مجله تصویر سلامت
سال یازدهم شماره 4 (زمستان 1399)

Human being has always faced different critical situations and unpredictable events such as floods, earthquakes and terrible infectious diseases such as cholera, plague, tuberculosis and influenza. However, it is believed that the Coronavirus (Covid-19) has been the most shocking pandemic that led to destructive effects in all geographical areas of the world and all aspect of terrestrial life. The governments increasingly enact quarantines, curfews, closures, and other restrictive controls against the countries, citizens, and institutions and deploy their facilities to tackle the infection and prevent its spread (1). Amid the anxiety of lock downs and the cancellation of educational programs around the world, researcher support has not stopped, and a group of knowledge brokers, led by librarians and medical informantionists, are constantly providing information services. Information is an urgent and essential commodity in any crisis. Therefore, librarians and information experts have to be always prepared to meet the information needs of society and provide the users with access to information.

It is difficult to run current organizations without delegating some of the authority to management levels. Despite the importance of delegating authority to managers, this seems to have been neglected in organizations. The aim of this study was to identify effective strategies for delegation of authority in Tehran University of Medical Sciences.

The present study was conducted in 2019 in two stages. In the first stage, existing strategies to increase the willingness of managers to delegate authority were extracted through a review study. In the second stage, by conducting 18 semi-structured face-to-face interviews and holding a focused group meeting, effective and appropriate solutions were identified to increase the desire of managers to delegate authority at the university from the perspective of stakeholders. At this stage, data were analyzed by thematic analysis method by 2 people.

The review of studies showed two groups of strategies at the organizational and individual levels to increase the willingness of managers to delegate authority. The effect of implementing the solutions has not been fully investigated in previous studies. In the analysis of qualitative findings, three themes (including the importance of delegation at the university management levels, barriers to delegation at university and effective strategies for delegation to administrators at the university) and four sub-themes (including clarification of the delegation process, teaching how to delegate, establishing methods Correct monitoring and evaluation and the use of motivational methods appropriate to the performance of managers) were identified.

with regard to the most important barrier to delegation at the managerial level is process-related, it is suggested that the training method and process of performance appraisal and organizational reward be reviewed to increase skills and motivate further delegation. So that, measure the effectiveness and implementation considerations, it is recommended to conduct further studies on the effective implementation of strategies and to monitor and evaluate the effects of the implementation of strategies.

Clinicians rely on clinical guidelines for decision making. Carefully formulated clinical guidelines are the result of a combination of relevant researches that links evidence to clinical practice. The purpose of this study was to determine the barriers to the use of clinical guidelines from viewpoints of residents.

This study is a qualitative phenomenological study that examines the experiences of the residents of Urology Department of Imam Reza Hospital in Tabriz City of Iran. The sampling method was purposive. Qualitative content analysis used to analyze this study. To validate the results, the interviews were repeatedly read and the opinions of colleagues were regularly used. External monitoring was used to increase its reliability.

11 semi-structured interviews were conducted with the urology residents of Imam Reza Hospital. The results showed that the challenges and barriers to the implementation of clinical guidelines were classified into three main themes: 1. Structural challenges: doctors' distrust of clinical guidelines, Illegitimacy and lack of local clinical guidelines. 2. Executive challenges: routine processes, Lack of agreeable atmosphere, resistance to change among physicians and high number of patients and lack of facilities. 3. Educational challenges: lack of residency time and lack of practical educational structure for students.

Given the importance of proper implementation of clinical guidelines as a link to up-to-date knowledge and practice and given the existing structural, executive and educational problems, obstacles and challenges, it is hoped that researchers, managers, policymakers and Patients should take steps to remove barriers to the proper implementation of clinical guidelines and provide high quality services to patients.

The drug distribution network is one of the most important pillars of the Iranian pharmaceutical system which plays a vital role in rapid and easy access to drugs. The purpose of this article is to evaluate drug distribution system in Iran and also to provide the suggestions for improvement.

In terms of purpose, the present study is among the applied researches and in terms of data collection method, it is a multi-method study that has used a quantitative and qualitative approach. Data collection tools were structured questionnaire and semi-structured interviews and also data evaluation was performed by thematic analysis. The study population includes pharmaceutical industry activists. To select the sample among industry players, snowball sampling method was used. Initially, existing drug distribution system was documented, current potentialities and flows in the network were identified and they were drawn by Bizagi Modeler. Then, distribution network evaluation indicators were extracted from relevant literature. Also, status of these indicators was evaluated by using a questionnaire. By using factor relationship technique (FARE), the priorities of these indicators were determined. Finally, existing bottlenecks were diagnosed by thematic analysis. Ultimately, guidelines to tackle such bottlenecks were provided.

In this study, 11 complications were identified for the drug distribution network. Drug unavailability or shortage, supply of near-expiration drugs, supply of counterfeit drugs, improper sale of over-the-counter drugs, black market activity and drug trafficking, sharp price fluctuations, insufficient interaction with consumption pharmacist, high distribution costs, low distribution network performance in emergency deliveries, long time to search and find drugs (in case of certain drugs) and low quality of response and consumer complaints seem to be some of the complications identified in this study.

Investments on measuring patients' needs correctly, supporting drug retailing competitive brands development, improving drug distribution system information comprehensive system throughout the country within needs measurement loops, network inventory, production and importation, improving the utilization of modern tools and technologies such as internet–based sales, seller-free shops, establishing electronic files for patients and similar ones, utilizing direct sale methods and fostering the roles of potentialities such as insurance in planning, decision making and monitoring drug distribution system countrywide are some of the solutions obtained from this research that are used to improve the drug distribution system in the country.

The aim of this study was to determine the predictive variables of emotional distress and their relative importance in patients with breast cancer. The aim of this study was to determine the predictors of emotional disturbance variables and their relative importance in patients with breast cancer.

The present research method was fundamental in terms of purpose, descriptive and exploratory in nature, so a high sample size was applied. The sample was among the patients with breast cancer who referred to Shohada Hospital in Tajrish, 736 patients ,19 - to 80 years old people with breast cancer who referred to the hospital during the first 8 months of 2019. Whole samples were selected but screened based on inclusion and exclusion criteria. Then the psychological scale of self-empowerment skills, interpersonal interaction quality scale, and emotional turmoil Scale were administered to assess participants.

The results showed that self-empowerment skills, quality of interpersonal interactions, age and head of household status showed a significant relationship with emotional turmoil. More precisely, it was found that the variables of the quality of interpersonal interactions and self-empowerment skills have the greatest impact on predicting emotional turmoil, respectively.

According to the results of this study, it can be said that interpersonal relationships, self-empowerment skills and demographic characteristics of patients with breast cancer play an important role in the emotional distress of patients. Therefore, it is suggested that psychologists pay special attention to these concepts in monitoring the mental state and improving the mental health of patients.

Nowadays, due to the increasing publication of articles in various scientific fields, analysis of the topics published in specialized journals is interesting for researchers and practioners. For this purpose, this study has identified and analyzed the issues published in the Iranian library and medical librarianship articles.

This study uses an exploratory and descriptive approach to analyze the library and information articles published in specialized journals in this field in Iran from 1997 to 2017 using text mining techniques. For this purpose, 982 articles on the library and medical librarianship have been selected from 16 journals. The TF-IDF weighting algorithm was used to identify the most important terms used in the articles and the LDA thematic modeling algorithm was used to determine the published topics. Python programming language has also been used to run text mining algorithms.

Results showed that the words of library (12.67), journal (12.47), information (12.23), hospital (9.90) and scientific (9.74) are the most important words based on their TF-IDF weight. The results of thematic modeling of these articles were based on the highest publication rates of scientometrics, information literacy, health information, knowledge management, webometrics, and the quality of the website and hospital information systems, respectively.

The results of this study showed that the topics of scientometrics, information literacy and health information have had the highest publication in the last 5 years. Also, the publication of knowledge management, webometrics and quality of the website and hospital information system has been less published in the last 5 years than in the past.

Contamination of surface and groundwater sources with aromatic compounds such as phenolic compounds is one of the newest environmental problems that humans encountered it today. One of the ways to remove these pollutants is the use of polymeric adsorbents. In this study, chitosan-bentonite-nano-graphene oxide nanosorbent was synthesized to investigate the phenol adsorption.

In this research, experimental design was performed using Design-Expert 7.0 software to investigate the effect of independent variables including nano graphene oxide, chitosan and bentonite on the dependent variable (phenol removal rate). Moreover, phenol absorption isotherm, kinetics and thermodynamics, were also examined.

Eventually, the optimum formulation of nano-adsorbent with specifications of 0.1 g of chitosan, 0.18 g of bentonite and 0.07 g of nano-graphene oxide was investigated. Optimal adsorption conditions were also obtained at a concentration of 100 ppm, pH=5 and 45 minutes of absorption time.

Finally, it was found that the synthesized nanosorbent follows the Langmuir isotherm, which represents physical adsorption, and also the kinetics of the adsorption process is the diffusion between particles. As a result, it was found that the optimal application of this nano-adsrbent is in wastewaters with a temperature of less than 400 °C.

Evaluation methods of health education are part of education program for all students. Evaluating health education curricula should show essential knowledge, attitudes, and skills. Therefore, the purpose of the present study is to explain the experiences of education specialists and health education experts to test health education in elementary school.

Qualitative methods used in this study. It based on an interpretive model and it was also implemented using a phenomenological approach. The method of data collection was semi-structured interviews with 15 health education experts who met the inclusion criteria. Colaizzi method used to analyze the interview data.

Findings consist of one main class "Evaluation of Health Education Knowledge and Health Promotion" and thirty subclasses "Written exams, conferences, doing classroom assignments correctly, class participation, practical assessment, classroom questions, evaluation of classroom activities, evaluation outside of the classroom, Peer to peer evaluation, self-evaluation, academic record, recording important events of students’ performance, personal and group testing and etc.

Studying the experiences of health education experts and evaluating health education showed that observation of children's behavior change over time is an effective methods of health education assessment in elementary school. Therefore, planning and prioritizing the proper formulation and implementation of health education evaluation curricula should focus on changing children's behavior over time.

The aim of this study was to explain the examples of "the Jurisprudential Rule of "Osr o- Haraj" or Denegation of Intolerable Hardship in the occurrence of congenital anomalies and genetic disorders and show that according to the current laws of the country, more of these diseases can be prevented.

Data for occurrence of congenital anomalies were derived from two major regional and national epidemiological studies based on 6,465,849 births in the country. A comprehensive review of literature was carried out on the details of ‘Denegation of Intolerable Hardship Rule. The details of medical termination of pregnancies diagnosed for congenital anomalies and the role of ‘Denegation of Intolerable Hardship’ principle in the prevention of birth defects were explored in several Focused Group Discussions formed by peditricians, geneticists, psychiatrists, neotatalogists and expert jurisprudents.

The statistical estimates indicate that there are now nearly 100,000 births with one of the birth defects occurring every year in Iran. The total prevalence of the anomalies has more than tripled in the last 18 years.

The occurrence of congenital anomalies and genetic disorders will undermine the gene pool of the population if preventive measures are not properly implemented in the community genetics services to control those disorders. According to the current law on therapeutic abortion, disorders that lead to the hardships of father, mother, family, community, as well as future generations may be diagnosed by the three specialists (before the 16th week of pregnancy, the time of onsetting the soul). They can then be referred for medical abortion. A minimum of 70,000 birth defects may be avoided using the therapeutic termination of pregnancies diagnosed for congenital anomalies if the ‘no hardship and negation of distress and constriction’ principle is suitably explored in maternal, pediatric, neonatal settings and for public health authorities.

Smell disorder such as dostorted olfaction (parosmia) is one of the most common symptoms of COVID-19. Therefore, this study aimed to investigate the improvement of symptoms of parosmia in patients with COVID-19 in 2020.

This cross-sectional study was conducted in summer and spring of 2020 using a data collection form which was validated with Cronbach's alpha of r=0.826. The study was done in an international health center in Tehran. To report descriptive results, mean, standard deviation, absolute frequency and absolute frequency percentage, and for analysis, independent t-test and chi-square test were used using SPSS software version 16 and the significance level was considered to be 0.05.

In total ,350 patients participated in the study, the prevalence of parosmia in patients was 15.14% and the mean and age deviation of patients was 32.71 ± 10.93 years. There was not a significant relationship between parosmia and gender (p value=0.317), age (p value=0.271), previous history of allergic symptoms (p value=0.083), family history of the disease (p value=0.638), taste disorder (p-value=0.768), and smoking (p-value=0.558). 31 cases (58.49 % of Patients) with parosmia had complete remission within 4-6 weeks.

Due to the high prevalence of olfactory disorders, especially parosmia in patients with COVID-19, parosmia and other olfactory disorders can be used to screen and triage patients with COVID-19, especially moderate and mild patients. Patients with parosmia should be followed for at least 4 to 6 weeks and if they do not recover for up to 12 weeks, they should be referred to ENT specialists for more specific measures.

In the year 2020 Covid-19 disease caused an extensive pandemic world-wide. It arose from Wuhan city in China and spread to whole world resulting in many deaths. Immediately, researchers conducted many studies to assess the etiology, epidemiology, ways of transmission and protective instructions and materials against Covid-19, but still there are not enough studies about challenges which dentists, dental students and patients referring to dental clinics encounter regarding their social, economic and psychological status. In this review, authors tried to focus on the literature regarding these problems. The literature search was conducted using natural language keywords and controlled vocabulary using MeSH through PubMed, Scopus and Google Scholar from 1st of January 2020 to 21st of November 2020. In addition, Gray literature and manual search of references were also performed. Articles with low quality methodology were excluded based on critical appraisal. The articles about the effects of Covid-19 on "dental education", "pediatric dentistry", "geriatric dentistry" and "dental professions and practice" were included in the study. The results showed that due to the practical nature of the dental profession and education and the importance of social distance during this pandemic (Covid-19), the dental community and even patients in need of dental treatment have been affected by this pandemic in different ways that should be considered by health officials for facilitating feedback to this pandemic.