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Background: Information dashboards are useful tools for up-to-date decision-making by visualizing data. Objectives: This study aimed to report the development of a dashboard in the emergency department (ED) during COVID-19 in a big hospital in Iran. Methods: The authors developed a dashboard by user-centered design (UCD) methodology in four phases, namely specification of the context of use, specification of the requirements, creation of design solutions, and evaluation. Indicators were determined by reviewing previous studies and interviewing focus groups with an expert panel. The Power BI Desktop software was used for the development of the dashboard. Users' comments about the dashboard were collected. The dashboard was then developed and revised according to the users' feedback and suggestions. Finally, user satisfaction was evaluated. Results: The authors identified 30 indicators for COVID-19 ED, classified as input, output, and process indicators. The final version of the dashboard was implemented in 2021, and then 28 ED and managerial staff participated in the evaluation of the dashboard. The average score of the system usability scale of the dashboard was 84.10 points, and the situation awareness index was 3.97, which indicates "good" usability and situation awareness. Conclusion: This dashboard presented key managerial and clinical indicators for decision-making in ED. Future studies can be designed to develop dashboards for accidents and burns EDs and create emergency information dashboards for several hospitals for better management in times of crisis.
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Background: Healthcare workers (HCWs) directly or indirectly involved in the coronavirus disease 2019 (COVID-19) treatment process may experience severe mental consequences of the pandemic. Hence, this study aimed to evaluate the mental health status of HCWs in hospitals affiliated with Shiraz University of Medical Sciences, Iran. Material(s) and Method(s): This cross-sectional study was performed on 503 HCWs from five hospitals in Shiraz, including one COVID-19 front-line hospital, two COVID-19 second-line hospitals, and two without COVID-19 wards. Then, to assess the levels of anxiety, depression, insomnia, and post-traumatic stress disorder (PTSD) among HCWs, the Persian versions of the Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), and Global Psychotrauma Screen (GPS) questionnaires were placed, respectively. Result(s): The mean age of participants was 33.94+/-8.26 years, and 252 (50.1%) were females. Anxiety, depression, insomnia, and moderate to high levels of PTSD were observed in 40.4%, 37.8%, 24.5%, and 71% of participants, respectively. A history of mental disorders was associated with all four outcomes (P<0.05). Females gender and living with elderly and/or children were correlated with anxiety and PTSD (P<0.05). Working at COVID-19 front- and second-line hospitals were similarly linked to higher insomnia and PTSD levels (P<0.05). Also, working in COVID-19 wards or non-clinical settings was associated with anxiety and depression (P<0.05). Conclusion(s): Most of the HCWs in this study may experience mental difficulties. Some factors may increase their risk of experiencing these difficulties. Hence, in the crisis era, mental health monitoring and identification of groups with predisposing factors are required to provide appropriate care as quickly as feasible.Copyright © 2023 Shiraz University of Medical Sciences. All rights reserved.
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Background: The safety and mental health issues of frontline nurses working during the coronavirus global outbreak must be a first/top priority. The present study aimed to investigate the association between nurses' occupation stress and organizational support in both infectious and non-infectious intensive care units (ICUs) wards during the COVID-19 crisis. Methods: This was a descriptive-analytical and cross-sectional study. The study population comprised nurses caring for COVID‐19 patients in Imam Reza Hospital complex in Mashhad City, Iran. The sample size was 129 nurses selected through random quota sampling and examined with a standard questionnaire. To analyze the information and test the hypothesis, the structural equation modeling approach using Smart PLS 2.0 software has been used. Descriptive and analytical statistical tests were used in this study. Results: The results indicated a significant negative correlation between stress and perceived organizational support for ICU nurses (P<0.001). Considering subscales in stress, the highest mean occupational stress scores were related to the "death and dying” dimension (n=21, 13.98%). Also, the difference between the two groups of nurses was statistically significant in different workloads (P<0.001) and lack of support (P<0.001). Conclusion: The results of the present study highlighted the importance of organizational support to reduce stress in nurses. To get through this unprecedented situation, nurses need their employers and organizations to support them with action, planning, and resources. © 2022, Gonabad University of Medical Sciences. All rights reserved.
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Purpose: The importance of management capacity in the health sector has been increasingly recognized. The World Health Organization (WHO) (2008) has claimed that limited "management capacity” in low-income countries is one of the main obstacles toward achieving health-related goals. The aim of this study is to answer the research question: "What are the elements of management and leadership capacity of senior managers from the perspective of senior managers.” Design/methodology/approach: Semi-structured individual interviews were conducted with 20 senior health managers. Sampling method was purposive. Data were collected using a researcher-made interview guide. The transcribed text was analyzed using framework analysis. Findings: Five main themes emerged from the analysis are: (1) competencies required for managers;(2) selection and appointment of managers;(3) establishment of managers' database;(4) deployment of functional support system;and (5) environmental sensitivity. Each of these themes contains sub-themes. Research limitations/implications: Due to the COVID-19 pandemic, the interviews were conducted virtually. This may have had an impact on obtaining wealthy data because in a face-to-face interview, it is possible to question and answer, get additional explanations and understand the interviewee's mentality. Practical implications: Extracting elements of management and leadership capacity helps managers to assess management capacity and leadership comprehensively and effectively. In addition, effective and useful operations can be done to strengthen the management and leadership capacity. Originality/value: This is the first study that has identified the main elements of management and leadership capacity from the perspective of senior health managers in Iran. This article provides the components of the health system management and leadership capacity that can be used at top management level. © 2022, Emerald Publishing Limited.
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Background: Tuberculosis (TB) is considered one of the most infectious diseases in the world. In this study, we intended to examine the epidemiology of tuberculosis by MIRU-VNTR to define the changes that occur in the transmission of tuberculosis in the region during the COVID-19 era. A total of 120 Mycobacterium tuberculosis isolates were collected from sputum samples of patients referred to East Azerbaijan Center TB from December 2020 to August 2021. Demographic information such as age, sex, place of birth, previous TB history, and relevant medical data was collected. The proportion method was performed for drug susceptibility testing, and the PCR-based MIRU-VNTR method was applied to identify molecular epidemiology relationships. Result(s): The isolates were collected from 78 male (65%) and 39 female (32.5%) Iranian patients and 3 (2.5%) Azerbaijani patients. Ninety-three distinct patterns were identified including 15 clustered patterns and 36 unique patterns. The largest cluster was composed of seven isolates. Furthermore, one cluster with 5 members, four clusters with 3 members, and nine clusters with 2 members. In MIRU-VNTR typing, 75 clusters belonged to the Tabriz region and just 3 to the Republic of Azerbaijan. All isolates were sensitive to rifampin, isoniazid, and ethambutol. Conclusion(s): Results of the current study showed COVID-19 pandemic had a direct effect on the transmission and diagnosis of tuberculosis. Less diagnosis and less clustering can indicate public controls and hygiene, and the use of masks had a direct effect on the transmission and diagnosis of tuberculosis. However, misidentification and less focus on other respiratory infections are expected during the pandemic. Studies on the co-infection of COVID-19 and tuberculosis and the role of mask and sanitization against TB are strongly recommended. Copyright © 2023, The Author(s).
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PurposeThe importance of management capacity in the health sector has been increasingly recognized. The World Health Organization (WHO) (2008) has claimed that limited "management capacity" in low-income countries is one of the main obstacles toward achieving health-related goals. The aim of this study is to answer the research question: "What are the elements of management and leadership capacity of senior managers from the perspective of senior managers."Design/methodology/approachSemi-structured individual interviews were conducted with 20 senior health managers. Sampling method was purposive. Data were collected using a researcher-made interview guide. The transcribed text was analyzed using framework analysis.FindingsFive main themes emerged from the analysis are: (1) competencies required for managers;(2) selection and appointment of managers;(3) establishment of managers' database;(4) deployment of functional support system;and (5) environmental sensitivity. Each of these themes contains sub-themes.Research limitations/implicationsDue to the COVID-19 pandemic, the interviews were conducted virtually. This may have had an impact on obtaining wealthy data because in a face-to-face interview, it is possible to question and answer, get additional explanations and understand the interviewee's mentality.Practical implicationsExtracting elements of management and leadership capacity helps managers to assess management capacity and leadership comprehensively and effectively. In addition, effective and useful operations can be done to strengthen the management and leadership capacity.Originality/valueThis is the first study that has identified the main elements of management and leadership capacity from the perspective of senior health managers in Iran. This article provides the components of the health system management and leadership capacity that can be used at top management level.
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Background: COVID-19 is a widespread viral disease that has severely affected our world. Although beneficial effects of vitamin D on immune system are well known, there are ongoing discussions about its role in patients suffering from SARS-CoV-2 infection. In this study, we examined the relationship between risk of COVID-19 infection and plasma vitamin D level. Methods: This case-control study was conducted on 133 participants in Kerman city, Iran. SARS-CoV-2 infection was confirmed by positive RT-Real time PCR test in 69 cases and another 64 participants were considered as-non-infected-control group. Plasma vitamin D levels were measured among all, and compared. Results: Sub-normal plasma vitamin D level were reported in about 51% of participants;however, there was no significant difference in the mean plasma vitamin D levels between COVID-19 and control groups. Mean plasma levels of vitamin D were significantly higher in females than males (P-value: 0.017). Conclusion: According to our results, risk of COVID-19 infection does not correlate with plasma level of vitamin D.
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Background: The COVID-19 pandemic, caused by SARS-Cov-2, has affected the care of patients with hemophilia, indicating the necessity of their vaccination. Nevertheless, there are concerns about using anti-SARS-Cov-2 virus vaccines for hemophilic patients, particularly concerning bleeding adverse events. Methods: Following a cross-sectional design, all adult hemophilic patients who received two doses of Sinopharm anti-SARS-Cov-2 virus vaccine in Afzalipour Hospital, Kerman, Iran, during May and June 2021 were recruited. The participants were followed for two weeks after receiving each dose of vaccine. Results: Fifty-one patients with a mean age of 37.07 ?? 11.45 years were included, of whom 27 (61.4 %) patients experienced at least one adverse reaction. Pain was the most frequent local adverse event (occurred in 20 (39.2%) and 15 (29.4%) cases after 1st and 2nd doses, respectively). Menometrorrhagia and epistaxis were reported by two and one patients, respectively. Conclusions: Overall Sinopharm anti-SARS-Cov-2 virus vaccine seems to be safe for patients with hemophilia in the short term.
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Background: COVID-19 is an infectious disease caused by SARS-CoV-2 and can lead to acute respiratory distress. Objective: We aimed to investigate the association between COVID-19 severity and serum apelin17 and inflammatory mediator levels. Methods: This cross-sectional study was conducted on patients with COVID-19. COVID-19 infection was confirmed by the RT-PCR test. The patients' data were extracted from their records. Venous blood samples were obtained from the patients to investigate the serum levels of apelin-17 and inflammatory mediators. Results: Eighty-six COVID-19 patients were studied. The mean age of the participants was 55.56±14.88, and 43 (50 %) were male. Clinical symptoms were dyspnea 77.6 %, fever 52.3 %, cough 48.8 %, gastrointestinal symptoms 15.1 %, and chest pain 7 %. The overall mortality rate was 7 %. No significant relationship was found between serum apelin-17 levels and COVID-19 severity (P= 0.48). However, there was a significant and direct relationship between COVID-19 severity and serum levels of CRP (P= 0.038) and D-dimer (P= 0.029). Conclusion: Serum apelin-17 levels were higher in recovered patients than those who died (4.90 vs. 3.19). Moreover, serum apelin-17 levels were higher in the patients admitted to the general ward than those admitted to the ICU (5.15 vs. 3.98). The difference was not statistically significant. However, there was a significant and direct relationship between serum apelin-17 levels and lymphocyte count (P= 0.022). Moreover, there was a significant and inverse relationship between lymphocyte count and COVID-19 severity (P= 0.004). Therefore, it can be interpreted that COVID-19 severity may decrease with an increase in serum apelin-17 levels. Therefore, to prove this hypothesis, a study with larger sample size is recommended.
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Background and Objective: Adequate health literacy and compliance with COVID-9 health and safety protocols are among the main ways to break the SARS-CoV-2 transmission chain. This study aimed to investigate the level and relationship between awareness, attitude and behavior of students, staff and faculty in Mashhad University of medical sciences, regarding compliance with COVID-9 health and safety protocols in 2021. Materials and Methods: This analytical cross-sectional descriptive study was conducted at Mashhad University of medical sciences, Mashhad, Iran in October 2021. The study sample included 411 students, staff and faculty selected through available sampling. The data were collected using a previous standard questionnaire and analyzed through the partial least squares (PLS) approach for structural equation modeling (SEM) using Smart PLS software (version 3.0). We employed descriptive and inferential statistics for our data analysis. Results: Respondents ‘awareness, attitude and behavior towards COVID-19 health protocols yielded significant positive correlations (P<0.001). Furthermore, the mean score percentage of awareness, attitude and behavior were 85%, 65% and 84% of the total score, respectively. Additionally, respondents’ mean scores for behavior and attitude differ significantly across age, gender, job and marital status. Conclusion: The level of awareness of the participants in Mashhad University of Medical Sciences about the COVID-19 health safety protocols was good. A significant relationship was observed between awareness, attitude and behaviors related to compliance with COVID-19 protocols. It seems that these people can be good representatives in the community to increase people’s awareness, considering the participants’ observance of the protocols. © 2022, Mashhad University of Medical Sciences. All rights reserved.
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Background: The ongoing COVID-19 pandemic increased the need for inpatient beds, indicating the need for hospitals to increase the efficiency of beds. Objectives: This study aimed to increase hospital bed capacity using the implementation of Electronic Patient Discharge (EPD).
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Density functional theory calculations were performed to examine electronic and structural features of favipiravir (Fav) for iron (Fe) chelation. Fav was well known for the possible medication of COVID-19;however, its mechanism of action has still been a challenging issue. Therefore, this work was done to provide information regarding the possible action of Fav for participating in the Fe chelation process. To this aim, various types of molecular and atomic descriptors were obtained to discuss the topic of this work. Obtained values of energies indicated different levels of stability for pure Fav compounds, in which such variations were also found for FavFe complexes. Molecular orbital-related features showed a different tendency to contribute to reactions for both pure and complex Fav models, in which changes of the energy levels of molecular orbitals raise the detection function of Fe for Fav compounds. Atomic-scale features also indicated direct and indirect roles of atomic sites for formations of FavFe complex models. As a consequence, the idea of Fe chelation by Fav compound was affirmed regarding the obtained results with providing detailed information for investigating the mechanism of action of Fav in treatment of COVID-19. © 2021 by the authors.
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Background : Nursing care activities in the context of infectious epidemics, such as COVID - 19, can lead to high levels of stress in nurses. Objectives: This study aimed to investigate the relationship between the occupational stress and adequacy of hospital support measures among nurses with the experience of caring for patients with infectious and non - infectious diseases during the COVID - 19 outbreak.