Safety and Efficacy of Stem Cell Therapeutics in Wound Healing: A Rapid Review of Available Evidence

Background: Skin and wound injuries are important health problems with great mortality rates. While there are different alternative therapies, there is no agreement on the best therapy for burn wounds and wound complications. Stem cell therapy has an optimistic prospect in many preclinical studies of burn wounds and diabetic wounds. Objectives: In this study, we performed a rapid review to evaluate the efficacy and safety of stem cell therapy in wound treatment. Methods: This rapid review of the evidence aimed to evaluate the potential effects of stem cells on wound healing to create a policy guide for policymakers in the health care system. We searched such databases as PubMed and Scopus on March 13, 2021 using keywords, including “stem cells and wound healing”, “safety”, and “efficacy”. The references of retrieved studies were also checked to ensure the capture of the literature. Studies evaluating the safety and efficacy of stem cells on wound healing published in Persian and English were included. Generally, we used the PICO (population, intervention, control, and outcomes) model for search strategy. Results: Out of a total of 92 retrieved papers, 22 studies were eligible for inclusion. The overall review showed that stem cell therapy improved wounds. Also, studies showed that using stem cell technology in a non-invasive way could be a good alternative. However, the limitations of this technology consisted of the need to improve cell delivery methods, cell sustainability, heterogeneity in the research of mesenchymal stem cells, and wound substrate. Further studies are needed to determine its safety and efficacy. Conclusions: Although the evidence on the safety and efficacy of using stem cells for wound healing was limited, studies showed that stem cell technology is a good alternative to traditional therapies. Future clinical studies should consider the differences in the studies to achieve maximum effectiveness.

Safety and Effectiveness of Lung Cancer Screening Using Low-dose Computed Tomography Scan in High-risk Individuals: A Comprehensive Review

Context: Lung cancer is the most important cause of cancer mortality. Given the incidence and mortality of this disease, the implementation of preventive interventions is necessary. Objectives: The present study investigated the effectiveness of one of the most important interventions of lung cancer screening with lowdose computed tomography (LDCT) in high-risk individuals. Evidence Acquisition: The present study was an applied study performed as a comprehensive review. For the assessment of safety, studies on the technical specifications of computed tomography scans and issues related to the safety of applying this device were searched using keywords in medical databases. For the evaluation of clinical effectiveness, a comprehensive review of health technology assessment studies, systematic review studies, and screening guidelines was performed. Results: Based on 15 studies extracted for the safety issue, the diagnosis of harmless tumors, false positives cases and Unnecessary invasive complementary interventions, and possible negative effects of radiation exposure are discussable safety issues. Based on the synthesis of 16 studies on effectiveness, lung cancer screening intervention using LDCT was determined to reduce lung cancer mortality by 15 - 20% and mortality from other causes by 0 - 6%. Additionally, the incidence of this disease in its upper stages decreases significantly. Conclusions: Lung cancer screening using LDCT does not threaten the health of individuals seriously and, in comparison to nonintervention is more clinically effective and will lead to a statistically significant reduction in lung cancer mortality and increase in the timely diagnosis of this disease.

Investigating Non-pharmacological Treatments for Psychological Problems Associated with Epilepsy: A Narrative Review

Epilepsy is one of the problems and diseases that accompanies a person for the rest of his/her life after diagnosis. This disease can severely affect a person’s physical condition and lead to psychological problems. Many patients with epilepsy suffer from psychological problems and are under the supervision of a psychiatrist, and they take medications to control the mental state. However, many patients are reluctant to take other medications, including psychiatric medications, due to long-term use of the drug. Therefore, in this study, we examined nonpharmacological treatments for psychological problems caused by epilepsy. In addition to developing epilepsy and receiving medications for the disease, these patients develop mental illnesses such as stress, depression, anxiety, and cognitive processes that require treatment. After searching for texts published in various English language databases, the required items were obtained. First, some of the psychosocial consequences of epilepsy, including negative attitude towards epilepsy, social stigma, family factors, quality of life, and sexual activity, were evaluated. Furthermore, the concurrency of psychological disorders (stress, depression, anxiety, cognitive processes, and theory of mind) along with non-pharmacological treatments were investigated.

Evaluation of Professors’ Satisfaction with a Short-Term Course of Medical Education in Birjand University of Medical Sciences During the COVID-19 Pandemic

Background: The aim of this study was to investigate the satisfaction of professors with the short-term course of medical education at Birjand University of Medical Sciences during the COVID-19 pandemic. Methods: Initially, needs assessment was conducted for the content of the course; after determining the content, the course was held online through Adobe Connect system and offline through Navid system. Following completing the course, evaluation was performed, and finally, satisfaction with the course was assessed based on a 34-item questionnaire whose validity and reliability were established. In total, 44 participants in the course answered the questionnaire. The data were analyzed using t-test and correlation coefficient by SPSS, version 18. Results: The mean age of the participants was 36.34 ± 5.64 years, and 56.8% (25 people) were female. In terms of academic rank, 75% were assistant professors. The average score of satisfaction was equal to 140.48, which indicates a high score of satisfaction with the course. In general, the score of satisfaction was higher than average in all fields. The average score of satisfaction in men was significantly lower than in women (P < 0.001). There was no significant relationship between satisfaction and degree, academic rank, age, and working experience (P > 0.05). Conclusions: Professors’ satisfaction with the online and offline medical education courses in the relevant systems is at a high level. Thus, it is suggested that combined in-person and online empowerment courses should be held in the post-COVID-19 era.

Investigating the Relationship of Organizational Performance with Employment Status and Shift Work in Nurses at the Shahid Rahnemoun Hospital

Background: Performance evaluation in facilitating organizational effectiveness is considered an essential task of human resource management that depends on nurses’ employment status. Objectives: The present study aimed to investigate the relationship of organizational performance with employment status and shift work in nurses at the Shahid Rahnemoun Hospital, Yazd, Iran. Methods: This descriptive-analytical study was conducted in 2018. The sample consisted of 151 nurses who were included using census. The instrument was a standard questionnaire whose content validity was confirmed by three experts, and its reliability was approved by Cronbach’s alpha coefficient. Data analysis was performed using SPSS.22 software through independent t-test, one-way analysis of variance, and one-sample t-test. Results: Among the four components surveyed in the study, the highest and lowest means and standard deviations were related to “participation and cooperation” (4.35 ± 0.48) and “infection control and prevention” (4.21 ± 0.60), respectively. There was a significant relationship between total performance and the two dimensions of “care and treatment” and “participation and cooperation” with employment status (P < 0.05). Conclusions: The results showed that the type of employment of nurses would affect the organizational performance. In an organization where employees feel job security, they will be committed to that organization and perform their duties more competently, with more motivation and satisfaction.

Prioritization of Interventions and Technologies to Prevent Fire Spread in Hospitals

Background: Fire is one of the potential dangers that threatens human activities more and more. Given that, this study sought to introduce the factors preventing the spread of fire in hospitals to policymakers through prioritization based on the techniques of applied mathematics (multi-attribute decision-making technique). Methods: This study consisted of two stages. In the first stage, through a comprehensive review of studies, factors preventing the spread of fire were identified, and then in the second stage, based on the experts’ opinions, the attributes affecting the prioritization and their weights were determined. Finally, based on the Simple Additive Weighting (SAW) model, the final prioritization was done for five types of hospital buildings. Results: Based on the literature review and experts’ opinions, seven factors and four attributes were identified. The most important factors were “the use of safety architecture and equipping with appropriate emergency exit accesses according to the standard” in highrise hospitals, “continuous firefighting training of the personnel” in wide hospitals, “use of fire extinguishing systems (automatic and manual)” in subsurface hospitals, “use of fire extinguishing systems (automatic and manual)” in combined hospitals, and “continuous firefighting training of the personnel” in portable hospitals. Conclusions: Fire safety is not limited to the installation of a manual fire extinguisher, but for fire safety, especially in hospitals, all aspects should be considered, including the architectural form of the building, how the materials and equipment in the building caught fire, fire behavior in terms of heat transfer, the firefighting training of the personnel, recognition, and application of modern and ready-made equipment for smoke ventilation systems and fire products, automatic and manual fire alarm systems, and extinguishing systems to prevent the spread of fire.

Impact of Outsourcing Medical Equipment Department on Costs and Profits: A Case Study of a University Hospital in Tehran, Iran

Background: Medical equipment plays a key role in diagnosis, treatment, and medical education. Outsourcing is delegating a part or all activities of an organization to a party (e.g., individuals or organizations) outside the organization, which has an important role in the organization’s productivity. Objectives: The current study aimed to investigate the effect of outsourcing the department of medical equipment of a university hospital in Tehran, Iran, by emphasizing costs, profits, and performance. Methods: This was a descriptive-analytical and cross-sectional study. This study investigated the documents and financial records of the Financial Office to calculate costs and revenues. Additionally, a researcher-developed questionnaire was used to evaluate the effect of outsourcing on employees’ performance and financial performance. A total of 36 subjects were randomly selected, following the sampling formula (the response rate: 72%). The Kolmogorov-Smirnov test was applied to test for a normal distribution. As the data were not normally distributed, the Wilcoxon test was used. Furthermore, the t-test and analysis of variance were used to study the difference in the effect of outsourcing and age, gender, and educational level. The data were analyzed using SPSS software (version 19). Results: According to the findings, there was a significant difference before and after outsourcing in the costs and revenues of the Medical Equipment Department. Concerning the effect of outsourcing on the performance, the “human resources” factor obtained the highest mean (3.37), which indicated the poor perspective of the staff in this aspect. Moreover, the lowest score was related to the “cost-effectiveness” (2.96), which was an average score. There were weak scores concerning the dimensions of management (3.28) and quality of services (3.36). Conclusions: Considering the importance of staff in the hospital, it is necessary to pay serious attention to the impact of different types of reforms intended to increase the revenues and reduce the costs of hospitals on the staff of the organization by emphasizing managerial and human resources dimensions, which not only will increase the efficiency of the organization and satisfaction of the staff but also translated into better quality.

Designing a Questionnaire to Measure Factors Affecting Utilization of Services for Diabetics in Health Centers Based on Social Marketing Model

Background: The needs and demands of patients as one of the pillars of marketing in the health field require the right tools to identify consumers’ requests. Objectives: This study was conducted to develop a tool to evaluate services utilization behavior by type 2 diabetics in health centers based on a social marketing model (ie, 7 Ps). Methods: This study was conducted in two main stages. The first stage was performed with the aim of the initial design of the tool (ie, a questionnaire) through a literature review and professionals’ opinions. The second stage was performed to confirm the validity and reliability of the prepared questionnaire in the previous stage through calculating the impact score, content validity index (CVI), content validity ratio (CVR), and Cronbach’s alpha coefficient. The study participants included 8 academic and executive experts in the field of health and diabetes, 30 diabetic patients to calculate the impact score, and 50 patients with diabetes to calculate the Cronbach’s alpha through test-retest. The data were analyzed using SPSS software (version 18). Results: According to the results of the first stage of the study, a questionnaire with 46 items was designed. After determining the formal and content validity quantitatively and qualitatively, 8 items were deleted, and a questionnaire with 38 items was provided. Finally, the validity and reliability of the instrument were confirmed (CVI = 0.91; CVR = 0.92; intraclass correlation coefficient = 0.89; Cronbach’s alpha = 0.92). Conclusions: This questionnaire with confirmed validity and reliability helps analyze the diabetics’ behavior and specifies the reasons for the acceptance or rejection of the services of the diabetes unit by patients. Therefore, it can be used in health centers providing services for diabetics.

Nurses’ Perspectives About Reasons for Not Reporting Medical Errors in Educational Hospitals, Ahvaz, Iran

Background: Reporting of medical errors is an approach to identify and prevent errors in hospitals. Objectives: The purpose of this study was to determine the barriers to error rError Reporting; Nurse; Hospital; Ahvazeport from the nurses’ viewpoints in Ahvaz Educational hospitals. Methods: This descriptive-analytical study was done on 206 nurses working in educational hospitals of Ahvaz selected by stratified random sampling. The measurement tool used in this study was a researcher-made questionnaire, which its validity was confirmed by content validity, and its reliability using Cronbach’s alpha was calculated to be 0.84. Data collection was performed from April to June 2019. Results: The causes of failure to error reporting included educational, attitudinal, process, structural, and managerial factors. The total mean score of the factors causing non-reporting of errors was 3.88 ± 0.53, which was between 3 and 4 (“important”). Also, educational, attitudinal, and process factors were reported as “very important” for nurses. Structural and managerial factors were rated reported “important” by nurses over 90% of nurses rated educational, attitudinal, and process factors as important and very important, and more than 70% of them rated structural and managerial factors as important and very important. Nurses with different levels of education or work experiences had different scores in reasons for not reporting errors. Conclusions: Some educational, attitudinal, process, structural, and managerial factors were critical reasons for not reporting errors. In order to reduce same errors in the future and promoting health care quality, officials need to develop strategies to remove barriers and consider the reasons for not reporting errors in nurses’ educational programs using team-based and forward-looking approaches, adopting an impersonal and systematic approach, and finally, modifying error reporting rules.

Role of Hospital Digital Services in Improvement of Clinical Regime of Patients

Context: Healthcare supply chain management is the regulation of the flow of medical goods and services from manufacturers to patients. Supply chain management encompasses the planning and managing of all activities involved in sourcing and procurement, conversion, and all logistics management activities. Therefore, it greatly helps material managers to manage through continuous improvement efforts while maintaining the quality of care. Moreover, reinforcing healthcare logistics information technology (IT) architecture immediately leads to more patient satisfaction. Objectives: This study aimed to develop an architecture for designing efficient software aiding with the management of the healthcare supply chain. Methods: This study showed the role of digital services in the improvement of the clinical regime of patients by presenting different approaches with distinguishing the main types of hospital logistics, such as physical flow management, food safety, and cold chain management approaches (e.g., “moving forward”), and modeling these components using the solution architecture principles of ITs, such as Business Process Model and Notation. Results: This study proposed a hospital enterprise architecture by modeling a system to have a base for building a digital catering service that improves the clinical regime of patients.