Differential construct definitions of six change score models within a correlational research context

Six change score models were comparatively evaluated within the correlational research context. The models compared included raw change, corrections of raw change for unreliability in x, correction of raw change for unreliability in both x and y, a regression correction, the raw residual model, and the base-free measure of change. The data were simulated for nine different parameter conditions. The manipulated parameter values were reliability coefficient values for x, y and w where x and y were the components of change and w was an outside variable, relative variability of x and y, colinearity between x and y, and relative validity coefficients for x and y. A set of true and two sets of observed change scores (total of 18 models) were generated for 2000 cases under each condition. Correlations among scores between models within and across conditions were generated. A principal component analysis was used to investigate the commonality of the change score models regarding the construct definition of change when w was considered and when w was partialed from the change score models. The latter analysis investigated the possible differential impact of w on the construct definition of change. The findings revealed that model differences do exist between the change scores under most of the parameter conditions, particularly for \sigma\sb{x} = \sigma\sb{y} where \rho\sb{xy} \sigma\sb{x} where \rho\sb{xy} = 0.75 when \rho \sb{xx\prime} \not= \rho\sb{yy\prime}. Selected parameter conditions had differential impact on discrepancy models versus residual models. Discrepancy models were more susceptible to manipulations of x and y variability, while the base-free measure of change was most affected by different reliability levels and colinearity coefficients. Removal of w had differential impact on the change score models. The results of this study lead to a conclusion that change scores in the form of any of the models are not sufficiently stable across research conditions to provide confidence in their use. Those conditions most favorable to change scores are rare in practice and use of a single variable (y) will result in an equal amount of information

Analysis of the spatial distribution of health care centers of Shahrekord by geographical information system

زمینه و هدف: توسعه فیزیکی نامتناسب شهرها و عدم تخصیص مناسب امکانات شهری از جمله توزیع نامتناسب مراکز بهداشتی درمانی سبب هدر رفت منابع مادی و انسانی شده و مشکلات شهر نشینی شهروندان را به دنبال داشته است. هدف از این پژوهش شناسایی مناطق فاقد دسترسی مناسب خدمات بهداشتی جهت توزیع بهینه امکانات بهداشتی بر اساس عدالت در سلامت در تمام مناطق شهری شهرکرد بوده است. روش بررسی: پژوهش حاضر یک مطالعه توصیفی- تحلیلی مبتنی بر روش‌های پژوهش اسنادی بود. پس از تلفیق دادهای تمام ده مرکز و پایگاه‌های بهداشتی درمانی سطح شهر شهرکرد، با استفاده از سیستم اطلاعات جغرافیایی با تعیین شعاع عملکردی و دسترسی در سال 1390، پراکنش فضایی این مراکز پس از تجزیه و تحلیل با استفاده از تحلیل سلسله مراتبی داده‌ها رتبه بندی مناطق انجام گردید. یافته ها: داده‌های مراکز و پایگاه‌های بهداشتی درمانی شهر شهرکرد نشان داد که اختلاف زیادی در تمام مراکز و پایگاه‌های بهداشتی شهر شهرکرد از نظر بیشترین به کم‌ترین وسعت تحت پوشش(4/4 برابر)، تعداد جمعیت (3/2 برابر) و تراکم جمعیتی (6/2 برابر) وجود دارد. مناطق حاشیه شمال و جنوب و شرق سطح دسترسی نامناسبی نسبت به مرکز شهر داشته و70 تراکم مراکز و پایگاه‌های بهداشتی شهر شهرکرد فاقد توزیع مناسب می‌باشند. نتیجه گیری: نتایج نشان می‌دهد که تراکم مراکز و پایگاه‌های بهداشتی شهر شهرکرد فاقد توزیع مناسب بوده و پراکنش مناسبی مشاهده نگردید. توزیع غیرمنطقی و محدوده بندی نامتناسب واحدهای بهداشتی منجر به کاهش سطح دسترسی مطلوب می‌شود که احتمال افت سطح شاخص‌های عدالت در سلامت را به دنبال خواهد داشت

The Effect of the Impact of Health Promoting Program on Environmental Indicators in Elementary Schools of Tabriz in Academic Year 2013-2014

Health promoting program take steps in eight levels toward improving school standards and 64 indicators are investigated in this program in schools. Based on the importance of environment and training of environmental issues since childhood, in this program seven environmental indicators in schools are mentioned. The impact of this program on environmental indicators is important for decision making. Method: this study was conducted as case-control among 128 schools. Data collection instrument was a 30-questions checklist that was completed by Environmental health experts in schools. The results indicated that there is no significant relationship between the indicators of green space, drinking water, toilet and bathroom, using clean fuels (for heating), conserving in uses of paper and conserving in uses of energy (power utilities e.g. electricity, water, fuel) in health promoting schools and non-promoting schools . There is a significant relationship between the indicators of location and space of school in terms of being away from environmental pollutants, sewage disposal system, collecting and disposal of solid waste in health promoting schools and non-promoting schools. Since the health promoting program is running aimed at improving the health and environmental indicators, it does not have the appropriate mechanism for raising infrastructural standards and environmental structures in schools

Developing a Model for Accreditation of Iranian Teaching Hospitals: A Qualitative Study

Background: Among different factors, accreditation is being widely used across the world to improve quality and safety in hospitals. Therefore, the purpose of the present study was to develop an accreditation model for teaching hospitals in Iran.Methods: This qualitative study was conducted in four phases from January, 2017 to March, 2018. To this end; firstly, existing accreditation models were extracted and reviewed comparatively. Within the second stage, dimensions and components of the accreditation model were extracted through semi-structured interviews. In the third stage, a new instruction was developed via integrating the findings from the first and the second stages. Finally, the model was validated in two phases of Delphi method and a specialized forum in the fourth step. Qualitative findings were then analyzed using content analysis method.Results: Models of Joint Commission International (JCI) and Word Federation for Medical Education (WFME) in other 6 countries were reviewed and compared with the current Iranianmodel. Extracted dimensions discovered to complement the present model included learner assessment, continuous reviews and revisions, and educational productivity. The final model was also developed with 12 dimensions and 94 standards. Content validity ratio (CVR) and content validity index (CVI) were also estimated to be 0.40 and 0.80, respectively. As well, the second round of Delphi method could increase the number of model standards to 97. Moreover, Cohen’s kappa coefficient was calculated to be at least0.71.Conclusion: This study led to the development of a comprehensive model for scientific accreditation of teaching hospitals through reviewing documentation, combining and comparing global approaches, as well as integrating them with the views of domesticexperts.

The Effect of the Impact of Health Promoting Program on Environmental Indicators in Elementary Schools of Tabriz in Academic Year 2013-2014

Health promoting program take steps in eight levels toward improving school standards and 64 indicators are investigated in this program in schools. Based on the importance of environment and training of environmental issues since childhood, in this program seven environmental indicators in schools are mentioned. The impact of this program on environmental indicators is important for decision making. Method: this study was conducted as case-control among 128 schools. Data collection instrument was a 30-questions checklist that was completed by Environmental health experts in schools. The results indicated that there is no significant relationship between the indicators of green space, drinking water, toilet and bathroom, using clean fuels (for heating), conserving in uses of paper and conserving in uses of energy (power utilities e.g. electricity, water, fuel) in health promoting schools and non-promoting schools . There is a significant relationship between the indicators of location and space of school in terms of being away from environmental pollutants, sewage disposal system, collecting and disposal of solid waste in health promoting schools and non-promoting schools. Since the health promoting program is running aimed at improving the health and environmental indicators, it does not have the appropriate mechanism for raising infrastructural standards and environmental structures in schools

Factors affecting the recurrence of medical errors in hospitals and the preventive strategies:a scoping review

Due to the high value of human life, the occurrence of even one error that leads to death or complications is of great consequence and requires serious attention. Although significant efforts have been made to ensure patient safety, serious medical errors continue to exist. This study aimed to identify the factors associated with the recurrence of medical errors and strategies to prevent them through a scoping review. Data were gathered through a scoping review of PubMed, Embase, Scopus, and Cochrane Library databases during August 2020. Articles related to factors influencing the recurrence of errors despite the available information, as well as articles related to measures taken worldwide to prevent them, were included in study. Overall, 32 articles were selected out of the 3422 primary papers. Two main categories of factors were identified as influential in error recurrence: human factors (fatigue, stress, inadequate knowledge) and environmental and organizational factors (ineffective management, distractions, poor teamwork). The six effective strategies for preventing error recurrence included the use of electronic systems, attention to human behaviors, proper workplace management, workplace culture, training, and teamwork. It was concluded that using a combination of methods related to health management, psychology, behavioral sciences and electronic systems can be effective in preventing the recurrence of errors

The Effect of the Impact of Health Promoting Program on Environmental Indicators in Elementary Schools of Tabriz in Academic Year 2013-2014

Health promoting program take steps in eight levels toward improving school standards and 64 indicators are investigated in this program in schools. Based on the importance of environment and training of environmental issues since childhood, in this program seven environmental indicators in schools are mentioned. The impact of this program on environmental indicators is important for decision making. Method: this study was conducted as case-control among 128 schools. Data collection instrument was a 30-questions checklist that was completed by Environmental health experts in schools. The results indicated that there is no significant relationship between the indicators of green space, drinking water, toilet and bathroom, using clean fuels (for heating), conserving in uses of paper and conserving in uses of energy (power utilities e.g. electricity, water, fuel) in health promoting schools and non-promoting schools . There is a significant relationship between the indicators of location and space of school in terms of being away from environmental pollutants, sewage disposal system, collecting and disposal of solid waste in health promoting schools and non-promoting schools. Since the health promoting program is running aimed at improving the health and environmental indicators, it does not have the appropriate mechanism for raising infrastructural standards and environmental structures in schools

Medical Errors Disclosure: Is It Good or Bad?

Background: In the treatment and health process, there are a lot of dangers to patients, and the increased number of medical errors is one of the most important circumstances of this process. Objective: The present research purposed to decrease medical errors through disclosure of them in hospitals of Tehran University of Medical Sciences. Methods: This qualitative-quantitative study included a population of 232 individuals, selected through targeted non-random selection, who were somehow connected with medical errors made in hospitals affiliated with Tehran University of Medical Sciences. The triangulation technique was utilized to collect data. Data was analyzed using the factor analysis technique. After the effective factors were determined, their internal correlation was determined through regression correlation. Results: Disclosure is made up of organizational culture, the factors related to the patient, the factors related to the presenter, the factors involved in the error, structural factors, and disclosure situation indexes, and is an effective factor in managing the medical errors in hospitals of Tehran University of Medical Sciences. Disclosure increases the immunity of patients. Conclusion: Disclosure is an effective factor in managing the medical errors that occur at hospitals affiliated with Tehran University of Medical Sciences. It is essential that managers identify the effective factors in disclosure and take steps to apply a suitable disclosure system to decrease errors

The Impact of Structure, Process and Output on the Establishment of an Accreditation System in Social Security Hospitals in Tehran

Background: The lack of an evaluation mechanism and effective accreditation for hospitals in addition to increasing healthcare costs jeopardizes the overall health of communities. This study was conducted to identify and prioritize factors affecting the establishment of an accreditation system in social security hospitals in Tehran in 2015.Methods: This is a cross-sectional study and participants consisted of academic experts, hospital chiefs, managers, head nurses and supervisors, and staff of quality improvement in departments of social security in hospitals in Tehran City, Iran. Study samples were of 170 participants. A 5-points Likert scale questionnaire, according to the Donabedian model (structure, process, and output), with 24 items, was used. For data analysis, SPSS software version 22 and Pearson correlation coefficient, one-sample t-test and linear regression were used.Results: Out of 170 participants, 49 (28.8%) were male and 121 (71.2%) were female. T-test results showed that all dimensions had a significant effect on the accreditation system (P<0.05). Also, pearson correlation coefficient results showed that all aspects had a significant correlation with each other (P<0.05). In the regression model, R2 showed that 89.6% of changes of the dependent variable could be predicted.Conclusions: The correct implementation of hospital accreditation requires the specific education for personnel so that they can easily understand the accreditation model and standardized processes that need to be established in the hospital