Design, development and evaluation of a mobile-based self-care application for patients with COVID-19 not requiring hospitalization; a study of Northwest of Iran.

BACKGROUND: Given the effective role of a mobile applications in disease management, disease monitoring, and self-care in patients with COVID-19 disease, we aimed to design, development and evaluation of a self-care Mobile app for COVID-19 patients not requiring hospitalization. METHODS: The design, development and evaluation the usability of the self-care and education mobile app for patients with COVID-19 disease were conducted in two main phases at 2021 in Northwest of IRAN; (1) Determine the features and capabilities and (2) Design, development and evaluation of self-care mobile App. JAVA programming languages and Android Operating System were used and selected to design and development of a mobile app. There were 25 participants who conducted evaluations of the mobile app's usability and impact using the mobile health app usability a Questionnaire of User Interface Satisfaction was administered to assess the usability of the developed application. The results were analyzed via Excel 2013. RESULTS: The model of developing a mobile app as an Information System was the Waterfall model. The smartphone application based on a set of capabilities and features was designed and consists of two main parts: the login screen for user registration, and the main home menu. The user interface includes three main pages or activities; (a) Main Menu for quick access to all of the pages, (b) Symptom management and monitoring to monitor the signs and symptoms during the illness, and (c) Set Reminders and Alarms to notify patients. The users' mean score of the application usability was calculated as 7.91 out of 9 indicating a good level of satisfaction. CONCLUSION: This app can be a guideline and a useful tools for managing and monitoring symptoms, reminding medications, and implementing self-care instructions in outpatients. The authors suggest evaluating the efficacy and functionality test of mobile-based applications for COVID-19 in clinical trial studies.

Usability of Emergency Department Information System Based on Users' Viewpoint; a Cross-Sectional Study.

Introduction: The emergency department is of special importance due to its emergency and vital services, the high volume of referrals, and the patients' physical condition. Thus, it requires a well-designed information system with no usability problems. This study aimed to evaluate the usability of the emergency department information system from users' perspectives. Methods: This was a cross-sectional study. The research setting was the emergency department of 3 hospitals. The research instrument was a 37-item questionnaire adapted from the USE and ISO Metrics questionnaires, consisting of five dimensions measuring the usefulness of the system, ease of use, ease of learning, user satisfaction, and suitability for the task. The content validity of the questionnaire was examined using the content validity ratio and content validity index, and its reliability was assessed using Cronbach's alpha (α = 0.88). Results: Fifty questionnaires were administered in the three hospitals, and the response rate was 80%. According to the findings, 55% of the respondents were female. The highest mean scores belonged to usefulness in emergency department information system (EDIS) A, ease of use in EDIS B, ease of learning in EDIS A, user satisfaction in EDIS C, and suitability for the task in EDIS A. According to the usability evaluation criteria, ease of learning (3.66 ± 0.74), usefulness (3.53 ± 0.87), and suitability for the task (3.47 ± 0.96) received the highest scores, and the lowest scores belonged to user satisfaction (3.29 ± 1.01) and ease of use (3.12 ± 1.00). Conclusion: In terms of usability criteria, the emergency department information system is at a relatively good level. The usability of these systems can be further enhanced by considering the users' working needs, improving software flexibility, customizing the software, using data visualization tools, observing consistency of features and standards, and increasing the quality of information and system services.

Effect of educational intervention on improving nurse's general health in military hospitals of Iran: a quasi-experimental study.

BACKGROUND: Nursing in military hospitals affects their general health. Educational interventions can help to maintain the general health of nurses. This study aimed to evaluate the effect of an educational intervention to improve the general health of nurses in military hospitals. METHODS: In this quasi-experimental study, 146 nurses working in military hospitals in Tehran, Iran in 2021 were included in the study. The one-month educational intervention included videos, pamphlets, and motivational messages about promoting general health. General health questionnaire with 28 items (GHQ28) was study tool. The allocation of nurses to groups was not random, it was based on personal interest. Frequency (percentage), and mean (standard deviation) were used to describe, and the chi-square test, Fisher's exact test, independent and paired t-test were used for data analysis. All analyzes were performed in SPSS 24 software with a significance level of 5%. RESULTS: A total of 146 nurses participated in the study, most of them were in the age group of 30 to 40 years (64 people, 43.8%), and 76.7% (112 people) of them were women. The results of the independent sample t-test showed after the intervention, general health scores in the intervention group had a significant decrease compared to the control (p < 0.001) (change in intervention group = -31.1, V.S change in control = 0.55). The results of paired t-test showed that only in the intervention group, the value of the general health score and its dimensions were significantly different (p < 0.001). CONCLUSIONS: The educational intervention performed well and decreased the score of the general health of military nurses. Given that these positive effects may be temporary, it is necessary to design and perform educational interventions over a longer period.

Developing A Minimum Data Set for A Rheumatoid Arthritis Registry in Iran.

Background: Using Minimum Data Set (MDS) is the first step in creating and developing a health care information system; it includes standard and key data elements to capture and manage patient care. Aims: This study aimed to develop an MDS in order for using it for designing registry of patients with rheumatoid arthritis in Iran. Methods: This study was conducted at two stages in 2018. In stage one, qualitative method and semi-structured interview were used to identify the registry data elements of patients with rheumatoid arthritis. Collected data was analysed using content analysis method. In stage two, using Delphi method, the developed data set was revised and validated by 15 rheumatologists. Descriptive statistics using SPSS software was used to analyse the data in Delphi. Results: The final MDS included 22 data elements, which were divided into two major categories of management data (including demographic data, and admission and discharge) and clinical data (including patient examination, treatment plans, and medication prescribed by physician). Conclusion: Minimum data set is one of the standard data collection tools playing an important role in health care data management. This study presented a MDS as a platform for creating a rheumatoid arthritis registry system in Iran recommended by rheumatologists.

Technology in the Era of COVID-19: A Systematic Review of Current Evidence.

BACKGROUND: During the COVID-19 pandemic, the use of technology-based services has been incremental by the care providers for patients scheduling, regulatory considerations, resource allocation, thus enabling virus exposure prevention while maintaining effective patient care. This study aims to review the currently available evidence to identify available technology solutions in the era of COVID-19. METHODS: A systematic review in July 2020 using the PubMed, Scopus, Embase, Science Direct, and Web of Science databases has been carried out. After evaluating the title and abstract to select the most relevant studies based on inclusion and exclusion criteria, the selected articles underwent quality assessment. The full text of selected articles was then thoroughly evaluated to extract the essential findings. RESULTS: In this study, 20 technology-based approaches have been identified for provision of healthcare services to patients with COVID-19. These methods included telemedicine, virtual visits, e-consult, tele-consulting, video conference, virtual healthcare, mobile-based self-care, social media, tele ICU, 3D printing technology, telemonitoring, teleradiology, telesurgical, and cloud-based service. CONCLUSION: Due to the rapid spread of the coronavirus, the use of technology-based methods for the provision of remote healthcare services can help control the disease. The effectiveness of each of these approaches can be investigated in future research.

Acceptability of picture archiving and communication system (PACS) among hospital healthcare personnel based on a unified theory of acceptance and use of technology.

BACKGROUND AND AIM: The picture archiving and communication system (PACS) is a healthcare system technology which manages medical images and integrates equipment through a network. There are some theories about the use and acceptance of technology by people to describe the behavior and attitudes of end users towards information technologies. We investigated the influential factors on users' acceptance of PACS in the military hospitals of Tehran. METHODS: In this applied analytical and cross-sectional study, 151 healthcare employees of military hospitals who had experience in using the PACS system were investigated. Participants were selected by census. The following variables were considered: performance expectancy, efforts expectancy, social influence, facilitating conditions and behavioral intention. Data were gathered using a questionnaire. Its validity and reliability were approved by a panel of experts and was piloted with 30 hospital healthcare staff (Cronbach's alpha =0.91). Spearman correlation coefficient and multiple linear regression analysis were used in analyzing the data. RESULTS: Expected performance, efforts expectancy, social impact and facilitating conditions had a significant relationship with behavioral intention. The multiple regression analysis indicated that only performance expectancy can predict the user's behavioral intentions to use PACS technology. CONCLUSION: Performance and effort expectancies are quite influential in accepting the use of PACS in hospitals. All healthcare personnel should become aware that using such technology is necessary in a hospital. Knowing the influencing factors that affect the acceptance of using new technology can help in improving its use, especially in a healthcare system. This can improve the offered healthcare services' quality.

Novel Mutations of the CHRNA3 Gene in Non-Small Cell Lung Cancer in an Iranian Population

Background: Lung cancer, the leading cause of cancer-related worldwide deaths, largely results from the combined effects of smoking exposure and genetic susceptibility. CHRNA3, a nicotinic acetylcholine receptor gene, is associated with lung cancer risk. This study sought to identify variations in exon 3 of CHRNA3 in an Iranian population with non-small cell lung cancer (NSCLC). Materials and methods: A case-control study including 147 individuals with lung cancer and 145 healthy individuals was conducted. As mobility shift caused by nucleotide substitutions might be due to a conformational change of single-stranded DNAs, we designated these as single-strand conformation polymorphisms (SSCPs). PCR amplified products with SSCP were subjected to DNA sequencing. Results: The sequencing results showed 3 polymorphisms in exon 3 of CHRNA3, rs8040868, rs763384023 and rs2869547 , the latter two of which have not been reported in NSCLC, previously. Conclusion: It appears that the rs8040868 may be considered as a pathogenic mutation associated with the clinical phenotype. Polymorphisms are important factors for development of cancers and may provide additional insights into mechanisms underlying NSCLC.

DNMT3B -149 C>T and -579 G>T Polymorphisms and Risk of Gastric and Colorectal Cancer: a Meta-analysis.

BACKGROUND: Numerous studies have investigated associations of DNA methyltransferase (DNMT) -149 C>T and -579 G>T polymorphisms with gastric cancer (GC) and colorectal cancer (CRC) susceptibility; however, the findings are inconsistent prompting the present meta-analysis. MATERIALS AND METHODS: Related studies were identified from PubMed, Google scholar, and SID until 10 October 2015. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the strength of the associations. RESULTS: Eleven studies were included based on the search criteria for CRC and GC related to the DNMT3B 149 C>T (3,353 cases and 4,936 controls) and DNMT3B 579 G>T (1,387 cases and 2,064 controls) polymorphisms. There was no significant association overall between DNMT3B -149 and 579 polymorphisms and the risk of cancer. In the stratified analysis by cancer type, DNMT3B 579G>T polymorphism was associated with the risk of CRC and GC. While the DNMT3B -149C/T polymorphism was related with a significantly increased risk of CRC in two tested models, dominant (GG+GT vs. TT: OR 0.51, 95 % CI 0.38-0.69; P = 0.00, Pheterogeneity=0.69, I2= 0 %) and heterozygote (GT vs. TT: OR 0.50, 95 % CI 0.37-0.69; P=0.00, Pheterogeneity=0.41, I2= 0 %), no evidence of any association with GC risk was observed as in the pooled analyses. CONCLUSIONS: More studies are needed to assess associations of DNMT3B -149C/T and DNMT3B 579G>T polymorphisms with cancer in different ethnicities with large population sizes to generate comprehensive conclusions.