مجله پیاورد سلامت
سال چهاردهم شماره 3 (امرداد و شهریور 1399)

Laboratories are one of the most important scientific and research centers. Laboratory information management systems provide a platform for recording the information and collaborating between researchers. The main purpose of this study was suggesting an organizational architecture model of laboratory information management systems. 

This study was a qualitative study. In this study, we extracted available documentation and information on laboratory information management systems from databases. Then, 16 faculties and staffs using the Sharif University of Technologychr('39')s laboratory services were selected by snowball sampling and interviewed to determine needs.  Based on needs, enterprise architecture models were extracted from databases. 16 experts have evaluated the enterprise architecture model to select the best model suitable for laboratory services. Due to various technical and managerial aspects of laboratory management systems two models of Zachman architecture and service-oriented architecture models were combined. In the next step, experts from laboratory service systems have evaluated the proposed model, using Delphi technique in three rounds.

The findings were analyzed in two parts: Evaluation of the needs of the laboratory information management system and presentation of the proposed model. In the proposed model, the content of each cell of the Zachman framework is approached Service-oriented were selected and integrated according to the specifications of the laboratory management system.The model was evaluated based on five levels of organizational architecture maturity. The improvement in the maturity of organizational architecture was evident at higher levels.

The use of enterprise architecture for laboratory management systems leads to optimal use of resources and ease of collaboration.

Asthma is a common and chronic disease of respiratory tracts. The best way to treat Asthma is to control it. Experts of this field suggest the continues monitoring on Asthma symptoms and adjustment of self-care plan with offering the preventive treatment program to have desired control over Asthma. Presenting these plans by the physician is set based on the control level in which the patient is. Therefore, successful recognition and classification of the disease control level can play an important role in presenting the treatment program to the patient and improves the self-care and strengthens the early interventions to alleviate the Asthma symptoms.  

Based on this objective, we collected the data of 96 Asthma patients within a 9-month period from a specialized hospital for pulmonary diseases in Tehran. Then we classified the Asthma control level by fuzzy clustering and different types of data mining method within a multivariate dataset with the multi-class response variable.

Our best model resulting from the balancing operations and feature selection on data have yielded the accuracy of 88%.

Our proposed model can be applied in electronic Asthma self-care systems to support the decision in real time and personalized warnings on the possible deterioration of Asthma control. Such tools can centralize the Asthma treatment from the current reactive care models into a preventive approach in which the physician’s decisions and therapeutic actions are resulting from the personal patterns of chronic Asthma control and prevention of acute Asthma.

A hospital website is an appropriate system for exchanging information and connecting patients, hospitals and medical staff. The purpose of this study was to identify and classify desirable web-based services in websites of Iranchr('39')s hospitals based on Kano’s Customer Satisfaction Model.

This was a survey study. The statistical population of the study consisted of hospital website users, of whom 120 were randomly selected. The data collection tool was a questionnaire based on Kano model. The validity of the questionnaire was confirmed by the information science and health information technology(HIT) professors. Data were analyzed using Kano model evaluation table, Excel software, and descriptive statistics. Cronbachchr('39')s alpha test was used to determine reliability(a=0.82).

First, the desirable web-based services of the hospitals’ websites were identified. Then, 67 identified services were classified into mandatory criteria(29 services), one-dimensional criteria(15 services), attractive criteria(14 services) and indifferent criteria(9 services). Most services were mandatory, attractive, one-dimensional and indifferent in content components.

Most services identified in this study were on the websites of the worldchr('39')s leading hospitals; HIT designers and professionals and hospital managers are expected to use such services in designing hospital websites. Although the comments of site designers and experts were practical in some cases, they attracted a limited number of users due to their unfamiliarity with specialized website design topics.

In recent decades, increasing productivity and reducing losses by improving abnormal behaviors in the workplace have attracted the attention of organizational behavior experts, especially health researchers. The purpose of the present research is to study the factors influencing the reduction of abnormal behaviors in health workplace.

By using meta-synthesis technique, the findings of the related internal and external studies were systematically analyzed using Sandelowski and Barroso seven-step method. The identified codes were classified, analyzed and interpreted by MAXQDA10. Kappa method and SPSS were used to measure reliability and quality control. The calculated kappa coefficient was 0.893, which indicated a good consistency.

From 435 articles investigated in this field, 46 articles were selected, based on which 68 factors were identified. These factors were classified into 3 main categories and 11 pivotal codes. The influential factors identified in this study include individual factors(psychological, demographic, religious, and contextual), group factors(communication, appropriate reward system, and deterrent behaviors) and organizational factors(organizational space, organizational measures, organizational emotions, and job position perception).

The results of this study show that individual factors are the most important ones affecting the reduction of abnormal behaviors. Therefore, the findings of this study emphasize psychological, demographic, religious, and contextual factors in planning and managers’ interventions to increase productivity in health workplace.

Human resources are one of the most important assets of any organization and the creation of a safe working environment enhances the quality of services in addition to satisfying this valuable capital. The purpose of this study was to evaluate the safety of diagnostic laboratories of hospitals affiliated to Iran University of Medical Sciences(IUMS).

This cross-sectional descriptive study was conducted in 7 IUMS hospitals in 2019. Data collection was performed using a checklist that was validated after being translated(by qualitative face validity method); Then, the safety status of the studied laboratories was classified into four categories: Excellent, good, average and poor. Finally, data were analyzed using descriptive statistics and SPSS software.

In determining the validity of the checklist using qualitative face validity, expertschr('39') opinions were applied as changes in the tool. In the descriptive part of the study and among the safety dimensions of diagnostic laboratories, the highest mean score was related to the dimensions of "communication hazards" and "safety information" and the lowest to the dimension of "fire safety".

According to the results of the study, the overall safety status of the diagnostic laboratories of the hospitals under investigation is at a good level; however, the "fire safety" component as one the most important safety components was considered poor, and necessary steps must be taken to improve it.

Cardiovascular diseases and medication errors are among the leading causes of morbidity and mortality around the world. Electronic prescribing and Medication Administration(ePMA) systems can prevent medication errors to some extent. This study aimed to determine the information requirements of ePMA systems.

This descriptive study was conducted in Imam Khomeini Hospital of Tehran and School of Allied Medical Sciences affiliated to Tehran University of Medical Sciences (TUMS) in the summer of 2019 in two phases: literature review and survey-based questionnaire. Information items obtained from reviewing the texts of 100 articles were organized in three questionnaires. In the survey phase, questionnaires were distributed among physicians, nurses, and the experts of health information management(HIM) and medical informatics, using census sampling method. The reliability of the questionnaires was measured using Cronbachchr('39')s coefficient alpha. Statistical analysis was done using SPSS.

The findings showed that based on specialists’ point of view, patientschr('39') demographic information items and unique identifiers gained the highest average, above 4.7. Physicians agreed most with clinical information, including medication history and generic names. From the nurses’ point of view, the information items of the patients’ problems and the procedures performed and the types of drug doses obtained a complete average of 5.

The need for information items varies among different users of ePMA systems, but there may be items that are common for them. Future studies should further investigate financial and pharmaceutical information requirements based on the perspectives of other hospital pharmacy and accounting staff.

Due to the increasing number of radiographic tests, TLD dosimeters can be used to measure the effective dose of critical organs in various radiographic tests. In this research, the progression of analogue to digital radiology devices, which facilitates and accelerates the performance of radiographs, especially emergency patients, was investigated, and then the effective dose of critical organs in digital radiographic devices was calculated using a thermoluminescence dosimeter.

In this cross-sectional study 29 thermoluminescence GR-200 dosimeters(LiF: Mg, Cu, P) were used first, the TLDs were calibrated by the Atomic Energy Organization of Tehran Protection Center, then using TLDs, equivalent doses were used in radiographic tests and finally, the effective dose of critical organs was calculated.

Data were analyzed using Anova in SPSS software. The mean effective doses of critical organs were 0/034±0/0015 mSv for eyes(in skull radiography), 0/0063±0/0004 for thyroid(in cervical radiography), 0/0067±0/0009 for breast(in lung radiography) and 0/2010±0/0652 for ovarian(in abdominal radiography). We found significant differences between effective doses of thyroid and ovaries in common position(Postero Anterior)(p˂0.05). We found non-significant differences between effective doses of the eyes and breast in common position(AntroPosterior)(p˃0.05).

According to the results of this study, the effective dose of the patient in radiographic exames depends on the thickness of the target organ and the patientchr('39')s position, which has a significant effect on the dose of radiation absorbed by the patient.

Nigella sativa with anti-inflammatory and antimicrobial effects is one of the most widely used medicinal plants that can be used as an alternative or adjunctive therapy due to many side effects of chemical drugs. The aim of this study was to evaluate the regenerative and protective effects of Nigella sativa from pathological point of view in rat gastrointestinal tract.

This study was carried on 30 wistar male rats which were divided randomly in to 3 groups. First and second experimental groups received 400 and 800 mg/kgbw Nigella sativa extract respectively and control group received normal saline orally by gavage for 2 months. The duodenum, jejunum, ileum and proximal colon samples were collected and after fixation with formalin 10% and tissue processing, the 5 μm sections were prepared and stained by hematoxylin eosin staining. Finally, light microscopy was used to determine the histological characteristics and the length of the small and large intestinal villi in the area of the duodenum, jejunum, ileum, colon, villus width and percentage of goblet cells. Data were analyzed by SPSS software.

The results showed that Nigella sativa significantly increased the length of the villi in duodenum, jejunum and ileum. The width of the villi and the percentage of goblet cells were also increased.

Based on the results, it can be concluded that the Nigella sativa causes enhancement of food absorption by increasing the length of villi and has protective effects.