International Journal of Hospital Research
Volume:9 Issue: 3, Summer 2020

Population aging has brought a rise in the prevalence of diabetes and hypertension, leading to more cases of renal failure. Hemodialysis, as a method of renal replacement therapy, by far prevails over peritoneal dialysis (93.5% vs. 6.5%). Although arteriovenous fistula (AVF) is frequently chosen as the vascular access route for chronic hemodialysis; it has limitations including non-maturation. As maintenance of an AVF is much more costly than its creation, foreseeing maturation failure can lead to a wiser allocation of patients to AVF surgery or other alternatives, with potential for significant cost containment. Previous studies have some challenges: they used intraoperative and postoperative parameters (AVF blood flow, diameter, and depth) or parameters that are costly to collect (morphologic and functional vessels characteristics), and they used statistical analysis that puts restrictions on data. In this study, we aim to provide a data mining framework for predicting AVF non-maturation using routinely available preoperative parameters, such as serum metabolic values and inflammatory markers.

We investigated the relationship of routinely available systemic inflammatory markers and baseline metabolic values in 114 end-stage renal disease patients (over 35 years of age undergoing their first radio-cephalic AVF access surgery at wrist level for chronic hemodialysis). In this study, for the first time to our knowledge, we applied predictive analytic tools such as Random Forest for retrospective analysis of prospectively collected data between 2011 and 2018.

Our results showed that a combination of inflammatory markers and serum metabolic values can prognosticate AVF maturation outcomes with an accuracy of 0.723, by the 95% confidence interval of (0.715, 0.731) and AUC of 0.853. Also, a combination of inflammatory markers, including albumin, c-reactive protein, erythrocyte sedimentation rate, hemoglobin, lymphocytes, neutrophils, white blood cells, platelets, and red blood cell distribution width, can prognosticate AVF maturation outcomes with an accuracy of 0.674, by the 0.95 confidence interval of (0.665, 0.684) and AUC of 0.824.

Risk stratification of patients for AVF non-maturation before attempting the first AVF surgery may help prevent multiple surgical failures and costly endovascular interventions by allowing vascular surgeons to make an individualized choice of vascular access method for new patients.

The main purpose of this study is to identify the structural factors affecting the implementation of policies developed in the health system of the country's hospitals. Most of the developed policies undergo changes in the implementation phase which take them away from realizing their goals.

Data collection method in the first stage was desk research through taking note and in the second stage was field research in which the interview tool was used in the qualitative part and the questionnaire was used in the quantitative part. The statistical population of the research is the heads of medical universities and hospitals. In this study, snowball sampling was used to select the interviewees. For data analysis, grounded theory has been used in the qualitative analysis, and the structural equation method using SPSS and Smart PLS has been used in the quantitative part of the analysis.

Findings of this study show that the main components include creation of team and self-governance structures in the organization to implement the policy, existence of performance appraisal system, support of senior managers, decentralized and flexible administrative structure, and formation of horizontal governmental management and managerial stability in public sector in charge of implementing health system policies. In the quantitative part of the research, according to the results of the confirmatory factor analysis of 64 questionnaires, all identified components had a positive and significant effect on the implementation of health system policies.

According to the obtained path coefficients, the component of formation of horizontal governmental management has the greatest impact on the implementation of the health system policies of the country. And then, respectively, the components of support of senior managers, decentralized and flexible administrative structure, and existence of a performance appraisal system, creation of team and self-governance structures in the organization have the greatest impact. Finally, the component of managerial stability in the public sector which is responsible for policy implementation has the least impact on the implementation of health system policies of the country.

Cybernetic management is a science that studies and controls its control and regulation in complex systems and its main goal is to find the fastest, most appropriate and effective way of control and regulation in complex organizations and systems such as hospitals to increase productivity. The aim of this study was to investigate the relationship between cybernetic management and organizational productivity in selected hospitals of Iran University of Medical Sciences.

Methode: 

This research was practical in terms of results and cross-sectional in terms of time and analytical-correlation in terms of implementation method. The population of this study included all staff and managers of selected hospitals of Iran University of Medical Sciences . through random Krejcie-Morgan table and using stratified sampling method 328 people were selected. Data were collected using the Standard scale of John Ston and Peter Jones Organizational Productivity Questionnaire (2003) and Ghorbanizadeh Cybernetic Management Function Questionnaire(2010). The obtained data were analyzed by Pearson correlation and multivariate regression analysis.

The results showed that between cybernetic management with organizational factory at a significant level (p <0.01), between cybernetic management with organizational effectiveness at a significant level (p <0.01), between cybernetic management with customer satisfaction Reference was at a significant level (p <0.01), and there was a relationship between cybernetic management and bureaucracy at a significant level (p <0.01).

 The present study shows a positive relationship between cybernetic management and organizational productivity. Therefore, providing training based on the application of cybernetic management functions in hospital settings to increase productivity is one of the recommendations of this study.

The main purpose of this study is to investigate the relationship between establishing a quality-based payment program and performance indicators of health care providers and health workers in health centers of Miyaneh city.

The target population of this study is health care providers and health workers in health centers in Miyaneh city and sampling is by census. Health workers working in all health centers, numbering 180, and health care workers working in health centers in Miyaneh city, numbering 48, were included in the study. Since in the present study, all members of the statistical community are studied, so the sampling method used is census. Data collection in this study was done through system data (registration) of East Azerbaijan Health Center on performance indicators of health workers and health care providers. The present study is descriptive of correlation and applied in terms of purpose. Repeated Measure test (repeated measures analysis of variance) was used to compare performance indicators over time. Because in this study, the target groups are measured at different times to determine the changes due to an intervention, the test includes: descriptive statistics and the introduction of variables related to the analysis, Multivariate Tests, two-to-two analysis and marginal mean And analysis of variance was repeated measures of size and combination of levels of operating variables. The significance level of the tests was considered 0.05. All data were analyzed using SPSS-19 statistical software.

The results showed that between the implementation of quality-based payment program with the performance indicators of health care providers including pregnancy care coverage index (pv=0.001 and p<0.05) and elderly care coverage index (pv=0.000 and p<0.05) a significant relationship was observed and also the results showed that between the implementation of quality-based payment program with the performance indicators of health care providers including child care coverage index (pv=0.168 and p>0.05) and Student care coverage index (pv=0.585 and p>0.05) a significant relationship was not observed. The results also showed that between the implementation of quality-based payment program with the performance indicators of health workers including pregnancy care coverage index (pv=0.000 and p<0.05), child care coverage index (pv=0.000 and p<0.05) students care coverage index (pv=0.000 and p<0.05) and elderly care coverage index (pv=0.000 and p<0.05) a significant relationship was observed.

Quality-based payment method can lead to the improvement of quantitative and qualitative indicators related to the performance of health workers and caregivers with measures such as improving the individual and team performance of service providers in health centers.

Body Area Networks (BAN) is an example of a Wireless Sensor Network (WSN) that includes several small electronic sensors that are placed inside or outside the human body. By collecting information and sending it to medical centers, these sensors can significantly help patients, the elderly and reduce treatment costs. One of the challenges in these networks is routing emergency packages to send to medical centers.

To reduce the delay of sending packets in the proposed protocol, packets are divided into two categories: emergency and normal. In order to send emergency packages, in addition to the delay of the nodes, we have also considered the traffic so that the packets are sent from the route with less delay and traffic. To send normal packets, the path with the most energy is selected from the shortest possible paths. In this research, we simulated the proposed algorithm using MATLAB software.

The analysis and simulation results of the proposed algorithm show that the delay of sending emergency packets in the proposed protocol is 34% improved compared to the other protocols.

In this study, we have expressed the importance of sending emergency packets as quickly as possible in the body's wireless sensor networks, and by providing a delay-sensitive routing protocol, we have been able to delay the delivery of emergency packets compared to previous protocols.

Despite managerial advances in hospital services, patient admission to ‎hospitals is still one of the problems that in addition to imposing additional treatment costs, ‎consumables and equipment depreciation, wastes time in providing services to New patients and also ‎dissatisfaction of patients and staff. Accordingly, in this study, the effect of each of the factors of ‎patient admission in Hasheminejad hospital has been identified and determined.‎

In order to achieve the purpose of the study, first the files of 314 patients admitted in 2019-‎‎2020 in this hospital were reviewed and the main reasons for patient admission were extracted. Then, ‎by using fuzzy hierarchical analysis, the effect of each of the identified causes was determined. In the ‎next stage, based on the brainstorming techniques with the presence of 20 experts in this field and ‎also the fish bone technique, the identified causes were identified. In the final stage, based on the ‎opinion of experts and brainstorming technique, executive solutions to reduce patient admission were ‎presented and using the approach of fuzzy hierarchical analysis from the point of view of 3 criteria, ‎cost and time required for implementation and feasibility of implementation. Were prioritized.‎

In this study, 5 main causes of disease recurrence, treatment follow-up, nosocomial ‎infections, cancellation of surgeries, disease complications and medication for patient admission were ‎identified in three treatment groups: urology, nephrology and vascular surgery. Based on the output ‎of the hierarchical analysis approach, it was found that: Nosocomial infections with an effect of 0.285 ‎and follow-up treatment with an effect of 0.229 had the highest effect on patients' return to the ‎hospital, also cancellation of surgery had the least effect compared to other factors. In the referral of ‎patients to the hospital, seven practical solutions were presented. Based on the output of fuzzy ‎hierarchical analysis approach, the solutions for recording and tracking hospital infections with the help ‎of the Internet of Things, the development of specialized nutritional training programs by hospital ‎nutrition experts, with scores of 0.182 and 0.165 had the highest executive priority.‎

The use of strategies proposed in this study to reduce patient admission to the hospital is ‎recommended to senior hospital managers.‎

The main objective of this study was to determine pregnancy & live birth rates after a new IVF/ICSI and fresh embryo transfer in patients with history of unexplained recurrent implantation failure (RIF).

In this prospective cohort study, 50 unexplained RIF patients who were scheduled for a new IVF/ICSI –ET treatment in Avicenna specialized and tertiary center for infertility treatment, were followed to determine pregnancy & live birth rates. All patients were assessed for inclusion and exclusion criteria also had informed consent before entering the study.

The mean age of patients was 33.57±4.63 years. Mean number of previous unsuccessful IVF/ICSI -ET cycles was2.72±1. The average number of oocytes picked up via ovarian puncture was 11.2±6.5   and mean number of grown embryos was 5±6. Four of 50 patients were excluded from the study,10 of 46(21.7%) patients had positive pregnancy tests, clinical pregnancy also live birth rates per ICSI cycle was   8/46 (17.3%). one case of ectopic pregnancy, one chemical and two clinical pregnancy losses also two twin pregnancies, one of them resulted in preterm labor in 34th week, happened. Sides effects such as infection, hemorrhage and fetal anomaly didn't occur in patients.

 This study showed that pregnancy and live birth   rates per new ICSI- ET cycle for unexplained RIF patients   were21.7% and 17.3% respectively. These rates are less than success rates among the general population scheduled for IVF/ICSI -ET with no history of unexplained recurrent implantation failure. Therefore, unexplained RIF patients may need to undergo a greater number of ART cycles to gain a live birth.

Citizens of all societies are currently exposed to the anxiety of ignorance about the events ahead during the COVID-19 epidemic.

To evaluate the COVID-19 effect on mental health, stress, and anxiety in people directly and indirectly associated with COVID-19 outbreaks in hospitals.

This study was a narrative review of studies focusing on the effect of COVID-19  on people working in hospitals, referring to hospitals and their families.

Based on 25 articles reviewed in this study, various aspects of the COVID-19 stress in health workers, Post-traumatic stress disorder (PTSD) in health workers, Fear of COVID-19 and family relationships, and COVID-19 stress in Maternity hospitals were reviewed in our study.

in the COVID-19 epidemic condition, people's mental health is very important, mainly in people who are in direct contact with medical centers as well as hospitals for their medical condition. Despite all the resources used to combat the outbreak of COVID-19, additional global strategies are needed to address mental health issues. In this study, stressors in the COVID-19 epidemic in hospitals and groups susceptible to these factors, including health workers, children, and pregnant women were examined.