How Do Hospitals Organize Diabetes Services? A Comparative Study

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.

Training needs assessment of hospital CEOs in a developing country: the example of Iran

BACKGROUND

It is essential to identify the necessary competencies of hospital CEOs in order to improve the quality and efficiency of services they provide. Expert leadership skills and competencies can have a significant impact on the success of an organization, benefiting both patients and staff. This study aimed to assess the competencies and training needs of hospital CEOs in Iran public hospitals.

METHODS

We conducted this cross-sectional analytical study through a self-assessment questionnaire, which was a web-based platform developed by the WHO country office in Iran, between July 2018 and September 2018. The questionnaire was completed by 180 hospital CEOs and included a core set of 81 items based on Assessing the Competency of Hospital CEO. These items were categorized into five superordinate categories: leadership, personality and quality of individual behavior, knowledge and business skills, social responsibility, and healthcare environment. In addition, we conducted focus groups with 30 hospital CEOs, supervisor assessments with 10 hospital managers, and interviews with 10 supervisors.

RESULTS

Of the 180 questionnaires distributed, 78% were returned, and most respondents were medical specialists. The need for leadership competencies such as individual behavior skills and change management received the highest priority. Most respondents required training in management skills, including financial management, governance, strategic thinking, quality improvement, and disaster management.

CONCLUSION

Providing needs-based education is crucial, especially in developing countries. In this study, leadership and strategic thinking were found to be the most needed competencies among hospital CEOs in Iran. These findings serve as reference points for developing countries with similar backgrounds and healthcare environments as Iran.

Response Time and Causes of Delay in Prehospital Emergency Missions in Mashhad, 2015

Background: The response time is considered as one of the most important criteria for the quality of given care to the injured. This research aimed to investigate the frequency and causes of prehospital emergency delays in the 115 emergency center, in city of Mashhad, in 2015.

Methods: In this cross-sectional study, 21,142 missions performed in 2015 were investigated, from among which 640 missions with delays in systematic sampling were recognized. For data analysis purposes, descriptive statistics (frequency, mean and SD) in Excel 2013 software was implemented.

Results: Nearly 60% of the injured were men, 23% women, and the gender of 17% was not recorded in their profiles. The mean age of the injured was 29.8+15.9 years and 30% of the injured were in the age group of 16 to 25. The mean response time was 9:01+2:46. The most prevalent causes related to missions out of the operational zone (29.3%) and the second cause has been related to traffic groups (24.2%).

Conclusion: Establishing new bases and completing the number of ambulances and human recourses, intervention in traffic causing factors, and training the public about emergency cases can be effective in reducing the number of missions and the pace and quality of services provided to the injured.

New financial management system for Iran public health sector: A qualitative study

BACKGROUND

Financial management system acts as a driving force and the first important principle of health sector reform. This study aimed to prepare a framework for new financial management system in Iran health sector.

MATERIALS AND METHODS

This qualitative study was conducted by content analysis approach and 15 key informant participants selected through purposive sampling consisted of three minsters of Ministry of Health and Medical Education (MOHME), three vice-chancellors in the Center of Resource Development and Management, Two members of the Health Assembly of the Islamic Consultative, four Medical Sciences university's presidents, and three managers in Budgeting and performance Monitoring Center of MOHME in 2017. Data were collected through semi-structured interviews and they were analyzed using Atlas T₆ software.

RESULTS

Six main themes were emerged as follow: "legal reform," "removing barriers to set up accrual accounting," "cost price calculation," "operational planning and budgeting," "human resources' organization, recruitment, and moderation," and "financial system output utilization (management accounting techniques) as the base for evidence-based policymaking and decision-making practices."

CONCLUSION

Any efforts for improving the current situation and reducing of mentioned limitations could be useful in providing required space for future phases of reforms and calculation of unit cost, operational budgeting, and management of cost and productivity. This can be achieved through an integrated system of recording and producing standard and accrual financial information. Furthermore, changing the accounting process and the financial system that complies with one single encoding in the country is a key issue.

Quality assessment of services provided by health centers in Mashhad, Iran: SERVQUAL versus HEALTHQUAL scales

Background

Primary health care is the entry point to the health-care system and regarded as an essential step to achieving universal health coverage. The present study aimed at evaluating the quality of health-care services provided in health centers in Mashhad, Iran.

Methods

This was a cross-sectional study implemented among 200 health service users who were referring to four health centers in Mashhad during January to June 2019. The quality of services in health centers was evaluated with the SERVQUAL and HEALTHQUAL models. Data was analyzed by employing paired t-test and independent sample t-test using SPSS version 16 software. The Levene test was used for examining the equality of variance (homogeneity). Significance level of all the tests was considered when p ≤ 0.05.

Results

According to the results of SERVQUAL questionnaire, the average scores of health service users’ expectations and perceptions were 4.97 and 3.26, respectively, and the quality gap in the provided services was equal to − 1.7. Based on HEALTHQUAL questionnaire, the average scores of health service users’ perception and expectations were 4.72 and 3.25, respectively, and the quality gap in the provided services was equal to − 1.16. Empathy was the highest quality dimension (− 2.019) based on SERVQUAL model, and efficiency dimension was the highest based on HEALTHQUAL model (− 1.761).

Conclusions

The findings of the current study showed a negative gap between the service users’ expectations and perceptions in both models. Therefore, the results of this study helps the health managers and policymakers to plan effective interventions for improving the provided services emphasizing the dimensions with the wider gaps.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06405-4.

Investigating the effect of music on labor pain and progress in the active stage of first labor

DESIGN AND PURPOSE: The purpose of this study is to investigate the effects of music-therapy on labor pain and progress in parturient primipara. Music-therapy during labor increases tolerance to pain; decreasing anxiety, it increases paturition and uterus activity and shorten labor duration.

SUBJECTS AND METHODS

The subjects of this research were 30 women, selected voluntarily and they have been put in two experimental and control group. This research has been conducted in the form of pre-test and post-test design. The experimental group listened to a relaxing music for 30 minutes in each hour for a two-hour period a nd the control group was not exposed to music during this period. For the purpose of gathering data in both groups, the pain scales (verbal, numeric and visual) was used to measure pain. The independent variable in this research is relaxing music and the dependent variables are the pain level and delivery progress.

FINDINGS

The independent t for sensations of pain in the experimental and control group before intervention has been (p = 0.875) 0.601 in numeric and visual pain and (p < 0.01) 2.92 in verbal pain, and one hour after intervention, it has been (p < 0.0001) 8.527 in visual and numeric pain and (p < 0.0001) 11.824 in verbal pain. Also, the equal value of independent t for the duration of delivery in control group before and after intervention shows that music has not had any effect on the rate of serotonin.

CONCLUSION

The results of statistical analysis show the effect of music on the decrease of sensation of pain in the experimental group as compared with the control group.

Excited state electric dipole moment of nile blue and brilliant cresyl blue: a comparative study

A solvatochromic study on the photophysical properties of two cationic oxazine dyes (brilliant cresyl blue and nile blue) was carried out. The electronic absorption and emission spectra of the dyes were recorded in various organic solvents with different polarity. The ground and the excited state dipole moments of the dyes were estimated from solvatochromic shift method. The solvent dependent spectral shifts in absorption and fluorescence spectra were analyzed by the Katritzky and Kamlet-Taft multi-parameter scales. This work is characterized by detailed quantitative studies on the nature and extent of solvent-solute interactions.

A comparative study on the aggregate formation of two oxazine dyes in aqueous and aqueous urea solutions

The visible absorption spectra of two oxazine dyes, brilliant cresyl blue and nile blue, in aqueous and aqueous urea solutions (0.01-1 M) were studied as a function of the dye concentration. Due to structural similarity of the investigated dyes, their spectral features were compared. The dimerization behavior of the dyes in water with or without urea was analyzed in terms of monomer-dimer equilibrium. The nature and structure of the interacting pairs for these dyes were discussed using the exciton theory. The dimerization constant values of the dyes in aqueous and aqueous urea solutions were calculated. For both the dyes in aqueous urea solutions, a reduction in dimer formation was observed. The excitonic parameters were compared with those of oxazine-1, which is structurally similar to the investigated dyes.