مجله پیاورد سلامت
سال چهاردهم شماره 5 (آذر و دی 1399)

Virtual Reality and Augmented Reality are immersive technologies that integrate virtual and real-world elements. These technologies have been used to help and improve human capabilities in many fields. Virtual and augmented systems are used in various medical situations. They are effective options in most stages of patient treatment and performing medical procedures. Therefore, the purpose of this study is to investigate the applications of virtual and augmented reality technologies in the field of medicine and rank them.

This applied research was conducted in two phases using mixed-method approach in 2020. Library resources were used in the qualitative phase and a questionnaire in the quantitative phase. The applications of virtual and augmented reality technologies were ranked by a panel of experts having 13 members. Finally, Stepwise Weight Assessment Ratio Analysis(SWARA) method was used to rank the applications of technologies in medicine.

The results of SWARA method showed that education(0.252), surgery(0.216), health games(0.188), patient control and diagnosis(0.186), and pharma(0.158) were the most important applications of virtual and augmented reality in medicine.

Based on the results of this study, it can be acknowledged that medical education and surgery are the most important applications of augmented and virtual reality technologies in medicine. Therefore, policymakers and hospital managers must use this ranking for the development of virtual and augmented reality technologies in their organization to provide better services to the customers and patients.

In angiography, the lens of the eye may be exposed to radiation and cause cataracts. In Iran, at present, only a single film dosimeter is used under the lead-apron to evaluate individual doses. The aim of this study was to investigate the status of occupational radiation as well as the validity of measuring the dose of the whole body of individuals and eye lenses using a single film dosimeter.

In this study, the dose of the whole body and eye lenses were measured using a combination of film and thermoluminescence dosimeters for 35 employees of the angiography departments in three selected hospitals under the auspices of Tehran University of Medical Sciences(TUMS). To measure the eye lens dose, three thermoluminescence dosimeter pellets were used on the forehead, and left and right eyes; and to measure the whole body dose using the two-dosimetry method, a TLD card mounted on the chest and on the lead apron and a film dosimeter on the chest and under the lead apron were used.

The angiography personnelchr('39')s monthly dose mean of the eye lenses and the whole body were approximately 240.6±6.4 μSv and 120.3±3.3 μSv, 
respectively(the corresponding amount for the annual dose is less than the levels recommended by international authorities). In addition, the dose ratio of film badge to whole body and eye  lens was 0.35 and 0.51, with correlation coefficients of 0.97 and 0.5, respectively. Also, the ratio of eye lens dose to depth dose(TLD) on the lead apron was 1.18 with a correlation coefficient of 0.79.

Using a single film dosimter under the lead apron to estimate the dose of the whole body is almost accurate but this dosimeter alone is not suitable for the assessment of the lens dose of the eye; it is necessary to use an individual dosimeter on the lead apron.

Fruit juices are an important part of modern diets that can infect various gastrointestinal tract infections if infected with pathogenic bacteria. The aim of this study was to determine the Frequency of Yersinia enterocolitica in traditional fruit juices shop in southern part of Tehran.

This was a descriptive cross-sectional study, 100 samples of fruit juice including orange juice, mango, carrot, apple and celery(5 samples from each fruit juice shop) were collected from south of Tehran and examined according to the national standard of Iran number 2946 and 9236 for Escherichia coli, Salmonella, Shigella and Yersinia enterocolitica. Data were analyzed using descriptive statistics and SPSS19 software. 

The rate of contamination by Yersinia enterocolitica was 2% followed by Escherichia coli 25%, Shigella 14% and Salmonella 1% respectively. The Escherichia coli were isolated from all the tested fruit juice samples, Shigella in carrot and celery, and Yersinia enterocolitica in mango and apple and Salmonella in carrot juice.

The results of this study suggest more attention and regular checking should be paid in preparation of juices in order to minimize the rate of 
contaminations to public health.

The fair access to health services is one of the most important challenges of the country health system. The family physician was designed to increase access to services, reduce parallel work, and make optimal use of the country’s health resources. The aim of this study was to investigate the factors related to the longevity of physicians in the family physicians

The applied study was descriptive, survey. The 32 family physicians working in the comprehensive rural health services centers of Sabzevar was selected by census method.  The research tool was a research-made pairwise comparison matrix consisting of 87 questions. The validity of the questionnaire was confirmed by examining the incompatibility rate of the questions. Dematel technique and Excel software were used for data analysis. 

The finding showed that environmental factor is the most important factor in the survival of family physicians(R=-0.1558), The managerial factors were also determined as the highest factor that affecting other factors(R=-0.09118). The environmental factors are(affective factor -0.006), managerial factor are(influential factor -0.003) and human factor are(effective factor 0.0037)

Environmental factor was the most effective factor on the survival of physician in this study. Creating suitable facilities, proper communication between family physician and villagers, education and culture of more villagers have the greatest impact on the survival of physicians. It is necessary for managers to planning more carefully by allocating more fund to environment factors.

Business process management is a comprehensive management approach that aims to align all dimensions and activities of the organization in line with customer needs and automates all processes of the organization. The aim of this study was to determine the effect of business process management on the financial performance of Tehran University of Medical Sciences.

This research is an applied, descriptive and survey type and was conducted between the financial managers of Tehran University of Medical Sciences and Health Services in 2019. The research sample is 181 managers of 85 hospitals, faculties and research and development centers of the university who were selected from Cochranchr('39')s formula and targeted sampling method. Data collection was done by questionnaires, in financial performance of Hernaeus et al.(2012) and business process management questionnaire, Yarmohammadian, et al.(2012). The validity of the questionnaires was confirmed by convergent and divergent validity and Cronbachchr('39')s alpha reliability. In data analysis, 65.2% of male respondents, 55.49% had a masterchr('39')s degree or higher, 40.49% had an age of 40 years and 34.4% had more than 20 years of experience. Structural equation modeling (Smart.PLS software) was used to test the hypotheses.

Correlation of index structures of guidelines and treatment procedures and electronic files with mean variance(AVE) of 0.587 and 0.823 and profitability structures of medical centers, return on investment and value added 0.737, 0.755 and 0.750, Shows sufficient and high correlation. The effect of business process management on university financial performance was confirmed as the main hypothesis with a path coefficient of 0.881 and a significant value of 15.383. Also, the effect of corrections related to guidelines and treatment procedures with financial performance with a coefficient of 0.422 and a significant value of 3.702 and corrections related to electronic records of patients with a coefficient of 0.476 and a value of 4.334.

Business process management system includes tools for modeling and analyzing data, integration programs, monitoring and optimization of activities that are effective in financial performance.

Diabetes is one of the most common metabolic diseases in the world, of which one of the most common and painful complications is diabetic foot ulcer. The accuracy and comprehensiveness of the contents of electronic medical record is effective in improving the quality of treatment and the care of diabetic foot ulcer patients. The aim of this study is to determine the minimum data set(MDS) essential for diabetic foot patientschr('39') electronic medical records.

In this descriptive-analytical study, authoritative internet and library resources were studied to collect diabetic foot ulcer information elements. Fourteen physicians and nurses working and collaborating with the Wound Healing Center affiliated to Academic Center for Education, Culture and Research(ACECR) were selected for clinical survey, and 5 health information technology specialists of Tehran University of Medical Sciences(TUMS) were chosen for demographic information survey. The study tools were a researcher-made questionnaire, CVR content validity method and test-retest method for reliability. 

Out of 23 information elements surveyed in demographic section, cases above 99% of the agreement were selected. Also, out of 86 information elements of the clinical section, more than 51% of the cases were selected. Clinical experts included 6 wound specialists, 4 general practitioners and 6 nurses. In the demographic information section, the lowest agreement was related to the element of identity and Education level with 20% agreement. In clinical information, the lowest agreement was related to surgery, leech therapy and MRI of the foot with 0% and PRP, G-CSF, Sono-Doppler liver with 14%.

The minimum information elements of diabetic foot ulcer electronic medical record were divided into history, wound information, lower limb information, paraclinical results, wound management, and follow-up in clinical section; and in demographic information section,  they were divided into identity, admission, finance, reporting, and system capability. The proposed model for manual and electronic medical records is available.

The field of medical engineering is the flagship interdisciplinary approach in Iran, which, due to its attention to knowledge-based economy, takes a step towards prosperity and smoothing progress and development. The purpose of this study is to investigate the interactions between university, industry and government of Iran in scientific articles in the field of medical engineering using the triple helix model. 

This is an applied research with a quantitative approach and uses scientometric techniques. The status of dynamic interactions of the main pillars of Iranian innovation in the field of medical engineering in WoS(Web of Science) database has been calculated using the .exe and the 4.exe softwares in the period of 2010-2019, and the transmission degree of uncertainty index in dual and national dimensions has been determined.

The T-index ranking was assigned to university-government(23.38 mb), university-industry(8.47 mb) and industry-government (1.13 mb), respectively, and finally, national interaction(-12.48 mb) was obtained. The interaction between university and industry had an increasing trend and the strongest dual interaction belonged to the university-government. Over the last ten years, national interaction has always had a negative value, which indicates the existence of dynamics in interactions in the national dimension.

The dual university-industry interaction has been increasing in recent years; however, in the long run, the national interaction of the pillars has been facing a declining trend, according to which some science and technology policies, and research and industrial strategies have been proposed as a necessity to promote the university-industry-government innovation network in the field of medical engineering in Iran.

Taking a wide range of medications in Multiple sclerosis (MS) patients can lead to side effects and drug interactions. Therefore, the use of intelligent systems such as drug monitoring systems can help in the effective and timely treatment of MS disease. In this regard, the present study was conducted to design, development, and evaluation of the drug monitoring system for multiple sclerosis patients.

The present descriptive-developmental study was performed in four stages. In the first stage, by searching the library resources and valid guidelines, the minimum data set was determined and provided to neurologists and MS fellowships in the form of checklists for validation. Then the software was designed logically and coded based on the opinion of experts. In the last stage, the software was evaluated by end-users.

The information elements in the software design were categorized into patient demographic information, medical history, clinical signs, imaging procedures, laboratory tests for ocrelizumab and fingolimod drugs, counseling, and treatment data. Finally, the performance of the drug monitoring system was evaluated with an average of 7.9 and was approved by users.

The results of software evaluation showed that the drug monitoring system can help general practitioners, neurologists, and MS fellowships in monitoring and follow-up of patients and lead to increased patient safety.