Background and Aim: Effective management of medical Equipment and Supplies during maritime crises is a critical determinant of healthcare response capacity and the protection of public health in vulnerable communities. This study aimed to identify key challenges, propose solutions, and review contemporary innovations in the supply chain management of medical items in maritime disasters. Methods: This narrative review was conducted in 2024 through searches in Web of Science, Scopus, PubMed, Google Scholar, SID, and Magiran. Searches were performed using relevant keywords without time restrictions. After preliminary screening, eligible articles were selected according to PRISMA principles and analyzed qualitatively. Results: The findings highlighted three major challenges: inadequate stockpiles of essential Supplies, difficulties in distribution and storage under crisis conditions, and lack of inter-organizational coordination. Identified solutions were categorized at three levels: Technological: adoption of blockchain-based tracking systems and artificial intelligence platforms for demand forecasting and inventory management. Organizational: establishment of standardized protocols for warehousing and distribution, and development of continuous training programs for personnel. Inter-organizational: strengthening international cooperation and forming regional coalitions for rapid response. Conclusion: The management of medical Supplies in maritime crises requires an integrated, systematic, and technology-driven approach. Comprehensive preparedness and response planning, investment in emerging technologies, and enhanced international collaboration can substantially improve the resilience of healthcare systems against maritime disasters.

Background: The World Health Organization emphasizes the critical role of medical Equipment in patient care, noting an increasing demand due to population growth and aging. This study explores the factors influencing out-of-pocket (OOP) payments for medical Equipment, examining both households that have made payments and those unable to do so due to financial or geographical limitations. Objectives: The present study aims to explore the factors influencing OOP payments among households that have made payments for medical Equipment and Supplies, as well as those that could not due to financial and geographic constraints. Methods: This cross-sectional study was conducted in two stages, utilizing household budget data from 2023. In the first stage, the Delphi method was employed to reach a consensus among experts on the influencing factors. In the second stage, a double hurdle model was used to assess the impact of these factors on household expenditures. Analyses were conducted using Excel 2019 and Stata 14 software, with a significance level set at 0.05 for all tests. Results: In the third round of the Delphi method, a panel identified 13 factors affecting household OOP expenditures based on a study of 37,883 predominantly urban, male-headed households. Gamma regression indicated that income and health insurance costs slightly increased health expenditures. The double hurdle model revealed that the gender of the household head significantly influenced participation in medical Equipment payments, with female-headed households experiencing a negative impact (B = -0.117, P < 0.05). Conclusions: This study demonstrated that socioeconomic factors such as income, health insurance, gender of the household head, and rural residence significantly affect both the decision to participate in the healthcare market and the level of expenditures on medical Equipment and Supplies. These findings highlight the need for targeted policies to enhance equity in health financing.

BACKGROUND: Medical Equipment plays an important role in the diagnosis, treatment, and medical education, and each year the major share of hospital costs (about 5%–, 15% annually) is allocated to the purchase of medical Equipment. The selection and allocation of medical Equipment should be appropriate and in line with the actual needs of the medical centers, clinical goals, human resources, and the conditions required to ensure safety. The purpose of this study was to study and evaluate current systems of medical Equipment management and identify their strengths and weaknesses in Isfahan educational hospitals in 2018. MATERIALS AND METHODS: This is a descriptive‑, applied research that was done in a cross‑, sectional way in 2018. The statistical population of the research is the authorities of medical Equipment and other persons related to the management of medical Equipment of selected educational hospitals in Isfahan. The data collection tool is a questionnaire. RESULTS: The result of this study was gathered in four areas: medical Equipment management, safety, preventive maintenance, and training. CONCLUSION: According to this study, there is no comprehensive program in hospitals for how to manage medical Equipment, which itself causes the loss of material and Equipment capital of the organization. In most cases, the lack of a system for planning and controlling the amount of inventory and purchasing and maintaining medical Equipment creates many problems, such as the accumulation and depreciation of Equipment or the lack of these facilities in critical situations. In this study, it is suggested initially a scientific control system. Medical Equipment is designed so that the hospital’, s need for Equipment at any time of year and the amount of its Equipment are clear so that it can be easily decided in this field.

Background: Recent studies recognized the smart customer experience as a sustainable competitive advantage. This study aimed to determine factors affecting the smart experience of purchasing health products. Methods: This research was a descriptive survey. The statistical population of the first phase consisted of16 People, who were experts in the field of shopping malls with intensity and snowball. The statistical population of the second phase was the customers of shopping malls whose managers were interviewed, which included 298 individuals. Data were collected with a standard questionnaire and were determined by open coding, axial coding, and selective coding in ATLAS. ti software. In phase two, LISREL software was used. Results: The coefficient of the exogenous variable of customer knowledge (0. 83), with T = 0. 01, perceived quality (0. 22), with T = 8. 83, sales promotion policies (47. 0), with T = 5. 08 on the smart customer experience was significant, while the direct path coefficient of the exogenous variable of the store environment on the smart customer experience (-0. 05), with T =-0. 20, was insignificant. The effect of smart customer experience on customer satisfaction (0. 52), with T =-0. 87 and on brand equity (0. 22), with T = 0. 08, was significant. The effect of customer experience on word of mouth (0. 50), with T = 8. 83 at P <0. 05, was negative and insignificant. Conclusion: It is essential to create a smart experience for knowledgeable customers to choose between competing companies that provide services with different levels from poor to excellent.

Background and Aim: Quality of services in hospitals should be continuously evaluated in terms of structure, process, and outcome. The purpose of this study was to compare patient satisfaction, physical space and medical Equipment between governmental and privative hospitals in Qom, Iran.Material and Method: In this descriptive-analytical study, 500 patients from selected Qom hospitals were recruited based on stratified random sampling. Data were collected by patient satisfaction form and assessment check lists of physical atmosphere and medical Equipments. Data were analyzed by SPSS, version 11.5. The authors declare that they have no conflict of interests.Results: Patient satisfaction in inpatient and emergency wards of governmental hospitals were, respectively %69 and %71/14. Patient satisfaction in inpatient and emergency wards of privative hospitals were %80 and %78, respectively. General and emergency wards of governmental hospitals were somewhat equipped with medical Equipments. Physical atmosphere, in terms of facilities and the building, was acceptable in general and relatively acceptable in emergency wards of governmental hospitals. This atmosphere was relatively acceptable for both general and emergency wards of privative hospitals.Conclusion: Satisfaction among patients was relatively good. It is possible to improve satisfaction through increasing the visiting time, improving quality of lavatories, and modifying personnel interactions with the patients. Also, promoting medical Equipments and physical space can improve the situation according to organizational goals.

Introduction: Mammography is the cornerstone of breast cancer screening and early detection. This study was conducted to investigate the status of digital mammography facilities in Isfahan City, Iran, in terms of Equipment and physical-quality requirements, to offer solutions to improve the current situation. Methods: In this descriptive study, all 15 active digital mammography facilities (DMF) in Isfahan City were visited by a medical physicist. Data were collected using a researcher-made checklist including 40 items and topics of calibration, general condition of Equipment, dosimetry, quality of images, and printers. Instructions and quality control reports of devices were evaluated and compared with the guidelines of Atomic Energy Organization of Iran (AEOI). Results: All the DMFs passed the standards of AEOI. The most important problem was that in majority of DMFs, the diagnosis room was not equipped with standard medical monitors or these monitors were not utilized. The differences between evaluated resolution measures of the device with results reported by quality control companies, lack of attention to expiration dates of received films by operator, lack of phantom for periodic calibration by operator, lack of attention to mean glandular dose and surface dose indicator, and printing four images on one film were the other observed problems. Conclusion: It is recommended to pay more attention to installation and operational standards of the Equipment and conduct periodic surveys of DMFs. Moreover, equipping the centers with the diagnostic rooms is essential. Although all the medical imaging centers are obliged to conduct annual quality control tests on their Equipment by qualified companies, investigating DMFs revealed that these quality control tests are not sufficient.

Background: Medical Equipment plays an important role in community health in critical situations such as the COVID-19 pandemic. Objectives: This study was conducted to determine and identify the factors affecting the management of medical Equipment in crisis situations. Methods: The present study was conducted as a mixed qualitative and quantitative study in 2020. In the qualitative section using the targeted sampling method, ten medical Equipment management experts and in the quantitative section using available sampling method, 200 managers and experts active in this field from hospitals and related companies were selected for this study. The qualitative part was conducted in two stages of reviewing texts and interviewing experts and in the quantitative part we evaluated the validity of the structure and the reliability of the questionnaire. Results: The validity of the structure was assessed using heuristic factor analysis. KMO index was 0. 971 and Bartlett test was significant (P < 0. 05). All six approved components in the content validity section, based on the mathematical model, explain and determine more than 77% of the variance related to the purpose of the study which is the management of medical Equipment in COVID-19 pandemic situations. Conclusion: The results showed that the instructions, management, information technology, Equipment, manpower, and physical space components had the highest and lowest priority in the management of medical Equipment in critical situations, respectively. In this regard, appropriate instructions should be provided first and localized protocols should be communicated from the same source at the same time.

Regardless of the clinical setting, a good back-up represents one of the most important conditions to ensure guide wire and balloon advancement and stent delivery. As a “mother and child” system, the GuideLiner catheter (Vascular Solutions Inc., Minneapolis, MN, USA) provides an extension to the guide catheter with better coaxial alignment and stability. We report two didactic cases showing the usefulness of the GuideLiner device in everyday catheterization laboratory practice. The first case was a primary percutaneous coronary intervention (PCI) in a 71-year-old diabetic man admitted for inferior STelevation myocardial infarction, related to tight proximal stenosis in a dominant tortuous and calcified left circumflex. The second case was an elective PCI in a 76-year-old man admitted for stable angina (Canadian Cardiovascular Society [CCS] class III), related to focal intra-stent restenosis of a saphenous venous graft to the left anterior descending. In both cases, the GuideLiner catheter provided a good back-up insuring the success of PCI and drug-eluting stents implantation, with a good in-hospital outcome.

Introduction: Legionella species are ubiquitous in both natural and man - made water systems. These organisms spread by the inhalation or aspiration of aerosolized organisms arising from water sources such as: rivers, hot springs, air conditioning systems, cooling towers and pools. Objective: In order to isolate and identify Legionella in therapeutic Equipments and the other water sources, in Ahwaz city (Iran). Materials and Methods: 210 samples collected from different sources, such as neonatal incubators, dental units, water bathes, cooling towers, drinking water reservoirs, hot water taps or showers and little pools in parks , were examined. Sediment of water samples were inoculated onto selective and non-selective media such as BCYE, BMPA and MWY, before and after acidic treatment with Kcl- Hcl buffer. Isolated colonies which were suspicious of Legionella, were examined by different biochemical tests. Results: This study resulted in isolation of 14 strains (6.6%) of Legionella, which 9 strains (64.3%) were identified as Legionella pneumophila and 5 strains (35.7%) as Legionella Spp by biochemical tests. The greatest contaminated sources were dental units (with 19 %) and the lowest ones (2.9%) were hot water taps and showers. 2 strains of Legionella were isolated from each of examined sources, such as water bathes, hospital cooling towers and neonatal incubators. Conclusion: The results of this study showed that therapeutic Equipments and different water sources such as drinking water reservoirs, were contaminated by Legionella and so, for recognition of the patients with Legionnaires disease and determination of different serogroups of Legionella, further epidemiological investigations in this regard are recommended.