 1 (1.8%) were investigated in this study, but they did not have a significant contribution. In order to assess the information needs, a search was conducted in library resources in three databases "Google Scholar", "PubMed" and "Scopus", with the aim of extracting articles of recommender systems in the field of health-related quality of life in chronic diseases, assessment tools and frameworks. The studies included 55 articles published in the period from 2003 to 2022. Results: The extracted systems in the present studies included 15 general mobile-based applications (27.3%), 16 mobile-based self-management and self-care applications (29.1%), 15 general internet platforms, sites and portals (27.3%), and 9 internet self-management and self-care platforms, sites and portals (16.4%). The studies used 4 methods of usability, effectiveness, satisfaction and technical evaluation. In most studies, usability evaluation was used with the aim of usability in 32 cases (58.2%) and effectiveness with the aim of health-related quality of life (behavior, knowledge and attitude) in 25 cases (45.45%). Ease of use features were used in 18 cases (32.7%), user- friendliness in 14 cases (25.45%), and usefulness in 10 cases (18.18%). In the second phase of the study, 98 assessment tools in the form of interviews and questionnaires from 55 studies were extracted and categorized. Ultimately, 50 usability tools, 26 effectiveness tools, 18 satisfaction tools, and 3 technical tools resulted from this study. Conclusion: With the growing number of mobile health applications and health-related quality of life systems, choosing the most suitable and effective option for users has become a challenging task. Paying attention to standard and evidence-based components of evaluation of these recommended systems can be effective in improving the quality of life related to patients’ health.
Background and aim: A Library is a safe place to research and study for some students, but it creates anxiety for others. The main purpose of this research is to investigate the library anxiety among Kermanshah University of Medical Sciences(KUMS) residents in using information sources and electronic services based on five factors of Bostick scale. Materials and Methods: The study was a cross-sectional survey. The sample size was 197 persons who were selected using simple random sampling. Data collection tool was a researcher-made questionnaire whose validity was confirmed by experts and its reliability was confirmed by Cronbachchr('39')s alpha coefficient of 0.809. The questionnaire consisted of 41 questions on a five-point Likert scale. The library anxiety questions were designed and localized based on the five factors of the Bostick scale. Data were analyzed using descriptive statistics, mean, standard deviation and analytical statistics by Kolmogorov-Smirnov test and Pearson correlation coefficient using SPSS 23 software. Results: The mean score of library anxiety was 78.32, the mean score of familiarity and usage was 32.08 and 29.54. Mechanical and emotional factors had the highest mean of library anxiety factors. Mean library anxiety was not significantly different between male and female residents(p>0.05). There was a significant relationship between residentschr('39') library anxiety and their skills in using information resources and e-services. Conclusion: The results indicate a level of library anxiety among the assistants. Accepting this fact can be a positive step in solving the problems associated with the use of information and electronic resources.
Background and Aim: The purpose of the present study is to map the coronavirus domain citation network to better understand this domain based on all other citation networks. Materials and Methods: The present study is applied in terms of purpose, and is descriptive scientometrics in terms of type, which has been done with the all-citation method. In this study, all scientific publications on coronavirus(6980 documents) in the period 1985-2019 AD were studied on April 10, 2020 in the Web of Science database. For analysis and drawing all citation maps, VOSviewer and Excel software were used. Results: In the field of coronavirus, 6815 documents, 10246 journals, and 40298 authors were identified. Ksiazek(2003) with the acute respiratory syndrome(SARS) topic received 875 citations and won the first place. The most cited documents in the field of coronavirus have 5 clusters; and the first cluster with 201 documents and with the topic of studying the structure of coronavirus is the largest one. Journal of Virology -- with the thematic range of genome structure and replication, virus identification, etc. -- ranked first with 35,383 citations. The most cited journals in the field of coronavirus are 5 thematic clusters, and the first one is the largest cluster with 121 journals and with the thematic domains of health policy, coronavirus, etc. Also, Woo won PCY first place with his specialization in identifying new microbes and emerging infectious diseases, and receiving 1491 citations. The most cited authors in the field of corona virus are in 6 thematic clusters; the first cluster with 195 authors in specialized field of virology and coronavirus is the largest cluster. Conclusion: By identifying the highly cited scientific products in the field of coronavirus, efforts have been made to provide a comprehensive view of top documents, top journals, and top authors so that it can be a decision-making tool in the shortest possible time.
Background and Aim: A hospital website is an appropriate system for exchanging information and connecting patients, hospitals and medical staff. The purpose of this study was to identify and classify desirable web-based services in websites of Iranchr('39')s hospitals based on Kano’s Customer Satisfaction Model. Materials and Methods: This was a survey study. The statistical population of the study consisted of hospital website users, of whom 120 were randomly selected. The data collection tool was a questionnaire based on Kano model. The validity of the questionnaire was confirmed by the information science and health information technology(HIT) professors. Data were analyzed using Kano model evaluation table, Excel software, and descriptive statistics. Cronbachchr('39')s alpha test was used to determine reliability(a=0.82). Results: First, the desirable web-based services of the hospitals’ websites were identified. Then, 67 identified services were classified into mandatory criteria(29 services), one-dimensional criteria(15 services), attractive criteria(14 services) and indifferent criteria(9 services). Most services were mandatory, attractive, one-dimensional and indifferent in content components. Conclusion: Most services identified in this study were on the websites of the worldchr('39')s leading hospitals; HIT designers and professionals and hospital managers are expected to use such services in designing hospital websites. Although the comments of site designers and experts were practical in some cases, they attracted a limited number of users due to their unfamiliarity with specialized website design topics.
Background and Aim: Medical concepts can be studied in language and literature. The purpose of this study is to investigate the term"pezeshk" and"medical terminology” in ancient Iran, in Persian language and literature, and in Mashreqi Shirazi poems. Materials and Methods: This research has been done by reviewing and studying three articles, three databases, and about fifteen books. Since the subject of study is “medicine in Iran” and “Persian language and literature”, non-Iranian physicians and Iranians whose works are in Arabic have been excluded from this study. Results: The history of medicine in Iran is as old as the history of Iran itself; and its influence can be clearly seen in Persian language and literature. The root of the term“pezeshk” is Avestan(Baesha-za), which has changed to Baesha-zak in the Middle Persian and in Bejeshk and Pezeshk in Parsian, which is still used today. The names of many Iranian ancient therapists are associated today with widely used medical terms: Trita is one of the first Aryan therapists, and his name is the same as“treat”. The names of some ancient Iranians are considered as the first ones in the world of medicine, e.g., Mehrdad II Ashkani, the first immunologist. Besides, in this study, the influence of medicine on literature was proved in the poetry of Mashreqi Shirazi(970-1038 AH), a shiite poet. Conclusion: Medicine is not an imported science to Iran and the history of medical science in this country is, as evidenced by history, as old as the history of Iran. This longevity can be seen in the Persian word “pezeshk” itself, and in the names of the first Aryan and Iranian physicians and the medical schools of ancient Iran. The global name of Medicine is taken from the first historical dynasty of Iran, Maad(Medi in Greek), and one of the first Maad healers, Cina(Cine) Moghani. In literature, it is apparent that Hakim Mashreqi was aware of medicine. Such awareness included the constituent elements of the body, name of some diseases, treatment and the name of some drugs.
