Comparison of the Rate and Causes of Surgery Cancellations before and after the Implementation of the Health Sector Evolution Plan: a case study in selected public hospitals

Background: Operating room efficiency is one of the main factors in determining hospital costs. Since Health Sector Evolution Plan (HSEP) was implemented with the idea of increasing people's access to hospital services, this study aimed to compare the rate and causes of cancellation of surgical procedures in public hospitals before and after HSEP. Methods: This descriptive-analytic study was carried out in two public hospitals in Zahedan in 2017. A total of 8138 of registered profiles were selected randomly and reviewed. A standard checklist containing 9 questions were used for data gathering. Data were analyzed using descriptive statistics and chi-square tests and through SPSS software version 21. Results: The number of surgies has increased after HSEP. Befor HSEP, most of the surgeries had been canceled for organizational and managerial reasons (58%) while after HSEP, patient issues were the main cause of cancellation of surgeries (66%). Surgery cancellation related to the surgery team, patient, anesthesia, medical, equipment and organisation had a significant relation with the marital status of patients (P=0.011) and their type of health insurance (P= 0.021). Conclusion: Performing detailed planning for operating rooms, providing necessary training programs for patients, patients' visit by anesthesiologists, as well as quantitative and qualitative improvement of operating room conditions can increase the efficiency of oprtaing rooms and hospitals

Opium use and risk of bladder cancer: a multi-centre case-referent study in Iran

Background Bladder cancer (BC) is the 10th most common type of cancer worldwide and the fourth most common type of cancer in Iran. Opium use is considered as one of the risk factors for BC. We aim to assess the association between various parameters of opium use, which in Iran is mainly ingested or smoked in various forms, and the risk of BC. Method In this multi-centre case-referent study in Iran, 717 BC cases and 3477 referents were recruited to the study from May 2017 until July 2020. Detailed histories of opium use (duration, amount, frequency) and potential confounders were collected by trained interviewers. Multivariable unconditional logistic regression models were used to measure adjusted odds ratio (OR) and 95% confidence intervals (CI). The ORs were adjusted for age, gender, place of residence and pack-years of cigarette smoking. Results Regular opium consumption was associated with an increased risk of BC (OR 3.5, 95% CI: 2.8, 4.3) compared with subjects who never used opium. Compared with continuous users, the risk decreased to one-third for those who stopped opium more than 10 years ago. The adjusted OR for those who used both crude opium (teriak) and opium juice was 7.4 (95% CI: 4.1, 13.3). There was a joint effect of opium and tobacco (OR for users of both opium and tobacco 7.7, 95% CI: 6.0, 9.7). Conclusions Regular opium use is associated with an approximately 4-fold risk for BC. The OR decreases along with the increasing time since stopping opium use

Opium use and risk of bladder cancer : A multi-centre case-referent study in Iran

Background: Bladder cancer (BC) is the 10th most common type of cancer worldwide and the fourth most common type of cancer in Iran. Opium use is considered as one of the risk factors for BC. We aim to assess the association between various parameters of opium use, which in Iran is mainly ingested or smoked in various forms, and the risk of BC. Method: In this multi-centre case-referent study in Iran, 717 BC cases and 3477 referents were recruited to the study from May 2017 until July 2020. Detailed histories of opium use (duration, amount, frequency) and potential confounders were collected by trained interviewers. Multivariable unconditional logistic regression models were used to measure adjusted odds ratio (OR) and 95% confidence intervals (CI). The ORs were adjusted for age, gender, place of residence and pack-years of cigarette smoking. Results: Regular opium consumption was associated with an increased risk of BC (OR 3.5, 95% CI: 2.8, 4.3) compared with subjects who never used opium. Compared with continuous users, the risk decreased to one-Third for those who stopped opium more than 10 years ago. The adjusted OR for those who used both crude opium (teriak) and opium juice was 7.4 (95% CI: 4.1, 13.3). There was a joint effect of opium and tobacco (OR for users of both opium and tobacco 7.7, 95% CI: 6.0, 9.7). Conclusions: Regular opium use is associated with an approximately 4-fold risk for BC. The OR decreases along with the increasing time since stopping opium use.publishedVersionPeer reviewe

Designing a Policy-Making Model for Biomass Energy Development Training in the Agricultural Supply Chain Sector

This basic-applied and hybrid survey aimed to design and validate a policy-making model for biomass energy development training in the agricultural supply chain sector. Creating a supply chain for basic agricultural products by including a wide range of agricultural subsectors from the supply of required production inputs to the final consumer’s access to the goods will lead to an increase in the productivity of the agricultural sector as well as the upstream and downstream industries related to it. Therefore, considering the importance of creating an optimal supply chain for various agricultural products, in this study, the situation of the supply chain of agricultural products in the country has been examined. Considering that the lack of appropriate policies regarding the management of the supply chain of agricultural products can lead to the inefficiency of the supply chain of agricultural products in various stages including supply of inputs, production and distribution, and marketing of products, it is suggested that planning and related policies should be implemented in order to improve the infrastructure that leads to increasing the efficiency of some logistics subsystems such as transportation, warehousing, communication, and information systems. Purposive sampling was used in the qualitative part, and stratified random sampling was utilized in the quantitative part. The data were collected by reviewing resources and interviewing ten experts, who were mainly policy-making managers of biomass energy development training and academic researchers. The interviews continued until reaching theoretical saturation, and the samples of the quantitative part included 384 members of the environmental and agricultural Jihad employees, who were selected based on Cochran’s formula. The effective components of the education policy of biomass energy development and their factors were identified by the exploratory method and evaluated through descriptive-survey research. The validity and reliability of the components were examined, and Cronbach’s alpha of all components was higher than 0.7. The essential components of the effective factors were measured in the education policy of biomass energy development in the agricultural sector. The model validity was verified through the structural equation method, and the selection of concepts, dimensions, and indicators was highly accurate and could provide a suitable framework for developing a policy perspective document for biomass energy education. According to the coding results, the development and acceptance of biomass energy systems by the Ministry of Agriculture Jihad and Environment in the country is unsuitable and sustainable, considering the passage of more than a decade of designing and implementing plans. According to experts, some farmers implement this method in their fields for one or two years and return to traditional methods after accepting this technology. The main achievements are as a core category or phenomenon conditions to casual conditions path with coefficient 0.916 is significant. Strategies to the core category or phenomenon conditions’ path with a coefficient of 0.051 are significant. Strategies to contextual conditions’ path with coefficients 1.231 are significant. Strategies for intervening condition path with coefficients 2.235 are significant. Consequences to strategies’ path with coefficients 0.807 are significant. Therefore, the development of biomass energy is an inevitable necessity, considering the erosion and reduction of soil organic matter, increasing energy costs, and other factors

Antibacterial effect of cerium oxide nanoparticle against Pseudomonas aeruginosa

Background Antibiotics have been widely used for the treatment of bacterial infections for decades. However, the rapid emergence of antibiotic-resistant bacteria has created many problems with a heavy burden for the medical community. Therefore, the use of nanoparticles as an alternative for antibacterial activity has been explored. In this context, metal nanoparticles have demonstrated broad-spectrum antimicrobial activity. This study investigated the antimicrobial activity of naked cerium oxide nanoparticles dispersed in aqueous solution (CNPs) and surface-stabilized using Pseudomonas aeruginosa as a bacterial model. Methods Gelatin-polycaprolactone nanofibers containing CNPs (Scaffold@CNPs) were synthesized, and their effect on P. aeruginosa was investigated. The minimum inhibitory and bactericidal concentrations of the nanoparticls were determined in an ATCC reference strain and a clinical isolate strain. To determine whether the exposure to the nanocomposites might change the expression of antibiotic resistance, the expression of the genes shv, kpc, and imp was also investigated. Moreover, the cytotoxicity of the CNPs was assessed on fibroblast using flow cytometry. Results Minimum bactericidal concentrations for the ATCC and the clinical isolate of 50 µg/mL and 200 µg/mL were measured, respectively, when the CNPs were used. In the case of the Scaffold@CNPs, the bactericidal effect was 50 µg/mL and 100 µg/mL for the ATCC and clinical isolate, respectively. Interestingly, the exposure to the Scaffold@CNPs significantly decreased the expression of the genes shv, kpc, and imp. Conclusions A concentration of CNPs and scaffold@CNPs higher than 50 μg/mL can be used to inhibit the growth of P. aeruginosa. The fact that the scaffold@CNPs significantly reduced the expression of resistance genes, it has the potential to be used for medical applications such as wound dressings.Medicine, Faculty ofNon UBCInfectious Diseases, Division ofMedicine, Department ofReviewedFacultyResearche

The Iranian Study of Opium and Cancer (IROPICAN) : Rationale, design, and initial findings

Background: The International Agency for Research on Cancer (IARC) recently classified opium use as a Group 1 carcinogen. However, much remains to be studied on the relation between opium and cancer. We designed the Iranian Opium and Cancer (IROPICAN) study to further investigate the association of opium use and cancers of the head and neck, bladder, lung, and colon and rectum. In this paper, we describe the rationale, design, and some initial results of the IROPICAN Study. Methods: The IROPICAN is a multi-center case-control study conducted in 10 provinces of Iran. The cases were all histologically confirmed and the controls were selected from hospital visitors who were free of cancer, were not family members or friends of the cancer patients, and were visiting the hospital for reasons other than their own ailment. The questionnaires included detailed questions on opium use (including age at initiation, duration, frequency, typical amount, and route), and potential confounders, such as tobacco use (e.g., cigarettes, nass and water-pipe), and dietary factors. Biological samples, including blood and saliva, were also collected. Results: The validation and pilot phases showed reasonably good validity, with sensitivities of 70% and 69% for the cases and controls, respectively, in reporting opium use. The results also showed excellent reliability, with intra-class correlation coefficients of 0.96 for ever opium use and 0.88 (95% CI: 0.80, 0.92) for regular opium use. In the main phase, we recruited 3299 cancer cases (99% response rate) and 3477 hospital visitor controls (89% response rate). The proportion of ever-use of opium was 40% among cases and 18% among controls. Conclusion: The IROPICAN study will serve as a major resource in studies addressing the effect of opium on risk of cancers of the head and neck, bladder, lung, and colon and rectum.publishedVersionPeer reviewe

Opium use and the risk of head and neck squamous cell carcinoma

Scant evidence exists to support the association of opium use with head and neck cancer, limited to the larynx and oral cavity. In a multicenter case- control study- Iran Opium and Cancer study, we recruited 633 cases of head and neck squamous cell carcinoma (HNSCC) (254 lip and oral cavity, 54 pharynx, 327 larynx and 28 other subsites within the head and neck) and 3065 frequency- matched controls from April 2016 to April 2019. Odds ratios (ORs) for opium use and 95% confidence intervals (95% CIs) were obtained using mixed- effects logistic regression because of heterogeneity among centers. The adjusted OR (95% CI) for regular opium use was 3.76 (2.96- 4.79) for all HNSCC combined. Strong dose- response effects were observed by frequency or amount of use, and duration of use. Regular opium uses significantly increased the risk of HNSCC of the pharynx, larynx and other subsites within the head and neck with OR (95% CI) of 2.90 (1.40- 6.02), 6.55 (4.69- 9.13) and 5.95 (2.41- 14.71), respectively. The observed associations were significant even among never tobacco smokers (including cigarette and water- pipe smoking). Moreover, by the multiplicative interaction scale, the effect of opium use could be varied by cigarette smoking on HNSCC, 8.16 (6.20- 10.74). For the first time, the current study showed opium users have an increased risk of several anatomic subsites of HNSCC.What’s new?Opium use has been associated with the risks of several cancers, but there is little data on whether opium contributes to head and neck cancer risk. Here, the authors conducted a multicenter case- control study, the Iran Opium and Cancer study (IROPICAN). They recruited 633 cases of head and neck squamous cell carcinoma and 3065 controls. The study drew from 10 provinces in Iran where opium use is most prevalent. They found that regular opium users have an elevated overall risk of HNSCC, and laryngeal cancer in particular.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/166166/1/ijc33289_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/166166/2/ijc33289.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/166166/3/ijc33289-sup-0001-TableS1.pd