Central Venous Pressure Monitoring; Introduction of a New Device

Hemodynamic monitoring is needed in up to 58% of patients presented to the emergency department. Central venous pressure (CVP) monitoring is generally useful to assess general volume status. There are several methods of CVP measurement, which can be categorized as invasive and non-invasive. CVP manometer and electronic transducer are among the invasive methods and direct observation, ultrasonography and plethysmography are examples of non-invasive ones. All the mentioned methods have some negative points and shortcomings. Here we introduce a new device that can facilitate CVP measurement and provide physicians with further data that can be helpful regarding decision making and patient management

Psychometric properties of the Persian version of the Cancer attitude inventory

Background: The Cancer Attitude inventory (CAI) was developed to measure attitudes toward cancer. The aim of the present study was to describe the development of the Persian version of the CAI and to evaluate its psychometric properties in an Iranian sample. Methods: The forward-backward method was used to translate the CAI scale from English into Persian. After linguistic validation and a pilot check, a cross-sectional study was performed and psychometric properties of the Iranian version of the questionnaire were assessed. The scale validation was conducted with a convenience sample of 820 laypeople. Construct validity was assessed through both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was assessed through Cronbach's alpha analysis and test-retest analysis. Results: Five factors were identified in CAI: isolation, helplessness, fear of consequence, belief of control and independence, and fear of death. The results achieved from the CFA displayed that the data fit the model: the relative chi-square (x2/df)= 2.98 (p <.001), and the root mean square error of approximation (RMSEA) =.07 (90% CI =.06-.07). All comparative indices of the model had scores greater than.80, demonstrating a good fit to the data. Cronbach's Alpha and the intra-class correlation coefficient (ICC) were .97, which is well above the acceptable threshold. Conclusions: The results indicate that the Persian version of the CAI is practical, reliable and valid. Consequently, the instrument could be used in plans to create positive attitudes about cancer control and treatment among Persian people

Requirements for effective academic leadership in Iran: A Nominal Group Technique exercise

Background. During the last two decades, medical education in Iran has shifted from elite to mass education, with a considerable increase in number of schools, faculties, and programs. Because of this transformation, it is a good case now to explore academic leadership in a non-western country. The objective of this study was to explore the views on effective academic leadership requirements held by key informants in Iran's medical education system. Methods. A nominal group study was conducted by strategic sampling in which participants were requested to discuss and report on requirements for academic leadership, suggestions and barriers. Written notes from the discussions were transcribed and subjected to content analysis. Results. Six themes of effective academic leadership emerged: 1)shared vision, goal, and strategy, 2) teaching and research leadership, 3) fair and efficient management, 4) mutual trust and respect, 5) development and recognition, and 6) transformational leadership. Current Iranian academic leadership suffers from lack of meritocracy, conservative leaders, politicization, bureaucracy, and belief in misconceptions. Conclusion. The structure of the Iranian medical university system is not supportive of effective academic leadership. However, participants' views on effective academic leadership are in line with what is also found in the western literature, that is, if the managers could create the premises for a supportive and transformational leadership, they could generate mutual trust and respect in academia and increase scientific production. © 2008 Bikmoradi et al; licensee BioMed Central Ltd

Investigation of the relationship between structural empowerment and organizational commitment of nurses in Zanjan hospitals

Background: The demanding nature of nursing work environments signals longstanding and growing concerns about nurses' health and job satisfaction and the provision of quality care. Specifically in health care settings, nurse leaders play an essential role in creating supportive work environments to avert these negative trends and increase nurse job satisfaction.Objective: The purpose of this study was to examine the relationship between structural empowerment and organizational commitment of nurses.Methods: 491 nurses working in Zanjan hospitals participated in this descriptive-correlational study in 2010. Tools for data collection were Meyer and Allen’s organizational commitment questionnaire and “Conditions for Work Effectiveness Questionnaire-II” (CWEQ-II). Data was analyzed by SPSS16. The statistical tests such as variance analysis, t-test, pearson correlation coefficient and linear regression were used for data analysis.Results: According to the findings, the perception of nurses working in hospitals on "Structural Empowerment" was moderate (15.98±3.29). Nurses believed "opportunity" as the most important element in structural empowerment with the score of 3.18 ±0.79. Nurses working in non-academic hospitals and in non-teaching hospitals had higher organizational commitment than others. There was a significant relationship between structural empowerment and organizational commitment.Conclusion: Generally, structural empowerment (relatively strong) correlates with nurses’ organizational commitment. We concluded that a high structural empowerment increases the organizational commitment of nurses.Keywords: Structural empowerment, organizational commitment, nurses, Zanja

Strategic planning, components and evolution in zoonotic diseases frameworks: one health approach and public health ethics

Zoonotic diseases are seen as a major public health concern. Routes of the rapid transmission of zoonotic diseases and the economic damage they cause to communities are all reasons why health institutions and systems need to pay more attention to these diseases. Strategic planning is one of the important tasks of policymakers in every organization and system. It is a very reliable and useful tool for leading all kinds of organizations, including health organizations. Countries with clear policy plans have succeeded in controlling and reducing zoonotic diseases. Such countries used appropriate strategic planning and pursued annual goals to control and prevent diseases. Three important steps (strategy development, strategy implementation and strategy evaluation) should be considered in developing a strategic planning for controlling and prevention of zoonotic diseases. Health systems need to develop strategic planning in order to upgrade their capabilities in combating zoonotic diseases. These programs must be flexible, in line with the one health approach, based on the current needs, and aligned with the new challenges faced with health systems. The strategic planning is directly related to national and international policies, organizational goals and missions, dynamism, degree of complexity, and organizational structure of each country's health system

Health Literacy among Women Referring to Healthcare Centers of Zanjan City, Iran: A Cross-sectional Study

Background and Objective: Health literacy refers to a collection of skills, which enable the individuals to read, hear, analyze, and decide on the health-related issues. The possession of these skills by women have a significant effect on the improvement of health and happiness in their family and community. Regarding this, the aim of the present study was to determine health literacy level among the women referring to healthcare centers in Zanjan, Iran. Materials and Methods: This cross-sectional study was conducted on 323 women referring to the urban healthcare centers of Zanjan in 2016. The study population was selected using stratified random sampling technique. Data collection tools included a demographic questionnaire and Short Test of Functional Health Literacy in Adults. The data were analyzed in SPSS (version 21) using Pearson correlation test, t-test, and one-way ANOVA. Results: The mean health literacy among the participants was obtained as 71.56±17.8. According to the results, 22.6%, 22.3%, and 50.1% of the subjects had inadequate, borderline, and adequate health literacy, respectively. Furthermore, health literacy showed a significant relationship with education level (P<0.001) and occupational status (P=0.44). Conclusion: As the findings indicated, about half of the women had no favorable level of health literacy. Considering the critical role of women in preserving and promoting the health of their family and community, it is necessary to consider educational plan in order to improve the health literacy among this important group

Investigation of the relationship between structural empowerment and organizational commitment of nurses in Zanjan hospitals.

Background: The demanding nature of nursing work environments signals longstanding and growing concerns about nurses' health and job satisfaction and the provision of quality care. Specifically in health care settings, nurse leaders play an essential role in creating supportive work environments to avert these negative trends and increase nurse job satisfaction. Objective: The purpose of this study was to examine the relationship between structural empowerment and organizational commitment of nurses. Methods: 491 nurses working in Zanjan hospitals participated in this descriptive-correlational study in 2010. Tools for data collection were Meyer and Allen\u2019s organizational commitment questionnaire and \u201cConditions for Work Effectiveness Questionnaire-II\u201d (CWEQ-II). Data was analyzed by SPSS16. The statistical tests such as variance analysis, t-test, pearson correlation coefficient and linear regression were used for data analysis. Results: According to the findings, the perception of nurses working in hospitals on "Structural Empowerment" was moderate (15.98\ub13.29). Nurses believed "opportunity" as the most important element in structural empowerment with the score of 3.18\ub10.79. Nurses working in non-academic hospitals and in non-teaching hospitals had higher organizational commitment than others. There was a significant relationship between structural empowerment and organizational commitment. Conclusion: Generally, structural empowerment (relatively strong) correlates with nurses\u2019 organizational commitment. We concluded that a high structural empowerment increases the organizational commitment of nurses

The Gap between Students’ Expectations and Educational Services Provided for them, Zanjan University of Medical Sciences, 2007

Background & Objective : One of the main problems which must be considered by the universities of medical sciences, nationwide, is to establish a solidarity system for providing desirable services and use of strategic methods in order to increase quality of services. Determining gap in quality of services can facilitate backgrounds for preparing programs for improvement of educational quality of services. This study was performed to determine the gap between college students’ expectations and provided educational services in Zanjan University of Medical Sciences, 2007. Methods : In this descriptive study, 362 students in medical sciences participated. Data was collected using a questionnaire based on SERVQUAL. By filling in the questionnaires, students defined realities and their expectations in five aspects of quality of services including physical, trust, reliability, responsiveness, and sympathy. The gap in services was calculated by subtracting students’ scores in realities from their expectations. Results: Results showed that there were gaps in all five aspects of quality of services. The highest gap mean was in sympathy aspect (-1.67) and then in aspects of responsiveness (-1.62), reliability (-1.54) and physical aspect (-1.52). The least gap mean was in trust aspect (-1.46). There was a significant difference between realities and expectations in all aspects (P=0.0001). Students of higher levels mentioned higher gaps in a significant way (P<0.01). Conclusion : Generally, the gap between expectations and realities was seen in all aspects which is due to not meeting students’ expectations of provided services. To improve quality of services, it is recommended that together with planning educational workshops about service providing and increasing staff’s communicative skills, authorities put those aspects with the highest gap in priority while allocating budget. Keywords: Gap, Quality of services, Expectations, Educational services, Realities, Students

Requirements for effective academic leadership in Iran: A Nominal Group Technique exercise

Abstract Background During the last two decades, medical education in Iran has shifted from elite to mass education, with a considerable increase in number of schools, faculties, and programs. Because of this transformation, it is a good case now to explore academic leadership in a non-western country. The objective of this study was to explore the views on effective academic leadership requirements held by key informants in Iran's medical education system. Methods A nominal group study was conducted by strategic sampling in which participants were requested to discuss and report on requirements for academic leadership, suggestions and barriers. Written notes from the discussions were transcribed and subjected to content analysis. Results Six themes of effective academic leadership emerged: 1)shared vision, goal, and strategy, 2) teaching and research leadership, 3) fair and efficient management, 4) mutual trust and respect, 5) development and recognition, and 6) transformational leadership. Current Iranian academic leadership suffers from lack of meritocracy, conservative leaders, politicization, bureaucracy, and belief in misconceptions. Conclusion The structure of the Iranian medical university system is not supportive of effective academic leadership. However, participants' views on effective academic leadership are in line with what is also found in the western literature, that is, if the managers could create the premises for a supportive and transformational leadership, they could generate mutual trust and respect in academia and increase scientific production.</p