مجله تصویر سلامت
سال سیزدهم شماره 4 (زمستان 1401)

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare genetic disease that is inherited as an autosomal recessive, and its cause is a genomic defect in tyrosine kinase; this disorder is mainly characterized by a lack of pain sensation, inability to sweat, and mental retardation.1 The probability of being born with this disease is about 1 in 125 million .2 The US National Institutes of Health puts the number of people with the disease at less than 5,000 in the United States. This institute has stated that about half of people with CIPA show signs of hyperactivity or emotional instability, and many people suffer from intellectual disabilities.2 Also, these patients are prone to multiple and frequent injuries, bruises, cuts, burns, bone fractures, and dislocations. In therapeutic and clinical conditions, to help the patient return to health faster, special exercises are designed and implemented with the opinion of experts.3 Performing these exercises is often associated with difficulties due to the patient's condition. To reduce these difficulties, virtual reality can be used in the rehabilitation of these patients. Virtual reality technology and video games can play a role in motivating and effective health care by creating simulated, motivating, interactive, and realistic environments. To date, the major applications of these technologies include medical simulation, telemedicine, medical education and health services, pain control, visualization for surgery, rehabilitation, and treatment of fear and trauma.4Since there is no treatment method for this disorder, encouraging patients to follow treatment instructions, raising awareness of health issues, monitoring and training patients for self-care in a remote manner, training people around and other caregivers, and continuous follow-up of their condition by nurses and other members of the health team can play an important role in reducing mortality in these people .5 In this field, health information technology can play an important and effective role. In recent years, mobile health technology has revolutionized the traditional way of providing health services by using wireless technologies such as Bluetooth, WiMAX, and Wi-Fi and sending text messages, data transfer, and access to various electronic health services. This has made it easier and provided a great opportunity for developing countries by saving scarce resources and telemedicine education, as well as health systems.5 Also, mobile applications have made it possible to record, transmit, and receive feedback anytime and anywhere, which facilitates remote monitoring and timely recommendations for healthcare. Mobile applications can also enhance self-care.6 Accordingly, considering the type of CIPA disease and the lack of suitable treatment for it, it seems that the use of mobile health technologies can bring many benefits, including long-term follow-up and care, reducing the significant financial burden for the patient, and healthcare systems. Transportation can increase personal empowerment and flexibility in life, and ultimately lead to significant positive effects on the quality of life of these patients. Competing interests: The authors declared that there is no conflict of interest.

Background:

Under count is a common phenomenon in health systems. One of the methods used for sensitivity identification of care system or identification of cases in registry is capture recapture method. Using two resources, this study aimed to estimate the actual mortality rates of under five-year-old children.

This study was conducted by capture-recapture method (two resources), using the recorded data in death cause systems of the Iranian Ministry of Health and Medical Education (MOHME) and Treatment and Registry Office. The population included all children aged five years in Tabriz, Iran. We also considered all the death cases in the target population from 2020.03.20 to 2021.03.20. The death cases were extracted from two resources and entered into the Microsoft Excel software. After removing duplicate cases with a special formula, we obtained the actual mortality rates using capture-recapture method with 95% confidence interval (CI) and estimated the actual mortality rates and death cases.

In 2020, the death rate of under five-year-old children was calculated to be 344 cases (338 to 350 with 95% CI). The sensitivity rate of causal registry system for all death cases in the target population was 43.17%. Also, the mortality rate of under one-year-old children was calculated as 275 cases (271 to 280 with 95% CI). While the sensitivity rate of causal death for the mortality of under one-year-old children was 92.72%, it was 82.28% for the Registry Office.

A combination of different software for death information registry and the registration of information in the occurrence location could be efficient techniques to reduce under count registrations. It is believed that better and more reliable information could be obtained on death case numbers through using two lists and capture-recapture method compared to using one of the two resources.

In addition to patient satisfaction and treatment compliance by patients, appropriate physician-patient communication leads to development of a relationship between physicians and patients based on trust. The purpose of this study was self-assessment of medical interns and stagers of Tabriz University of Medical Sciences in communicating with the patients during COVID-19 pandemic.

The population of this cross-sectional study included all medical stagers and interns at Tabriz University of Medical Sciences, Iran from November to December, 2020. The research tool was a standard questionnaire of Interpersonal Communication Skills Scale developed by Vakili et al. to assess interpersonal communication skills. After the online questionnaires were filled by the students, we calculated and compared the mean score of self-assessment of communication skills for the medical stagers and interns. Additionally, we compared the mean scores of students’ self-assessment in term of educational level, gender, wards and on duty hours during a week.

In this study, a total of 152 medical stagers and interns participated. More than half of the participants were female (55.92%). The mean self-assessment score of the participants was 93.83±9.78. The mean self-assessment score of medical stagers and interns was 93.15±8.13 and 94.51±12.26, respectively. There was no statistically significant difference in self-assessment score of patient communication based on educational level and ward (surgical and non-surgical), but the mean score of self-assessment was significantly higher in females (P=0.044).

Most medical interns and stagers had an average self-assessment score regarding patient communication during COVID-19 pandemic. So, appropriate training can improve medical students’ communication skills. However, the communication skills required for medical students may vary depending on whether they are dealing with a pandemic or non-pandemic situation.

Critical thinking, an important construct in the educational dimension, is an active process which uses a specific set of skills and enables one to make appropriate decisions and discriminate between information received. Therefore, critical thinking is considered as an important aspect of information performance in library education. In the field of library and information science, so far, no coherent study has investigated the possible aspects of teaching critical thinking. Hence, this narrative study aimed to review the available literature to determine if critical thinking is considered in the librarianship education and research. To this end, four electronic databases, including Medline (PubMed), ERIC, ProQuest, and Scopus were searched using the following keywords: Critical Thinking; Thinking; Education; Curriculum, Teaching; Librarianship; Library and Information Science; Medical Library and Information Science; and Knowledge and Information Science. A total of 439 articles were identified. After the initial review of the titles and abstracts and the removal of irrelevant and repetitive articles, 67 articles entered the evaluation stage. After reviewing the full text of the remaining articles, 32 articles were eligible to enter the study. Based on our review, the literature on the critical thinking in library science could be categorized into four classes. Moreover, critical thinking should be improved through using different educational strategies and be integrated into education curricula.

Flipped classroom, as one of the new educational techniques, can lead to effective clinical practice. Applying this method to basic lessons provides for students’ more in-depth learning. Therefore, this study examines flipped classroom teaching method in improving the knowledge and readiness of medical students in disaster management.

This quasi-experimental single-group pretest-posttest study included a total of 106 medical students at Shiraz University of Medical Sciences, Iran. The participants were selected from the students admitted to the course in two consecutive years 2018 and 2019. Different teaching methods were used to cover the topics based on PowerPoint, clip showing, small group work, discussion, and question sessions. Data analysis was performed using paired t-test and Wilcoxon non-parametric test.

Based on the results, out of 106 participants (65 or 61.3% females vs. 41 or 38.7% males), 85 students completed the course. The age group of students was 19-39 years (mean age: 20.29±3.27). There was no significant relationship between gender and readiness in terms of knowledge and attitude (P≥0.05). There was a significant difference between attitude and level of preparation before and after the test. The average level of knowledge, attitude, and readiness in response to risks in the post-test compared to the pre-test (after teaching upside down) increased by 1.93%, 3.82%, and 3.35%, respectively.

The importance of disasters requires the growth of awareness and preparedness. Teaching flipped classroom for the concepts of disasters can create more dynamism in students and improve their knowledge and preparedness to deal with disasters.

Lack of anger control and impulsiveness can lead to different personal and social harms. This study aimed to investigate the effect of emotion regulation training according to the source of control on anger control and impulsiveness of medical students.

This quasi-experimental research was conducted with pre-test post-test design, including a control group with follow-up. The population consisted of general medicine students studying basic sciences and physiopathology. After completing three questionnaires of anger control, impulsivity, and locus of control, 60 students were randomly selected and assigned to experimental and control groups. The participants in the experimental group received eight sessions of emotion regulation training. The questionnaires were administered to all participants after training in two sessions of post-test and follow-up post-test. The data were analyzed using multivariate analysis of variance (MANOVA). The data were analyzed through two-factorial multivariate analysis of covariance (MANCOVA) using the Statistical Package for the Social Sciences (SPSS) v. 24.

Emotion regulation training and its interaction with the locus of control had a positive effect on anger and impulsiveness control.

Training emotion regulation and other social skills to university students can help them face the challenges during their studies.

The growing trend of useless care might lead to negative consequences for patients, staff, and the organization. The employees who care for patients in their last stages of life for a long time might not tend to pay enough attention to the patients' pain. As a result, the quality of care services might be negatively affected. This study aimed to compare the perceptions of operating room technicians and nurses regarding futile care in the selected hospitals in Hamadan province, Iran from October to December.

Using available sampling method, the present descriptive cross-sectional study was performed on 200 health care workers (114 nurses and 86 operating room technicians). Data collection tools included a two-part demographic information questionnaire and the perception of futile care designed based on the Corley’s Moral Distress Questionnaire. The questionnaires were distributed in person and electronically. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 26. We used frequency, mean, and standard deviation for descriptive statistics and independent t-test and analysis of variance (ANOVA) for analytical statistics.

The mean score of nurses' perceptions regarding futile care was significantly higher (16.53±6.18) than that of operating room technicians. While the nurses' perceptions of futile care in both dimensions of intensity (66.71±13.72) and repetition (60.03 13 13.72) were at a high level, the perceptions operating room technicians in both dimensions of intensity (50.19±18.90) and repetition (52.43±18.8) were at an average level.

Nurses seem to have a relatively better understanding of futile care compared to operating room technicians. This is probably due to frequent contacts with patients overlooking death, as well as direct contacts with their family and relatives. In this regard, it is essential to develop guidelines in Iran delimiting the standards for the staff’s provision of futile care.

In most developing countries, concern about leachate pollution is serious. This study aimed to determine the best alternative for leachate management and disposal using the Analytic Hierarchy Process (AHP) method.

In this descriptive-applied research, the criteria and alternatives for leachate management and disposal were selected, including evaporation pond (natural with sunlight), recirculation/evaporation, and treatment (physical and chemical, biological/advanced). Then, three criteria and 11 sub-criteria were selected. The criteria and sub-criteria were weighted, using the Expert Choice 11 software and compared two by two to determine the relative importance of each. Then, each of the alternatives was compared and prioritized two by two in relation to the criteria and sub-criteria.

The results of the study showed that the evaporation pond (natural with sunlight) was the most preferable alternative with an importance coefficient of 0.569. The alternative of recycling/evaporation and treatment (physical and chemical, biological/advanced) with an importance factor equal to 0.216 was placed in the next priority. The consistency ratio (CR) of all the paired matrices of the alternatives was equal and less than 0.1.

By considering the economic, technical, operating, health, and environmental criteria, the evaporation pond method (natural with sunlight) was chosen as the best method for managing and disposing landfill leachate in Iran. Therefore, it is recommended to consider the alternative of leachate management in landfills, especially considering the climatic conditions of the country (90% dry and semi-arid climate).

Considering the need for new health programs, the Health Transformation Plan, as one of the largest health system reform programs, has been implemented in Iran since 2014.

This cross-sectional, applied study was conducted qualitatively on 27 participants in 2019 (19 service providers and eight service recipients). The data collection tool was a semi-structured interview guide that was validated through a comprehensive literature review, and consultation with health strategy transformation experts. The research plan was approved by the ethics committee and the research work commenced accordingly. The research work was carried out at the research participants’ workplace (employees) via interviewing process. All the interviews were recorded daily. The data interpretation and analysis were conducted through coding and content analysis approach.

The data analysis for participants’ groups (i.e., service givers, human resources, infrastructure, education, and service recipients), using the open coding stage and the initial concept in the sub-coding stage, indicated 10 minor and five major categories.

Appropriate education, quality of services, financial support, and specialized manpower can be considered as possible ways to cope with the challenges in the health transformation plan.