Implementing a Diabetic Foot Care Program in a Virtual Primary Care Clinic

Abstract Background Healthcare professionals (HCPs) have a key responsibility in delivering preventative and early intervention diabetes foot management within primary care. Diabetic foot ulcers (DFUs) are a major complication of diabetes and can lead to amputations and other wound issues. Comprehensive care and treatment of diabetes are most effective when patients can access a supportive connection with providers. Before the pandemic, there were many reasons to utilize a technology-based distance approach to health care. The coronavirus pandemic in 2019 prompted additional reasons for the transition to distant care. Problem The yearly screening of a virtual foot exam on patients with diabetes in the intervention clinic setting had been held since the beginning of the COVID-19 pandemic. Methods A pre-and post-assessment survey and the educational module were created and distributed to 11 HCPs of the clinic. Surveys were completed by four HCPs. Interventions The HCPs were instructed through an asynchronous educational module. A foot care educational handout was selected and submitted to the clinic to send to the patients. A reminder flag at the electronic chart of diabetic patients was designed to prompt the practitioners when foot screenings were due. Results The confidence level of the HCPs to perform virtual screening of DFUs increased from 75% to 93.75%. The rate of practitioners’ willingness to perform online screening of DFUs was the same at pre-and post-instructional surveys (93.75%). The rates of passing on the foot care educational pamphlet to diabetic patients and documenting diabetic foot screening in the EHR were raised from 62.50% to 93.75%. Conclusions Continuing a diabetic foot care program in an online primary care clinic is possible and can improve the quality of diabetic foot care

The Use of Online Applications to Improve Chronic Wound Care in Primary Care; A Literature Review

Abstract Background: Chronic wounds are a major burden on patients, health care professionals, and the healthcare system. Primary care professionals need to be prepared with the information and skills that will help them perform high-quality wound care. Objective: The purpose of this manuscript is to assess the use of mobile applications to support health care providers in primary care who care for patients with chronic wounds. Data Sources: A review of the evidence was performed using CINAHL, Cochrane/ DARE, PubMed, Ovid, and Evidence-Based Journals to explore the consequences of using online wound care applications by primary care practitioners. Conclusions: The literature showed that using smartphone applications in wound management had positive outcomes. The professionals who access the software apps were better equipped to provide wound management than those who were not. Implications for practice: Wound care smartphone applications would allow primary care providers to overcome time stress by accessing resources needed for evaluating, recognizing, and treating wounds. Keywords: Wound care, wound management, wound assessment, measurement, documentation, mobile application

Does leadership effectiveness correlates with leadership styles in healthcare executives of Iran University of Medical Sciences

Background: Effective leadership is essential to passing through obstacles facing the health field. The current health care system in Iran has major problems and gaps in the field of effective leadership. The aim of this study was to evaluate hospital managers' leadership style through self-assessment and to determine the correlation between leadership styles with healthcare executives' leadership readiness and leadership effectiveness. Methods: In this cross-sectional study a self-administered questionnaire completed by all internal healthcare executives of all teaching and non-teaching hospitals affiliated to Iran University of Medical Sciences. Questionnaire was composed to determine demographic information, leadership style questions, leadership effectiveness and leadership readiness. Descriptive statistics and Pearson correlation coefficient were used for data analysis. Results: According to the findings, the dominant style of healthcare executives was transformational leadership style (with a score of 4.34). The leadership effectiveness was estimated at about 4.36 that shows the appropriate level of leadership effectiveness. There was a significant correlation (correlation coefficient of 0.244) between leadership readiness and transformational leadership style (p<0.05). Also, there was a significant correlation between leadership effectiveness with transformational (0.051) and transactional (0.216) styles. Conclusion: There was a correlation between leadership readiness and leadership effectiveness with leadership styles. Application of this research will be crucial to universities and healthcare executives. This study suggests that strengthening the scientific basis is essential for leadership readiness and leadership effectiveness in healthcare system

Quality measurement indicators for Iranian Health Centers

Background: Recently, quality is a serious concern in development of organizations. There are various indicators to assess quality and the purpose of this study was to identify the main indicators for quality measurement of Iranian health centers. Methods: This qualitative study was conducted in three stages: first, review of the literature was performed to identify different indicators for quality measurement in health centers; second, a two-round Delphi process was used with participation of 18 experts in both rounds; third, Analytical Hierarchy Process (AHP) method was applied to give weights to each indicator. Results: Twenty-seven indicators were identified from the literature review stage. The Delphi method reduced the list to 4 indicators. Developing a quality plan in the health center had the highest weight (38) and percentage of followed complaints the lowest (12). The consistency rate was 7.2 indicating appropriateness of the data. Conclusion: This list of indicators can be used as a template for measuring quality of health centers in Iran and possibly in other developing countries

Geological, geochemical and fluid inclusion investigations on the Duna Pb-Ba-(Ag) deposit, Central Alborz, North Central Iran

The Duna Pb-Ba-(Ag) mine is located ca. 155 km north of Tehran in the central Alborz structural zone, northern Iran. The ore mineralization occurs as stratabound, epigenetic, E-W and WSWENE trending veins and veinlets in fracture-controlled as well as massive and open-space filling textures within a Permian dolomitic limestone host rock. Field observations as well as mineralogical and petrographic studies show dolomitization, silicification and possibly haematisation in the host rock. In the mineralization zone, galena and barite are the main minerals, followed by pyrite, quartz, chalcopyrite, tetrahedrite, sphalerite, calcite and supergene minerals such as covellite, malachite, azurite, cerussite, anglesite, and Fe-oxides. The chemical analyses of the highgrade ore samples show an average grade of 18.66 wt. % for Pb, 19.99 wt. % for Ba, and 120 ppm for Ag together with substantial quantities of Zn (0.15 wt. %), As (690 ppm), Cu (0.86 wt. %), Sb (0.25 wt. %), and Sr (0.56 wt. %). The amount of silver in some samples from the tunnel and discordant layers is up to 7030 ppm. The positive Eu/Eu⃰ ratio and the weak negative Ce/Ce⃰ anomaly in the ore samples were most likely inherited from magmatic water. The presence of minerals such as pyrite and chalcopyrite together with the co-precipitation of sphalerite and chalcopyrite suggest a high-temperature for mineralizing fluids. The homogenization temperatures of fluid inclusions from barite in concordant layers span between 135 and 165 ºC with salinities between 18.54 and 23.65 wt. % NaCl equivalent, while the homogenization temperatures of fluid inclusions from barite of discordant layers span between 113 and 285 ºC with salinities between 7.34 and 23.65 wt. % NaCl equivalent. The structural, geological, geochemical, and mineralogical studies together with the paragenesis of the ore minerals and fluid inclusion data allow consideration of the Duna Pb-Ba-(Ag) mine as a two stage mineralization scenario; 1st stage /older/MVT-type (Early Cimmerian tectonic phase), and the second stage/younger/Irish-type (Laramide orogenic movements). The structural data, high temperature of the fluid inclusions, positive Eu/Eu⃰ ratio and high silver content, especially in the discordant layers, indicate the involvement of a magmatic water mixed with meteoric and connate fluids comparable to the Irishtype mineralization in the second stage, which formed along brecciated zones of the thrust faults. The second stage of mineralization was most likely influenced by the Akapol granitoid intrusive mass, which overprinted the 1st stage/older/MVT-type

Utilizando el enfoque de relación de bandas, metodologías FULL-PIXEL (SAM y SFF) y SUB-PIXEL (MF y SID) para descubrir áreas con alteración utilizando el sensor Aster: un estudio de caso en el noroeste de Irán - Área de Sivardaghi

Los datos del sensor ASTER se encuentran entre los datos satelitales más potentes disponibles para realizar investigaciones geológicas, con imágenes de toda la superficie de la Tierra. Para probar la capacidad de este sensor para detectar lugares con alteraciones geoquímicas, en este estudio se utilizaron fotografías del monte Seiver Daghi en la provincia occidental iraní de Samal. Esta región, que comprende terreno magmático y volcánico, es parte del territorio de Arsbaran y está cubierta por masas intrusivas con depósitos aluviales y sedimentarios. Para llevar a cabo este estudio, se utilizó un marco de medición ASTER, que, después de realizar correcciones atmosféricas utilizando el método de reflectancia relativa promedio interna (IARR) de imágenes compuestas de falso color y análisis de componentes principales (PCA), fue capaz de diferenciar entre diferentes unidades litológicas utilizando el método de asignación de banda, métodos de píxeles completos de mapeador de ángulos espectrales (SAM) y algoritmo de espectro base de ajuste de características espectrales (SFF), así como métodos de subpíxeles de filtrado adaptado. El estudio demuestra que el método de análisis de componentes principales y composición de color falso es eficiente para distinguir unidades de rocas sedimentarias de unidades de rocas ígneas, y se sugiere su aplicación para las unidades de rocas designadas. Debido a la falta de características espectrales de los feldespatos y el cuarzo en el rango de longitud de onda infrarroja corta, los métodos espectrales básicos utilizados en este trabajo son incapaces de identificar dichos minerales. No se recomienda utilizar estos algoritmos para distinguir entre varias unidades magmáticas

Lithological Mapping and Identification of Argillic and Propylitic Alteration Zones at Anjerd Volcanic Terrain

Anjerd area is part of Arasbaran volcanic-magmatic terrain in northwestern Iran. The area is covered by multiple intrusive bodies of diverse compositions, volcanic, volcaniclastic, sedimentary and young alluvial deposits. The usefulness of Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) data for the lithologic mapping of the area and identification of alteration zones is investigated in this study. To carry out the study, one ASTER frame was atmospherically calibrated by Internal Average Relative Reflectance (IARR). The False Color Composite (FCC) and Principal Component Analysis (PCA) images were used for discriminating lithologic units along with Spectral Angle Mapper (SAM) and Matched Filtering (MF). The pure endmember image spectra were extracted from Pixel Purity (PPI) algorithm. The results showed that PCA and FCC can be used to discriminate sedimentary rocks from magmatic and volcanic rocks. Because feldspars and quartz are relatively featureless in shortwave infrared (SWIR) spectral region the methods were not capable to distinguish between various magmatic rocks except for basalts with darker color and higher pyroxene content. The MF gave better results than SAM algorithm and therefore MF is recommended over SAM for studying similar terrains. The argillic and propylitic alteration zones were detected by band ratios. The results showed that MF algorithm in combination with band ratios can be used to distinguish magmatic rocks from sedimentary rocks and delineate the alteration zone

Lithological Mapping and Identification of Argillic and Propylitic Alteration Zones at Anjerd Volcanic Terrain

Anjerd area is part of Arasbaran volcanic-magmatic terrain in northwestern Iran. The area is covered by multiple intrusive bodies of diverse compositions, volcanic, volcaniclastic, sedimentary and young alluvial deposits. The usefulness of Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) data for the lithologic mapping of the area and identification of alteration zones is investigated in this study. To carry out the study, one ASTER frame was atmospherically calibrated by Internal Average Relative Reflectance (IARR). The False Color Composite (FCC) and Principal Component Analysis (PCA) images were used for discriminating lithologic units along with Spectral Angle Mapper (SAM) and Matched Filtering (MF). The pure endmember image spectra were extracted from Pixel Purity (PPI) algorithm. The results showed that PCA and FCC can be used to discriminate sedimentary rocks from magmatic and volcanic rocks. Because feldspars and quartz are relatively featureless in shortwave infrared (SWIR) spectral region the methods were not capable to distinguish between various magmatic rocks except for basalts with darker color and higher pyroxene content. The MF gave better results than SAM algorithm and therefore MF is recommended over SAM for studying similar terrains. The argillic and propylitic alteration zones were detected by band ratios. The results showed that MF algorithm in combination with band ratios can be used to distinguish magmatic rocks from sedimentary rocks and delineate the alteration zone

The relation characteristics of personality of managers working in Iran University of Medical Sciences with success and desirable job

Background: Several studies suggest the existence of an effective relationship between individuals' characteristics and important factors such as occupational and organizational performance, job satisfaction, organizational commitment, and etc. This study was designed based on the dimensions of personality (introversion/extroversion) of managers of Iran University of Medical Sciences at three levels (executive, middle and senior) with their career success rate. Methods: This was a cross-sectional descriptive study, whose population was all managers of Iran University of Medical Sciences. To collect data, two valid and reliable questionnaires were used. The first questionnaire assessed personality characteristics of each director, and the second measured occupational success. Related tests such as Pearson correlation test and independent comparison (independent t-test) at a significance level of 0.05 were used for data analysis. Results: Findings revealed no significant relationship between variables of introversion and extroversion and occupational success among the senior managers, (p > 0.05). However, there was a direct but incomplete relationship between introversion and extroversion, which correlated with job success among middle and executives managers. Conclusion: It seems that in all three levels of managers, if the managers communicated more with employees and if the subject of communication was more of executive nature, the correlation rate would increase between extroversion and introversion with job success variables. Therefore, it is suggested to give attention to organizational interaction and communication, and contingency variables such as organization condition, structure, formality and complexity

Assessment of Propolis Supplementation on Serum Concentrations of Liver Enzymes in Endurance Athletes with Four Weeks Aerobic Training

Background: Aerobic and intense exercises with an increase in free radicals cause damages at the cellular level, heart disease, cancer, and the development of aging processes, which one of its symptoms is increased serum concentrations of liver enzymes. Objective: The purpose of this study was to investigate the concurrent effect of four weeks of aerobic training and propolis supplementation on the activity of liver enzymes, including ALT, AST, and SOD in endurance athletes. Methods: Thirty-two male athletes (age: 21±1.4 years) in track and field were randomly divided into three groups: exercise group, exercise with placebo group, and exercise with supplement group. Propolis supplementation was taken as two tablets (500 mg) twice a day and aerobic exercise was performed for 4 weeks and in 24 sessions with an intensity of 60 to 65% of heart rate. The statistical method was done using one-way ANOVA and Tukey post hoc test by SPSS v. 18 software. Findings: The results showed that there was a statistically significant difference between groups in serum levels of SOD, AST, and ALT (P<0.05). There was not a statistically significant difference between the exercise group and placebo+exercise group in serum levels of SOD, AST, and ALT (P>0.05). Conclusion: The results showed that aerobic exercise alone can increase SOD levels and propolis supplementation with aerobic exercise can reduce AST and ALT serum levels and lead to improved liver cell function