Feasibility of telemedicine deployment in major public hospitals: a case study in Yazd

Background: Health care organizations are faced with a new technology called telemedicine which provides a platform for remote cooperation, training, and consulting. Telemedicine is the use of information technology for clinical care of patients. This study aimed to establish the feasibility of telemedicine in two educational hospitals of Yazd

Methods: This cross - sectional study was conducted in 2014. Census and random sampling were applied to recruit 200 out of 722 clinical and administrative staffs of both hospitals. Data were then collected through a standardized three-part questionnaire entitled "telemedicine measurement tools". The first two parts of the instrument were in the form of checklist that evaluated the infrastructure, administrative culture, and education dimensions. Questionnaires were distributed among hospitals' managers and IT staffs. The third part of the questionnaire was in a five-item Likert questionnaire format that evaluated staff preparation and also any obstacles to the deployment of telemedicine from the employees' perspectives. Data were analyzed through SPSS18 software and by using descriptive statistics, frequency, and percentage

Results: Providing raining and providing care were selected as the best applications in telemedicine by respectively 82.4% and 76.2% of respondents. Additionally, lack of technical staff and insufficient bandwidth in telemedicine were reported by respectively 85.4% and 77.8% of participants as the biggest barriers for use of telemedicine. Distance learning and remote monitoring were experienced by 14.5% and 10% of employees, respectively. There was no strategic plan and support for the use of telemedicine in the two hospitals. Employees had the necessary knowledge on the benefits of telemedicine, as well as barriers to its deployment. Technical infrastructure required for the deployment of telemedicine at the two hospitals was not available

Conclusion: For the deployment of telemedicine, the two hospitals should invest in technical infrastructure and administrative culture. Also, the preparation of the two hospitals' staffs is the reliable implementation of this plan

Zoroastrians support oocyte and embryo donation program for infertile couples

The main goal was to evaluate the attitudes and knowledge of Zoroastrians living in Iran towards oocyte donation [OD] and embryo donation [ED] program. This cross sectional study consisted of 318 Zoroastrians [n=175 for OD and n=143 for ED] of both sexes. The questionnaire form comprised two parts of general demographic characteristics of the participants and twenty multiple-choice questions about attitude and knowledge of participants towards OD and ED. For statistical analysis, the chi-square test was applied for comparison of data generated from ED and OD groups. Majority of the participants supported OD [69.7%] and ED [71.3%] for infertile patients. In addition, 40% and 42% preferred donation program [OD and ED, respectively], compared to adoption. About 60% of the respondents believed that the donors have no right to find the child and claim it as their own. In addition, more than half of the respondents thought that the recipients of oocyte/embryo should never know the name and address of the donors. More than half of the participants did not know whether their religion accepts donation program or not. Approximately, 80% of respondents supported psychological counseling for both donors and recipients. Moreover, about 56% of the participants necessitated the advertisement on OD/ED program in the mass media. Our preliminary data showed that Zoroastrians supported both OD and ED program equally for infertile couples

effect of educational intervention on decreasing mothers' expressed breast milk bacterial contamination whose infants are admitted to neonatal intensive care unit

Various reasons accounted for the infection of infants kept at Neonatal Intensive Care Unit [NICU]. Expressed breast milk may be regarded as a source of infection in infants. This study investigated the source of bacterial contamination and the impact of educational interventions on the contamination of mothers' expressed breast milk [EBM] level whose infants are hospitalized at NICU. Fifteen mothers used to express breast milking their infants admitted at NICU, involved in this study was conducted during October 2011-March 2012. Samples taken from hands, breast, pumps, breast milk, and milk storage containers and therefore 244 samples were prepared by sterile cotton swab and cultured on Blood Agar and EBM. After presenting enough training to mothers, cultures of the same positions were carried out again. Only those samples proved infected that number of their bacterial colonies exceeded 104 cfu / ml or even there was a growth of pathogenic organism. Before intervention 80% of mothers had infected by at least one sample that reduced to 36% after the intervention. Before intervention 25.4% of samples were contaminated; however after intervention, it reduced to 8.2%. The main source of contamination was milk containers and pumps; moreover, Pseudomonas, E-coli, and Klebsiella were among the most common bacteria of samples' contamination. The possibility of EBM contamination was relatively high but educational interventions might reduce the risk of prevalence