A concept analysis of hope to patient recovery among nurses in intensive care: A hybrid model

Introduction: Nurses are considered as one of the most essential members of patents’ health care team. They play an important role in patient recovery or any other changes in patient health conditions. However, it seems that nurses’ caring of patients depended on their hops of recovery. Therefore, it is expected that nurses’ hopes be a fundamental part of the offering of any care. With due attention to this issue, this study analyzed the concept of nurses’ hope of patient recovery. Method: The hybrid model, which includes theory, practice, and final analysis, was used and interviews were analyzed according to the analytical method of inductive content analysis. Results: In the theoretical stage, nurses’ hopes were characterized by availability, professionalism, positive expectations, future-oriented, targeted, and etcetera. In the next stage, the practical definition of the concept (the nurses’ hopes is a necessity in the quality of health care) was studied. In the final analysis stage, the concept was defined with the characteristics of dynamic, realistic, and goal-based expectations. It was also defined as leading to better performances and attitudes in offering effective health care and nurses’ tranquility. Conclusion: The analysis of the concept of hope in nurses illustrated that nurses’ awareness of concepts such as hope in health care (the most important task of a nurse) could lead to their better performance. Keywords: Hope of recovery, Nurse, Patient, Intensive care, Concept analysis, Hybrid mode

Dosimetric Parameters Estimation for I-125 (model 6711) Brachytherapy Source

Determining dose distribution around the applied sources in brachytherapy, especially ones with low-energy is so crucial in treatment designing. In this study dosimetric parameters of a brachytherapy source I-125 (model6711) were calculated using Monte Carlo simulation method.A homogeneity water phantom with dimensions of 30´30´30 cm 3 were simulated with MCNPX(2.6.0) code. A brachytherapy source I-125 (model6711) considering its details (materials, dimensions and its emitted spectrum) was located in the center of phantom. Positioning the source inside the vacuum sphere its air kerma strength, S k , was calculated. Recommende

Utilization Evaluation of Antimicrobial Agents in Neutropenic Cancer Patients in a Teaching hospital: Urgent of Drug Utilization Evaluation Studies

Background: More than 80% of patients with hematologic  malignancies will develop fever during more than one chemotherapy cycle combined with neutropenia. We aim to evaluate empiric antibiotic strategies in Febrile Neutropenic (FN) cancer patients. Methods: This is a concurrent study performed in the “Shahid Ghazi” teaching hospital, hematology-oncology center of Tabriz, Iran during the period of December 2011 to September2012. During this period, patients with FN were evaluated in view of antibiotics utilization based on Infectious Disease Society of America (IDSA) and National Comprehensive Cancer Network (NCCN) instructions. Results: Seventy patients had a total of 91 episodes of FN in the duration of this study. Among them 63 (90%) patients were the cases of acute leukemia. For 88 (96.7 %) patients, imipenem was used as the initial empirical antibiotic regimen. It was changed to piperacillin/tazobactam in 8 (8.8%) of them without indication. Cultures didn’t obtain before the initiation of empirical therapy in 19 (20.9%) episodes. Empiric vancomycin didn’t discontinue after 3 days even if it was not warranted in 23 episodes. In 16 cases vancomycin was switched to teicoplanin. The fluconazole dosages generally given to patients were all suboptimal. Adjusting the dosages of vancomycin or imipenem was not done correctly in 13 (14.29%) episodes. Conclusion: The results of this study showed that choosing antimicrobial agents and their dosing for prophylaxis and treatment of FN patients and discharge antimicrobial planning of FN patients do not follow the evaluated guidelines. Drug Usage Evaluation studies need to be done regularly in such a center

Robust approach to DEA technique for supplier selection problem: A case study at Supplying Automotive Parts Company (SAPCO)

Abstract In many industries such as automotive industry, there are a lot of suppliers dealing with the final products manufacturer. With growing numbers of suppliers, the suppliers' efficiency measurement often becomes the most significant concern for manufacturers. Therefore, various performance measurement models such as DEA, AHP, TOPSIS, are developed to support supplier selection decisions. After an exhaustive review of the supplier selection methods, we employ data envelopment analysis (DEA) for computing the relative efficiency of the suppliers and introducing the most efficient supplier as a benchmark. In reality, there are large amounts of uncertainty regarding the suppliers' measurements; therefore, we propose the robust optimization approach to the real application of DEA (RDEA). In this approach, uncertainties about incomes and outcomes of decision making units (DMUs) are involved in the relative suppliers' efficiencies. The proposed RDEA approach is utilized for the selection of suppliers which manufacture the automotive safety components in Supplying Automotive Parts Company (SAPCO), an Iranian leading automotive enterprise. Numerical example will illustrate how our proposed approach can be used in the real supplier selection problem when considerable uncertainty exists regarding the suppliers' input and output dat

The Effect of education based on Awareness and Performance of hospitals service personnel about protective behaviors against the harmful effects of detergents and disinfectants

Background and objective: The individual protective behaviors have essential role in prevention or decrease the incidence of the harmful effects of detergents. This study aimed to determine the Effect of education based on Awareness on the harmful effects of detergents and disinfectants on hospital service personnel. Methods: This Quasi-experimental study was conducted on 100 off hospital service personnel that randomly divided to control and Intervention groups. Data collection tool was a Multi-section questionnaire includes demographic, Awareness and practice, that its validity and reliability was confirmed by expert and Cronbakh Alpha test. After primary data collecting, educational intervention performed and two months later data in both groups was collected again and analyzed in spss16 soft-ware using descriptive and analytical statistics. Results: Results showed that after intervention only in experimental group the mean scores of Awareness off 12/82±2/42 with 18/06±3/25 and preventive behaviors on hospital service personnel off 14/50± 3/41 with 20/06 ± 3/76 meaningful increased. Conclusion: The results showed that education intervention based on Health education was useful in increasing Awareness and promoting preventive behaviors of detergents and disinfectants on hospital service personnel Paper Type: Research Article

A novel best worst method robust data envelopment analysis:Incorporating decision makers’ preferences in an uncertain environment

Data Envelopment Analysis (DEA) has been widely applied in measuring the efficiency of Decision-Making Units (DMUs). The conventional DEA has three major drawbacks: a) it does not consider Decision Makers’ (DMs) preferences in the evaluation process, b) DMUs in this model are flexible in weighting the criteria to reach the maximum possible efficiency, and c) it ignores the uncertainty in data. However, in many real-world applications, data are uncertain as well as imprecise and managers want to impose their opinions in decision-making procedure. To address these problems, this paper develops a novel multi-objective Best Worst Method (BWM)-Robust DEA (RDEA) for incorporating DMs’ preferences into DEA model in an uncertain environment. The proposed model tries to provide a new efficiency score which is more reliable and compatible with real problems by taking the advantages of the BWM to apply experts’ opinions and RDEA to model the uncertainty This bi-objective BWM-RDEA model is solved utilizing amin-max technique and so as to illustrate its usefulness, this model is implemented for assessing Iranian airlines

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Global burden of peripheral artery disease and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Peripheral artery disease is a growing public health problem. We aimed to estimate the global disease burden of peripheral artery disease, its risk factors, and temporospatial trends to inform policy and public measures. Methods Data on peripheral artery disease were modelled using the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019 database. Prevalence, disability-adjusted life years (DALYs), and mortality estimates of peripheral artery disease were extracted from GBD 2019. Total DALYs and age-standardised DALY rate of peripheral artery disease attributed to modifiable risk factors were also assessed. Findings In 2019, the number of people aged 40 years and older with peripheral artery disease was 113 million (95% uncertainty interval [UI] 99·2–128·4), with a global prevalence of 1·52% (95% UI 1·33–1·72), of which 42·6% was in countries with low to middle Socio-demographic Index (SDI). The global prevalence of peripheral artery disease was higher in older people, (14·91% [12·41–17·87] in those aged 80–84 years), and was generally higher in females than in males. Globally, the total number of DALYs attributable to modifiable risk factors in 2019 accounted for 69·4% (64·2–74·3) of total peripheral artery disease DALYs. The prevalence of peripheral artery disease was highest in countries with high SDI and lowest in countries with low SDI, whereas DALY and mortality rates showed U-shaped curves, with the highest burden in the high and low SDI quintiles. Interpretation The total number of people with peripheral artery disease has increased globally from 1990 to 2019. Despite the lower prevalence of peripheral artery disease in males and low-income countries, these groups showed similar DALY rates to females and higher-income countries, highlighting disproportionate burden in these groups. Modifiable risk factors were responsible for around 70% of the global peripheral artery disease burden. Public measures could mitigate the burden of peripheral artery disease by modifying risk factors. Funding Bill & Melinda Gates Foundation

Global burden of peripheral artery disease and its risk factors, 1990–2019 : a systematic analysis for the Global Burden of Disease Study 2019

peripheral artery disease were modelled using the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019 database. Prevalence, disability-adjusted life years (DALYs), and mortality estimates of peripheral artery disease were extracted from GBD 2019. Total DALYs and age-standardised DALY rate of peripheral artery disease attributed to modifiable risk factors were also assessed. Findings In 2019, the number of people aged 40 years and older with peripheral artery disease was 113 million (95% uncertainty interval [UI] 99·2–128·4), with a global prevalence of 1·52% (95% UI 1·33–1·72), of which 42·6% was in countries with low to middle Socio-demographic Index (SDI). The global prevalence of peripheral artery disease was higher in older people, (14·91% [12·41–17·87] in those aged 80–84 years), and was generally higher in females than in males. Globally, the total number of DALYs attributable to modifiable risk factors in 2019 accounted for 69·4% (64·2–74·3) of total peripheral artery disease DALYs. The prevalence of peripheral artery disease was highest in countries with high SDI and lowest in countries with low SDI, whereas DALY and mortality rates showed U-shaped curves, with the highest burden in the high and low SDI quintiles. Interpretation The total number of people with peripheral artery disease has increased globally from 1990 to 2019. Despite the lower prevalence of peripheral artery disease in males and low-income countries, these groups showed similar DALY rates to females and higher-income countries, highlighting disproportionate burden in these groups. Modifiable risk factors were responsible for around 70% of the global peripheral artery disease burden. Public measures could mitigate the burden of peripheral artery disease by modifying risk factors

Zdolności militarne Iranu a możliwości zablokowania cieśniny Ormuz przez Iran

Following official announcement of oil embargo on Iran by the EU, official positions of Islamic Republic were introduced by political and military authorities based on “blocking Hormuz Strait under certain circumstances”; an issue of great concern in western officials. They warned about their military capabilities in the field of reopening Strait and maintaining security of energy transit lines in the Strait of Hormuz. They questioned the West military methods against Iranian military officials reopening the Strait of Hormuz.This study seeks to answer this question that “what are Iranian military capabilities to block Hormuz Strait?”, “If the Strait is blocked, when western military forces can reopen it?” “Iranian military capabilities which can be called ‘five pillars of military strategy’ based on cruise and ballistic anti-ship missiles, small speedboats, drones, small submarines, nautical mines and standoff missiles supported by air defense and electronic warfare (Jangal), allows Islamic Republic to block Hormuz strait in long term. However, previous to any military conflict with trans-regional forces, the main Iranian weapon is nautical mines to block Hormuz Strait”.Po oficjalnym ogłoszeniu przez UE embarga na ropę Iranu, władze polityczne i wojskowe przyjęły oficjalne stanowiska Republiki Islamskiej w oparciu o „blokowanie cieśniny Ormuz w określonych okolicznościach”; kwestia wielkiej troski zachodnich urzędników. Ostrzegali o swoich zdolnościach militarnych w zakresie ponownego otwarcia cieśniny i utrzymania bezpieczeństwa linii tranzytowych energii w Cieśninie Ormuz. Kwestionowali metody wojskowe Zachodu przeciwko irańskim urzędnikom wojskowym, którzy ponownie otworzyli cieśninę Ormuz. W badaniu tym starano się odpowiedzieć na pytanie: „Jakie są irańskie zdolności wojskowe do zablokowania cieśniny Ormuz?”, „Jeśli cieśnina zostanie zablokowana, czy zachodnie siły zbrojne mogą ponownie ją otworzyć?”. „Irańskie zdolności wojskowe, które można nazwać »pięcioma filarami strategii wojskowej«, opartymi na pociskach wycieczkowych i balistycznych przeciw okrętom, małych łodziach motorowych, dronach, małych łodziach podwodnych, minach morskich i pociskach dystansowych wspieranych przez obronę powietrzną i wojnę elektroniczną (Jangal), pozwalają Islamskiej Republice na długoterminowe blokowanie cieśniny Ormuz. Jednak przed jakimkolwiek konfliktem zbrojnym z siłami transregionalnymi główną bronią Iranu są miny morskie blokujące cieśninę Ormuz”