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Background: Although preventable, healthcare-associated infections (HAIs) continue to pose huge health and economic burdens on countries worldwide. Some studies have indicated the numerous causes of HAIs, but only a tiny literature exists on the multifaceted measures that can be used to address the problem. This paper presents stakeholders' opinions on measures for controlling HAIs in Iran. Methods: We used the qualitative research method in studying the phenomenon. Through a purposive sampling approach, we conducted 24 face-to-face interviews using a semi-structured interview guide. Participants were mainly key informants, including policy-makers, health professionals, and technical officers across the national and subnational levels, including the Ministry of Health (MoH), medical universities, and hospitals in Iran. We performed thematic framework analysis using the software MAXQDA10. Results: Four main interdisciplinary themes emerged from our study of measures of controlling HAIs: strengthening governance and stewardship; strengthening human resources policies; appropriate prescription and usage of antibiotics; and environmental sanitation and personal hygiene. Conclusion: According to our findings, elimination of HAIs demands multifactorial interventions. While the ultimate recommendation of policy-makers is to have HAIs among the priorities of the national agenda, financial commitment and the creation of an enabling work environment in which both patients and healthcare workers can practice personal hygiene could lead to a significant reduction in HAIs in Iran. [ABSTRACT FROM AUTHOR]

Introduction: Since human resources are the most important element in any organization and success or failure of any organization is dependent on having efficient human resources, all organizations must continually seek ways to develop their own manpower. Awareness of the current human resources situation through the process of diagnosis is the first step in this endeavour. Objective: This study aims to identify the main human resources problems through a diagnostic survey at staff departments of Kerman University of medical sciences. Methods: The present descriptive-analytical study was carried out cross sectionally. The research population consisted of all employees working in staff departments of Kerman medical university deputies, of whom 159 participated in this study. Data was collected by a questionnaire. Data analysis was done through SPSS software using Friedman test, Chi-square and T-test. Results: Behavioral (mean = 2.33) and contextual factors (mean= 3.24) had respectively the highest and the lowest impact on human resources malfunction in Kerman University of medical sciences. Among subsets of behavioral factors, motivation and job satisfaction (mean = 2.27) and customer-orientation (mean= 1.77) had the highest and the lowest impact on human resources malfunction in all three dimensions respectively. Conclusion: Dissatisfaction with the salary system, performance evaluation and promotion and appointment system are the biggest problems of human resources in Kerman University of Medical Sciences. These problems are not confined to Kerman University of Medical Sciences and in regard to the fact that they are structural factors, solving these problems are beyond the authorities of executives. Therefore, the Presidential deputy of human capital should provide fundamental changes in public organizations payment systems and performance evaluation to increase employees' motivation. [ABSTRACT FROM AUTHOR]

Background: Despite growing evidence, there is still uncertainty about potentially modifiable risk factors for neonatal early-onset sepsis (EOS). This study aimed to identify potential clinical risk factors for EOS based on a literature review and expert opinions. Methods: A literature search was conducted in PubMed (MEDLINE), Cochrane, Embase, and Scopus databases. Articles in English, published up to May 2021, on clinical risk factors for neonatal EOS were included. Initially, a questionnaire on risk factors for EOS was developed and validated. The fuzzy Delphi method (FDM) was used to formulate the final version of the questionnaire. The validity of the risk factors was assessed using the Chi square test. P<0.05 was considered statistically significant. Results: In the review phase, 30 risk factors were approved by two neonatologists and included in the FDM phase. In total, 25 risk factors met the consensus criteria and entered the validation phase. During the observational study, 114 neonates (31 with and 83 without EOS) were evaluated for two months. The results of the Chi square test showed that cesarean section was not a significant risk factor for EOS (P=0.862). The need for mechanical ventilation and feed intolerance was observed in about 70% of neonates with EOS, and therefore considered significant risk factors for EOS (P<0.001). Finally, 26 potential clinical risk factors were determined. Conclusion: Neonatal-related risk factors for EOS were birth weight, one-min Apgar score, and prematurity. Maternalrelated risk factors were gestational age and urinary tract infection. Delivery-related risk factors were premature rupture of membranes, chorioamnionitis, and intrapartum fever. [ABSTRACT FROM AUTHOR]

Background: Identifying the challenges of implementing clinical practice guidelines (CPGs) can provide valuable information for decision-makers and health policymakers at the national and local levels. The implementation of CPGs requires the development of strategies to facilitate their use. This research aimed to determine the challenges, barriers and solutions for implementing CPGs from the expert point of view in Bushehr University of Medical Sciences., Methods: This qualitative research uses content analysis conducted in 2022 in southern Iran. In-depth interviews were conducted with the physicians and experts in the health system. Interviewing continued until reaching the saturation level. Altogether, 22 experts were interviewed. The interview guide was used to explore experts' opinions. All the interviews were recorded and then transcribed. Finally, coding and data analysis was done using MAXQDA 2022 software., Results: The analysis revealed 4 main themes and 20 subthemes. The four main themes included challenges related to physicians, medical education, the health system and patients. The most common themes were the lack of sufficient training (related to the medical education system), equipment and infrastructure, and the lack of adaptation of clinical guidelines (related to the health system). The solutions included 4 main themes and 19 subthemes., Conclusion: The most mentioned topic by the experts was training CPGs in medical schools. In Iran's current medical education system, the training of CPGs is not included in the curriculum. It is proposed to reform the medical education system in Iran. In addition, health inequalities such as lack of access to equipment, supplies and insurance in under-resourced areas and disparities in research/training/medical education should be addressed to improve the validity of guidelines., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Mobile technologies are widely used in healthcare. The purpose of this study was to compare the effectiveness and cost-effectiveness of fixed computed tomography (CT) and magnetic resonance imaging (MRI) with the mobile ones., Methods: In this systematic review, PubMed, Cochrane Library, Scopus and CRD database were searched from 1995 to 2015. The data on safety and effectiveness of technologies were extracted from included studies. Because the review showed no significant differences in the performance of mobile CT and MRI compared to the fixed ones, then a cost minimization approach was used to explore the cost-effectiveness of three scenarios., Results: Twenty two articles were included in the review that showed no statistically significant differences in the performance of mobile MRI and CT scan compared to the fixed ones. The cost minimization approach showed that the third scenario based on purchasing a common mobile MRI and CT scan; and using it by two or more hospitals that are in rational distance from each other is associated with the lowest costs, so it is the most cost-effectiveness strategy., Conclusion: The performance of Mobile CT and mobile MRI is comparable to the fixed ones; and using a combined mobile CT and MRI by two or three hospitals is the most cost-effective approach., Competing Interests: Conflict of interest The authors declare that there is no conflict of interests., (Copyright© Iranian Public Health Association & Tehran University of Medical Sciences.)

Background: Injuries and fatalities from road traffic Injuries are global public health concerns, and a major problem in the Iran. This study aimed to explore strategies to control road traffic Injuries (RTI) in Iran., Methods: We conducted a qualitative study to explore possible ways to reduce the occurrence of road traffic Injuries in Iran in 2016. Interviewees were purposively sampled from various sectors due to multidisciplinary nature of RTIs. Participants were mainly representatives from the police, Ministry of Road, Municipal, emergency services and Ministry of Health. Besides, public health authorities, researchers, and university professors were interviewed. We conducted in-depth interviews using generic guides. Data was analyzed using MAXQDA 10 software. Through content analysis, we interpreted core themes relevant to the accomplishment of our study objectives., Results: Themes that emerged from our study include; road traffic management, governance, education, improving accident database, enforcement, driving license restrictions, and construction of pedestrian overpass., Conclusion: This study revealed key informants' views regarding available and affordable solutions to reduce RTIs in Iran. Many applicable strategies are identified in the control of RTIs in Iran. Although some solutions such as highway construction and/or expanding rail transportation have been suggested as effective measures for reducing accident, but they are costly and may not be fully applied in developing countries like Iran.