Producing the Standard Content in Virtual Education, a Necessary Need

A new world of distance education demands new thinking. Key components to complete the distance educational system require that institutions determine how the process is designed, delivered, integrated and supported. To have a better chance to develop online education in Iran, the academic staff should mention a lot of punctual notes in order to prepare the material which is going to be published as the online course. As a rule, teachers must pay careful attention to the common principles and standards in virtual education. Moreover, they must improve their skills in designing and editing course contents. In the process of virtual education, taking five exact steps can lead us to achieve the main educational goal that is effective learning. These five steps include analysis, instructional design, interface design, development, online testing and evaluation. The key to success in virtual education concerns serious attention to the quality of educational content and the capability to reuse learning objects. It is definitely necessary for the country’s higher educational system to consider this fact having a specialized and scientific view

The Trend of Prescribing Ceftriaxone Injection in the Medical Prescriptions of the Social Security Organization-insured Persons in Kerman during 2006- 2012

Background: Rational drug usage is a main priority in health research, and controlling prescribing Ceftriaxone injection due to its fatal adverse effects is a crucial challenge in Iran. The aim of this study was to assess the trend of prescribing Ceftriaxone injections in the medical prescriptions of the Social Security Organization-insured persons in Kerman during 2006- 2012. Methods: In this Cross-sectional study, using descriptive data mining all data about prescribing the three types of Ceftriaxone injection that were prescribed by the physicians and dentists and dispensed in Kerman pharmacies during 78 months (December 22, 2005 to June 20, 2012), obtained from The Comprehensive Medical Documentation System, in the Medical Documents Audit Office of Social Security Organization in Kerman was extracted by census sampling. Then, the prescribing rate of Ceftriaxone injection (defined daily dose) was analyzed and compared in different groups. Results: About 17 million prescriptions from 3621 physicians and dentists (aged 28-91 years) with male/female ratio as 1.7 were analyzed. About 300 thousands of prescriptions (1.75%) contained Ceftriaxone. The average number of monthly prescriptions; count of monthly prescriptions with the drug; and the ratio of prescribing Ceftriaxone in all prescriptions were significantly different between general practitioners and specialists/sub-specialists (P<0.001). The trend of Ceftriaxone prescribing has slightly decreased during 6.5 years. Conclusion: The studies on drug prescribing in Iran show the inappropriate patterns of drug prescribing and use, and also low adherence to the prescribed medications; therefore, serious interventions should be performed by the responsible organizations to control this challeng

Modeling a Data Mining Decision Tree and Propose a New Model for the Diagnosis of Skin Cancer by Immunohistochemical Staining Methods

Introduction: New diagnostic methods like immunohistochemistry staining in skin cancer can help the physicians to have more accurate diagnosis. The purpose of this study was to compare a method based on decision tree for differential diagnosis of two kind of skin cancer (Basal cell cancer and Squamous cell cancer) based on the results of staining methods. Method: Sixty skin cancer patients’ data from Malaysia were assessed by two methods of decision tree, CART and CHAID, in data mining and using Clementine 12 and SPSS 19. The results of three staining methods including B-cell lymphoma-2 antibody (BCL2), Galectin-3 (Cytoplasm), and Galectin-3 (Nucleus) were analyzed. The best predictive model for decision tree induction was compared with another researcher-made model based on critical values resulted from Receiver Operating Characteristic (ROC) curve analysis. Results: In final synthetic model, the sensitivity and specificity for Basal Cell Carcinoma (BCC) were 82.1% and 100%, and for Squamous Cell Carcinoma (SCC) were 100% and 82.8%, respectively. The overall accuracy of the model was 90.38% and the positive predictive values (PPV) for SCC and BCC were 82.1% and 100%, and the positive likelihood ratios (PLR) were 5.8 and 5.5 respectively. Conclusion: The decision tree model based on two methods of immunohistochemistry staining in skin cancer, can help in the diagnosis of these malignant disease and provide further studie

Evaluating the Quality of Content and Degree of Completeness of Discharge Summaries from the Physicians\' Perspective

Introduction: Discharge summaries (DSs) are among the most important tools for transferring information from hospital physicians to other physicians and play an important role in the continuity of care. Low quality and lack of information are the main problems of DSs, and evaluation of their quality from the physicians' perspective in Iran has rarely been done. This study aimed to evaluate the DSs' quality of content and completeness. Method: This descriptive cross-sectional study was performed on the DSs of Shafa Hospital in Kerman. A valid and reliable researcher-made questionnaire (α=0.97) was used. This questionnaire had three sections, including questions related to demographic information, evaluation of the quality of DSs (8 questions), and the degree of completeness of the DSs (8 questions). Results: Out of 110 physicians, 98 (89%) filled out questionnaires. Completeness, awareness, continuity of care, legibility, relevancy, length, consistency, organization, and physicians’ satisfaction were below the average (50%) throughout the hospital. The highest level of physicians' satisfaction with the quality of the content (79.27%) and completeness (77.73%) was attributed to electronic discharge summaries of the neurology department. Organization, legibility, and consistency, respectively, were identified as the best predictors of physicians' satisfaction with the quality of the DSs’ content. Conclusion: Policymakers should increase the quality of DSs by creating instructions, holding documentation training courses, increasing the supervision of senior physicians on interns and residents, and finally developing electronic automated DSs

The effect of registry-based performance feedback via short text messages and traditional postal letters on prescribing parenteral steroids by general practitioners--A randomized controlled trial

It is conjectured that providing feedback on physicians' prescribing behavior improves quality of drug prescriptions. However, the effectiveness of feedback provision and mode of feedback delivery is not well understood. The objective of this study was to assess and compare the effect of traditional paper letters (TPL) and short text message (STM) feedback on general practitioners' prescribing behavior of parenteral steroids (PSs). In a single-blind randomized controlled trial, 906 general practitioners (GPs) having at least 10 monthly prescriptions were randomly recruited into two interventions and one control study arms with 1:1 allocation, stratified by percentage of prescriptions. The intervention was the provision of 3 feedback messages containing prescribing indices in TPL and STM (in the first two arms) versus the control arm (CG) with an interval of 3 months between these messages. We calculated the PS Defined Daily Dose (DDD) for every GP, every month, and compared between the 3 arms, before and after the interventions. The expected primary outcome was to reduce prescription of parenteral steroids by participants. The study was performed in the Kerman Social Security Organization in Iran. A total of 906 GPs were selected for the trial, but only 721 of them (TPL=191, STM=228, CG=302) were recruited for the 1st feedback. The mean age of GPs was 44 and 59% of them were male. The prescribed parenteral steroid DDDs at baseline were similar (TPL=121.62, STM=127.49, CG=115.68, P>0.5). At the end of the study, DDDs in the TPL and STM arms were similar (TPL=104.38, STM=101.90, P>0.9) but DDDs in each intervention arm was statistically significantly lower than in CG (CG=156.17, P <0.0001). Being in TPL and STM arms resulted in 36.1 and 41.7 units of decrease in DDD respectively, compared to the control arm (P <0.02 and P <0.005) after the one-year duration of the study. Feedback by TPLs and STMs on prescribing performance effectively reduced prescribing PSs by GPs. STM, being a cheap and fast tool, is potentially powerful and efficient for drug prescription rationalizatio