مجله پیاورد سلامت
سال هفدهم شماره 4 (مهر و آبان 1402)

Operating room students have experienced anxiety for various reasons that affect their educational process such as stitching. Due to the effective role of simulation in improving the education of students, this study was conducted with the aim of the effect of animal skin suturing simulation on the skill level and anxiety level of operating room students.

In this study, 30 people (75%) of the samples were aged 18-25 and 10 people (25%) of them were 26-35. 10 people (25%) were men and 30 people (75%) were women. Also, in terms of marriage, 7 people (17.5%) were married and 33 people (82.5%) were single. The present quasi-experimental study was performed with a two-group plan before and after with 40 operating room students of Shahrekord University of Medical Sciences (Shahrekord, Broujen) in 2020. The samples were randomly assigned to two test and control groups using the method based on the purpose of selection. Data were collected before and after the intervention by Spielberger Anxiety Tool and Suturing Skills Questionnaire and analyzed by SPSS software and descriptive and analytical statistical tests (Chi-square test, t-test, paired t-test).

The t-test test showed that the mean of obvious anxiety in the intervention group (36.35±10.22) and the control group (41.15±7.92) after the intervention was not significant (P=0.346). Also, the mean hidden anxiety in the intervention group (36.65±10.47) and the control group (38.65±6.13) had no significant difference (P=0.089). The t-test test showed that there was a significant difference in sewing skills after the intervention in the two intervention groups (28.2±58.22) and the control group (23.42±3.12) (P=0.04).

The texture of suture mannequins is very different from human skin in terms of consistency, and it does not convey the same feeling of sutures on natural skin to students. On the other hand, it is easier to enter and exit and move the needle and thread in the sheepskin, and this provides the students with the possibility of stitching more easily. Therefore, it is suggested to buy and prepare sheep skin for training students and teach them stitches on it.

Nutrition recommender systems are one of the most prominent technologies in the field of nutrition informatics that help users to have a healthy diet. These systems are able to suggest the most appropriate foods and meal plans considering the child's physical condition. Considering that children are the most vulnerable age group, one of the most important health goals in the early years of a child's life is achieving balanced and correct nutrition, and as a result this study was conducted with the aim of designing, creating and evaluating a children's nutrition recommendation system.

This research was conducted in 2022 in three stages to assess the needs of the informational elements of the nutrition recommender application. First, in order to determine data capabilities of the program, data needs analysis has been done. In the following, based on the needs assessment, the application was designed and its final version was created. The application was created in the Android Studio environment and then its technical applicability was done using the Nielsen questionnaire by 5 medical informatics and health information management experts.

The required information capabilities of the program were determined and after the statistical analysis of the questionnaire, most of the items raised in it were deemed necessary by the experts participating in the research with a high percentage (90%) and were included in the application program. Then the design and creation of the nutrition recommender application for children 1 to 5 years old was done in the Android Studio programming environment. Finally, the use of Nielsen's exploratory evaluation questionnaire and its technical applicability were evaluated by experts. The average severity of the problems related to Nielsen's ten principles was 1.3, which is classified as minor problems.

Using the nutrition recommender application will be a useful solution to increase parents' awareness of the child's growth status in terms of age, height and head circumference. This program has improved nutritional health, improved mental health, and better growth of children and will play a significant role in preventing the occurrence of diseases by using appropriate nutritional recommendations.

Health literacy is recognized as a key determinant of health and is a central focus of public health policy strategies. The present study aimed to assess the health literacy level and identify the factors influencing it among the clients of comprehensive health service centers in Ilam city.

In 2022, a descriptive-analytical study was conducted to examine 429 clients aged 18-65 years who visited comprehensive selected health service centers in Ilam city. For adults the data collection tool used was the Helia health literacy questionnaire. Sampling was conducted in nine clusters, with each cluster consisting of 50 samples. The data was analyzed using SPSS software, which included descriptive statistical tests, Pearson’s correlation coefficient, and one-way analysis of variance, with a significance level set at 0.05.

Based on the results, the average health literacy score was 80.16 ± 16.50. In terms of health literacy, 18.97% of people had inadequate or not very adequate health literacy, while 44.39% of the participants had excellent health literacy. The average health literacy scores across different dimensions are as follows: access to health information 65.74, comprehension of information 81/81, reading information skills 12.74, evaluation of information 05.75, and decision making and behavior based on information 61.92. A significant relationship was observed between job, education, and income variables and various dimensions of average health literacy (p-value≤0.001). However, there was no significant relationship between general health literacy and age, gender, and place of residence (P≤0.05).

The results of the present study demonstrate that vulnerable groups have significantly lower literacy levels. Furthermore, given the impact of education on enhancing people’s health literacy, it is advisable to leverage mass media, social networks, and educational centers to enhance literacy levels as a potential factor in community health.

With the increase of the covid-19 epidemic, wearable devices have received a lot of attention in the field of managing this disease. The present systematic review study was conducted with the aim of investigating the role of wearable devices in the management of the covid-19 disease.

The present study was conducted according to the guidelines of PRISMA. For this purpose, Web of Science, PubMed, and Scopus databases were searched to retrieve English articles without time limit, until August 16, 2022. The search strategy included the terms “Wearable Device” and “COVID-19”. The inclusion criteria for the study were original and English-language articles that have been carried out to design and implement wearable tools in managing Covid-19. All short articles, letters to the editor, conference abstracts, observational studies, review articles, as well as articles whose full version was not available and in a language other than English, as well as unimplemented items, were excluded from the study process. In order to evaluate the quality of articles, the AXIS evaluation tool was used to evaluate the quality of cross-sectional studies. After selecting the studies, data was collected based on the data extraction form. Then the data was analyzed through the content analysis method.

Finally, 10 articles were included in the present review and the wearable devices introduced in them were examined. Seventy percent  of wearable devices are used for symptom monitoring, health status, and quarantine, and 30% for diagnosis. The primary users of these tools were patients, the general public, doctors, and Authorities of statistics and information. The types of wearable devices used were bracelets and smart watches (60%), sensors (30%), pulse oximeters, and chest patches (10%).The most important capability and feature of wearable devices include transferring data and activities to mobile phones and low energy consumption. Using the AXIS quality assessment tool, four studies were rated as very good, five as good, and one as poor.

The review of studies showed that wearable devices provide many capabilities for disease monitoring and patient empowerment, disease diagnosis, and remote monitoring of vital signs of Covid-19 patients. These tools are presented in different forms. It is suggested to develop new tools with the aim of monitoring the covid-19 disease with an emphasis on the use of patients in the form of bracelets and smartwatches, and also the necessary attention should be paid to privacy and confidentiality issues.

Social accountability is defined as identifying social problems and needs, planning for resolving them and evaluating the effect of the plans. Considering the vital role in providing public health, the universities of medical sciences are the most important ones for fulfilling this mission and directing their education, research and service activities toward addressing health concerns of the community. Despite of these attempts, social accountability has not realized completely and satisfying yet. The aim of this study was exploring factors affecting social accountability and community-based medical education in universities of medical sciences from Iran’s educational development authorities’ view point.

This was a qualitative study performed by Education Development Center of the Ministry of Health and Medical Education in November 2022. Participants were 68 managers of Education Development Centers and 323 managers of Education Development Offices of schools and hospitals of universities of medical sciences in Iran. Participants were assigned to 8 focus groups. Conventional content analysis was used to extract the categories and subcategories.

At the first step 541 codes were extracted which were integrated in to 86 ones after defining similarities. These codes then were categorized into 18 sub-categories and 6 categories, namely “Curriculum” including: curriculum revision, approaches, credits and longitudinal themes and new disciplines, “Community-based education” including: educational fields and creating the foundation, “Students” including: students as teacher, educating students and graduates, “Faculty members” including: faculty members’ services, motivation and compensation and administration, “Evaluation” including: student assessment and program evaluation, and “Management” including: management and leadership, organizations, Interdepartmental communication and research.

In this study a comprehensive collection of factors affecting SA in universities of medical sciences were identified and categorized. These factors that are compatible with medical education context in Iran can be used by top managers and educational administrators as a framework for short and long-term planning.

This study aimed to determine the position of Iran in terms of scientific publications in Immunology and Microbiology, and also to identify the general status of science production and the patterns of publishing in the world, the Middle East, and Iran, analyze Iran scientific collaboration with the Middle East and the world, and explore the relationship between these indicators.

The study population contained 30622 Middle Eastern publications in Immunology and Microbiology from 2009 to 2018. Positioning the countries and exploring the relations of indicators, the exploratory factor analysis, and the correlation matrix were conducted using Scival.

According to the findings Iran, Turkey, and Saudi Arabia were among the most powerful countries in the region in terms of publication, citation, regional, international, and overall scientific collaboration. As for regional positioning, the citations had the highest weight comparing to other indicators. Iran have the first rank in the indices of scientific production and citations with 43.63% and 33.76% respectively, third rank in the regional cooperation index with 43.63%, second rank in the extra-regional cooperation index with 23.56%, and also second rank in the total cooperation index with 22.12%.

The indicators were strongly connected togather; however, the citations and international scientific collaborations displayed the strongest amongst others. Despite Iran’s prominent position in both fields, the quality of the publication was lower than the regional and global average. This identified the most powerful and weak countries in the region in regards to scientific capacities in Immunology and Microbiology. Moreover, it reckoned that there was a strong relation between citations and scientific production in contrast with others.

Diabetes is a metabolic disorder characterized by an elevated blood glucose level, resulting from impairments in insulin action, insulin secretion, or both; which causes abnormalities in the metabolism of carbohydrates, protein, and lipids. Chronic hyperglycemia is associated with long-term damage, dysfunction, and failure of various organs. Adropin and irisin are newly described proteins that can be an essential component in the pathophysiological pathways of diabetes mellitus. The current study was designed to evaluate Irisin and Adropin biochemical markers in patients with type 2 diabetes mellitus and their correlation with risk factors.

 A case control study, that included 90 patients of type 2 diabetes mellitus and 90 healthy individuals, who matched for both age and sex with patients. Fasting blood sugar (FBS), HbA1c, serum insulin, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG), irisin and adropin were measured at the chemistry laboratory of AL-Faihaa teaching Hospital by standard methods.

Serum irisin (8.154±1.642 vs. 14.06±3.916 ng/ml) and adropin (25.39±8.897 vs. 59.43±8.768 pg/ml) levels were significantly lower in the patient group than in the control cases, respectively (P.value<0.0001). Serum adropin levels were significantly and positively correlated with age (r=0.236, P=0.025) and negatively with BMI (r=-0.209, P=0.048). While, serum irisin levels were significantly and negatively correlated with TG (r=-0.248, P=0.018). Based on ROC analysis, the AUC for irisin was 0.937 (95% CI: 0.906-0.969), which showed a sensitivity of 91.1% and a specificity of 80.0% at the cut-off of 9.715 (P<0.0001). In addition, the AUC for adropin was 0.991 (95% CI: 0.980-1.00), which showed a sensitivity of 100.0% and a specificity of 91.1% for this biomarker at a cut-off of 37.945 (P<0.0001).

Our findings showed that the serum levels of irisin and adropin were lower in the patient group than in the control group. Probably, the reduction of adropin and irisin may be used as a biomarker to predict the risk of T2DM, which requires more studies in this regard.

The Hospital Information System is a complete one to provide high-quality patient care and enhance community health, so it must be designed and produced accordingly. In this regard, the current research was carried out with the aim of providing the document of standards for producing Hospital Information System software for Iran. 

In this study, following extraction of the features and services of the Hospital Information System from the texts, they were matched with the generalities of the document of standards compiled by the Statistical Data Management and Information Technology Office of the Ministry of Health, Treatment, and Medical Education (SDMITO). Also, the Hospital Information System was reviewed observationally, all defects of document of standards were identified, and the document was amended throughout. After providing the proposed document of standards, it was consulted by a group of experts, which included ten health information management professors, ten medical informatics professors (with at least seven years of experience as members of the academic staff), and five heads of the information technology field of the Ministry of Health. An agreement coefficient of 85% was considered to accept and approve the document of standards. After obtaining the agreement coefficient, The Hospital Information System software production document of standards was provided.

The document of standards provided for the production of Hospital Information System software includes the Hospital Information System design meta model, Hospital Information System subtypes, standards for the structure and content of Electronic Health Record, information terminology standards, data classification standards, security data standards, data exchange standards, clinical services, and management services, which were placed in the four areas of “features”, “services”, “documentation requirements” and “rules and policies”.                     

The application of this document of standards leads to the production of a higher quality, efficient, and standard Hospital Information System software, which is effective in improving the health level of society and provides the conditions for the implementation of Electronic Health Record.