مرجان قاضی سعیدی

Computerized programs for brain empowerment with regular, intensive, and continuous cognitive exercises improve cognitive functions such as attention in attention deficit hyperactivity disorder. This review study aimed to identify effective computerized programs for improving attention in children and adolescents with attention deficit hyperactivity disorder (ADHD).

This descriptive narrative review was done in 2018 through library review and searching keywords including "attention deficit hyperactivity disorder", "computerized cognitive rehabilitation programs", and "play therapy" in databases such as PubMed, Scopus, and Google Scholar. The results of this review were investigated through the semi-structured interview and classified based on the attention areas of children and adolescents with ADHD.

Based on the review, Caption Log, Pay Attention, Cogmed Working Memory, Memory GYM, Attention GYM, Brainware Safari, 8 Sciences' ACTIVATET, Lumosity, My Happy Neuron, Smart Driver, and educational packages such as Maghzine were effective programs to improve different types of attention (focused, divided, intermittent, continuous, and selective) in the ADHD children aged four years old and older.

Considering the significant effects of computerized cognitive rehabilitation programs in empowering cognitive skills such as attention, their use as a complementary treatment in improving the quality of life of children and adolescents with ADHD is promising. However, it is suggested to evaluate such programs with larger samples, transfer their educational effects to daily life, and improve their quality by providing more components of such programs.

 Telemedicine provides medical services remotely. There are some problems with implementing telemedicine projects. The purpose of this study was to investigate the most common telemedicine services in Iran and other developed countries as well as examine the legal, financial and privacy challenges of telemedicine services in these countries, especially in the era of the COVID-19 epidemic.  

 In this study, the status of telemedicine in Iran and developed countries was reviewed. Thus, related papers and grey literature were retrieved from PubMed, Scopus, SID and Magiran scientific databases. Also, related websites including the Ministry of Health and Medical Education of the Islamic Republic of Iran were examined. According to the study’s purposes, the relevant resources were selected and summarized by researchers.       

 Radiology, psychiatry and cardiology are the most widely used telemedicine services for interaction with patients as well as emergency, pathology and radiology for healthcare professional communication. Teleconsulting is the most widely used telemedicine service in Iran. There are some laws such as article 74 from section 14 in the Iran development plan to support the provision of e-health and telemedicine services. Also, there are some limited laws for patients’ privacy. In Europe, there is a set of guidelines for health websites, mobile health and cross-border exchange of health information, etc. although there are no uniform laws about telemedicine. HIPAA in the United States and GDPR in Europe are some privacy laws in developed countries. There are some restrictions on telemedicine reimbursement in the United States including the fee-for-service payment model; however, the costs of telemedicine in the United States are usually less than face-to-face treatment. 

 In the present era using telemedicine services become a requirement due to the outbreaks of epidemics such as COVID-19. Concerning the experience of developed countries, telemedicine services development in Iran requires some considerations in terms of legal, financial and privacy aspects including the creation of explicit laws on patients and healthcare provider’s rights, providing the telemedicine guidelines in different clinical fields such as structured formats for teleconsultation as well as the explicit laws for preserving the patient’s privacy.

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.

When clinical decision support systems are developed, implementing solutions that enable these systems to be -used on a large scale can reduce the production costs associated with the creation, maintenance and by sharing these systems, producing multiple clinical decision support systems will be prevented. In recent years, one of the approaches used for this purpose in combination with clinical decision support systems is the service-oriented architecture approach. The purpose of this study was to investigate the role and importance of service-oriented architecture in delivering scalable architectures of clinical decision support systems focusing on different approaches to this architecture.

This article is a simple review article. Bibliographic databases of IEEE Explore, Science Direct, Springer, Web of Science, and Scopus were reviewed. The keywords "Service Oriented Architecture" and "clinical decision support systems" were used as keywords along with related terms for searching these databases.

The clinical decision support systems based on service-oriented architecture brings benefits such as Facilitate knowledge maintenance, reducing costs and improving agility. Point-to-point communication, enterprise service bus, service registry, clinical and engine guiding engine, and service choreography and orchestration are general architectural designs that are evident in the use of web-based clinical decision support systems based on a service-oriented architecture approach.

Service-oriented architecture is a potential solution for delivering scalable platforms for clinical decision systems.