The relationship between succession and intellectual capital with entrepreneurship in hospitals.

BACKGROUND: The hospital environment is very dynamic and faces many internal and external changes. Healthcare knowledge and technology are developing at a swift pace. This study investigated the relationship between succession and intellectual capital with entrepreneurship at the Qazvin University of Medical Sciences hospital, Iran. METHODS: The number of employees working in six hospitals was 2256, and according to Morgan's table, the required number of samples was 331. We distributed three hundred sixty-five questionnaires considering 10% of sample loss. We used a multi-stage stratified sampling method. In the first stage, each hospital was considered a stratum. After that, occupational groups were considered the next stratum within each hospital, and based on the ratio, the required number of samples for each occupational group was randomly selected. We used the Sobel test to investigate the mediating role of intellectual capital and the structural equation model to fit the research model. RESULTS: Succession aspects, including culturalization, meritocracy, job promotion path, and the role of senior managers, have a positive and significant effect on intellectual capital. Succession is only effective on intellectual capital and does not affect the personnel's entrepreneurship directly or through intellectual capital. CONCLUSION: Conducting training classes and intervention programs and using localized succession models can create a suitable platform for increasing organizational creativity and entrepreneurship, motivating the hospitals' personnel, and increasing intellectual capital.

Perceived stress, stress coping strategies, and post-traumatic-growth among healthcare professionals during COVID-19 pandemic.

AIM: The purpose of this research was to identify the perceived stress, stress coping strategies, and Post-Traumatic-Growth (PTG) among Iranian healthcare professionals. DESIGN: A cross-sectional study was applied. METHODS: This study was conducted among 402 healthcare professionals in northwestern Iran. Participants completed demographic, perceived stress, stress coping strategies, and PTG questionnaires. Multiple linear regression was employed to identify the predictors of perceived stress and PTG. RESULTS: The overall score of perceived stress was calculated 30.55 (6.18). The problem-oriented strategy was the most common stress coping by healthcare professionals (52.66 (8.72)). Also, the total score of PTG was calculated at 45.72 (30.42). Perceived stress, stress coping strategies (except problem-oriented), and PTG scores were significantly different between hospital and health centres participants (p-value < 0.05). Previous experience in critical situations, crisis-related course, degree, age, department, and stress coping strategies were related to the stress level. Moreover, workplace, department, work experiences, and employment status were the predictors of PTG.

Work-family conflict, burnout, and related factors among nurses during the COVID-19 pandemic in the Northwest of Iran.

BACKGROUND: Nurses, as the largest working group in the hospital, experience many problems, conflicts, and stressors in the workplace and family especially after the widespread distribution of coronavirus 2019 (COVID-19). OBJECTIVE: The perceived conflict and burnout among nurses, as well as the correlation between these two variables and the associated factors, were the main subjects of this study. METHODS: This cross-sectional study involved 256 nurses from three COVID-19 referral hospitals in northwest Iran. Participants completed demographic, work-family conflict (WFC), and burnout questionnaires. The nonparametric tests including Mann-Whitney U, Kruskal-Wallis, and Spearman correlation coefficient were applied to statistical analysis. RESULTS: The overall score of conflict was 55.3 (12.7). The time dimension received the highest score 11.4 (2.9). In terms of intensity 27.6 (8.7) and frequency 27.6(8.8), nurses had the most burnout in the lack of personal accomplishment dimension. All aspects of WFC, emotional exhaustion, and depersonalization characteristics of burnout had statistically significant positive correlations (p < 0.01). The ward, hospital and employment status variables were associated with WFC (p < 0.05). The association between taking the crisis management course and the severity of depersonalization, and the frequency of lack of personal accomplishment was confirmed (p < 0.01). Additionally, the frequency and severity of emotional exhaustion were associated with employment status and work experiences (p < 0.05). CONCLUSION: The findings showed that nurses had WFC and burnout rates that were above average. Regarding the negative effects of these two phenomena on health, and also nurse's clinical practices, rearranging work conditions and providing better organizational support seem necessary.

COVID-19 mortality and its predictors in the elderly: A systematic review.

Background and Aims: Older people have higher rates of comorbidities and may experience more severe inflammatory responses; therefore, are at higher risk of death. Herein, we aimed to systematically review the mortality in coronavirus disease 2019 (COVID-19) patients and its predictors in this age group. Methods: We searched PubMed, Web of Science, and Science Direct using relevant keywords. Retrieved records underwent a two-step screening process consisting of title/abstract and full-text screenings to identify the eligible studies. Results: Summarizing findings of 35 studies demonstrated that older patients have higher mortality rates compared to the younger population. A review of articles revealed that increasing age, body mass index, a male gender, dementia, impairment or dependency in daily activities, presence of consolidations on chest X-ray, hypoxemic respiratory failure, and lower oxygen saturation at admission were risk factors for death. High d-dimer levels, 25-hydroxy vitamin D serum deficiencies, high C-reactive protein (≥5 mg/L) levels plus any other abnormalities of lymphocyte, higher blood urea nitrogen or lactate dehydrogenase, and higher platelet count were predictors of poor prognosis and mortality in the elderly. Studies have also shown that previous treatment with renin-angiotensin-aldosterone system inhibitors, pharmacological treatments of respiratory disorders, antibiotics, corticosteroids, vitamin K antagonist, antihistamines, azithromycin, Itolizumab (an anti-CD6 monoclonal antibody) in combination with other antivirals reduces COVID-19 worsening and mortality. Vaccination against seasonal influenza might also reduce COVID-19 mortality. Conclusion: Overall, a critical consideration is necessary for the care and management of COVID-19 in the aged population considering the drastic contrasts in manifestation and prognosis compared to other age groups. Mortality from COVID-19 is independently associated with the patient's age. Elderly patients with COVID-19 are more vulnerable to poor outcomes. Thus, strict preventive measures, timely diagnosis, and aggressive therapeutic/nontherapeutic care are of great importance to reduce acute respiratory distress syndrome and severe complications in older people.

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.

Design and Development of a Mobile-Based Self-Care Application for Patients with Type 2 Diabetes.

INTRODUCTION: Mobile-based applications play a leading role in changes in life-style, improve medication adherence, and provide a unique opportunity to aid patients with type 2 diabetes mellitus (T2DM) elevate their healthcare level. Therefore, we aim to design and develop a mobile-based self-care application for patients with T2DM. METHODS: The present study was an applied and developmental study to design and develop a mobile-based self-care application for people living with T2DM conducted in 2020. The design and development of the T2DM self-care application were done in 2 main phases of determining the key features and capabilities, and design and development of the T2DM self-care mobile app. RESULTS: We identified the main model and a set of capabilities and features for the T2DM self-care application. By content analysis on 32 different applications and a previous study by the author, 18 features were extracted for the T2DM self-care mobile app. JAVA programming languages were used to design T2DM applications. Moreover, because of the cost-effectiveness, the Android operating system (AOS) was selected as a platform, and because of the widespread use of smartphones; these phones were chosen as the format of T2DM self-care application. CONCLUSIONS: In this study, we design and develop a mobile-based self-care application for patients with type 2 diabetes that shows potential in solving the shortcomings of mobile apps for diabetes care. By utilizing the T2DM self-care mobile app we are able to deploy a self-care application with a wide range of functionality such as text messaging, blood glucose monitoring, insulin dose suggestions, educational messaging, metabolic management, pedometer counts, and reporting. Future studies are needed to develop self-care applications for a different type of diabetes with different functions of diabetes care.

Mobile applications in HIV self-management: A systematic review of scientific literature.

Self-management through mHealth by mobile apps creates new opportunities for people living with HIV (PLHIV) for integrated and accurate management. Our study focused on current evidence on HIV selfmanagement mobile applications to identify and assess their objective, infrastructure, and target populations. A systematic review was conducted on studies that use apps to improve self-management among HIV-positive patients, using PubMed, Scopus, Embase, Science direct, UpToDate, and Web of Science databases. The search was limited to English-written articles and published in the past 10 years. A search of Google Play for Android and App Store for iOS devices was performed to find the apps identified in the included articles. Concerning the aim of this study, the target populations of 17 identified HIV-apps were found to be mainly directed at PLHIV (n = 15). Furthermore, the objectives of 17 identified HIV-apps were found to self-care, self-monitoring, and self-management (n = 7), improve medication adherence (n = 5), prevention and treatment (n = 5), adherence to antiretroviral therapy (ART) (n = 4), Cognitive Behavioral Stress Management (n = 1), and support safer conception among HIV couples (n = 1). The operating system of most HIV-apps was Android (n = 15), one app for iOS and seven apps was both of them, and most apps were free (n = 19). The findings indicate that mHealth strategies for PLHIV have had a substantial positive effect on ART, drug adherence, prevention, and treatment, as well as social and behavioral problems affecting PLHIV. Even though the mHealth market needs to be regulated, it specifies that mHealth is relevant and should be used in the self-management, self-monitoring, and self-care of PLHIV.

Security challenges and solutions using healthcare cloud computing.

Cloud computing is among the most beneficial solutions to digital problems. Security is one of the focal issues in cloud computing technology, and this study aims at investigating security issues of cloud computing and their probable solutions. A systematic review was performed using Scopus, Pubmed, Science Direct, and Web of Science databases. Once the title and abstract were evaluated, the quality of studies was assessed in order to choose the most relevant according to exclusion and inclusion criteria. Then, the full texts of studies selected were read thoroughly to extract the necessary results. According to the review, data security, availability, and integrity, as well as information confidentiality and network security, were the major challenges in cloud security. Further, data encryption, authentication, and classification, besides application programming interfaces (API), were security solutions to cloud infrastructure. Data encryption could be applied to store and retrieve data from the cloud in order to provide secure communication. Besides, several central challenges, which make the cloud security engineering process problematic, have been considered in this study.

The effects of hyperbaric oxygen therapy (HBOT) on coronavirus disease-2019 (COVID-19): a systematic review.

BACKGROUND: Oxygenation serves as a cornerstone in the treatment of COVID-19, and several methods have been extensively studied so far. Herein, we aimed to systematically review the studies discussing hyperbaric oxygen therapy (HBOT) to examine its reported efficacy and adverse events in patients with COVID-19. METHODS: We systematically searched and retrieved the relevant articles using keywords on the online databases, including PubMed, Scopus, Embase, Web of Science, and Cochrane databases up to April 11th, 2021. The retrieved records underwent a two-step title/abstract and full-text screening process, and the eligible papers were identified. National Institutes of health (NIH) quality assessment tool was used for this study. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with ID CRD42021269821. RESULTS: Eight articles from three countries were included. All the included studies had good and fair quality scores, with no poor studies included in this systematic review (Good: n = 5, Fair: n = 3). Studies were divided into clinical trials and case reports/series. Most of the studies used HBOT less than 1.5-2 absolute atmospheres (ATA) for 90 min sessions and thereafter sessions were decreased to 60 min. Trials demonstrated most of the patients recovered after receiving HBOT, and blood oxygen saturation increased after several sessions of HBOT. CONCLUSION: Overall, HBOT seems to be a safe and effective oxygenation method in patients with COVID-19. However, there is limited knowledge and evidence regarding the effects and mechanism of HBOT in COVID-19 treatment, and further evaluations require extensive well-designed studies.

Genetic susceptibility of COVID-19: a systematic review of current evidence.

INTRODUCTION: While COVID-19 pandemic continues to spread worldwide, researchers have linked patterns of traits to poor disease outcomes. Risk factors for COVID-19 include asthma, elderly age, being pregnant, having any underlying diseases such as cardiovascular disease, diabetes, obesity, and experiencing lifelong systemic racism. Recently, connections to certain genes have also been found, although the susceptibility has not yet been established. We aimed to investigate the available evidence for the genetic susceptibility to COVID-19. METHODS: This study was a systematic review of current evidence to investigate the genetic susceptibility of COVID-19. By systematic search and utilizing the keywords in the online databases including Scopus, PubMed, Web of Science, and Science Direct, we retrieved all the related papers and reports published in English from December 2019 to September 2020. RESULTS: According to the findings, COVID-19 uses the angiotensin-converting enzyme 2 (ACE2) receptor for cell entry. Previous studies have shown that people with ACE2 polymorphism who have type 2 transmembrane serine proteases (TMPRSS2) are at high risk of SARS-CoV-2 infection. Also, two studies have shown that males are more likely to become infected with SARS-CoV-2 than females. Besides, research has also shown that patients possessing HLA-B*15:03 genotype may become immune to the infection. CONCLUSION: Combing through the genome, several genes related to immune system's response were related to the severity and susceptibility to the COVID-19. In conclusion, a correlation was found between the ACE2 levels and the susceptibility to SARS-CoV-2 infection.

Health Literacy Status and Its Relationship with Quality of Life among Nurses in Teaching Hospitals of Shiraz University of Medical Sciences.

BACKGROUND: Health literacy can be considered as a factor affecting healthcare providers' decision-making. The aim of this study was to investigate health literacy status and its relationship with quality of life among the nurses working in teaching hospitals affiliated with Shiraz University of Medical Sciences in Iran. MATERIALS AND METHODS: This cross-sectional study was conducted in 2017. To this end, 185 nurses from hospitals were selected by stratified random sampling. The data collection instruments included the standardized Health Literacy Questionnaire and the 36-Item Short Form Health Survey. The data were analyzed through descriptive statistics as well as t test, analysis of variance, Pearson correlation coefficient, and multivariate linear regression analysis using SPSS23 (α = 5%). RESULTS: The mean scores for health literacy and quality of life were 70.06 (12.98) and 60.86 (17.26), respectively. A significant relationship was observed between the health literacy and quality of life (p <0.001), Access (p = 0.004), reading skills (p = 0.004), understanding (p = 0.016), and application of health information (p = 0.012) as the dimensions of health literacy were identified among the predictors of quality of life. In addition, there was a significant relationship among age (r = 0.22, p = 0.008), work experience (r = 0.27, p = 0.002), and employment relationship (F = 3.89, p = 0.005) and the mean score for nurses' health literacy status. CONCLUSIONS: A significant relationship was observed between health literacy and quality of life in nurses. Healthcare policy-makers are suggested to take measures to develop programs on promoting health literacy and related skills to improve the status of quality of life among nurses.

Effectiveness of teaching cognitive-behavioral techniques on locus of control in hemodialysis patients.

BACKGROUND: Many of the cognitive behavioral models and therapeutic protocols developed so far for psychological disorders and chronic diseases have proved effective through clinical research. OBJECTIVE: This study aimed to determine the effectiveness of teaching cognitive-behavioral techniques on locus of control in hemodialysis patients. METHODS: This controlled clinical trial study was conducted in 2015 with 76 patients selected by census and treated with a hemodialysis machine in the dialysis department of Vali-Asr Hospital in the city of Meshkinshahr. A total of four patients were excluded because of their critical conditions while the rest, who were recruited, were randomly divided into two equal groups of 36 patients as the intervention and control groups. First, the locus of control was measured in both groups through a pretest, and cognitive-behavioral techniques were then taught to the intervention group during eight 45 to 90-minute sessions. The locus of control in patients of both groups was finally re-measured through a posttest. Data were collected using Rotter's Locus of Control Inventory. The Wilcoxon test and Mann-Whitney U test were respectively used in SPSS18 for data analysis. RESULTS: In the pretest and posttest stages respectively, 4.8% and 14.3% of samples in the control group as well as 14.3% and 33.3% of samples in the intervention group enjoyed internal locus of control. The difference between the pretest and posttest scores of internal locus of control in the intervention group was significant (p=0.004), which indicates the positive effect of cognitive-behavioral psychotherapeutic intervention on internalization of locus of control in this group. CONCLUSIONS: Given the external locus of control in most of the study patients and also the positive significant effect of cognitive-behavioral psychotherapy on internalization of locus of control in this group of patients, it appears necessary to have a psychology resident present in the hemodialysis department to teach the necessary cognitive-behavioral techniques to internalize the locus of control. TRIAL REGISTRATION: The trial was registered at the Thai Clinical Trial Registry (http://www.clinicaltrials.in.th) with the TCTID: TCTR20170707003. FUNDING: The authors received no financial support for the research, authorship, and/or publication of this article.

Explaining the role of organizational culture on succession-planning at the Ministry of Health and Medical Education: A qualitative study.

BACKGROUND: Developing and guiding new knowledge are futile unless the organizational culture can also be transformed. Future leaders cannot emerge out of an organizational environment that is not conducive to the accumulation of experiences. OBJECTIVE: The aim of this study was to explore the role of organizational culture in creating a succession-planning system at the Ministry of Health and Medical Education in 2014. METHODS: The present qualitative framework analysis held interviews with 23 director generals, administrative directors and deputies from the headquarters of the Iranian Ministry of Health and Medical Education in 2014 who were selected through snowball sampling. The data obtained were analyzed in MAXQDA-10. Codes were extracted using inductive techniques. RESULTS: The cultural factors affecting succession-planning at the Ministry of Health and Medical Education were identified and classified under three main areas, including the cultural factors related to the directors with four themes (Directors' job security, Constructive competition, Transparency and trust development, Creating opportunities), to the personnel with four themes (Organizational identity and loyalty, Trust in the organization, Talent and merit, Peer envy) and to the system with two themes (Values and beliefs, Politicization). CONCLUSION: Findings of the study show that establishment and institutionalization of the succession planning to the Ministry of Health and Medical Education is deeply affected by the components of organizational culture. Accordingly, unprofessional organization culture can deprive the organization of numerous advantages in multiple-succession planning.

Pathology of Social Violence Phenomenon in Ardabil Province: A Qualitative Study.

INTRODUCTION: In all human societies, domestic violence is known as a threat. Violence is imposing one's will on others through mental pressure and physical damage then can cause a feeling of anxiety and insecurity in them, especially for the weaker and more vulnerable groups such as women, children, elderly and minority groups who are the victims of oppression and socioeconomic inequalities. According to statistics, Ardabil, in comparison with other Iran's provinces, has the most number of violent crimes. This qualitative research was conducted with the aim of exploring pathological phenomena of social violence in Ardabil province. METHODS: this qualitative study was conducted with expert panel. Eighteen participants were selected with targeted sampling method from professors and the heads of the administrative offices who were linked to the phenomenon of social violence and have rich experiences with the social violence issues. After obtaining an informed consent from the participants, expert panel were conducted in two sessions of 150 minutes. At each session all discourse was recorded and after that, immediately transcribed verbatim. Then, the codes, sub-themes and the themes were obtained. RESULTS: The five main extracted themes included: social, historical and anthropological, cultural, economic and regional factors and 13 sub-themes were classified. CONCLUSION: Social, economic, cultural and regional structure, which have been formed and institutionalized in the society over the years, can be influenced and changed by government policies and a variety of programs.

Pabon Lasso and Data Envelopment Analysis: a complementary approach to hospital performance measurement.

BACKGROUND: Performance measurement is essential to the management of health care organizations to which efficiency is per se a vital indicator. Present study accordingly aims to measure the efficiency of hospitals employing two distinct methods. METHODS: Data Envelopment Analysis and Pabon Lasso Model were jointly applied to calculate the efficiency of all general hospitals located in Iranian Eastern Azerbijan Province. Data was collected using hospitals' monthly performance forms and analyzed and displayed by MS Visio and DEAP software. RESULTS: In accord with Pabon Lasso model, 44.5% of the hospitals were entirely efficient, whilst DEA revealed 61% to be efficient. As such, 39% of the hospitals, by the Pabon Lasso, were wholly inefficient; based on DEA though; the relevant figure was only 22.2%. Finally, 16.5% of hospitals as calculated by Pabon Lasso and 16.7% by DEA were relatively efficient. DEA appeared to show more hospitals as efficient as opposed to the Pabon Lasso model. CONCLUSION: Simultaneous use of two models rendered complementary and corroborative results as both evidently reveal efficient hospitals. However, their results should be compared with prudence. Whilst the Pabon Lasso inefficient zone is fully clear, DEA does not provide such a crystal clear limit for inefficiency.