Explanation of the Status of Nosocomial Surveillance System in Iran: A Qualitative Study

Introduction: The national nosocomial surveillance system has been newly developed in Iran; therefore, it is necessary to investigate its different aspects in order to improve the quality of this system. Thus, the aim of this study was the explanation of the status of the nosocomial surveillance system in Iran. Method: This qualitative study was conducted through qualitative content analysis. The study participants were selected through purposeful sampling method. Data collection was carried out through 17 in-depth interviews and 3 focus group discussions with relevant stakeholders. Data were analyzed using content analysis method. In order to assess the accuracy and validity of the study, validity, confidentiality, and confirmability criteria were evaluated. Results: Through the analysis of interviews, 9 main themes (planning and policy making, human resources, infection control committee, quality and quantity of resources, protocols, software, surveillance, coordination and education) and 42 subsidiary themes concerning the status of the national nosocomial surveillance system were extracted. According to the participants’ opinions, the planning and algorithm of the program are acceptable. However, some issues exist in components such as applicability, priority, comprehensiveness of the definitions, attitude and behavior of the human resources, and ambiguity of the roles and responsibilities. Conclusion: This qualitative study showed that numerous factors influence the improvement of the nosocomial surveillance system. The interviews indicated that its design pattern is acceptable. Nevertheless, some of its components are not executed uniformly in all domestic hospitals. Keywords: Surveillance, Nosocomial, Qualitative study, Hospita

The quality assessment of family physician service in rural regions, Northeast of Iran in 2012

Background: Following the implementation of family physician plan in rural areas, the quantity of provided services has been increased, but what leads on the next topic is the improvement in expected quality of service, as well. The present study aims at determining the gap between patients’ expectation and perception from the quality of services provided by family physicians during the spring and summer of 2012. Methods: This was a cross-sectional study in which 480 patients who referred to family physician centers were selected with clustering and simple randomized method. Data were collected through SERVQUAL standard questionnaire and were analyzed with descriptive statistics, using statistical T-test, Kruskal-Wallis, and Wilcoxon signed-rank tests by SPSS 16 at a significance level of 0.05. Results: The difference between the mean scores of expectation and perception was about -0.93, which is considered as statistically significant difference ( P ≤ 0.05). Also, the differences in five dimensions of quality were as follows: tangible -1.10, reliability -0.87, responsiveness -1.06, assurance -0.83, and empathy -0.82. Findings showed that there was a significant difference between expectation and perception in five concepts of the provided services ( P ≤ 0.05 ). Conclusion: There was a gap between the ideal situation and the current situation of family physician quality of services. Our suggestion is maintaining a strong focus on patients, creating a medical practice that would exceed patients’ expectations, providing high-quality healthcare services, and realizing the continuous improvement of all processes. In both tangible and responsive, the gap was greater than the other dimensions. It is recommended that more attention should be paid to the physical appearance of the health center environment and the availability of staff and employee

A Hybrid Algorithm for Simultaneous Retrieval of Thermal Conductivity and Time-Dependent Heat Flux

Abstract: This paper presents a hybrid technique for simultaneous estimation of parameter and function in inverse heat conduction problems. No prior information is used for the functional form of the heat flux in the present study. The scheme presented here is a combination of two different classical methods: The Variable Metric Method (VMM) and Gauss Method (GM). The determination of the unknown thermal coefficients includes two steps per iteration of the estimation algorithm: the function estimation step; and the parameter estimation step. VMM and GM are used to handle function estimation and parameter estimation problems, respectively. It is shown via simulated experiment that unknown quantities can be obtained with reasonable accuracy using this method despite existing noise in the measurement data

Hamid Mohammadiun Real-Time Evaluation of Severe Heat Load Over Moving Interface of Decomposing Composites

Decomposing composites undergo both surface removal and in-depth decomposition, when they are subjected to severe heating environments. As a result, the gas phase and the chemical species are injected into the boundary layer, resulting in a reduction of the heat flux entering into the solid structure. Under such conditions that geometry changes, the reconstruction of heat flux at the ablating front is quite complicated. Utilizing a procedure based on the sequential function specification method, an inverse problem is solved to anticipate the front-surface heating condition. Temperature measurements as well as measurement of the position of the ablating surface accompanied with additive noises are used for the implementation of the current procedure. Taking into account a complex set of phenomena, a numerical experiment is employed to examine the accuracy and appropriateness of the proposed technique for such problems. The results obtained demonstrate the usefulness and efficiency of the proposed method for the estimation of heat flux at the moving boundary of decomposing materials

Comparisons of the effect of Private Speech Training on Executive Function of Attention Deficit and Normal Students

In this Research, the effect of private speech training on executive function of boys between 9 to 11 years old in Isfahan City was examined. This research is an experimental study of pre-test/post-test with control groups. It had a two-stage sampling. Final sample included 20 attention deficit boys (10 for experiment group and 10 for first control group) and 9 normal boys for second control group. Instruments used in this research included British Picture Vocabulary scale, Short form of Wechsler's Intelligence Scale for Children- Revised, Tower sub test of NEPSY Neuropsychology test. To analyze private speech of children, their speech were videotaped while solving Tower sub test and Videos were content analyzed by three encoders. Results showed that children with attention deficit, had significantly more errors in compare to first and second control groups; while both experiment and second control group (which both had been trained) had significantly more amount of private speech in compare to first control group- which had not trained. According to the findings of the research, it can be concluded although private speech training can increase the amount of private speech produced by attention deficit children, this increase in speech, not only will not necessarily increase function of children, but it may backfire on difficult tasks

Estimation of Boundary Conditions in the Presence of Unknown Moving Boundary Caused by Ablation

Ablative materials can sustain very high temperatures in which surface thermochemical processes are significant enough to cause surface recession. Existence of moving boundary over a wide range of temperatures, temperature-dependent thermophysical properties of ablators, and no prior knowledge about the location of the moving surface augment the difficulty for predicting the exposed heat flux at the receding surface of ablators. In this paper, the conjugate gradient method is proposed to estimate the unknown surface recession and time-varying net surface heat flux for these kinds of problems. The first order Tikhonov regularization is employed to stabilize the inverse solution. Considering the complicated phenomena that are taking place, it is shown via simulated experiment that unknown quantities can be obtained with reasonable accuracy using this method despite existing noises in the measurement data

Enhancement of Temperature Blending in Convective Heat Transfer by Motionless Inserts With Variable Segment Length

Stationary spiral inserts can effectively enhance heat transfer and temperature blending in the heat convection systems. In this paper, the impact of the segment length on the performance of a stationary insert is studied for flow Re numbers from ~80 to ~7900 through numerical simulation of heat transfer in streams of cold and hot gases flowing across it. The segment length to width ratio is from 1.11 to 2.33. The temperature of the studied gas is from 300 K to 1300 K. It is shown that the insert with variable segment length is more effective in temperature blending for two compressible streams compared with an insert with constant segment length, especially for low-Re-number turbulent flows