Universities Of Medical Sciences In Iran Research Articles

Integration of social determinant of health in patient’s history-taking in medical education: an educational scholarship and action research study: phase I

Background and objectiveOne of the most important aspects of health is social health. Addressing social health and social accountability is possible by education of social determinants of health (SDH) to medical students. The aim of current study is to integrate the SDH variables to patient’s history-taking in medical education during clerkship stage as an action research and scholarship in education. Pediatric patients were selected as the target population for this study.MethodsThe present study is an action-research including three phases of the program's design, implementation, and evaluation. The present paper reports the results of phase I including the following steps; rapid scoping review and expert panel for development of history-taking form. The goal of this phase was to prepare an SDH checklist for history-taking in the Pediatrics Ward of Firoozabadi Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran. The checklist of history-taking was evaluated in terms of measurability, feasibility, priority, and clarity using a 5-choice Likert scale.ResultsAccording to the results of the scoping review and consensus-based methods, the preliminary version of the program was prepared including the SDH history-taking checklist. A total of 21 items were selected after two expert panel rounds. The overall absolute agreement was 0.704 (95% CI: 0.587 – 0.793) which was significantly higher than 0.5 (P < 0.001). The range of scores was 3.5 – 4.83 (out of five).ConclusionWe developed a SDH history-taking form including nine domains and 21 items. This form should be piloted and evaluated by an expert panel in the next phases. The present phase of the project proposed a consensus-based program for the imputation of SDH education in the education program of medical students. The reason for the importance of choosing children is that social factors in the group of children can have a greater impact considering the long life ahead and being in the growing age. After the implementation and evaluation phases, this program may be imputed in the medical education curriculum.

Studying the Relationship between the Teaching Status of Research Methods, Biostatistics Courses and, Academic Research Skills, from the Graduates Point of View

Introduction: This study aimed to evaluate the relationship between passing biostatistics and research methods courses and academic research skills in graduates. Methods: This cross-sectional study included 633 graduates during 2016-2022 from Iran University of Medical Sciences, Tehran, Iran. The explanatory factors were passing biostatistics and research methods courses and having statistical consultant. The outcomes were the duration of preparing proposal and thesis, and paper publication. Univariate and multiple logistic regression was used to estimate the odds ratio (OR) with %95CI. Significance level was set to 0.05 Results: 433 (68.4%) were female, and 371 (58.6%) were married. The mean±SD age of the graduates was 34.5±7.06 years. 413 (65.2%) were graduates from MSc and MPH and 128 (20.2%) from PhD. For Masters and MPH, the odds of prolonging the duration of preparing the proposal for who had Biostatistical consultant in their research team was 40% lower than the graduates who had no Biostatistical consultant (OR=0.6[95%CI:(0.39,0.91], P=0.01). In PhD graduates, the odds of prolonging the duration of preparing the proposal for who passed research methods course was 2.94 (1.06, 8.2) times than that of did not pass (P=0.03). Passing Biostatistics course was associated with lower odds of prolonging the duration of preparing thesis (OR=0.3[95% CI: (0.1, 0.86)], P=0.04). The odds of paper publication was marginally associated with research methods workshop participation (OR=3.7[95%CI: (0.82, 16.74], P=0.09) in PhD graduates. Conclusion: Passing Biostatistics and research methods courses and presence of a statistical consultant in the students’ thesis team were associated with shortened proposal or thesis preparation duration, and having publications from thesis more likely.

The Association Between Mental Health Literacy of Parents and Referral of Children and Adolescents to Mental Health Service Centers

Background: Mental health literacy refers to an individual’s knowledge and beliefs about mental health, which can aid in the detection, management, and prevention of mental illnesses. Prompt diagnosis of mental disorders is crucial for timely intervention and treatment. This study aims to investigate the mental health literacy and help-seeking behaviors of parents with children and adolescents under the age of 18. Methods: In this descriptive-analytical study, a cross-sectional design was utilized, and a surveying method was employed. A total of 134 parents of children and adolescents under 18, who were referred to the mental health service centers at Iran University of Medical Sciences and private psychiatric clinics in 2019 and 2020, participated in the study through convenient sampling. Two psychiatrists evaluated the psychiatric disorders of the children, and the parents completed the General Health Questionnaire-28 (GHQ-28) and the Mental Health Literacy Questionnaire. The collected data were analyzed using SPSS version 24. Results: The results of the one-way analysis of variance indicated that the total score of mental health literacy significantly differed among groups with varying levels of maternal education (p=0.001). Conclusion: This study underscores the impact of maternal education on mental health literacy among parents. Notably, parents with higher levels of education exhibited greater mental health literacy. It is essential to consider these findings in developing targeted interventions to improve mental health literacy among parents from diverse educational backgrounds. Further research should explore effective strategies for increasing awareness and knowledge about mental health in communities with varying levels of education.

A dynamic management model for sustainable drug supply chain in hospital pharmacies in Iran.

Sustainable supply chain management encompasses the strategic coordination and control of material, information, and financial flows, as well as the collaborative efforts among the entities engaged in the medicinal supply chain. This research proposes a dynamic and sustainable supply chain management model tailored explicitly for the inpatient pharmacies of Medical Centers and Hospitals affiliated with Iran University of Medical Sciences. This is a quantitative study in terms of research objective and a qualitative study based on the stages in the conceptual development of the model. Therefore, the current study can be considered a mixed-methods approach. After identifying the key factors influencing the sustainability of the medicine supply chain, we conducted a dynamic analysis of the problem using system dynamics methodology. In order to simulate the system's behavior over 24 months, we utilized a combination of existing documentary information and expert opinions. The developed model was implemented using Vensim PLE software, allowing us to simulate and analyze the impact of various policies on the system. Medicine disposal exhibited an upward trend, particularly during the second 12-month period. Conversely, the trend of medicine expirations remained relatively stable in the initial months but showed an upward trajectory after that. The cost associated with disposed medicine experienced a consistent increase, with a higher rate observed during the second 12-month period. In contrast, sales of low-consumable medicine experienced a significant initial surge followed by a slower growth rate. Finally, the pharmacy's profit demonstrated an overall increasing trend, although the rate of increase was higher during the first 12 months. Among the various scenarios considered, namely "increasing the adequacy of human resources," "increasing the speed of response," and "utilizing pharmacists in the drug prescribing team," it was found that these interventions had a substantial effect on both enhancing the pharmacy's profit and reducing medication waste. Therefore, these scenarios were identified as having the most significant impact. The proposed model can serve as a valuable tool for forecasting and informing policy-making, providing insights into addressing the challenges associated with the sustainable drug supply chain in hospital pharmacies.

Investigating the Challenges of Infertility Treatment Development in Centers of Iran University of Medical Sciences and Health Services

Investigating the Challenges of Infertility Treatment Development in Centers of Iran University of Medical Sciences and Health Services

Molecular Investigation of Seven Respiratory Viruses in Patients with Acute Respiratory Tract Infections

Introduction: Respiratory tract infection (RTI) is among the important factors that can threaten human health and is one of the most prevalent etiological agents of death, especially in young children. Viruses account for approximately 80% of various RTIs worldwide. Our study aimed to investigate the molecular prevalence of seven respiratory viruses in RTI. Our results can help develop appropriate public health strategies and treatment management of RTIs. Materials and Methods: 120 respiratory samples were obtained from patients with flu-like manifestations from hospitals referred to the Iran University of Medical Sciences during 2020-2022. Nucleic acid extraction was performed, and then real-time polymerase chain reaction was performed to analyze the specimens to investigate seven respiratory viruses. Results: Of the 120 respiratory specimens collected from patients with RTI, viruses were identified in 41 (34.16%) samples, encompassing 24 (40.7%) females and 17 (27.9%) males. SARS-CoV-2 (n = 22, 18.3%) and Parainfluenza virus (n=18, 15%) were the predominant detected viruses in the present study, followed by respiratory syncytial viruses (n=1, 0.8%). Other viruses like Metapneumovirus, Adenovirus, Bocavirus, and Rhinovirus were not found in our study. We could not detect any co-infection in our analysis. Conclusion: SARS-CoV-2 and Parainfluenza-virus were the predominant viruses detected in our study, followed by respiratory syncytial viruses. Other viruses, such as Metapneumovirus, Adenovirus, Bocavirus, and Rhinovirus, have not been found in our study. We could not detect any co-infection in our consideration. This result can help develop appropriate public health strategies, targeting prevention and avoiding inappropriate treatment such as using unnecessary antibiotics.

Placebo-controlled effect of topical Qust (Costus) oil on postmenopausal women's sexual desire disorder: a double-blind, randomized clinical trial.

Decreased libido and anorgasmia are common problems for women after menopause that reduce the quality of life of couples. This study examined the effect of topical Qust oil on sexual desire disorder in postmenopausal women. In this double-blind, randomized, clinical trial, 110 postmenopausal women with decreased sexual desire visiting a Traditional Medicine Center and Hazrat Rasool Akram Hospital (affiliated to Iran University of Medical Sciences) were selected by convenience consecutive sampling and randomly assigned to experimental and control groups. The experimental group received qust oil, while the control group was given a placebo (liquid paraffin); they were instructed to massage the product topically on their pubic area and perineum daily. The sexual function of both groups was assessed and compared before the intervention and four weeks after the intervention using the Female Sexual Function Index. The mean and standard deviation of the improvement of sexual function post-intervention were 37.66±32.52% and 11.96±11.18% in the experimental and control groups, respectively (p<0.001). In terms of the improvement of components of sexual function, a significant difference was observed between the two groups in the sub-scales of sexual desire [57.05±42.99% vs. 21.25±27.85%, p<0.001], arousal, orgasm, and satisfaction (p<0.001 for all); however, no significant difference was observed in terms of lubrication (p=0.25) and pain during intercourse (p=0.776). In postmenopausal women with sexual dysfunction, massaging the pubic area and perineum with qust oil for at least four weeks significantly improves desire, arousal, orgasm, and sexual satisfaction.

Designing an Entrepreneurial Model of Remote Communication Technologies in Clinical Medicine: A Qualitative Study

Background: Today, information technology has permeated all fields, transforming numerous aspects of our lives, while entrepreneurship has become increasingly essential. In medicine, the integration of this technology is becoming crucial. Objectives: This research focuses on designing an entrepreneurial model that leverages modern communication and information technologies in the health sector. By capitalizing on created opportunities, entrepreneurs can drive innovation, leading to cost savings, time efficiency, and greater access to health and medical services for people everywhere. Methods: In this qualitative study, the sample included faculty members from Iran University of Medical Sciences, selected through purposive sampling. Following this, the sample was expanded using snowball sampling, introduced through key experts, to include additional informed individuals. Data collection was conducted through semi-structured interviews with faculty members, experts, and knowledgeable individuals who were willing to participate. The interviews continued until data saturation was reached. Data analysis was carried out using content analysis, with coding performed using MAXQDA10 software. Results: After coding and identifying the main and sub-themes, content analysis was completed, resulting in 10 main themes and 57 sub-themes. All interviewees highlighted sub-themes such as "infrastructure and hardware," "internet bandwidth," "access to electronic health records," "equipment and supplies," "data privacy," "qualified physicians," and "counseling." Conclusions: When designing an entrepreneurial model in any region or country, it is essential to consider the existing needs and conditions, environmental demands, population characteristics, culture, habits, preferences of service recipients, infrastructural capabilities, governing laws, and security issues. Additionally, the model must incorporate specific leadership, management, and oversight to ensure it becomes a responsive and effective system.

Effect of simulating training of the fundamentals of laparoscopic surgery on the attitude of operating room nurses students: an intervention study

Abstract Objective Clinical education plays a key role in preparing students for patient care. Laparoscopy is one of the most important minimally invasive surgeries (MISs) wherein surgical technologists are responsible for camera navigation and assistant surgeons are responsible for peg transfer. Therefore, it is necessary to improve the attitude of the operating room students toward these skills during their study period. The present study was conducted to determine the effect of simulating training in the fundamentals of laparoscopic surgery (FLS) on the attitude of the operating room students. Methods This interventional study was conducted on 28 operating room students of Iran University of Medical Sciences in 2019. The census sampling method was used. The data-collection tool included the “Intrinsic motivation inventory (IMI) questionnaire.” The educational intervention was carried out in theoretical (booklet design) and practical (simulation) sections. Data analysis was carried out using descriptive and inferential analyses including the paired t-test, Mann–Whitney U test, and independent t-test. The collected data were analyzed using R and SPSS software. P-value &lt;0.05 was considered as the significant level. Results The mean ± SD of the participants’ age was 22.93 ± 2.14 years, and the majority of them were women (67.9%). There was a significant difference in the mean scores of students’ attitudes toward the FLS before and after the educational intervention (P &lt; 0.001) in all dimensions (interest, perceived competence, perceived choice, and tension). There was also a significant correlation between gender and interest dimension (P = 0.005). Conclusions The results of the present study showed that simulating the training FLS curriculum positively affects students’ attitudes. Therefore, the researchers suggest that for creating a positive attitude, increasing students’ interest in laparoscopic surgery, and ensuring a more effective presence in the operating room, this training should be considered in the operating room curriculum.

Chemotherapy delays among cancer patients in Iran during COVID-19 pandemic

Background and objectivesFollowing the outbreak of COVID-19, a set of restrictions, health advice, and limitations were put in place to reduce the spread of the virus. These restrictions, together with fear and anxiety of the population, limited people’s access to public services such as health care services. Cancer patients during this era are a significant concern due to being at high risk for COVID-19 infection and also being exposed to delays in their diagnosis, treatment, and follow-ups. Delays in the treatment of cancer could lead to a poorer prognosis. In this study, we attempted to determine the magnitude of delays in chemotherapy and factors associated with delays during the COVID-19 pandemic.MethodAll patients diagnosed with colorectal, lung, gastric cancer, and lymphoma who had chemotherapy at teaching hospitals of Iran University of Medical Sciences (IUMS) between February 20, 2020, and March 20, 2022, were included. Age, gender, cancer type, having metastatic cancer, and date of each chemotherapy session were included for each patient individually. Every session with delays longer than two days was recorded. A three to six-day delay was considered a moderate delay, and a seven-day or longer delay was considered a severe delay in receiving each chemotherapy session. Additionally, each patient’s total number of delays in the entire course was calculated. Logistic regression was used to examine the impact of pandemic waves on delays. On the other hand, Poisson regression was used to evaluate the number of delays in the entire course of chemotherapy.ResultsThe research findings indicated an association between the male gender and having metastasis with a higher likelihood of a moderate delay in the treatment regimen. Regarding cancer type, colorectal cancer was associated with higher rates of moderate delays (IRR = 1.88, P < 0.001), but gastric (IRR = 0.75, P = 0.001) and lung cancer (IRR = 0.59, P = 0.002) were associated with reduced rates of severe and moderate delays, respectively. Compared to the COVID-19 pandemic plateau periods, the first (OR = 2.08, P < 0.001), third, and fifth waves of the pandemic were associated with increased delays.ConclusionWe found an association between the male gender, colorectal cancer, metastatic disease and higher rates of moderate delays. The initial COVID-19 pandemic wave was associated with increased severe delays in the chemotherapy course. According to the findings of this study, male cancer patients and those with metastatic cancer are at risk of poorer prognosis due to lower adherence to treatment. These findings can assist policymakers in developing targeted strategies to lessen the delay rates in the more vulnerable population.

Investigating the Potential Impact of CCR5-Δ32 Variant on COVID-19 Outcome: A Case-Control Study in Iranian Population.

The impact of CCR5-Δ32 on COVID-19 outcomes has been the focus of much research. This genetic variant may protect against SARS-CoV-2 infection, while others have produced conflicting results. Given the controversial results of previous research on different populations, we aimed to investigate the possible association between the CCR5-Δ32 variant and COVID-19 severity in an Iranian population. This case-control study was conducted between 25th of April till 10th of October 2021 at Rasoul Akram Hospital of Iran University of Medical Sciences, Tehran, Iran. We investigated the association between CCR5-Δ32 genotype and COVID-19 severity in 200 unrelated Iranian patients. The patients were divided into 2 groups: 100 patients with severe COVID-19 (case group) and 100 patients with mild COVID-19 (control group). Genotyping of CCR5-Δ32 was performed using the polymerase chain reaction (PCR) technique. The frequency of CCR5-Δ32 allele was 11 in the case group and 16 in the control group. However, no significant association was found between this genetic variant and the clinical outcomes of COVID-19. The CCR5-Δ32 variant cannot serve as a reliable predictive factor for identifying individuals prone to developing severe COVID-19 in Iranian population. Additionally, targeting CCR5 would not be a viable treatment approach for COVID-19 in Iranians.

Assessment of Alvarado criteria, ultrasound, CRP, and their combination in patients with suspected acute appendicitis: a single centre study

BackgroundAcute appendicitis (AA) is one of the most common reasons for visiting the emergency room. The lack of proper diagnosis and rapid treatment of AA may lead to severe complications such as intestinal perforation and increased mortality. This study aimed to evaluate the diagnostic accuracy of the Alvarado criteria, ultrasound, and CRP criteria in comparison with their combined use in patients with suspected AA who presented to the emergency room.MethodsIn this diagnostic accuracy study, 1411 patients with suspected AA who presented to the emergency department of Firoozabadi Hospital affiliated with Iran University of Medical Sciences and underwent appendectomy from October 2019 to October 2021 were examined. Nine hundred eighty-eight patients were enrolled. All patients were assessed using Alvarado, CRP, and ultrasound. The definitive diagnosis of AA was based on pathological findings and was considered the gold standard. Statistical analyses were performed with STATA VER 11.5. The diagnostic accuracy for each group was compared using the Pearson chi-square test. A value of p < 0.05 was considered statistically significant.ResultsThe mean age was 29.57 ± 13.66 years. The sensitivity and specificity of Alvarado in the diagnostic accuracy of appendicectomy were 75.2% and 61.3% (CI = 95%), respectively. The sensitivity of ultrasound and CRP for predicting appendicitis was significantly higher than the Alvarado criteria. The diagnostic accuracy for CRP was significantly higher than ultrasound (64.9% vs. 60.7%, P: 0.003). The diagnostic accuracy of the simultaneous use of Alvarado + CRP and CRP + Ultrasound was significantly higher than that of Alvarado + ultrasound. The sensitivity, specificity, and diagnostic accuracy of the simultaneous use of all three criteria together (Alvarado + Ultrasound + CRP) were estimated to be 94.9%, 25.8%, and 81.5% (CI = 95%), respectively, which were significantly higher than the use of other criteria.ConclusionThis study showed that the Alvarado criteria had inadequate diagnostic sensitivity and accuracy for diagnosing acute appendicitis. The diagnostic accuracy of acute appendicitis increases to over 90% using the three Alvarado, ultrasound, and CRP criteria at the same time.

Nurse caring in Iran and its relationship with patient satisfaction

Objective: The aim of this study was to determine the relationship between patients’ reports of nurse caring and patient satisfaction with nursing care. Design: The study used a cross sectional design. The Persian versions of the Revised Caring Behaviors Inventory (CBI) and the Patient Satisfaction Instrument (PSI) were used to establish the strength of association between nurse caring and patient satisfaction with nursing care. Data were analysed using SPSS version 10. Setting: The setting was the educational hospitals affiliated to Iran University of Medical Sciences (IUMS). Heavy workloads and severe staff shortages are common characteristics of Tehran educational hospitals and the time that nurses previously allotted to direct care has been reduced. Subjects: Two hundred and fifty patients who were hospitalised for medical conditions or surgical procedures were selected through a quota sampling method during 2007. Results: The findings indicated a statistically significant relationships between patient reports of nurse caring and satisfaction with nursing care (r=0.72, p=0.000; CI 95%; 178.31‑189.99 for the CBI and 82.81‑86.71 for the PSI). Male patients were more satisfied with nursing care than female patients. Admissions to hospital during the last five years were positively correlated with patients’ perceptions of nurse caring and satisfaction with nursing care. Conclusion: This study which was carried out in Tehran, Iran supports earlier western evidence that nurse caring is associated with patient satisfaction with nursing care. It is important to reflect on the impact of the current health care environment and cultural religion of Iran on caring behaviors of nurses and patient satisfaction with nursing care. Heavy workloads and severe staff shortages are common characteristics of Tehran educational hospitals and the time that nurses previously allotted to direct care has been reduced which may contribute to changes in patients’ perceptions of nurse caring and satisfaction with nursing care possibly reducing the effects of nursing care services. Iranian nurse managers need to consider the religious and cultural barriers to nurse caring and recompense it by providing more human resources.

Predictors of health-related quality of life after total knee arthroplasty: a case–control study

Total knee arthroplasty (TKA) improves patients’ Health-related quality of life (HRQoL) compared to before surgery. However, based on our knowledge, the improvement in HRQoL after TKA, which depends on various factors, has yet to be investigated compared to healthy people. This study aimed to evaluate the HRQoL of patients compared to healthy people and the factors affecting the HRQoL after TKA. In this matched case–control study (1002 participants), HRQoL in 501 patients who underwent TKA between 2015 and 2022 at Shafa Yahyainan Hospital affiliated with Iran University of Medical Sciences were compared with 501 healthy controls. HRQoL was evaluated in two parts (before compared to 12 months after TKA and 12 months after TKA compared to the healthy population). The 36-item short-form health survey (SF-36) was used to evaluate HRQoL 12 months after surgery. The influencing factors on HRQoL were evaluated by multivariate logistic regression analysis. No significant difference was observed in the demographic characteristics of the participants in the two groups. The mean overall SF-36 score, 12 months after surgery, significantly improved compared to before surgery (64.21 ± 22.2 vs. 37.55 ± 15.13, p:0.001). The mean total score of SF-36 was statistically similar between the case and control groups (64.21 ± 22.2 VS 72.53 ± 25.3). The multivariate analysis showed that sex, BMI, number of comorbidities, postoperative compliance, and complications were significantly related to the decrease in patients’ HRQoL (P < 0.001).TKA can improve the HRQoL except for two subscales of happiness/vitality and physical performance, similar to the healthy population. Female gender, obesity and overweight, comorbidity, bilateral TKA, non-adherence to postoperative physiotherapy, and complications were associated with decreased HRQoL.

Psychometry of Physician Teaching Motivation Questionnaire at Iran University of Medical Sciences

Background: The development of societies relies on the type and manner of activities performed at universities. Professors play a pivotal role in the development of universities and societies. Assessment of professors’ motivation and behavior and factors affecting them can improve the educational system and increase its performance. This study aimed to assess the validity and reliability of the Physician Teaching Motivation Questionnaire (PTMQ) from the viewpoint of clinical professors at Iran University of Medical Sciences (IUMS). Methods: This is an instrument psychometric study in which the questionnaire’s validity was determined through the face and content validity and its construct validity through exploratory and confirmatory factor analysis. Reliability was determined through the calculation of Cronbach’s alpha and intraclass correlation coefficient and consistency between agreers. The data were analyzed in SPSS 23 and LISREL 8.8. Results: The results showed that all 18 items had acceptable content validity (0.68-0.97). The Cronbach’s alpha and intraclass correlation coefficients were 0.81 and 0.86, respectively. The number of items remained unchanged at 18 according to exploratory factor analysis which classified them into six categories (intrinsic motivation, identified motivation, introjected motivation, career motivation, external motivation, and teaching assistant motivation) and explained 54% of the total variance of the mentioned variables. Also, the value of CFI was equal to 0.93 and the value of Cohen’s kappa was between 0.77 and 0.84. Conclusion: The Persian version of PTMQ is a valid and reliable instrument that can be used for research, educational, and practical purposes to evaluate the teaching motivation of clinical professors in other groups.

Perspectives of Patients with Mental Health Disorders on Integrating the Spirituality and Religion into Psychiatric Assessments: A Study in Iran

Background: In recent years, there has been a growing emphasis on exploring the influence of spirituality/religion on the management of mental health disorders. The aim of this study was to investigate the viewpoints of Iranian patients with mental health disorders regarding the incorporation of spirituality into their assessment. Methods: This cross-sectional study was conducted in 2021 at Iran University of Medical Sciences. Initially, a questionnaire was developed based on key spiritual concepts identified from a literature review. The content and face validity of the questionnaire were evaluated by an expert panel, and its reliability was assessed using Cronbach’s alpha coefficient. Data collection was carried out in the second phase, with the questionnaire consisting of 4 questions examining the patients’ perceived need and willingness for their therapist to explore their spiritual and religious dimensions. Data analysis was performed using appropriate statistical tests. Results: The questionnaire’s validity was confirmed, and its reliability was demonstrated with a Cronbach’s alpha value of 0.79. A total of 368 patients participated in the study. No significant associations were observed between the participants’ educational level, diagnosis type, gender, and the questionnaire scores. Approximately half of the patients with mental health disorders expressed a desire to incorporate spiritual assessments into their psychological evaluations, with most welcoming this integration. Conclusion: The findings of this study suggest that despite challenges and barriers, efforts should be made to integrate spiritual dimensions into the treatment of patients.

Educational ranking model of faculties in Iranian universities of medical sciences

Educational ranking model of faculties in Iranian universities of medical sciences

The effect of TeamSTEPPS® mobile-based training on perceptions of teamwork and team performance of operating room staff

IntroductionTeamSTEPPS® aims to create an environment where all members feel comfortable to speak about patient safety concerns. The aim of this research was to determine the effect of TeamSTEPPS® mobile-based training on the perceptions of teamwork and team performance of operating room staff. MethodsThis study was a quasi-experimental method with measurements at baseline and after 2 months of intervention. The research samples included 105 OR staff (operating room technologists, anesthesia technologists, and nurses) working in 6 teaching hospitals of Iran University of Medical Sciences in 2022, which were selected by stratified random method and proportional allocation. The research tools included the demographic form, the Persian version of the ‘TeamSTEPPS® Teamwork Perception Questionnaire’ (T-TPQ) and the Persian version of the ‘Team Performance Observation Tool’ (TPOT). The intervention was carried out with sending the link of the TeamSTEPPS® 2.0 course files to participants by mobile messengers so that they could study them during five sessions, with an interval of one week between each session. Data analysis was done by calculating descriptive statistics and paired t-test. ResultsThe results showed that TeamSTEPPS® mobile-based training significantly improved the perception of teamwork (P < 0.011) and team performance of operating room staff (P < 0.001). ConclusionWith the determination of the effect of TeamSTEPPS® mobile-based training on the perception of teamwork and team performance of operating room staff, it is suggested to present this training program to this group.

Comparison of the Effect of Cumin Cyminum and Nettle Oral Drops on the Breast Milk Sufficiency Indicators in New Mothers.

This study aimed to compare the effects of green cumin (Cuminum cyminum) and nettle (Urtica dioica L.) oral drops on the indicators of breast milk adequacy in lactating mothers. Due to the presence of phytoestrogens in the combinations of cumin and nettle, it is stipulated that they may have milk-increasing properties. A triple-blind, randomised, controlled clinical trial was conducted on 117 lactating mothers who had given birth to healthy infants aged 10-15 days and who received cumin oral drops (n = 39), nettle oral drops (n = 39) or placebo (n = 39) from August 2020 to March 2021. The participants were recruited from a regional public health care centre affiliated with Iran University of Medical Sciences of Tehran, Tehran, Iran. The 3 study groups received 15 drops thrice a day for 4 weeks. Infant weight, breastfeeding frequency, number of wet diapers, diaper weight and frequency of infant defecation were evaluated before and after the intervention. At the beginning of the trial, no statistically significant differences were observed between the 3 groups for infant weight (P = 0.891), breastfeeding frequency (P = 0.921), number of wet diapers (P = 0.783), diaper weight (P = 0.841) and frequency of infant defecation (P = 0.898). However, following the intervention, the mean scores of all indicators were significantly higher in the experimental groups than in the placebo group (P <0.001). In addition, all the indicators in the cumin group increased significantly compared to those in the nettle group (P <0.001). Considering the effectiveness of cumin and nettle drops in increasing milk and the availability of these native plants in Iran, it is suggested that they, especially cumin, be used postpartum to increase breast milk production.

The Attitude of Healthcare Providers and the General Population on the Concept of Do-Not-Resuscitate (DNR) Order in End-Stage Patients

Background: The do-not-resuscitate (DNR) order in end-stage patients constitutes a critical medical decision, directing healthcare providers to withhold cardiopulmonary resuscitation (CPR) in the event of cardiopulmonary arrest upon the patient's request. Objectives: This study aims to analyze the attitudes of healthcare providers and the general population toward the concept of DNR orders in end-stage patients. Methods: Conducted from September 2021 to May 2022, this cross-sectional study aimed to gauge the attitudes of healthcare providers and the general population toward DNR orders in end-stage patients using a questionnaire assessing attitudes toward DNR. The research population included healthcare providers—physicians and nurses—from healthcare centers affiliated with Iran University of Medical Sciences, selected through convenience sampling, and the general population comprising individuals frequenting parks near these healthcare centers within the relevant municipal districts. Results: Among the 164 participating healthcare providers, 139 (84.8%) were female. Participants' ages ranged from 21 to 57 years, with an average age of 36.78 ± 7.79 years. The study found that healthcare providers had a significantly higher average attitude score toward DNR (29.85 ± 9.46) compared to the general population (27.08 ± 9.78). Healthcare providers with adequate financial status exhibited a more positive attitude toward DNR in end-stage patients compared to those with excellent or poor economic status (P = 0.001). Additionally, the relative frequency of individuals experiencing a poor prognosis of disease was significantly lower among healthcare personnel than the general population (P = 0.018). Healthcare providers without family members or friends in their end-stage of life demonstrated a more favorable attitude toward DNR for these patients (P = 0.001). Conclusions: The study revealed that healthcare providers exhibited a significantly more positive attitude toward DNR compared to the general population. Furthermore, healthcare providers experienced a lower relative frequency of individuals facing a poor prognosis of disease compared to the general population. However, the relative frequency of experiencing family members or friends in the end stage did not significantly differ between healthcare providers and the general population. Healthcare providers with less than 2 years or more than 20 years of experience in the medical field demonstrated a more positive attitude toward DNR.