Medical school department chair performance improvement: A qualitative study

INTRODUCTION

In medical education, department chairs should play a significant role. The present qualitative study was conducted to identify factors that influence the performance improvement of department chairs at medical schools in Iran.

METHODS

The study was conducted in Iran in 2022 and used a thematic analysis method. Using a purposeful sampling method, 20 participants were invited to participate, including medical school deans and department chairs. Focus group discussion (FGD) was used for qualitative data gathering. Braun and Clarke's thematic analysis was used to analyze data.

RESULTS

There were 18 males and 2 females among the participants. The mean age of the participants was 45±4 years. Five overarching themes were formulated: human resource management, organizational behavior management, performance support system, leadership, and financial resources. Also, nine subthemes emerged, including performance evaluation, job and work design, educational and non-educational support, motivational efforts, organization culture, organizational knowledge management, planning for change, and financing.

CONCLUSIONS

In this study, we found factors influencing DC performance improvement. Department chairs' effective performance may have a positive impact on department operations, processes, or outcomes.

Mapping Global Research in Emergency Medicine; a Bibliometric Analysis of Documents Indexed in the Web of Science Database

Introduction

Emergency medicine is a relatively new and rapidly growing specialty, and its research monitoring is important for future policies. This study aimed to analyze the published literature related to emergency medicine, to create a documented research perspective for this field.

Methods

This research is a bibliometric study that analyzes the research outputs of the subject area of emergency medicine indexed in the Web of Science database from the beginning to 2023. VOSviewer software was used to visualize and predict the trends in research on the topic.

Results

The findings showed that the University of California, The Journal of Neurotrauma and Brain Injury, Elsevier, and the USA were the most prolific units in the cycle of scientific productions in the field of emergency medicine. Results showed that most scientific productions in this field fall into 6 clusters: psychological impressions, injuries caused by traumatic events and the effects of traumas on children, pathophysiology and nervous system issues and related diseases, complications of traumatic events and injuries, biomechanics and complications caused by sports injuries, and consciousness.

Conclusion

In addition to interventions and clinical complications, research in the field of emergency medicine has also focused on psychological structures. So, based on various measurement indicators, the subjects of this field have been the focus of researchers' attention.

Temporal and spatial pattern of dust storms, their polycyclic aromatic hydrocarbons, and human health risk assessment in the dustiest region of the world

This study evaluated the concentration and health risks of polycyclic aromatic hydrocarbons (PAHs) in Abadan City under 4 different climatic conditions: normal days, dusty days, dust with northwesterly winds, and dust with southeasterly winds. It also determined the sources of aromatics and discussed the relationship between meteorological parameters and PAH concentrations. The spatiotemporal distribution of dust in the area was determined using the HYSPLIT (hybrid single-particle Lagrangian integrated trajectory) back trajectory model, moderate resolution imaging spectroradiometer (MODIS) images. For this purpose, sampling was performed for 70 days using an Omni device. The concentrations of 16 PAHs (USEPA) ranged from 46.22 to 90.96 ng/m³. The highest concentration of high molecular weight (HMW) PAHs was 4-6 rings, of which 4 rings were predominant in all samples. PAH sources were identified using diagnostic ratios and principal component analysis (PCA), and it was shown that PAHs mainly originate from a mixture of sources, including vehicular emissions, petrol emissions, and traffic. Wind speed was negatively correlated with dust, except on dusty days. This result indicates a decrease in PAH concentrations when wind speed increases. On the other hand, the dust correlation with PAH was positive on normal days, but a negative correlation was observed on dusty days. This result was due to the lower concentration of PAHs from natural resources (such as dust source areas) vs. human resources (such as traffic and industry). PAH health risk assessment in Abadan City showed that the risk of carcinogenesis was higher on normal days and through skin contact. The probability of incremental lifetime cancer risk (ILCR) in all sampling conditions was potential in terms of carcinogenic risk (10^-4-10^-6). As a critical risk factor, relevant authorities should prevent, control, and reduce it.

Design, development, and evaluation of a surveillance system for suicidal behaviors in Iran

BACKGROUND

Suicide is a serious cause of morbidity and mortality in Iran and worldwide. Although several organizations gather information on suicide and suicide attempts, there is substantial misperception regarding the description of the phenomenon. This study proposes the minimum data set (MDS) for suicidal behaviors surveillance.

METHODS

A literature review was first conducted to achieve a thorough overview of suicide-related items and map the existing evidence supporting the development of the MDS. The data items included in the literature review were then analyzed using a two-round Delphi technique with content validation by an expert panel. The suicidal behaviors surveillance system was then established based on the confirmed MDS, and ultimately, its performance was assessed by involving the end-users.

RESULTS

The panel of experts consisted of 50 experts who participated in the Delphi phase and validity content review. Of these, 46% were men, and their mean age and average work experience were (36.4, SD ± 6.4) and (12.32, SD ± 5.2) years, respectively. The final MDS platform of our study contained 108 items classified into eight main categories. A web-based system with a modular and layered architecture was developed based on the derived MDS.

CONCLUSION

The developed system provides a framework for recording suicidal behaviors' data. The integration of multiple suicide-related information systems at the regional and national levels makes it possible to assess the long-term outcomes and evolutions of suicide prevention interventions.

Corrigendum to "The relationship between knowledge of leadership and knowledge management practices in the food industry in Kurdistan province, Iran" [Data Brief 15 (2017) 155-159]

[This corrects the article DOI: 10.1016/j.dib.2017.09.031.].

Serum Proteomic Study of Women With Obsessive-Compulsive Disorder, Washing Subtype

Introduction

Many genetic studies are conducted on Obsessive-Compulsive Disorder (OCD). however, a high-throughput examination of proteome profile of this severe disease has not been performed yet.

Methods

Here, the proteomic study of OCD patients' serum samples was conducted by the application of Two-Dimensional Electrophoresis (2DE) followed by Mass Spectrometry (MALDI-TOF-TOF).

Results

A total of 240 protein spots were detected and among them, five significant differentially expressed protein spots with the fold change of ≥1.5 were considered for further evaluations. These proteins include IGKC, GC, HPX, and two isoforms of HP. While IGKC and HP show down-regulation, GC and HPX indicate up-regulation. Moreover, a validation study of overall HP levels in patients' serum via nephelometric quantification confirmed the lower levels of this protein in the serum of OCD patients. Additionally, enrichment analysis and validation test revealed that inflammation is one of most dominant processes in OCD.

Conclusion

It is suggested that these candidate proteins and their underlying processes (especially, inflammation) may be linked to OCD pathophysiology and can promise a clinical use after extensive validation studies.

Health Concerns of Various Nanoparticles: A Review of Their in Vitro and in Vivo Toxicity

Nanoparticles (NPs) are currently used in diagnosis and treatment of many human diseases, including autoimmune diseases and cancer. However, cytotoxic effects of NPs on normal cells and living organs is a severe limiting factor that hinders their use in clinic. In addition, diversity of NPs and their physico-chemical properties, including particle size, shape, surface area, dispersity and protein corona effects are considered as key factors that have a crucial impact on their safe or toxicological behaviors. Current studies on toxic effects of NPs are aimed to identify the targets and mechanisms of their side effects, with a focus on elucidating the patterns of NP transport, accumulation, degradation, and elimination, in both in vitro and in vitro models. NPs can enter the body through inhalation, skin and digestive routes. Consequently, there is a need for reliable information about effects of NPs on various organs in order to reveal their efficacy and impact on health. This review covers the existing knowledge base on the subject that hopefully prepares us better to address these challenges.

Protein-Protein Interaction Analysis of Common Top Genes in Obsessive-Compulsive Disorder (OCD) and Schizophrenia: Towards New Drug Approach Obsessive-Compulsive disorder (OCD) and Schizophrenia Comorbidity Gene Analysis

Comorbidty is common among psychiatric disorders including obsessive-compulsive disorder and schizophrenia with a high rate. Many studies suggested that the disorders may have same etiological bases. In this regard, shared pathways of glutamate, dopaminergic, and serotonin are the known ones. Here, the common significant genes are examined to understand the possible molecular origin of the disorders in terms of sequence and functional features. Exploring the underling mechanisms of OCD and schizophrenia is important to achieve a better treatment options. Methods of Cytoscape software following R statistical software were applied for this purpose. Needleman-Wunsch global alignment algorithm was used to determine pair-wise similarities followed by clustering methods, AGNES and PAM in R statistical programming software. The results indicate that SLC1A1, DRD2, DRD4, BDNF, ESR1, CDH2, GRIN2B, TNFa, GABBR1, and OLIG2 are significantly common for the two disorders and PPI network analysis showed the important key genes in the interaction profile. ESR1 (estrogen receptor α) as a key hub-bottleneck gene regulates many underling mechanisms of the brain. Application of global alignments indicates some of the genes with sequence similarities also elucidate similar biological terms.

The relationship between knowledge of leadership and knowledge management practices in the food industry in Kurdistan province, Iran

The aim of this study was to identify the relationship between the knowledge of leadership and knowledge management practices. This research strategy, in terms of quantity, procedure and obtain information, is descriptive and correlational. Statistical population, consist of all employees of a food industry in Kurdistan province of Iran, who were engaged in 2016 and their total number is about 1800 people. 316 employees in the Kurdistan food industry (Kurdistan FI) were selected, using Cochran formula. Non-random method and valid questions (standard) for measurement of the data are used. Reliability and validity were confirmed. Statistical analysis of the data was carried out, using SPSS 16. The statistical analysis of collected data showed the relationship between knowledge-oriented of leadership and knowledge management activities as mediator variables. The results of the data and test hypotheses suggest that knowledge management activities play an important role in the functioning of product innovation and the results showed that the activities of Knowledge Management (knowledge transfer, storage knowledge, application of knowledge, creation of knowledge) on performance of product innovation.

Psychometrics of the Instrument Measuring Beliefs Related to Drug Abuse among Iranian College Students

Background:

Researchers in the field of drug abuse need standard instruments in order to investigate the underlying factors behind the inclination to use drugs in different groups of society so that they could be able to design preventive interventions based on those instruments. The aim of this study is psychometrics of the questionnaire of the beliefs related to drug abuse among Iranian male medical college students.

Methods:

This cross-sectional study was done on 425 male students who were randomly selected to participate voluntarily in the study conducted in two medical universities in Iran. The studied constructs included attitude, outcome expectation, outcome expectancies, self-control and subjective norms. Data were analyzed by SPSS software (ver. 21.0) and Amos software (ver. 21.0).

Results:

All of the loads of the exploratory factorial analysis were larger than 0.4. The calculated Kaiser–Meyer–Olkin (KMO) value was 0.906. Overall, five factors under investigation accounted for 61.15 per cent of the variance in the hypothesized model. Cronbach’s alpha for the measured constructs including attitude, outcome expectation, outcome expectancies, self-control and subjective norms were 0.92, 0.90, 0.91, 0.81 and 0.73, respectively.

Conclusion:

The investigated questionnaire is adequately reliable and valid for measurement of the constructs of attitude, outcome expectation, outcome expectancies, self-control and subjective norms for prediction of drug abuse among Iranian male medical college students.

The anti-candidal activity of Satureja khuzistanica ethanol extract against clinical isolates of C. albicans

Candida albicans is the common cause of some infectious diseases such as vaginal candidiasis or candidemia. Due to the emergence of drug resistant isolates of C. albicans, finding a new anti-Candida agent is a new strategy for current treatments. This study evaluated the anti-candidal activity of Satureja khuzistanica ethanol extract against clinical isolates of C. albicans. S. khuzistanica ethanol extract from aerial parts of plant at full flowering stage was evaluated against 30 clinical isolates and two ATCC reference strains of C. albicans by disc diffusion and micro-broth dilution assay. Also, in this study we evaluated the synergistic effects of amphotericin B, clotrimazole and ketoconazole with S. khuzistanica ethanol extract. The means of MIC and MFC of S. khuzistanica ethanol extract against clinical isolates were 299.4 and 722.6 (μg/mL), respectively. S. khuzistanica ethanol extract increased the anti-candidal effect of amphotericin B and ketoconazole, while it had no synergistic effect on clotrimazole against clinical isolates of C. albicans. Therefore, S. khuzistanica ethanol extract can be introduced as a new source of anti-candidal agent against clinical isolates of C. albicans.

Effects of piroxicam administration on pregnancy outcome in intrauterine insemination (IUI) cycles: a randomized clinical trial

BACKGROUND

Uterus contractibility is considered a powerful prognostic factor in predicting the embryo transfer outcome. Moreover, uterine contractions are known to be stimulated by prostaglandins which are produced by cyclooxygenase from arachidonic acid. As such, suppressing the inflammatory response and contractions using anti-inflammatory and relaxant agents is expected to result in increased success rate of embryo transfer and artificial insemination.

OBJECTIVE

To investigate the effect of piroxicam administration on the success rate in intrauterine insemination (IU) cycles in patients presenting with unexplained infertility.

MATERIALS AND METHODS

This randomized, placebo-controlled clinical trial included 260 women with unexplained infertility undergoing IUI cycles. Patients were randomly assigned to receive either piroxicam ten mg/day on days 4-6 after IUI or placebo (control group). The main outcome measures were number of IUI cycles, pregnancy, abortion, and multiple pregnancy rates.

RESULTS

The pregnancy rate was found to be 25 (19.2%) and 16 (12.3%) in piroxicam and control groups, respectively (p = 0.039). Five patients (3.8%) in piroxicam group experienced twin pregnancy whereas only three patients (2.3%) in control group had twin pregnancy (p = 0.361). The pregnancy rate per cycle was also significantly higher in those who received piroxicam as compared to controls (11.16 vs. 6.66; p = 0.021).

CONCLUSION

Administration of piroxicam after IUI is associated with decreased number of cycles, as well as increased pregnancy rate and pregnancy rate per cycle in IUI cycles. However, piroxicam did not have any effect on abortion, multiple pregnancy, and ongoing pregnancy rates.

Association Between Lifestyle and Hypertension in Patients Referred to Health Care Centers of Ilam City in 2014

INTRODUCTION

Lifestyle is referred to an individual's healthy and unhealthy behaviors that can affect their health statues. The present study aim was association between lifestyle and hypertension in patients referred to healthcare centers of Ilam city in 2014.

MATERIALS & METHODS

This research study was a case-control study. The data were collected through a standard questionnaire of health-promoting lifestyle profile (HPLPII) as well as the researcher's direct visit to the health care centers in the city of Ilam. After the questionnaires were collected and classified, the data were entered into SPSS software and analyzed by descriptive statistics, chi-square tests, T-Tests and logistic regression.

RESULTS

The mean and the standard deviation of the age of the main and the control groups were 57.1 (2.22) and 56.5 (2.99) years old, respectively. 10.9%of the control group and 25.5. % of the cases was smoking cigarettes or hookah. The results of the data analysis showed that the mean scores obtained by the main and the control groups on measures of physical activity, psychological growth, stress and total lifestyleare significantly different, so that the obtained score in the dimensions in patients with hypertension was significantly lower than the score obtained among the healthy individuals.

CONCLUSIONS

According to the results it seems that educational interventions in the field of healthy lifestyle for individuals with hypertension risk can have an effect on controlling this disease and reducing its incidence.

Comparing Intelligence Quotient (IQ)among 3 to 7-year-old strabismic and nonstrabismic children in an Iranian population

This study was designed to compare the Intelligence Quotient (IQ) among 3 to 7-year-old strabismic and nonstrabismic children in an Iranian population.

In this cross-sectional study, 108 preschool children with equal numbers of strabismic/non-strabismic disorder (age 3–7 years) were randomly selected from exceptional strabismus clinics of Ahvaz and were evaluated with the preschool and primary scale of intelligence versions of Wechsler (WPPSI).

In the current study, 108 children were evaluated. In strabismic patients the mean performance, verbal and total IQ were 89.46±19.79, 89.57±21.57 and 91.54±22.08 respectively. These mean scores in normal children were 91.89±47.53, 87.56±15.6 and 89.96±17.62consecuently. The results showed that these three different IQ subscales were not significantly different among 3 to 7 years old strabismic and nonstrabismic children ((P>0.05 for all comparisons). There was no significant difference in IQ between two sexes (P>0.05) while Persian tribe children had greater IQ score compared to other tribes (P<0.05). Also, higher paternal educational status of children related to higher IQ score. IQ score was better in combined deviations and was higher in exotropes than esotropes; however, these differences were not statistically significant (P>0.05).

In this evaluation, we did not found a significant negative interference of strabismus on IQ score of preschool children. It can be concluded that paternal educational level and tribe have a significant effect on intelligent quotient, while this is not the case on sex and ocular deviation.

Safety and Efficacy of Propranolol in Comparison With Combination of Fentanyl and Ketamine as Premedication in Cataract Surgery Under the Topical Anesthesia

This study evaluated the safety and effects of propranolol as a premedication before cataract surgery and compared them with the usual combination doses of fentanyl and ketamine. Among all reffered patients to Feiz Hospital of Esfahan for cataract surgery, 122 patients between Mar to Sep 2010 were enrolled in this study and randomly allocated into one of the following equal groups: 40 mg propranolol, 2 hours before surgery and combination of 15 mg ketamine and 50 µg fentanyl l. 5 min before surgery. The ability to control of hemodynamic instabilities caused by stress and to gain patients satisfaction was compared between two groups. Also, the efficacy of each premedication to control of hemodynamic changes during surgery were evaluated and compared. No significant differences were seen in the patients satisfaction and controlling of stress induced hemodynamic changes between two groups (P>0.05). However, patients in ketamine + fentanyl group showed more nausea and less pain during and after surgery. Moreover, no significant adverse effects were reported during and after the surgery. Our results demonstrated that propranolol can be used safely as a premedication in cataract surgery in the comparable efficacy to ketamine plus fentanyl premedication.

The antifungal activity of Artemisia sieberi essential oil from different localities of Iran against dermatophyte fungi

Dermatophyte fungi are the most common cause of dermatophytosis in humans and animals. Artemisia sieberi is traditionally used for treatment of fungi related skin infections. In this investigation, we analyzed five samples of A. sieberi oils (different harvesting times and distinctive collecting locations) by GC-FID and GC-MS. The antifungal activities of A. sieberi oils were evaluated against different dermatophytes. The anti-elastase activities of essential oils were also evaluated. The results of analysis showed that the harvesting time and collecting location can affect the chemical compositions and oil yields. The best time for collecting the A. sieberi with high yield was spring season (January-February). There was no significant difference between the desirable anti-dermatophyte activities of A. sieberi oils with different chemical compositions. M. gypseum, T. rubrum and M. canis had more sensitivity than others to A. sieberi oils. The oils with higher amounts of α-thujone, β-thujone showed the higher anti-elastase activity. Therefore, A. sieberi can be used as topical antifungal agent for treatment of skin dermatophyte infections.

Cognitive factors related to drug abuse among a sample of Iranian male medical college students

BACKGROUNDS

Drug abuse is one of the most serious social problems in many countries. College students, particularly at their first year of education, are considered as one of the at risk groups for drug abuse. The present study aimed to determine cognitive factors related to drug abuse among a sample of Iranian male medical college students based on the social cognitive theory (SCT).

METHOD

This cross-sectional study was carried out on 425 Iranian male medical college students who were randomly selected to participate voluntarily in the study. The participants filled out a self-administered questionnaire. Data were analyzed by the SPSS software (ver. 21.0) using bivariate correlations, logistic and linear regression at 95% significant level.

RESULTS

Attitude, outcome expectation, outcome expectancies, subjective norms, and self-control were cognitive factors that accounted for 49% of the variation in the outcome measure of the intention to abuse drugs.  Logistic regression showed that attitude (OR=1.062), outcome expectancies (OR=1.115), and subjective norms (OR=1.269) were the most influential predictors for drug abuse.

CONCLUSIONS

The findings suggest that designing and implementation of educational programs may be useful to increase negative attitude, outcome expectancies, and subjective norms towards drug abuse for college students in order to prevent drug abuse.

Chance Constrained Input Relaxation to Congestion in Stochastic DEA. An Application to Iranian Hospitals

This article developed an approached model of congestion, based on relaxed combination of inputs, in stochastic data envelopment analysis (SDEA) with chance constrained programming approaches. Classic data envelopment analysis models with deterministic data have been used by many authors to identify congestion and estimate its levels; however, data envelopment analysis with stochastic data were rarely used to identify congestion. This article used chance constrained programming approaches to replace stochastic models with ‘‘deterministic equivalents”. This substitution leads us to non-linear problems that should be solved. Finally, the proposed method based on relaxed combination of inputs was used to identify congestion input in six Iranian hospital with one input and two outputs in the period of 2009 to 2012.

A study of the influence of dexamethasone on lipid profile and enzyme lactate dehydrogenase

Dexamethasone is an exceptionally applied glucocorticoid unfortunately prescribed too much. This drug is attached to its receptors in the cytoplasm by going through the cell layer, and opens the cell nucleus by the drug-receptor system, being ultimately responsible for systematic effects of corticosteroids. This study was conducted to explore the influence of dexamethasone on serum level of some biochemical parameters in adult men rats. 40 adult male rats were put into 4 test and check collections. The test collection only received saline and the experimental group received dexamethasone of 0.4, 0.7, and 1 mg/ kg doses daily in the form of intraperitoneal inoculation of 1 mL/ day. After serum separation, the serum value of cholesterol, triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and lactate dehydrogenase were measured and the outcomes were examined by using SPSS and Dunnett software. The test of lipid profile and lactate dehydrogenase was done by using the biochemistry tools and the collections were examined. In this research, meaningful differences in the application of the above hormones were not observed up to 0.7 mg/ kg dose. However, important differences were seen in higher doses i.e. 1mg/ kg in the test collection associated with the administration group (P<0.05). The final result was that the injection of dexamethasone followed in the development of cholesterol and adverse lipid and it could cause tissue damage by increasing lactate dehydrogenase.

Clinical outcomes of MyoRing implantation in keratoconic eyes by using the Femtosecond laser technology

Purpose: To assess the outcomes of the insertion of the MyoRing (DIOPTEX, GMBH, Linz, Austria) by applying the Femtosecond Laser Technology (FLT) method in eyes that have keratoconus problem. Methods: A prospective, nonrandomized, clinical examination was managed. 27 eyes of 15 subjects with stable keratoconus (6 females and 9 males), with lifetimes differing from 14 to 49 years were involved. All subjects have problems about decreased fine-accurate ocular awareness, lens intolerantness or trouble, and also the middle corneal height larger than 350 micrometers. MyoRing additions of about 320 micrometers into height and 2.5 mm into radius were inserted in each subject inside an Intrastromal Corneal Pocket using(ICP) formed with applying FLT. Ocular, refractive errors, corneal shape, and pachymetry changes were assessed throughout a 6-months follow-up period. Results: The average UDVA (uncorrected distance visual acuity) notably increased originating at 1.73 ± 0.53 LogMAR preoperationally to 0.54 ± 0.40 LogMAR post-operationally. The average CDVA (corrected distance ocular awareness) notably increased from 0.59 ± 0.47 LogMAR preoperationally to 0.27 ± 0.16 LogMAR post-operationally. The change in the average UDVA and CDVA was analytically meaningful (P< 0.000). The average reduction in the average keratometry from preoperational to 26 weeks post operational was -6.41 ± 3.62 D. This change was analytically meaningful (P< 0.000). The average lowest and highest keratometry amounts were similarly analytically notable at shorter than 26 weeks preoperatively. A notable increase in UDVA and CDVA was observed 26 weeks following the operation, that was compatible with the notable decrease in sphere and cylinder. Moreover, a notable corneal straightening with an average amount of -6.41 ± 3.62 diopters (D) was determined. Conclusion: MyoRing implantation employing FLT would be a harmless, effective, and predictable method to treat selected subjects of keratoconus, being a helpful choice for the therapy of keratoconus.

The effect of radiology services outsourcing on patients' satisfaction in Tehran city hospitals

Background: To have a developed society we should have healthy, active, and happy individuals and present that extended healthcare services perform an essential function in increasing the society's health level. Health in a society includes the society's, and people comfort with the condition and an assuring the situation that they can live healthily. Also, considering the self-governing plan of hospitals from 1995, the hospital authorities should choose a method of presenting services, and, the hospital is ready to present those activities during its own activities from an economic viewpoint. The current study was done while trying to discover the effect of the Outsourcing of the Radiology Unit on the patients' satisfaction in hospitals of Tehran. Method: The present research was done in a case-evidence and sectional study. Considering the weight of a month's references to the Radiology Unit, which included around 1200 individuals, the volume of samples for measuring the frequency of the patients' satisfaction with the means of Morgan table was similar to 291 individuals. To decrease the error percentage in each hospital we questioned 300 individuals. (n+10) were questioned and the gathered information were examined by what means SPSS application variant 21 and were then studied by climagraph - Smirnoph, Du Whitman - Vitney K tests. Findings: the mean of the patients' satisfaction of turned over and non-turned over Radiology Unit services were 41.46 and 45, respectively (from the maximum score of 60). A meaningful variation was seen among the patients' Satisfaction in the two hospitals from the analytical viewpoint (p-value<0.001) and there was also a significant difference between the patients' waiting time (p-value<0.001). The research's findings showed that the outsourcing has a negative influence on the patients' satisfaction and the duration of their waiting time. Conclusion: Many times, managers do the outsourcing without considering individual and organizational dimensions and characteristics by just justifying it based on decreasing the expenses. Therefore, it is essential for authorities to consider not only the economic characters but also the individual and human aspects while setting the outsourcing contracts and arrangements.

The challenges and recommendations of accessing to affected population for humanitarian assistance: a narrative review

Objective:

Access to affected people pays an important role in United Nation Organization for Coordination and Humanitarian Affairs (OCHA). The aim of this article is to identify the main obstacles of humanitarian access and the humanitarian organization responses to these obstacles and finally suggest some recommendations and strategies.

Methods:

In this narrative study the researchers searched in different databases. This study focused on the data from five countries in the following areas: access challenges and constraints to affected population and response strategies selected for operations in the affected countries by humanitarian organizations.

Results:

Three main issues were studied: security threats, bureaucratic restrictions and indirect constraint, which each of them divided to three subcategories. Finally, nine related subcategories emerged from this analysis.

Conclusion:

Most of these constraints relate to political issues. Changes in policy structures, negotiations and advocacy can be recommended to solve most of the problems in access issues.

Evaluation of work engagement and its determinants in Kermanshah hospitals staff in 2013

OBJECTIVE

Work engagement is a new concept in the field of psychology and human resource management. Increased vitality and enthusiasm is a social phenomenon that brings work engagement for society. This study aimed to evaluate work engagement and its determinants in Kermanshah hospitals' staff.

METHODS

This cross-sectional study was conducted on 387 hospital administrative, clinical, paraclinical, and service staff. The sample size was calculated using Krejcei-Morgan table. The data were collected using a questionnaire including demographic characteristics and job engagement components. Then, the data were analyzed using descriptive statistics as well as independent sample t-test and one-way ANOVA.

RESULTS

The participants' mean (SD) of age was 32.63±2.7 years and most of them were female (57.6%). The results revealed a significant relationship between work engagement and age group (P=0.01) and work experience (P=0.04). However, no significant relationship was found between work engagement and sex, education level, and job unit.

CONCLUSION

The results of this study showed that only job experience and age were associated with work engagement. However, no significant relationship was found between work engagement and education level, sex, and job. Thus, further studies are suggested to investigate the cultural factors and personality traits associated with job enthusiasm among the hospital staff, especially nurses.

The evaluation of time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah

This study evaluated the time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah. This study was a descriptive retrospective cross-sectional study. In this study 500 cases of patients from Shahrivar (September) 2012 to the end of Shahrivar (September) 2013 were selected and studied by the non-probability quota method. The measuring tool included a preset cases record sheet and sampling method was completing the cases record sheet by referring to the patients’ cases. Data were analyzed using SPSS version 18 and the concepts of descriptive and inferential statistics (Kruskal-Wallis test, benchmark Eta (Eta), Games-Howell post hoc test). The results showed that the interval mean between receiving the mission to reaching the scene, between reaching the scene to moving from the scene, and between moving from the scene to a health center was 7.28, 16.73 and 7.28 minutes. The overall mean of time performance from the scene to the health center was 11.34 minutes. Any intervention in order to speed up service delivery, reduce response times, ambulance equipment and facilities required for accuracy, validity and reliability of the data recorded in the emergency dispatch department, Continuing Education of ambulance staffs, the use of manpower with higher specialize levels such as nurses, supply the job satisfaction, and increase the coordination with other departments that are somehow involved in this process can provide the ground for reducing the loss and disability resulting from traffic accidents.

Negative predictive value of the chorionic villous sampling (CVS) in diagnosis of thalassemia in genetic laboratory of Dastgheib Hospital, Shiraz, Iran, 2012

BACKGROUND

Chorionic Villous Sampling (CVS) is a diagnostic method for determining genetic disorders. The present study aimed to determine the negative predictive value of the CVS in the diagnosis of major thalassemia in genetic laboratory of Dastgheib Hospital, Shiraz, Iran.

METHODS

The present research was an evaluation diagnostic test conducted on 372 records of embryos examined through CVS in the genetic lab in 2010 and definitely diagnosed by electrophoresis after birth in 2012. The sensitivity and positive predictive value of the test were assessed for minor thalassemia. The negative predictive value and the specificity of this test were determined, as well.

RESULTS

A total of 3 embryos (0.8%) were aborted due to testing. In this study, the sensitivity and specificity were 94.8% and 80.4%, respectively. Also, the negative predictive values for diagnosis of major and minor thalassemia were 100% and 89.2%, respectively. No relationships were found between the gestational age and the test results.

CONCLUSION

The results of this study showed that CVS genetic testing in genetic laboratory of Dastgheib Hospital was valid and had a high diagnostic value. Thus, minor couples can undergo this test with relative safety in order to prevent major thalassemia.

Post traumatic endophthalmitis: incidence and risk factors

Post traumatic endophthalmitis is an uncommon but severe complication of ocular trauma. We aimed to identify the incidence of post traumatic endophthalmitis and its contributing risk factors in Feiz hospital (Isfahan, Iran) from 2006 until 2010. Medical records of 1042 patients with open globe injury were analyzed and data were collected including age, sex, location of being injured, visual acuity (VA), time from injury to hospitalization and to repair, site of ophthalmic injury and the presence of foreign body. The frequency of post-traumatic endophthalmitis was about 2.1% (N = 22) of all patients. Nine of 22 cases with endophthalmitis were under 8 years. The visual acuity at the time of admission was seen to be contributed to high rate of endophthalmitis. Intraocular foreign body was detected in 139 patients; and the rate of endophthalmitis was 5% among these patients. Statistical analysis showed significant relationship between presence of foreign body and higher rate of endophthalmitis. Also, duration of hospitalization was significantly different between two study groups (P = 0.019). There were no significant differences between two groups in terms of other studied variables. Patients with low age, low visual acuity at admission, presence of intraocular foreign body and long duration of hospital stay had a higher risk of endophthalmitis after the repair of the globe. Compared to the reports of other large institutions, we can attribute the low incidence rate of endophthalmitis in our institution to the early use of systemic antibiotics such as gentamycin and cephalosporins in the first hour of hospitalization until discharge.

Intention and willingness in understanding Ritalin misuse among Iranian medical college students: a cross-sectional study

Ritalin misuse can create powerful stimulant effects and serious health risks. The main aim of present study was compared that two cognitive construct (behavioral intention or behavioral willingness) for predicting Ritalin misuse. This cross-sectional study was conducted among 264 Iranian medical college students; participants selected in random sampling, and data were collected by using self-report questionnaire. Data were analyzed by SPSS version 21 at 95% significant level. Our findings showed, the three predictor variables of (1) attitude, (2) subjective norms, and (3) prototype accounted for 29% of the variation in intention and 25% of the variation in willingness to Ritalin misuse. In addition, behavioral intention was a stronger prediction factor compared to willingness for Ritalin misuse, with odds ratio estimate of 1.607 [95% CI: 1.167, 2.213]. There is some support to use the prototype willingness model to design interventions to improve individuals’ beliefs that academic goals are achievable without the misuse of Ritalin.

Using the PRECEDE model in understanding determinants of quality of life among Iranian male addicts

Quality of Life (QOL) in opiate-addicted patients who are receiving methadone maintenance therapy is one of the important issues to be considered in the treatment of addiction. To determine a needs assessment using the PRECEDE model to find out factors related to QOL among Iranian male opiate addicts. This cross-sectional study was conducted in Kermanshah, Iran in 2013. A total of 762 male opiate addicts, who were referred to addiction treatment centers for receiving methadone maintenance treatment, were randomly selected to participate voluntarily in the study. SF-12, predisposing factors, enabling factors, reinforcement factors, and methadone maintenance treatment intention were used to find the related factors. Data were analyzed by the SPSS software (ver. 21.0) using the t-test, one-way analysis of variance (ANOVA), bivariate correlations, and linear regression at 95% significant level. Linear regression analysis showed the determinant variable accounted for 17% of the variation in QOL. Our findings suggest, providing social support for addicts could be beneficial results for the increasing quality of life among them.

Effect of foot hyperpronation on lumbar lordosis and thoracic kyphosis in standing position using 3-dimensional ultrasound-based motion analysis system

Based on clinical observations, foot hyperpronation is very common. Excessive pronation (hyperpronation) can cause malalignment of the lower extremities. This most often leads to functional and structural deficits. The aim of this study was to assess the effect of foot hyperpronation on lumbar lordosis and thoracic kyphosis. Thirty five healthy subjects (age range, 18030 years) were asked to stand on 4 positions including a flat surface (normal position) and on wedges angled at 10, 15, and 20 degrees. Sampling was done using simple random sampling. Measurements were made by a motion analysis system. For data analysis, the SPSS software (ver. 18) using paired t-test and repeated measures analysis of variance (ANOVA) was applied.

The eversion created by the wedges caused a significant increase in lumbar lordosis and thoracic kyphosis. The most significant change occurred between two consecutive positions of flat surface and the first wedge. The t-test for repeated measures showed a high correlation between each two consecutive positions.

The results showed that with increased bilateral foot pronation, lumbar lordosis and thoracic kyphosis increased as well. In fact, each of these results is a compensation phenomenon. Further studies are required to determine long-term results of excessive foot pronation and its probable effect on damage progression.

Health-related quality of life and its related factors in HIV(+) patients referred to Shiraz Behavioral Counseling Center, Iran in 2012

BACKGROUND

HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole. Nowadays, using anti-viral medication delays the onset of the disease cycle and increases the patients' life time. From the psychological point of view, however, such patients are faced with a great number of social and cultural limitations which affect various dimensions of their health as well as quality of life. Therefore, the present study aimed to investigate the quality of life and its related factors in HIV patients in Shiraz Behavioral Counseling Center.

METHODS

The present analytical cross-sectional study was conducted on 129 HIV patients in Shiraz Behavioral Counseling Center who were selected through convenience sampling. The data were gathered using demographic as well as SF-36 questionnaires and analyzed through T-test, ANOVA, X(2), and Schiff's post hoc test.

RESULTS

In this study, the patients' mean score of quality of life was 48.8+14. In addition, the mean scores of males' and females' life quality were 47.7+16.2 and 59.5+20.4, respectively and the difference was statistically significant (p<0.05). The mean difference of the patients' quality of life was also found to be significant based on employment status, marital status, and history of drug abuse (p<0.05), while it was not significant regardin gage, level of education, length of disease, and the distance between the house and the service providing center.

CONCLUSION

In comparison to the physical dimension, the HIV-positive individuals' quality of life mean score was lower in the mental dimension. In addition, the mean difference revealed to be significant based on marital as well as employment status. These findings show such patients' needs for psychological support, more psychological interventions, and creation of appropriate job opportunities.

Biochemical Activities of Iranian Cymbopogon olivieri (Boiss) Bor. Essential Oil

Cymbopogon olivieri essential oil from aerial parts was analyzed by gas chromotography and gas chromatography-mass spectrometry and led to the identification of 38 compounds. Piperitone (72.8%), 4-carene (11.8%) and β-himachalene (7.6%) were found as the major components of the oil. The antimicrobial activity was achieved using disc-diffusion and microbroth dilution assays and microbicidal kinetics of oil was screened against different microorganisms. The possible antioxidant activity of oil was evaluated by diphenylpicrylhydrazyl free-radical scavenging system. The oil had excellent antimicrobial activity against Bacillus cereus, Staphylococcus epidermidis and Streptococcus pneumoniae. The oil exhibited inhibitory effect against Bacillus subtilis and fungi. D_values of oil were 12.5, 10 and 2.4 min for Escherichia coli, Staphylococcus aureus and Candida albicans, respectively. The IC₅₀ value of Cymbopogon olivieri oil was 35 mg/ml and its antioxidant activity was lower than that of butylated hydroxytoluene. Cymbopogon olivieri oil possesses compounds with antimicrobial properties that can be used as antimicrobial agents.

The role of biocompatible coatings of biomaterials for creation of direct and appropriate chemical bounding between bioimplant and bone tissue

Background:

Nowadays, the surface modification of biomaterials to increase biocompatibility and improve other aspects of environmental performance is widely prevalent and is developing. Biological host response depends on the primary interactions of biological and biomaterials systems at the molecular surfaces. Therefore, the surface properties at the atomic scale influence on compatibility and optimal performance of the material in body. The present study aims to survey the most common surface modification techniques of biomaterials focusing on the surface coating techniques and their applications in bone tissue engineering and tissue repairing field. Furthermore, the process and features of biomaterial surface coating in complex superficial modification of biomaterials as a representation of biomaterials interfaces with the biological environment are discussed. Finally, the potential applications and advantages of these techniques in repairing damaged tissues in neurosurgery and orthopedic surgery are presented.

Methods:

In this review article, the most common and important methods of surface modification of biomaterials (thermal spray, electrophoresis, pulsed laser deposition, electrochemical, biomimetic, sputtering, Chemical Vapor Deposition (CVD), and, Sol–Gel techniques) which the reputable manufacture companies of biomaterial are applying and many published articles in the biomaterial field (since 2004 up to now). Furthermore, the potential applications and current positions of these methods in bone tissue engineering and effective factors for an optimal tissue repairing using biomaterial surface coating are presented.

Results:

The Sol-gel method is suitable for obtaining nanoscale structures. Plasma spraying method has a high-speed balance and is the only commercially available method. The pulsed laser coating method can be used in multilayer coatings and structures with a fixed Stoichiometric.

The electrophoresis coating methods are able to coat relatively complex shapes with precise control over coating thickness.In recent years, several coating methods such as electrochemical, biomimetic, sputtering, and CVD have been proposed and used by researchers some of them with good satisfactory results.

Conclusions:

Findings of our survey show that surface modification of biomaterials can keep the crucial physical properties of the biomaterials unchanged which is an important feature in biological reactions. The main advantages of biomaterial surface modification including surface coating can be presented as follows:

Reducing protein adsorption:Biomaterials sometimes need to have the lowest protein adsorption, otherwise, will cause uncontrolled immune responses.

Lack of cellular coherency

Cellular absorption:Biomaterials that are used as replacement tissue cells must have high capability for cell absorption and also should facilitate their growth process.

Reducing Clot formation:Biomaterials that are used as blood implants should have the lowest capacity of clot formation.

High coherency to bacteria

Reducing friction and grinding

Keywords:

Biomaterials, Coating, Biocompatibility, Grinding, Bounding, Implant

Chemical composition and antimicrobial activity of Satureja hortensis and Trachyspermum copticum essential oil

BACKGROUND AND OBJECTIVES

The aim of this study was to evaluate the chemical composition and antimicrobial activity of Satureja hortensis and Trachyspermum copticum essential oils against different kinds of microorganisms in vitro.

MATERIAL AND METHODS

The antimicrobial activity was evaluated by micro broth dilution assay and the chemical composition of essential oils was analyzed by GC and GC/MS.

RESULTS

Thymol, p-cymene, γ-terpinene and carvacrol were the main components of S. hortensis oil while thymol, γ-terpinene, and o-cymene were the major components of T. copticum oil. Two essential oils exhibited strong antimicrobial activity but the antimicrobial activity of T. copticum oil was higher than that of S. hortensis oil.

CONCLUSION

Thymol as a main component of oils plays an important role in antimicrobial activity.

The Antimicrobial Activity of Essential Oil from Perovskia abrotanoides Karel and its Main Components

In Iranian folk medicine, Perovskia abrotanoides is used for treatment of leishmaniasis. These patients may develop secondary infections with opportunistic microorganisms. Therefore, the antimicrobial activity of essential oil from aerial part of P. abrotanoides and its main components was evaluated against different microorganisms. Disc diffusion and broth micro dilution assays were used for in vitro antimicrobial screening. The antibacterial activity of this oil and main components on viability of S. aureus was determined. The oil showed antimicrobial activity against Candida albicans and Gram positive bacteria especially Staphylococcus aureus with zone inhibitions and minimal inhibitory concentration values in the range of 7.6 to 29 mm and 2 to 8 μl/ml respectively, whereas the least susceptible were Aspergillus niger and Gram negative bacteria. In viability test, the results showed that the antimicrobial activity of 1,8-cineole was more than that of α-pinene and camphor but after 60 min this effect gradually decreased only for 1,8-cineole and ultimately the antibacterial activity of camphor was more than that of α-pinene. 1,8-cineole had weak antimicrobial activity against all of the tested microorganisms. Hence the use of P. abrotanoides oil could be useful in fighting secondary infections in leishmaniasis especially against S. aureus.

In vitro synergistic efficacy of combination of amphotericin B with Myrtus communis essential oil against clinical isolates of Candida albicans

In this study, we evaluated the antifungal activity of the essential oil from Myrtus communis (myrtle) leaves against Candida albicans (eight clinical isolates and one ATCC type strains) and different species of Aspergillus sp (A. niger, A. parasiticus, six isolates of Aspergillus flavus) using broth micro dilution assay. In addition, we evaluated the synergistic effect between the essential oil and the antifungal compound amphotericin B by checkboard micro titer assay. The essential oil was obtained from myrtle leaves by hydrodistillation method and the oil was analyzed by GC and GC-MS methods. Chemical analysis of oil revealed the presence of 70 components, representing 99.23% of the total oil. 1,8-cineole (36.1%), alpha-pinene (22.5%), linalool (8.4%), bornyl acetate (5.2%), alpha-terpineol (4.4%), linalyl acetate (4.2%) and limonene (3.8%) were found to be the major components of the oil. The antifungal evaluating showed that myrtle oil exhibited good antifungal activity against fungi. Myrtle oil showed significant antifungal activity when combined with amphotericin B.

Earliest known simian primate found in Algeria

The record of early fossil Simiiformes (Anthropoidea) from the Late Eocene and Early Oligocene of Africa and the Arabian Peninsula has increased dramatically in recent years. We report here the discovery of a new, diminutive and much older (Early or Middle Eocene) simian from an Algerian locality, Glib Zegdou. This species is smaller than any other living or fossil African simiiform. Derived similarities shared with Aegyptopithecus suggest that the new genus is more closely related to propliopithecines than to oligopithecines, implying that these two subfamilies differentiated during the Early Eocene. The new discovery confirms predictions about the great antiquity of Simiiformes and emphasizes a long and endemic African history for higher primates.

Earliest known proboscidean from early Eocene of north-west Africa

The earliest known proboscidean remains have now been found at a new early Eocene locality at Brezina in southern Algeria (El Kohol). These new finds, represented by complete skulls and postcranial material, show several unexpected derived characters shared with the modern representatives of the Elephantoidea and the Deinotheriidae, suggesting close phylogenetic affinities and demonstrating also the great antiquity of the differentiation of modern proboscideans in Africa. These remains have been dated by associated charophyte flora and vertebrate remains which constitute the oldest known vertebrate community from the African Eocene.