Association of smoking and drug abuse with treatment failure in individuals with tuberculosis: a case-control study

Introduction: Treatment failure in tuberculosis (defined as a positive sputum smear 5 months after the initiation of anti-TB treat-ment) is a major threat to the control over TB. This study aimed to investigate the association of smoking and drug abuse with treatment failure among individuals with TB.Material and methods: Out of 286 TB patients with available data registered by the health system of Hamadan Provinces in western Iran, 24 TB patients with treatment failure (positive sputum smear, 5 months after initiation of anti-TB treatment) and 262 patients without treatment failure (negative sputum smear, five months after initiation of anti-TB treatment) were selected as case and control groups, respectively. These two groups were compared to each other in terms of demographic status which include age, sex, job, residence, and risk factors such as smoking and drug abuse status. An odds ratio (OR) with a 95% confidence interval was used as a measure of association. The Bonferroni correction was used to counteract multiple comparisons, therefore, a p-value of less than 0.004 was statistically significant. Results: No significant association was found between treatment failure and age, residence, comorbidity, education level, job status, sex, smoking, and method of drug abuse (P > 0.004). However, a significant association was found between duration of smoking, number of cigarettes per day, and drug abuse with treatment failure in univariate analysis (P < 0.004). In multivariate analysis, only an association with drug abuse was significantly associated with treatment failure (P = 0.047). Conclusion: Drug abuse substantially increases the risk of treatment failure. Therefore, in order to control TB, it is suggested that preventive programs are designed in order to decrease drug abuse among TB patients before starting treatment

The Role of Effective Information In Decision Making By Managers At Shahid Beheshti of Teaching Hospitals of Shahid Beheshti University of Medical Sciences

Abstract: Today, one of the most fundamental factors in the field of management is providing managers with effective information in order to improve the quality of their decision-making. In this paper, we studied the role of effective information in decision making by managers and directors i

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Relationship between organizational culture and commitment of employees in health care centers in west of Iran

Introduction: Presence of committed personnel in each organization not only reduces their absenteeism, delays, and displacements but also leads to a dramatic increase in performance and efficiency of an organization, mental freshness of employees, better manifestation of noble objectives, and organizational mission as well as fulfillment of personal goals. Therefore, the purpose of this study was to determine the relationship between organizational culture and organizational commitment of employees in administrative units of health care centers in the cities of Hamedan Province based on the Denison model in 2015. Methods: In this cross-sectional study, 177 employees in administrative units of health care centers in the cities of Hamedan Province were selected by a multistage stratified sampling method. The data collection instruments included the standardized Denison organizational culture survey and organizational commitment questionnaire by Meyer and Allen. Data were analyzed by IBM-SPSS version 21 using descriptive statistics and Pearson product- moment coefficient. Results: Among the 12 indicators of organizational culture, the highest mean scores were assigned to empowerment (16.74), organizational learning (16.41), vision (16.4), and strategic direction (16.35); respectively. Furthermore, the indicators of capability development (14.2), core values (15.31), team orientation (15.45), and goals (15.46) received the lowest mean scores in this respect. Among the four dimensions of organizational culture, the highest mean score was related to “mission” in organizational culture and the lowest score was associated with “involvement.” Meyer and Allen’s organizational commitment model also had three components in which affective commitment in this study obtained the highest score (26.63) and continuance commitment received the lowest score (24.73). In this study, there was a significant correlation between all the components of organizational culture and organizational commitment of employees in administrative units of health care centers (p < 0.05). Conclusion: Reflecting on all the dimensions and indicators of organizational culture can lead to an escalation of organizational commitment among employees. Furthermore, focus on factors affecting the improvement of continuance commitment can promote organizational commitment of employees in administrative units of health care centers

Association of Smoking and Drug Abuse with Treatment Failure in Individuals with Tuberculosis: A Case-Control Study

Introduction: Treatment failure in tuberculosis (defined as a positive sputum smear 5 months after the initiation of anti-TB treat-ment) is a major threat to the control over TB. This study aimed to investigate the association of smoking and drug abuse with treatment failure among individuals with TB. Material and methods: Out of 286 TB patients with available data registered by the health system of Hamadan Provinces in western Iran, 24 TB patients with treatment failure (positive sputum smear, 5 months after initiation of anti-TB treatment) and 262 patients without treatment failure (negative sputum smear, five months after initiation of anti-TB treatment) were selected as case and control groups, respectively. These two groups were compared to each other in terms of demographic status which include age, sex, job, residence, and risk factors such as smoking and drug abuse status. An odds ratio (OR) with a 95% confidence interval was used as a measure of association. The Bonferroni correction was used to counteract multiple comparisons, therefore, a p-value of less than 0.004 was statistically significant. Results: No significant association was found between treatment failure and age, residence, comorbidity, education level, job status, sex, smoking, and method of drug abuse (P &gt; 0.004). However, a significant association was found between duration of smoking, number of cigarettes per day, and drug abuse with treatment failure in univariate analysis (P &lt; 0.004). In multivariate analysis, only an association with drug abuse was significantly associated with treatment failure (P = 0.047). Conclusion: Drug abuse substantially increases the risk of treatment failure. Therefore, in order to control TB, it is suggested that preventive programs are designed in order to decrease drug abuse among TB patients before starting treatment

The Correlation between Conflict Management Styles and Nurse Managers\' Demographic Characteristics in Hamadan Therapeutic and Educational Centers

Introduction: Presence of conflict seems inevitable in organizations, especially in therapeutic and educational centers, considering the variety of personnel, patients, and their families' education and cultures. Nurse managers could effectively be involved in conflict management at these therapeutic and educational centers. This study aimed at assessing nurse managers' conflict management strategies at Hamadan therapeutic and educational centers. Methods: A correlation descriptive study was conducted by Putnam and Wilson's conflict management questionnaire on 400 nurse managers of Hamadan therapeutic and educational centers. Data were analyzed by SPSS (Version 16) via Pierson correlation coefficient, t test and Analysis of Variance (ANOVA). Results: Overall, 52.2% of nurse managers used problem solving (collaboration and accommodation), 37.8% used none-confrontational strategies (avoidance and compromising) and 3% employed control (competing) styles for conflict management at Hamadan therapeutic and educational centers. There was a significant correlation between their conflict management strategies and age, marital status, work experience, managerial work experience, and employment status (P < 0.05). Conclusions: There were direct and significant correlations between nurse managers' conflict management styles and some of their demographic characteristics. Therefore, it is important to consider demographic characteristics before the selection of managers. Conflict management education could improve nurse managers' capabilities for conflict management at Hamadan therapeutic and educational center

Correlation of Nurses’ Quality of Working Life and Job Satisfaction in Teaching Hospitals of Hamadan University of Medical Sciences

Introduction: Nurses are considered as the major part of the human resources of the health system. The aim of this study was to determine the relationship between quality of working life and job satisfaction of nurses in teaching hospitals of Hamadan University of Medical Sciences. Methods: The study is descriptive-analytic. A total of 269 nurses from Hamadan hospitals were randomly selected. The collection tools were two job satisfaction questionnaires and quality of working life with a Cronbach’s alpha coefficient of 94.9 and 81 respectively. Data were analyzed by SPSS21 using t-test, ANOVA and Chi-square test. Results: Findings showed that there is a significant relationship between quality of working life and job satisfaction (P<0.05). The results also showed that there is a meaningful relationship between the job satisfaction from the perspective of salaries and benefits (P<0.05), job promotion. But there are no significant relationships with other dimensions such as, the nature of the work, supervisor, and relationships with colleague and job promotion. There was a significant relationship between working life and job satisfaction (P=0.001). Conclusion: The results indicated that there is a significant and stable relationship between job satisfaction and quality of working life of nurses in the studied population. Therefore, the attention of policymakers, health system planners and hospital managers to the key needs of nurses, such as increasing salaries and benefits, job security, job promotion and fair evaluation can play an important role in increasing job satisfaction and improving the quality of working life of nurses

Novel Aldehyde-Terminated Dendrimers; Synthesis and Cytotoxicity Assay

Introduction: Polyamidoamine (PAMAM) dendrimers are a unique family of dendritic polymers with numerous pharmaceutical and biomedical applications. One major problem with these polymers is their cytotoxicity. The purpose of this study is to synthesize novel dendrimers with aldehyde terminal groups and compare their cytotoxicity with that of dendrimers containing amine terminated groups. Methods: G1 (first generation) and G2 (second generation) dendrimers with amine terminated groups were synthesized by divergent method and then the amine terminated groups were converted to the aldehyde groups using surface modification of the functional group inversion (FGI) method. The cytotoxicity of the novel G1 and G2 polyamidoaldehyde (PAMAL) dendrimers together with that of G1 and G2 PAMAM-NH2 dendrimers was investigated by MTT assay using MCF-7 cell line. Results: The results showed that cytotoxicity of dendrimers with aldehyde terminated groups is much lower than that of G1 and G2 PAMAM-NH2 dendrimers. Conclusion: Dendrimers with aldehyde terminated groups could be used as novel and convenient carriers for drug delivery with low cytotoxic effect compared with the amine terminated denderimers. The results revealed that the same generations of the dendrimers with aldehyde-terminated groups are far less toxic than the corresponding amine-terminated denderimer

Interventions on reducing burnout in physicians and nurses:A systematic review

Background: Burnout is one of the main factors in reducing the performance quality among hospital staff. Appropriate interventions can reduce burnout among physicians and nurses and result in promotion of the quality of services provided at hospitals. The present study aimed to provide a more comprehensive understanding of the interventions on burnout reduction among hospital physicians and nurses. Methods: Studies were searched from January 2000 to June 2017 in PubMed, Embase, Scopus, Cochrane, and Web of Science. Randomized clinical trials (RCTs) and pretest-posttest studies that had interventions to reduce the burnout of physicians and nurses were included. However, studies conducted on medical and nursing students and nonmedical providers or beyond hospitals were excluded. Results: Based on the study inclusion criteria, 12 RCTs and 6 pretest-posttest studies were included in the review. Most of the included studies were from Netherlands, the United States, and England. The interventions included team-based program, EMH-approach, and coping and communication skills training. Most of the interventions had a positive effect on burnout reduction. Nevertheless, some studies had no significant impact. Conclusion: The results showed that the most interventions used to improve burnout were improving communication skills, teamwork, participatory programs, and psychological interventions (Yoga, meditation, and mindfulness). The impact of these interventions can increase mental health in the long term. Burnout is a complicated problem and should be treated by combining interventions

Relationship between Occupational Stress and the Performance of Health Care Units in Hamadan Health Center, Iran

Introduction:&nbsp;Since human resources and employees are one of the most important assets of organization, identification of factors associated with these resources that can affect their performance and job stress is becoming increasingly important to study.The present study examined the relationship between job stress and the performance of different health units. Methods:&nbsp;The present study is a cross-sectional study.All of the health care workers of urban and rural health centers in Hamadan city were included in this study.The study population included 150 people and all of them were examined.The questionnaires included the Stress Relief Elliot(1994)and an annual checklist provided by the Ministry of Health.The data analyzed in SPSS software with Pearson and independent &ndash;T test. Results: &nbsp;The mean of stress level and performance were55.16, 79.64 which respectively was 55.14, 78.21in family Health unit, 57.06 and 76.87&nbsp;&nbsp; in Disease control unit and 54.03, 83.31in Occupational and Environmental Health unit respectively.The results showed that the significant and negative relationship between employees stress and performance of units (p=0.001).The results also showed that age had a significant positive correlation with service history and performance (p =0.001) and negative significant relation with stress (p =0.001). conclusion:&nbsp;Regarding the confirmation of relationship between stress level and staff performance that shown in this study, and the fact that human resources are the key factor in determining the quality, accessibility and cost of health care, it is recommended that managers take effective actions for reducing stress and increasing productivity planning