Developing a scale for quality self assessment in pre-hospital emergency services

Establishing of total quality management in any organization including emergency medical services need to an appropriate tool to help developing, implementing and evaluating of quality programs. The objective of this study was to develop a valid and reliable tool for self assessing enabler criteria of Iran EMS centers according to European Foundation for Quality Management (EFQM) model.The study was conducted using the Delphi method, and 43 participants as panelists were enrolled in 3 round modified Delphi technique. Initially, a rating scale was developed in response to main question of study; which items should be contained in self assessing tool of quality in Iran EMS area? This scale was judged by 5 experts primarily, and after some modification was entered in Delphi process. The comments of panelist were collected by E Mail and final scale was developed in the end of 3th rand.Pre-hospital Emergency Self assessing Rating Scale (PHESARS), Was main result of this study that developed in 190 items in 5 enabler criteria according to EFQM model including; Leadership (52), Policy & Strategy (21), staff (41), Resources& partnership (36) and Processes (40).Self assessing scale was developed by TQM and excellence perspective and because of experts' consensus in developing it, has content validity and can be used in self assessing of pre-hospital area and determining improvement opportunity and, can leads the Iran EMS centers to total quality management and organizational excellence

Introducing a Framework for Planning and Selecting Suitable Evacuation and Emergency Sheltering in Disasters: Case Study of Tehranpars District

سابقه و هدف: نحوه مکان‌يابي فضاهاي مناسب براي اسکان اضطراري در زمان بحران همواره به‌عنوان يکي از چالش‌هاي مواجهه با تبعات سوانح مطرح بوده است و تحقيقات زيادي در اين رابطه انجام شده است. در اين پژوهش تلاش شد تا الگوي مناسبي براي اين موضوع مبتني بر شرايط بومي و وضعيت خطر و ريسک سوانح و ميزان آسيب‌پذيري فيزيکي و انساني ارائه شود. از اين الگو مي‌توان در سکونت‌گاه‌هاي شهري، براي برنامه‌ريزي فرايند اسکان اضطراري استفاده نمود. روش بررسي: در اين پژوهش ابتدا مطالعات گذشته درباره اسکان اضطراري به روش کتابخانه‌اي بررسي، سپس جهت تعيين ميزان اهميت پارامترهاي موثر در جانمايي مکان‌هاي مناسب براي اين نوع اسکان، پرسشنامه‌اي طراحي و جهت تحليل سلسله مراتبي، بين سي نفر از متخصصان اين حوزه توزيع و بهترين جواب‌ها با توجه به ضرايب ناسازگاري استخراج شد. سپس با توجه به ضريب اهميت هر پارامتر، مدلي مفهومي و الگويي رياضي بين پارامترها و معيارها برقرار گرديد تا بتوان از آن براي انتخاب مکان مناسب اسکان اضطراري مبتني بر شرايط مختلف کالبدي و بومي نقاط مختلف کشور استفاده نمود. يافته‌ها: اين پژوهش نشان‌داد، عدم مجاورت مکان اسکان اضطراري با محل‌هاي خطرناک (با 074/0)، اطمينان از بهداشت محدوده (با 072/0) و همچنين امکان آتش‌سوزي مکان مدنظر (با 063/0) اثرگذارترين عوامل در انتخاب يک مکان به‌عنوان مرکز اسکان اضطراري مناسب مي‌باشند که از نتايج تحليل سلسله مراتبي برداشت گرديد. همچنين انتخاب اين عوامل که هرکدام از جنبه‌هاي متفاوتي هستند نيز نشان از اهميت بالاي اين پارامترها و تأثير زيادشان در ارزيابي مکان‌هاي منتخب اسکان اضطراري داشت که در بررسي ساير مطالعات و پژوهش‌ها به اين اندازه جامع و کافي به اين موضوعات پرداخته نشده است. همچنين سرعت کافي براي انتخاب مناسب‌ترين مکان و در کوتاه‌ترين زمان از بين گزينه‌هاي پيش‌رو و شناسايي نقاط ضعف محدوده ها بزرگترين دستاورد اين پژوهش بود. نتيجه‌گيري: الگوي به‌دست‌آمده در محدوده تهران‌پارس به‌عنوان مورد مطالعاتي پياده‌سازي شد و بوستان‌هاي شهداي تهران‌پارس، آراليا و مهرنامي مناسب‌ترين مکان‌ها بر اساس اين الگو براي زمان بحران شناخته شدند. نتايج استفاده از اين الگو نشان داد که غرب محدوده مطالعاتي براي اسکان در زمان بحران با کمبود فضا روبه‌رو خواهد شد. How to cite this article: Mirhakimi SA, Amini Hoseini K, Mansouri B, Izadkhah, Y. O. Introducing a Framework for Planning and Selecting Suitable Evacuation and Emergency Sheltering in Disasters: Case Study of Tehranpars District. J Saf Promot Inj Prev. 2021; 8(4):247-59.Background and Objective: This study presents a pattern for planning and evacuation and emergency sheltering management based on the risk of disasters and human and physical vulnerability, and thus it can be used for taking necessary actions in urban settlements and improve preparedness for dealing with disasters. In addition, the most important use of this study is in disaster situations such as earthquakes or floods where there is not enough time to plan and therefore this research would be very practical. Materials and Methods: To accomplish this research, weak points of previous research about emergency sheltering was investigated and defined at first in order to specify the difference and novelty of the present work. Then, an AHP questionnaire was designed in order to determine the weight and importance of effective parameters which are efficient in the identification of proper places, and was distributed among experts. A model was prepared from the results with different parameters and concerning the rate and importance of each parameter. A conceptual/ mathematical pattern was established for various native and climate conditions. Results: This research showed that lack of proximity of the emergency shelters to the dangerous places, assurance of the neighborhood health issues (with 0/0072), and probable fire occurrence in that location (with 0/0063), are the most effective factors in selecting an appropriate location for emergency shelters which has been derived from the results of this hierarchical analysis. Also, choosing these factors from various aspects shows the high importance of the parameters and their effects in assessing the selected emergency shelters, which has not been considered comprehensively in other studies and research so far. In addition, the speed in choosing the most appropriate location in the shortest time from the existing alternatives and identifying the weaknesses of the locations is one of the most important outcomes of this research. Conclusion: The model obtained in the Tehran Pars area was implemented as a case study and according to it, the parks of the Shohadaye Tehran Pars, Aralia, and Mehrnami were identified as the most suitable places for sheltering in disaster situations. The results of this model showed that the West of Tehranpars will face a shortage of space in the occurrence of future disasters. How to cite this article: Mirhakimi SA, Amini Hoseini K, Mansouri B, Izadkhah, Y. O. Introducing a Framework for Planning and Selecting Suitable Evacuation and Emergency Sheltering in Disasters: Case Study of Tehranpars District. J Saf Promot Inj Prev. 2021; 8(4):247-59

Medical Students\' Learning Styles

Introduction: Considering students' learning styles may change teaching methods in accordance with their learning styles and consequently improve the educational outcome. The aim of this study was to investigate learning styles of medical students in Isfahan University of Medical Sciences. Methods: This descriptive study was performed during the academic year of 2008-2009 in Isfahan Univer-sity of Medical Sciences. Ninety medical students were selected through random sampling method as study samples. VARK learning style inventory was used as the research tool. Data was analyzed by SPSS software using descriptive and inferential statistics. Results: Medical students use different learning styles. The most preferable one among them was visual learning style with the score of 39.26±6.87. The learning style of Male and female students were different. Conclusion: Improving educational quality requires for paying attention to learning style in teaching and educational technology. Teachers and educational technologists are recommended to make use of media and various technologies

The Relation of Carotid Arteries' Intima-Media Thickness With Snoring and Obstructive Sleep Apnea in Type 2 Diabetes Patients

In recent decades, the relation of carotid artery intima-media thickness (IMT) as a marker of atherosclerosis with snoring and sleep disorders has been drawing attention. The aim of this study was to evaluate the relation of carotid arteries IMT with snoring in type 2 diabetic patients. This cross-sectional study was performed on type 2 diabetes patients referring to Mashhad University of Medical Sciences' clinics. The stop Bang, Epworth sleepiness scale, and Stanford questionnaires were used for evaluation of daily sleepiness and snoring. For assessment of carotid artery thickness, Madison X8 ultrasound with 10 MHz superficial probes was utilized. The data were entered into SPSS software, and then the ANOVA test with Turkey, chi-square comparison technique, and Kruskal Wallis with Mann-Whitney U technique was used. The level of significance was considered P≤0.05. In total 80 patients (37 snorers and 43 non-snorers) entered the study. The mean carotid artery IMT in the group of snoring patients (0.72±0.17) was significantly higher than non-snorers (0.56±0.17) (P<0.001). Frequency of daily based on Stanford and ESS questionnaires was 23.8% and 39.2%. The association of sleepiness and snoring was confirmed by Stanford and ESS questionnaires with P=0.026 and P=0.007. Patients with higher risk of apnea had higher thickness of the mean carotid artery IMT (P<0.001). The mean carotid artery IMT had a positive significant relation with age (P=0.002), serum creatinine level (P<0.002), blood cholesterol (P=0.02) and HbAIC level (P=0.04). Findings of this study provides evidence on the relation of carotid artery IMT in diabetic patients with snoring independent of other effective factors. Also, results showed that snoring is associated with increased daily sleepiness and patients with higher risk of apnea had higher thickness of the mean carotid artery IMT