Development of a store-and-forward telescreening system of diabetic retinopathy: lessons learned from Iran

Background: The present study describes the development and identity phases of a teleophthalmology system used for screening of diabetic retinopathy. Methods: A questionnaire was used to identify the main factors necessary for diagnosis of diabetic retinopathy and the features required for a teleophthalmology system. In the second phase, a web-based prototype of the system was designed using the data collected in the previous phase. In the final phase, the system was optimized based on the users� ideas and comments; then, it was evaluated through a standard usability testing questionnaire. Results: The results showed that the lowest average percentages were related to ethnicity (61), optometrist�s office address (61), and consultant physician�s office address (65). A web-based prototype was designed using the Visual Studio and Dreamweaver programming tools. This system comprised patient identity data, medical history, clinical data, and retinal images of the patient. The mean score of usability testing and user satisfaction including specialists, residents, and optometrist was 7.3, 7.1 and 7.3 (out of a total 9), respectively. The evaluation results revealed that the system was classified as good. Conclusion: The telescreening system suggested in the current study could be helpful in timely diagnosis. Moreover, it would reduce the treatment costs and complexities. Regardless of the positive points of telemedicine systems, one of the most challenges in this study was the Internet infrastructure to design and apply the system. The future studies, therefore, could focus on the application of cell phone technology for rendering teleophthalmology. © 2018 Springer International Publishing A

Development of a store-and-forward telescreening system of diabetic retinopathy: lessons learned from Iran

Background: The present study describes the development and identity phases of a teleophthalmology system used for screening of diabetic retinopathy. Methods: A questionnaire was used to identify the main factors necessary for diagnosis of diabetic retinopathy and the features required for a teleophthalmology system. In the second phase, a web-based prototype of the system was designed using the data collected in the previous phase. In the final phase, the system was optimized based on the users� ideas and comments; then, it was evaluated through a standard usability testing questionnaire. Results: The results showed that the lowest average percentages were related to ethnicity (61), optometrist�s office address (61), and consultant physician�s office address (65). A web-based prototype was designed using the Visual Studio and Dreamweaver programming tools. This system comprised patient identity data, medical history, clinical data, and retinal images of the patient. The mean score of usability testing and user satisfaction including specialists, residents, and optometrist was 7.3, 7.1 and 7.3 (out of a total 9), respectively. The evaluation results revealed that the system was classified as good. Conclusion: The telescreening system suggested in the current study could be helpful in timely diagnosis. Moreover, it would reduce the treatment costs and complexities. Regardless of the positive points of telemedicine systems, one of the most challenges in this study was the Internet infrastructure to design and apply the system. The future studies, therefore, could focus on the application of cell phone technology for rendering teleophthalmology. © 2018, Springer International Publishing AG

Higher Adherence to the Mediterranean Dietary Pattern Is Inversely Associated With Severity of COVID-19 and Related Symptoms: A Cross-Sectional Study

Background and AimsAdherence to the Mediterranean diet (MD) has been associated with a decreased risk of developing a variety of chronic diseases that are comorbidities in COVID-19 patients. However, its association to the severity and symptoms of COVID-19 are still unknown. This study aimed to examine the association between adherence to the MD pattern and COVID-19 severity and symptoms in Iranian hospitalized patients.MethodsIn this cross-sectional study, 250 COVID-19 patients aged 18 to 65 were examined. We employed a food frequency questionnaire (FFQ) to obtain data on dietary intake of participants in the year prior to their COVID-19 diagnosis. COVID-19 severity was determined using the National Institutes of Health's Coronavirus Disease 2019 report. Additionally, symptoms associated with COVID-19, inflammatory markers, and other variables were evaluated. The scoring method proposed by Trichopoulou et al. was used to assess adherence to the MD.ResultsThe participants' mean age was 44.1 ± 12.1 years, and 46% of them had severe COVID-19. Patients who adhered more closely to the MD had lower serum C-reactive protein levels (7.80 vs. 37.36 mg/l) and erythrocyte sedimentation rate (14.08 vs. 42.65 mm/h). Those with the highest MD score were 77% less likely to have severe COVID-19 after controlling for confounding variables. The MD score was also found to be inversely associated with COVID-19 symptoms, including dyspnea, cough, fever, chills, weakness, myalgia, nausea and vomiting, and sore throat.ConclusionHigher adherence to the MD was associated with a decreased likelihood of COVID-19 severity and symptoms, as well as a shorter duration of hospitalization and convalescence, and inflammatory biomarkers

Factors influencing health self-management in adherence to care and treatment among the recipients of liver transplantation

Malihe Sadat Moayed,1 Abbas Ebadi,2 Masoud Khodaveisi,3 Mohssen Nassiri Toosi,4 Ali Reza Soltanian,5 Mahnaz Khatiban6 1Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran; 2Nursing Education, Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran; 3Chronic Diseases (Home Care) Research Center, Community Health Nursing Department, Hamadan University of Medical Sciences, Hamadan, Iran; 4Internal Medicine, Hepatologist, Liver Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran; 5Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran; 6Mother and Child Care Research Center, Medical-Surgical Nursing Department, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran Introduction: Liver transplantation is the global treatment of end-stage liver diseases. Since the patients’ survival rate has been improved, the patient may experience reductions in physical, cognitive, and psychosocial functions after liver transplantation influencing their adherence to care and treatment. The transplant survival is complex and patients’ adherence to care and treatment should be considered when health care providers make decisions regarding treatment. This qualitative study aimed to explore factors influencing health self-management in adherence to care and treatment among the recipients of care and treatment.Methods: In this study, 23 interview sessions were carried out with a total 18 patients, 2 family members and 3 transplantation team members from May to November 2017. The patients were selected using the purposive method from both genders, with a various age range and initial diseases leading to liver transplantation, and time passed from liver transplantation. A semi-structured interview guide was developed based on literature review and pilot interviews. The participants were asked to describe their experiences of self-management behaviors in adherence to treatment and care. The data were analyzed using a conventional content analysis method and managing via the MAXQDA-10 software.Results: Two themes were developed during data analysis as “self-regulation” and “self-care”. “Self-regulation” consisted of “intentionally changing”, “positively thinking”, “information seeking”, “problem-solving”, “past knowledge transferring”, and “self-controlling”. “Self-care” had three sub-themes “shift to independence”, “vigilance”, and “self-care support”.Conclusion: The participants perceived the health self-management in adherence to care as a set of factors related to “self-regulation” and “self-care” behaviors. “Self-regulation” is required to create a balance in life. Also, “self-care” efforts can help with maintaining and improving patients’ health. Keywords: liver transplantation, qualitative research, self-management, self-care, self-regulation, adherence, recipient, compliance, treatmen

Construction of professional ethics questionnaire in midwifery

The midwifery ethics is a branch of professional ethics it wants morality for functional safety box midwifery practice and ethical decisions in the midwifery. The aim of this study was to develop a tool to measure the midwives’ awareness of midwifery professional ethics. Questionnaire awareness of professional ethics in midwifery as first initial list of 38 questions was prepared. To check the validity, respectively the face and content validity and reliability, the Pearson correlation coefficient was used and the data using SPSS software version 18 were analyzed. 26 questions have high content validity and 12 questions were rejected. Validity of the questionnaire was calculated an overall index value 0.88 that amount is acceptable. The final results showed that the final questionnaire with the Pearson correlation coefficient 0.97 and p< 0.001 is stable. To assess professional ethics in midwifery to a valid and reliable questionnaire that can accurately measure the extent is needed according to the results, questioning the outcome of this study is a useful tool for evaluation of ethics in midwifery. © 2017, Indian Journal of Forensic Medicine and Toxicology. All rights reserved