مجله تصویر سلامت
سال نهم شماره 1 (بهار 1397)

Health information plays an important role in increasing the community's awareness of health issues, developing the ability of people to adapt to the surrounding environment and improve the quality of human`s life (1). Physicians also need reliable clinical information to prevent, diagnose, treat and rehabilitate patients. This information should be up-to-date and based on sufficient scientific evidence. Evidence-Based Medicine (EBM) is the result of this type of perception. In this area, physicians, should not only have experience, but also should be familiar with the sources of clinical information and technologies related with access to this information. Sahebalzamani et al quoted Sultani and Ahmadi Abhari as saying that "in fact, the use of the best evidence are evidences that are obtained from clinical research with the least error on patients and the efficacy and safety of treatment diet, prevention, the value of diagnostic tests and other health care items in different conditions of the patients are taken into consideration. In fact, EBM teaches how to be good users of health information" (2).
Clinical decision-making is not based on mental judgment and guess. Clinical decision-making should be based on the knowledge, experience of the physicians and other colleagues, considering patient feedbacks and scientific evidence. If physicians have adequate, up-to-date and valid evidence for a specific condition (such as illness), decision-making and treatment will be easier, more effective and successful. This ability and capability can be called “Clinical Information Intelligence (CII)”.
This term was extracted from technological intelligence, which is defined as "the ability and capability of technology professionals to make informed decisions about the current and future status of technology in an organization, and the opportunities and challenges of using it" (3). In fact, clinical information intelligence is the physician's ability to choose the best decision based on his or her own experiences, scientific evidence, colleague’s experiences, and the patient's values. The healthcare systems require physicians with clinical information intelligence capabilities. This ability will lead to better and more accurate decision-making by physicians, increase patient satisfaction and improve patient quality of life. To enhance this capability, physicians need to be familiar with clinical information resources such as EBM, PubMed and ClinicalKey and specialized resources. They should also have cognitive-behavioral abilities and capabilities. However, given the rapid changes in clinical information and clinical information retrieval technologies, medical librarians need to provide good policies, training and planning, access infrastructure, and the use of clinical information and training for physicians and patients. Physicians will increase their clinical information intelligence and capabilities by participating in these courses. Also, enhancing patient medical knowledge through information therapy and providing feedback and their participation in clinical decision-making can help to operationalize clinical information intelligence. Health information technology professionals also provide the necessary platform for telemedicine in order to health care and diagnosis and develop applications that provide physicians with access to reliable health information (4, 5). In summary, the capabilities that enhance the clinical information intelligence of physicians include the power of appraisal of scientific evidence, scientific communication with other colleagues around the world, a positive attitude toward specialized care, analyzing different patient situations, the power to utilize the knowledge and experience of the treatment teams in clinical decision- making, and the ability to identify opportunities or threats of clinical information for physicians and their parent organization.

Swimming pool water is quickly contaminated by swimmers which can cause the transmission and prevalence of various types of microbial infection through contact with the human body or accidently ingestion. Proper and regular chlorination of water in swimming pools, along with health monitoring by health care providers, and regular measurement of remaining chlorine along with controlling pH values, can be a useful tool to ensure the lack of risk to aforementioned diseases.
Material and In a cross-sectional study, during the four seasons of the year, 44 active swimming pools in Tabriz from 57 existing swimming pools were examined and the remaining chlorine, water temperature, ambient temperature and pH were measured. In addition to extraction of descriptive parameters, the obtained data were under the analysis of variance to compare the mean of the data.
In the studied pools, the minimum residual chlorine content was measured at zero and the maximum value of 5 mg/L was measured. The pH of the pools was in most cases near neutral and more alkaline (>7). In the main pools, there was no significant difference between the mean of measured parameters with regard to different seasons (P> 0.05). Correlation analysis indicated a significant inverse relationship between residual chlorine and water temperature in these pools (R = -0.694, p Based on the results of this study, it was revealed that the limits and recommended standards for residual chlorine, pH, pool temperature and ambient temperature in the pool environment are not observed in four types of main, Jacuzzi, chiller, and children pools examined in Tabriz. Particularly, in the case of Jacuzzi and chiller pools, the present situation was more unfavorable in terms of residual chlorine and water pH compared to other types, which requires serious attention.

Stroke has an unexpected and destructive effect on patient's lives and affects their quality of life. The aim of this study was to evaluate the quality of life and its related factors in patients with stroke in Tabriz city.
Material and This was a descriptive-analytic, cross-sectional study. The study population consisted of all patients who visited the neurological department of the Razi Hospital in 2015 with a diagnosis of stroke in Tabriz city. The quality of life in 72 patients was assessed by the quality of life questionnaire (SIS-16) using census method. To evaluate the relationship of quality of life with demographic variables and clinical features, one-way ANOVA and t-test were applied using SPSS (version 23) software.
In this study, the mean of total quality of life score was 73.66 ± 29.18. Results showed that there was a significant relationship between educational level and physical therapy with quality of life (p 0.05).
According to the results of this study, patients’ quality of life is reduced after stroke. To prevent side effects and improving the damages made, rehabilitation services (physical therapy) can be applied. Therefore, according to the importance of rehabilitation for stroke patients, it is suggested that access (physically and financially) to rehabilitation and counseling services are provided.

Success in any sport requires special physical and physiological capabilities. Therefore, designing an optimal and appropriate training program to achieve each individual's goals in terms of physical fitness is important. The purpose of the present study was to evaluate the effect of 8-week of plyometric training in a 90- 80 (Percent Heart Rate) on body composition, anaerobic power, quality of life and cardiovascular endurance of active female students in 1395-1396.
Material and This quasi-experimental study was performed on 45 female students aged 14-18 years. They were randomly divided into experimental and control groups. The experimental group consisted of 23 participants with a mean age of (16 ± 2 years), height (164 ± 0.09 cm), and weight (57 ± 7.7 kg). Control group included 22 participants with a mean age of (16 ± 2.3 years), weight (60.9 ± 9.96 kg), and height (163 ± 0.09 cm). The pre- and post-test measurements included strength, anaerobic power, cardiovascular endurance, body composition and quality of life through questionnaires (WHOQOL). The covariance analysis test was used for data analysis.
There was a significant increase in anaerobic power (0.001) and a significant decrease in body composition (p= 0.046). However, there was no significant increase in cardiovascular endurance (p= 0.180). Also, there was a significant increase in total score of quality of life.
The results of this study showed that eight weeks of plyometric training improved the body composition, quality of life and anaerobic power.

Recently, use of E-Epidemiology methods (internet, e-mail, cell phone, etc.) in epidemiological and medical sciences researches has had a prominent improvement. Therefore, the present study was designed and conducted with the aim of studying the knowledge, attitude, and practice of epidemiology researchers worldwide about using E-Epidemiology methods.
Material and This mix study (quantitative-qualitative) was conducted in 2013 in Tabriz University of Medical Science. The participants consisted of epidemiology researchers from all over the world. The data gathering instrument in quantitative section was a researcher-made questionnaire in English whose validity and reliability were measured respectively with content-validity method and Chronbach’s alpha method with a sample of 15 participants (α=89). For qualitative section, an open-ended question was asked. After extracting participants’ (76) e-mail addresses, the questionnaires were sent to them via e-mail. The qualitative data were statistically analyzed using descriptive statistical methods (Frequency (percent), Mean, and Standard Deviation) and One Way ANOVA test by SPSS.16 software.
The results showed that the epidemiology researchers scored 51.22±14.7 in knowledge, 71.25±45 in attitude, and 46.98±14.03 in practice sections (from100). According to researchers’ attitude, using E-Epidemiology methods results in improvement of qualitative and quantitative level and also validity of the studies; however, there are some limitations by facilities, infrastructure, and culture for using them.
In order to use E-Epidemiology in researches, increasing the knowledge level, changing the epidemiology researchers’ attitude, encouraging people to participate in these studies and providing appropriate facilities and good conditions in this field are necessary.

Integrated solid waste management is one of the biggest environmental challenges facing the public and private institutions. This requires knowledge of the composition and sources of waste production. The aim of this study was to determine the quality and quantity of common waste at the faculty of health and nutrition and medical schools.
Material and This study was a cross sectional and descriptive study on the point of all-waste generated in both schools. A total of 24 samples were taken and weighted from each school. Data were analyzed with SPSS and Excel. T-test was used for comparison of means following normality test of the data.
Average of waste produced at faculties of health and nutrition and medicine were 37±7 and 30±3 kg per day, respectively. Paper and metals were the highest and lowest part of solid waste, respectively with daily average of 15 and 2 kg. Paper is accounted about 40 to 45 percent by weight of the total waste. Per capita waste production in the faculty of health and nutrition is nearly twice faculty of medicine. The total waste per capita of university was estimated at about 15 kg per person per year.
University solid waste per capita, especially the amount of paper, is high compared with the other researches. The highest amount of waste material examined in this study is recyclable at source. Training programs and changes in attitude and practice must be applied for students and staff to produce less waste to protect environment and natural resource and create a green university.

Administrative and financial affairs are one of the most important activities in any organization. Determining the processes related to these affairs is necessary. Therefore, the present research was designed and implemented to improve the administrative and financial processes of Management and Medical informatics school of Tabriz University of Medical Sciences by action research methodology.
Material and This was a qualitative study with action research approach. After understanding about the lack of transparency and time consuming of administrative and financial processes, it was planned to resolve this problem. The correct form of the processes was determined and presented after reviewing the jobs description, interviewing with personnel and drawing the flowchart of the administrative and financial processes. Then, an evaluation was done by selecting 20 percent of the processes and examining personnel’s performance and timing.
Current situation analysis showed that administrative and financial processes are done mainly based on individual experience and interest. The lack of coordination with school's educational and research timetable prevents timely performance of tasks. After taking action research steps, 49 processes were identified and documented. (accounting: 13, secretariat: 2, public affair administration: 7, staffing: 16, property: 7, and procurement: 4). The results of the evaluation showed that 97% of the processes were in accordance with the standard and the time spent on implementing the processes was reduced between 30% to 100%.
Action research, as part of a collaborative process between researchers and process owners promoted administrative and financial processes. In order to increase the readiness level of the financial department of the faculty and coordination with the education and research departments, adjusting the administrative and financial calendar at the beginning of the year predicting the action time before receiving the request receipt of the units was suggested.

Inappropriate care during pregnancy can lead to undesirable results, including preterm delivery and low birth weight. One of the new, accurate and comprehensive indicators is the measurement of the adequacy of prenatal care. The aim of this study was to evaluate the use of prenatal care among pregnant women in East Azarbaijan province during 2008-2013.
Material and This retrospective cohort study was conducted on a group of 1142 pregnant women in East Azarbaijan province between 2008 and 2013. Information was extracted from the notebook of Maternal Care and the Household records of health centers. Data analysis was performed using independent t-test and one-way ANOVA by Stata11 software.
The mean age and standard deviation of pregnant women were 26.31 ± 5.81. Most of the pregnant women, 86.69% (965) had term delivery, 50.36% (554) had caesarean, 97.17% (1063) had sufficient care, 97.78% (1101) had starting care during the first trimester and 58.66% had normal hemoglobin (11-13.2 g/dl) in the first trimester of pregnancy. The coverage of at least four cares by rural and urban healthy worker was over 97%. According to the results, 90.2% of women received at least three care visits from midwives of community health centers, 97.67% received at least one visit by the family physician, and 79.77% received at least one visit by a gynecologist. As the number of prenatal cares increases, the number of low birth weight decreases significantly.
Utilization of prenatal care in East Azarbaijan Province was consistent with the recommendations of World Health Organization and national guidelines regarding the number of provided care.

Alcoholic beverages consumption affects all body organs and causes wide range of diseases such as cancers, psychopathy and violent behaviors. There is no precise statistics on alcohol consumption prevalence in Iran. Nevertheless, it is estimated that there are more than one million abusers of alcoholic beverages in the country. Various programs and interventions have been conducted to prevent and reduce alcohol consumption in different nations. The current narrative review study aimed at determining the effective strategies and programs applied in other societies and identifying appropriate approaches to the current situation of Iran. National and international databases were assessed by the research team and related studies were retrieved and categorized after quality assessment. Results of this study indicated that effective programs in prevention and reduction of alcohol consumption can be categorized in six general parts as follows: education and training, health-sector programs, community programs, regulations and policies regarding driving under the influence of alcohol, access-related policies and harm-reduction programs.