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Most patients with diabetes will present to hospital for a reason not directly related to their diabetes. When a person with diabetes is not cared for properly, hospitalization can become complicated and lead to worse consequences for the patient. In fact, it is important to know how to manage a diabetic patient while in hospital. Therefore, a special organization is needed in hospitals for adaptation to chronic diseases such as diabetes. This study intends to help hospital adaptation to the special needs of diabetic patients by identifying patterns of care delivery in selected countries. This comparative study was performed in 2021. The data collection was conducted by searching in PubMed, Web of Knowledge, Scopus, Science Direct, Springer, Proquest, and also the websites of the selected countries hospitals. Based on the sampling method, three countries, Turkey, United Kingdom, and the United States, were selected from the countries with eligibility. However, during the study, according to the good practices about special diabetic care of countries such as Australia and Denmark, they were also examined. In this review study, we organized and compared the effective measures taken in selected countries in relation to the management of these patients in the hospital, focusing on the dimensions of service package, human resource, process, structure, equipment/technology, and information system required by diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Psychosomatic medicine is a systemic model of care based on the biopsychosocial model in which the physical, emotional, and social aspects of clinical conditions are considered. Family Medicine (FM) and psychosomatic medicine have many similarities in their community-based and family-based approaches. Studies have shown the necessity and effectiveness of psychosomatic medicine training for general practitioners (GPs) and family physicians. Methods: We designed a psychosomatic course for FM residents. This semi-experimental study was performed at Isfahan University of Medical Sciences, Iran, in 2018. The target population included 11 FM residents. A compact 20-hour module (4 days, 5 hours each) was designed for the training. The Knowledge and Practice of Psychosomatic Medicine Questionnaire (self-administered) for the concepts and skills of psychosomatic medicine was filled out by each of the FM residents before and after the intervention. For each resident, caring for patients was monitored and a Performance Appraisal Checklist was completed by the supervisor. Finally, the questionnaire scores before and after the intervention were compared using paired t-test. Results: The total knowledge and practice score increased significantly after the intervention (258.5 ± 40.3 vs. 174.6 ± 62.9; P = 0.002). There was also a significant increase in the mean psychosomatic care performance scores after the intervention (28.65 ± 3.52) compared with baseline (21.18 ± 5.94) (P = 0.001). Conclusion: This study showed that basic psychosomatic care training for family physician residents, even in short courses, can have a positive effect on their clinical knowledge and performance. [ABSTRACT FROM AUTHOR]

The assessment of staff resilience at work and the following assessment of the effectiveness of interventions aimed at increasing the resilience of the employees requires valid and reliable instruments. The purpose of this systematic review was assessing the psychometric properties of workplace resilience measurement scales. Four electronic databases including PUBMED, Web of Science, SCOPUS, and Google Scholar were searched using keyword "resilience" combined with "instruments," "tool," "inventory," "questionnaire," "scale," "workplace," "staff," and "occupational" with Boolean operators OR and AND. Two of the authors, independently, assessed the process of data gathering and the quality of psychometric properties of the tools using Terwee et al. (2007) study. We found 11 instruments, none of which covered all aspects of psychometric properties of the Terwee criteria. Because of the recent development of many of the staff resilience assessment instruments, it seems they need more time to be assessed properly. Besides, due to the different nature of different occupations, and differing cultures and backgrounds, there is a need for the development of the staff resilience at workplace assessment instruments convenient for the local needs. [ABSTRACT FROM AUTHOR]

Background: Methodology of Failure Mode and Effects Analysis (FMEA) is known as an important risk assessment tool and accreditation requirement by many organizations. For prioritizing failures, the index of "risk priority number (RPN)" is used, especially for its ease and subjective evaluations of occurrence, the severity and the detectability of each failure. In this study, we have tried to apply FMEA model more compatible with health-care systems by redefining RPN index to be closer to reality. Methods: We used a quantitative and qualitative approach in this research. In the qualitative domain, focused groups discussion was used to collect data. A quantitative approach was used to calculate RPN score. Results: We have studied patient's journey in surgery ward from holding area to the operating room. The highest priority failures determined based on (1) defining inclusion criteria as severity of incident (clinical effect, claim consequence, waste of time and financial loss), occurrence of incident (time - unit occurrence and degree of exposure to risk) and preventability (degree of preventability and defensive barriers) then, (2) risks priority criteria quantified by using RPN index (361 for the highest rate failure). The ability of improved RPN scores reassessed by root cause analysis showed some variations. Conclusions: We concluded that standard criteria should be developed inconsistent with clinical linguistic and special scientific fields. Therefore, cooperation and partnership of technical and clinical groups are necessary to modify these models. [ABSTRACT FROM AUTHOR]

Background and Aim: Transforming government hospitals into autonomous units improved hospitals. This study was performed to evaluate the responsiveness of board of trustees hospital according to the world bank’s organizational reform model (Preker Model) in isfahan city. Materials and Methods: The study was a qualitative research method. In this research, depth and semi-structured interviews were carried out and purposive sampling was used. The study population were top managers of Amin and Alzahra hospitals. Sampling was started with the first participant until saturated level of information, participants completed the 8 cases. Results: According to interviews, the current role and contribution of non-university institutions (e.g. municipalities representatives) in hospital board of trustees is neither bold nor transparent. These hospitals can address minimum changes in their mechanisms of accountability after developing board of trustees. Conclusion: It is rational for hospitals as they undergo organizational reform and developing board of trustees, to have more rights for decision making. Further more, their accountability mechanism should change accordingly. [ABSTRACT FROM AUTHOR]

Introduction: Behavioral science experts believe that all entities capable of stimulating a person can be addictive; and whenever a habit changes into an obligation, it can be considered as an addiction. Researchers also believe that there are a number of similarities as well as some differences between drug addiction and behavioral addiction diagnostic symptoms. The purpose of this study is to consider different approaches in this field. Methods: This is a descriptive research using content analysis method. First, differences and similarities of various perspectives on addiction and addiction behavior in different substances were obtained, thereafter, the data was coded and categorized, subjects were discussed and major issues were extracted. Results: Behavioral addiction such as internet addiction is similar to drug addiction except that in the former, the individual is not addicted to a substance but the behavior or the feeling brought about by the relevant action. In addition, the physical signs of drug addiction, are absent in behavioral addiction. Others have stated that behaviorally addicted individuals have certain symptoms and will undergo the same consequences brought about by addiction to alcohol and drugs as well as other obsessive behaviors. Conclusion: Similar to substance abuse prevention, programs aimed at addicted individuals and specialized training can educate adolescents about the warning signs of online addiction, in order to assist the early detection of this disorder. For prevention of behavioral addiction (such as internet addiction) authorities, cultural institutions and parents should monitor the use of internet and teach to the adolescent and children, the useful and appropriate methods of internet use. [ABSTRACT FROM AUTHOR]

Objectives: Infected hospital wastes are among hazardous wastes, and special treatment methods are needed for their disposal. Having information about present status of medical waste management systems is of great importance in finding weak, and for future planning. Such studies have not been done for most of the hospitals in Iran. Methods: This paper reports the results of a study on the present status of medical waste management in Isfahan hospitals. A ten page researcher made questionnaire was used to collect data in terms of collection, transportation, segregation, treatment and disposal. For assessment of autoclaves, standard tests including TST (Time, Steam, and Temperature) strip test and spore tests were used. Samples were made of stack gases of incinerators. Quantity and composition of hospital wastes in Isfahan were also measured manually. Results: Of all wastes in selected hospitals, 40% were infected wastes (1.59 kg/day/bed), which is 15 to 20% higher than World Health Organization (WHO) standards. TST and Spore test results were negative in all samples. Stack gases analysis showed high concentration of CO in some samples. Besides, the combustion efficiency in some samples is less than 99.5%, which is the standard criterion in Iran. Conclusions: This study may create awareness regarding the magnitude of the problem of waste management in hospitals of Isfahan and may stimulate interests for systematic control efforts for hospital waste disposal. Hospital waste management cannot succeed without documented plans, certain equipment, defined staff trainings, and periodic evaluations. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the impact of internet addiction on some psychiatric symptoms among university students. Methods: This cross-sectional study was conducted among 250 students selected via quota sampling from universities in Isfahan, Iran. Participants completed demographic questionnaire, Young Diagnostic Questionnaire, Internet Addiction Test and Symptom Checklist-90-Revision (SCL-90-R). Finally, the means of psychiatric symptoms of internet addicted and non-addicted subjects were compared. Also, t-test and multivariate analysis of covariance were used through SPSS16 software for data analysis. Results: The mean±standard deviation (SD) of psychiatric symptoms such as somatization, obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, aggression (hostility), phobic anxiety, paranoid ideation and psychoticism in the addicted group were 11.27 ± 6.66, 14.05 ± 7.91, 10.5 ± 6.20, 15.61 ± 8.88, 10.77 ± 5.52, 6.77 ± 4.88, 6.05 ± 4.47, 7.61 ± 4.28, and 9.66 ± 6.87, respectively, and in the non-addicted group were 6.99 ± 6.42, 7.49 ± 5.23, 5.46 ± 4.95, 9.27 ± 7.92, 6.35 ± 6.69, 3.57 ± 3.35, 2.41 ± 2.79, 5.47 ± 4.1, and 5.29 ± 4.95, respectively. There were significant differences between the means of psychiatric symptoms in all SCL-90-R subscales and Global Severity Index, Positive Symptom Distress Index, Positive Symptom Total in the addicted and non-addicted individuals (P<0.05). Also, internet addiction (with controlling sex variable) seemed to affect psychiatric symptoms. Conclusion: Psychiatrists and psychologists involved in the field of mental health need to be well informed about mental problems due to internet addiction, such as anxiety, depression, aggression, and job and educational dissatisfaction. [ABSTRACT FROM AUTHOR]

Introduction: Health system management is regarded a chief duty and skill of health care providers. However, medical students do not receive enough training for it. The first national Olympiad for students of medical sciences was designed to motivate students for acquiring managerial skills, improve reasoning and problem solving skills, and also propagate team working in students in an excitingly competitive and joyful atmosphere. Methods: Designing a model for the olympiad included four phases: building up a framework for designing the exam questions, determining topics of the exam, setting the exam questions and administering it, and finally judging. In summer 2009 the first national olympiad for the students of medical sciences on reasoning & decision making in health system management was held in Isfahan University of Medical Sciences. The first two days of the five-day-long open source olympiad were spent on individual competition. The following three days were devoted to group competitions. Six groups of three Students competed in this part. Results: After 19 months, with the help of a large group of university teachers with related specialties, a framework for the selection of the exam questions was built up. The themes of the Olympiad were decided to be Health policy and health economics. The topic for group competition phase was current problems in implementation of the family physician project in Iran. In the individual competition phase, the students were to answer 194 questions and in the group phase they were asked 3 open-ended questions. 106 students studying different medical fields nationwide participated in the event; 71 students (66.98%) were girls. most participants were students of medicine (33 students) and others were students of nursing (26 students), health management (20 students), and other fields of study (27 students). Conclusion: Considering the significance of medical students' awareness of heath system management and the importance of improving reasoning and decision making abilities in them, holding such examinations could facilitate the achievement of these objectives. [ABSTRACT FROM AUTHOR]