Knowledge and Information Sources of Standard Precautions among Physicians in Mashhad, Iran

Introduction: Health care workers are exposed to percutaneous injuries. They are at risk of infection from bloodborne pathogens during routine clinical duties. Adherence to standard precautions can protect health care workers. The purpose of this study was to assess the level of knowledge of physicians about standard precautions and the use of information resources in the field of infection control. Material and Methods: A cross-sectional survey was conducted during January and March 2015, on 308 physicians working in the five academic hospitals affiliated with Mashhad University of Medical Sciences. Demographic and additional related data were obtained by questionnaire from all participants. Data were analyzed in SPSS 16. Result: most of the participants were Specialists and female (60.7%). Specialists for some items related to standard precautions scores were over 90%; However for items related to “knowing the standard precautions, a goal of standard precautions and washing hand after taking off the gloves” scores were below 70%. There was no significant difference in knowledge of standard precautions among different medical groups (p-value=0.87). The most frequently mentioned information sources by specialists (90%) were “local instructions” but residents and interns (76%) preferred “discussion with colleagues” as the first source information in relation to standard precautions. The most Specialists had not received enough training about standard precautions (52.2%). Conclusion: There is a need for guidelines for training the standard precautions among health care workers

Investigating the Effects of Telerehabilitation on Improving the Physical Activity of Individuals with Multiple Sclerosis: A Systematic Review of Randomized Controlled Trial

Introduction: This study systematically evaluates the effect of telerehabilitation on improving physical activity, physical function, and quality of life (QoL) in individuals with multiple sclerosis (MS). Materials and Methods: Studies were obtained by searching the title, abstract, and keywords without time limit in the Scopus, PubMed, Embase, and Web of Science databases. The quality of the included studies was assessed using the Joanna Briggs institute checklist. The same checklist was used for data extraction. Results: A total of 16 eligible articles were found. In 12 studies, the results showed significant performance improvement, reduced fatigue, improved physical activity, and general balance in the telerehabilitation approach. Furthermore, of the 16 included studies, 5(31) reported an improvement in individuals’ QoL, two of which showed a significant improvement in the individuals’ QoL in the intervention group compared to the control group. Conclusion: The findings of this review showed that telerehabilitation services for MS individuals’ precautions are comparable to or better than conventional services. Telerehabilitation is an effective educational instrument to restitute and maintain physical activity and balance in individuals with MS; however, no considerable improvement in individuals’ QoL was reported

Effects of sexual education mobile applications on men’s sexual awareness and satisfaction: A randomized controlled trial

BACKGROUND: Sexual education programs can improve sexual awareness and satisfaction. Yet, sex education is ignored in developing countries. Under such circumstances, we have used IT tools to improve sexual education. OBJECTIVE: In this article, we used a mobile application (mHealth) to impart sex education. Methods: A randomized controlled trial was held, in which participants were randomly assigned to one of two groups: The control group, with 25 participants, which received only counseling from sex therapists, and the intervention group, with 25 participants, which received the mobile application system in addition to counseling from sex therapists. Participants were persons referred to sex therapists at a clinic. In each group, sexual satisfaction and awareness were evaluated. We measured sexual satisfaction with the help of the Larson questionnaire and sexual awareness by the Ann Hooper questionnaire. Results: Our data demonstrated that sexual satisfaction was not statistically significant (P=0.44), but awareness showed statistically significant differences (P=0.007) in the intervention vs. the control group. Also, the mean in both groups had statistically significant differences before and after the intervention (P=0.001). Conclusion: Our results showed that mobile applications can improve sexual awareness but cannot affect sexual satisfaction in the short term. Trial Registration: The clinical trial was registered with the Iranian Registry of Clinical Trials (IRCT) under registration ID:  IRCT2016110130640N

Barriers to participation in center-based cardiac rehabilitation programs and patients’ attitude toward home-based cardiac rehabilitation programs

Purpose: The mortality rate of cardiovascular diseases in such developing countries as Iran is on the rise. Despite sufficient evidence pointing to its efficacy, cardiac rehabilitation (CR) approach is only employed to a limited extent. In the present study, barriers to participation in center-based cardiac rehabilitation programs and patients’ attitude toward home-based cardiac rehabilitation model were examined. Methods: In this study, 204 eligible patients for CR visiting an academic hospital were examined during the first three months of 2017. Patients had either abandoned rehabilitation programs midway through or had not attended one in the first place. Data about perceived barriers were collected using the modified Cardiac Rehabilitation Barriers Scale. Also, Patients’ attitude toward home-based CR was collected using a pre-validated researcher-made questionnaire. Results: The results revealed that the most effective barriers were transportation problems (70%), travel costs (70%), considerable distance to the rehabilitation center (67%), and lack of insurance coverage for rehabilitation costs (64%), respectively. Patients with longer than 30-minute drive time were less likely to attend in training sessions in the center. In addition, the important patient expectations about home-based CR programs included: communication with specialists, training before entering the rehabilitation program, and making periodic visits to maintain motivation and adhere to the home-based CR programs. Conclusions: The results revealed that logistical factors were the major barriers to participation in rehabilitation programs. Alternative models such as home-based CR programs, positively evaluated by the participants, can be used to overcome these barriers

Medical Information Sources Used by Specialists and Residents in Mashhad, Iran

Background: Physicians continually need to update their knowledge to ensure appropriate decision making about patient care. Objectives: We aimed to identify and compare information sources used by specialists and residents, their reasons for choosing these sources, and the level of their confidence in these sources. Materials and Methods: We conducted a cross-sectional study among specialists and residents using a validated questionnaire in the five academic hospitals affiliated with Mashhad University of Medical Sciences (in northeast Iran). We compared the specialists with residents in terns of gender, age, years since graduation, use of information sources, confidence in use of information sources, and reasons for selecting the information sources. Within each group, we also investigated the effect of work experience and gender on frequently used information sources and users' confidence in them. Results: The questionnaire was sent to 315 physicians, including 155 specialists and 160 residents. One hundred twenty-six specialists (response rate: 81 %) and 126 residents (response rate: 79%) completed it. The most frequently mentioned sources by all specialists included "English textbooks" (84.9%), "web/internet" (74.6%), "English medical journals" (62.3 %), and "discussions with colleagues" (57%). Among residents, "web/internet" ( 65.9%), "discussion with colleagues" (61.3%), and "Persian textbooks" (50.4%) were the most frequently used sources of information. In both groups, high confidence was demonstrated in "English textbooks," "English medical journals," and "international instructions/guidelines." Both groups counted reliability, easy accessibility, and being up to date as their primary reasons for the selection of their information sources. There was also a significantly negative correlation between using the internet as an information source and age in specialists (Spearman's rho=-0.238, p=0.01), but not in residents. Conclusions: Reliability, easy accessibility, and being up to date should be considered in establishing information sources for physician

Designing a Human T-Lymphotropic Virus Type 1 (HTLV-I) Diagnostic Model Using the Complete Blood Count

Objective(s): Infection caused by Human T-Lymphotropic Virus Type 1 (HTLV-I) can be observed in some areas of Iran in form of endemic. Most of the cases are asymptomatic, and few cases progress to malignancies and neural diseases. Designing and implementing a model to screen people especially in endemic regions can help timely detection of infected people and improve the prognosis of the disease. Materials and Methods: In this study, results of the complete blood count (CBC-diff) for 599 healthy people and the patients with different types of Leukemia and HTLV-I have been examined. Modeling was made using CHAID method. The final model was carried out based on the number of white blood cells (WBC), platelets, and percentages of eosinophils. Results: The accuracy of the final model was 91%. By applying this model to the CBC-diff results of people without symptoms or miscellaneous patients in endemic regions of our country, disease carriers can be identified and referred for supplementary tests. Conclusion: With regard to the prevalence of different complications in infected people, these individuals can be identified earlier, leading to the improvement of the prognosis of this disease and the increase of the health status especially in endemic regions

A Comparative Study of Rehabilitation Information Systems in 8 Countries: A Literature Review

Objectives: This study aims to comparatively review the rehabilitation information systems in 8 countries: Canada, the United States, the United Kingdom, Sweden, Australia, Malaysia, Russia, and Iran. Methods: A comprehensive review of published studies without a time limit was explored by searching the keywords, titles, and abstracts. Studies were obtained from the Web of Science, Scopus, PubMed, and Embase databases on May 2, 2021. We also did a Google search engine to explore rehabilitation information system websites in each country. The inclusion criteria included all English and Persian articles in the field of rehabilitation information registration systems or minimum data sets and the availability of complete text of the articles. A total of 13151 related studies were extracted and finally 25 main articles and 6 websites were selected. A similar standard checklist was used to extract and compare the findings. The data items in this checklist included reference, country, registry name, established year, founder, scope, standard classification systems (coding system), data elements, and subcategories of data elements of the registry. Results: The literature review revealed that the United States has international rehabilitation outcomes in three areas of inpatient, outpatient, and pediatric rehabilitation that collect data from around the world. Australia has a national clinical registry for outpatient and inpatient rehabilitation outcomes for adults and children. Canada, with its national rehabilitation reporting system, gathers only adult inpatient rehabilitation information. In sweden, the Swedish Rehabilitation Medical Register includes rehabilitation activities in both inpatient and outpatient care. Rehabilitation in Malaysia with no data sharing and integration is still in its infancy. The rehabilitation information system in the UK only includes specialized rehabilitation services. In Iran, the Welfare Organization registers and collects (inpatient, outpatient, and home care) rehabilitation and financial data of the disabled with the “payment” system. In Russia, only some studies have proposed the launch of a rehabilitation information system. Discussion: The results of this literature review demonstrate that the most comprehensive rehabilitation information systems first belonged to the United States, and then to Australia, Canada, Sweden, the United Kingdom, and Iran in descending order. Meanwhile, a rehabilitation information system is being developed in Malaysia. However, Russia has not yet developed a comprehensive rehabilitation information system

Incidence of occupational exposure to blood and body fluids and measures taken by health care workers before and after exposure in regional hospitals of a developing country: a multicenter study

This cross-sectional study was conducted on 371 health care workers working in government hospitals in the Northern Khorasan province of Iran. Exposure to sharp objects was 44% and 31% of participants had a history of being in contact with blood or body fluids of patients. Among health care workers who had needlestick injuries, 82 had a positive hepatitis B surface antibody titer measured after injur

Sources and Information Needs of Patients with Colorectal Cancer and Physician's Viewpoints in the Northeast of Iran: A Cross‐sectional Study

Introduction: Colorectal cancer is one of the most common gastrointestinal cancers, and it is the third and fourth most common cancer among Iranian men and women, respectively. Patients suffering from cancer have different information needs, and one of the most important and reliable sources of information for them is their physicians. Therefore, this study aimed to assess the sources and information needs of patients suffering from colorectal cancer and physicians' viewpoints regarding this issue. Material and Methods: This cross-sectional questionnaire survey-based study was conducted from May to December 2017. All patients diagnosed with colorectal cancer and physicians in oncology outpatient clinics at a specialized cancer hospital and a radiotherapy oncology center in Mashhad, Iran were invited to participate in the study using the census technique. The patient questionnaire was about patients' attitudes toward the consultant's information and disease, information leaflets, the treatments and complications and information sources for the disease. The physician questionnaire was about the information the physician would give to the patients. Results: The mean ages of the patients and physicians participating in this study were 50.72±16.15 and 40.03±11.08 years, respectively. Most of the cases (44.8%) wanted to know everything about their illness as much as possible, while 45.5% of the patients needed the information. The majority (85.9%) of the participants were willing to know about all possible therapies regarding their illness, while 63.3% of the physicians provided treatment options that were suitable for the patient in their view, and only 33.3% of the physicians told the patients all possible treatment options. Conclusion: Information regarding the illness, diagnosis, and treatment is one of the essential needs for patients suffering from colorectal cancer. It seems that it is necessary to have a good and organized plan to provide the patients suffering from colorectal cancer with the required information and increase their health information literacy as one of their undeniable rights

Artificial Intelligence Literacy Among Healthcare Professionals and Students: A Systematic Review

Introduction: In the digital age, since the application of artificial intelligence (AI) is increasingly penetrating the world, the cultivation of AI literacy has become increasingly important for everyone. This systematic review investigated the level of AI literacy among healthcare professionals and students. Material and Methods: We searched the databases PubMed, Embase, Scopus, and Web of Science for relevant material. The evidence gathered from the studies included in this systematic review was reported in this study using preferred reporting items for systematic reviews and meta-analyses (PRISMA). Studies that assessed the level of AI literacy among medical and healthcare professionals and students met the inclusion criteria for this study. The quality of the included study for this review was assessed using the analytical cross-sectional critical assessment checklist developed by the Joanna Briggs Institute (JBI). The same standard checklist was used for data extraction. Results: Of the 10 included studies, 4 (40%) reported a low level of preparation, knowledge, and literacy. In a study, it was also shown that radiologists had acceptable literacy about AI, and it seems that they had a better study of this field compared to other specialists. Another study showed that initially the level of AI literacy was not acceptable but improved significantly after training. Two studies also hailed AI's contribution to improving healthcare. Conclusion: Evidence from this review indicated that half of the studies on the AI literacy of professionals and students were very low, and other included studies also reported the basic literacy of AI acceptably. Finally, in all included studies, AI training courses and their application in healthcare were considered necessary for professionals and students, and they were trying to improve the educational infrastructure