Razavi International Journal of Medicine
Volume:6 Issue: 2, Spring 2018

Context: 

This literature review mostly emphasizes on the challenges and barriers for acceptance and implementation of electronic health records (EHRs) in developing countries. Although the willingness of developing countries for acceptance and implementation of EHRs is rising, they will face some challenges and barriers which can slow down their progress due to the multidisciplinary and complexity characteristics of EHRs. Some of these challenges and barriers can be seen in the past and present histories of EHRs acceptance process in developed countries too. Familiarity with these challenges and barriers will help developing countries to have better understanding of these problems towards successful EHRs. The main goal of this survey is to study the challenges and barriers of acceptance and implementation of EHRs in the developing countries and how they can overcome such problems.

Evidence Acquisition: 

Two databases, Pub-Med and Scopus with Combination of terms such as Electronic Health Records, Developing Countries, Barriers, Challenges, Acceptance, and Adoption were searched. Totally, 514 articles extracted. Some exclusive criteria such as date of publication (year 2000 and above) and having a close relation to the subject of the study (through abstract) were applied. The result was eight articles from Scopus and 12 articles from Pub-Med. Also, 7 articles were extracted by general search in internet. Also, 11 articles with the same search policies were selected from Journal of Health informatics for Developing Countries (JHIDC) with no exclusion criteria.

Developing countries must be fully aware of challenges and barriers in their way towards EHRs. They also need to study the experiences of countries which are successful in acceptance and implementation of EHRs. Developing countries also need to provide infrastructures needed for a successful implementation of EHRs.

Despite the positive effects of EHRs in healthcare services, the acceptance rate of EHRs in developing countries and even developed countries is still low. The developing countries are facing many problems in their way toward implementing successful EHRs. Lack of infrastructures in information and communication technology, cost, and cultural resistance are considered as main barriers for developing countries in their approach to accept and implement EHRs.

Iran is estimated to have about 73000 (50000-130000) people living with human immune deficiency virus (HIV) by end of 2015. Medical students are of special emphasis in agenda setting against Acquired Immunodeficiency Syndrome (AIDS).

The aim of this study was to assess the Knowledge, attitudes and practice of medical students to HIV/AIDS.

This cross-sectional study was conducted among medical students in Mashhad, Iran in a six-month period at the second half of the year 2016. Stratified cluster random sampling technique was used to select 202 students in 4 courses of medical education. The world health organization’s instrument was used for assessing knowledge, attitudes, and beliefs about HIV/AIDS. One way ANOVA or Kruskal wallis test were used for data analysis.

The mean age of the subjects was 22.31+2.97 years. Most of them were male (65.7%) and 77.4% were single. Medical students had almost good general knowledge about HIV/AIDS. 28.9-98% answered correctly to this section. In transmission knowledge section there were some misconceptions about the routes of transmission and 15.6-98.5% answered correctly. The majority of students had positive attitudes toward HIV/AIDS, 74-98.2% of respondents answered correctly to this section. Overall 56-98% of students responded correctly to different beliefs domain questions. There were significant differences in mean knowledge score between four different courses of medical education (P=0.004).

Findings indicated a statistically significant betterment in some aspect in knowledge, attitude and belief toward HIV/AIDs, but it was expected that final year medical students had more correct information, a fact not indicated in this study.

Suicidal attempt is considered to be a major health problem around the world. Recent statistics in Iran indicate the rising trend of committing suicide in recent years.

The aim of this study was to determine the risk factors in subjects who attempted suicide and were admitted in Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz, Iran from 2010 to 2015.

In a cross-sectional study, 81 out of 243 suicidal attempt patients were selected to participate in the study and interviewed and 81 patients with unintentional injuries were selected by systematic random sampling from trauma patients who referred to the above-mentioned hospital by other mechanisms of injury in the same period. Demographic data and risk factors were evaluated through a data collection form.

In this study, in suicidal attempt patients group, 87.7% were men and 12.3% women and for the unintentional injury group, 25.9% were women and 74.1% were men. Mean age for patient in case and control group were respectively 27±10.41 and 37.28±16.85. Age

Prisoners are a certain part of the population. Prisoners are kept in a closed environment for a long period of time and are prone to various diseases. Inflammatory biomarkers, including hs-CRP, are new risk factors for cardiovascular disease.

The aim of this study was to compare hs-CRP levels in male and female prisoners and investigate the relationship between hsCRP levels with related factors.

In this cross-sectional study, 316 prisoners in Mashhad Prison were investigated. A blood sample (7ml) was taken from each subject. Enzyme-linked immunosorbent assay (ELISA) technique was used to measure serum levels of highsensitivity C-reactive protein (hs-CRP). Descriptive statistics, chi-squared test, T-test, Pearson and Spearman’s correlation coefficients were used. P<0.05 was considered to be the level of significance.

316 prisoners were investigated of whom 211 (66.8%) were male and 105 (33.2%) were female. Mean hs-CRP level was 5.72±7.93 µg/ml in men and 7.48±8.39 in women. The difference between the two genders were statistically significant (p<0.001). The mean hs-CRP level was significantly higher in prisoners who did injection drug use compared to those who inhaled or consumed drugs (p<0.001). A significant correlation was observed between age, systolic blood pressure, frequency of imprisonment, height and BMI and hs-CRP levels.

Since hs-CRP is an important biomarker for non-communicable diseases, considering these factors and other risk factors for chronic diseases in the high-risk and vulnerable groups of prisoners, prevention and control measures can be planned by this group of people.

Context: 

To deal with health problems, using an approach, based on prevention perspective, consist of different types of prevention, can be a proper way to manage the health problems such as surgical site infections (SSIs). Introducing an action plan from the perspective of “prevention” for dealing with surgical site infections (SSIs).

Evidence Acquisition: 

We have used 5 known prevention levels as a simple approach for dealing with surgical site infections. For gathering information, electronic databases, including Scopus, Medline, ISI, IranMedex, and Irandoc sites were used.

For prevention of surgical site infection, a comprehensive evidence based instruction, consist of 75 related factors and 74 proposed measurable and operational preventive activities was developed.

We concluded that, to deal with surgical site infections use of the proposed action plan may be useful. Even we believe that, this approach can be used to deal with any health problems including diseases, disorders, accidents and events.   Keywords: Hospital Infection Control, Prevention Levels, Prevention, Risk Factors, Surgical Site Infection

Satisfaction of physicians could effect on their quality of life and quality of care of their patients.

The aim of current study was to determine the job satisfaction and lifestyle of specialist physicians in Tehran.

Using a cross-sectional survey between October 2014 and April 2015, convenience samples of 645 specialist physicians were evaluated. We used a self-administered questionnaire included items about demographic variables, lifestyle, overall health status, happiness, and job satisfaction. Physicians based on specialty type are categorized to two groups included surgical and non-surgical.

Mean age was 44.22 (±8.23) years old. The body mass index (BMI) had a mean of 25.07 (±2.98). Overall, 413 (64.5%) of participants were rated their happiness as “extremely happy” and happy. Four hundred and eight (69.5%) physicians were in an excellent or good status of health. Almost 70% (453) of studied specialist physicians were satisfied with their job. Orthopedic surgeons and obstetricians had the bests and worst general health respectively. The neurologists were happiest physicians. The general surgeons had the highest BMI.

Majority of studies physicians were in a good status of health and almost two third were happy. More than two third of physicians were satisfied with their job. About 40% had less than once physical activity per year and more than 45% were overweight and obese.