An application of Soft System Methodology

AbstractThe typical course timetabling problem is assigning Classes of students to appropriate faculty members, suitable classrooms and available timeslots. Hence, it involves a large number of stakeholders including students, teachers and institutional administrators. Different kinds of Hard Operational Research techniques have been employed over the years to address such problems. Due to the computational difficulties of this NP complete problem as well as the size and the complexity of the real world instances, an efficient optimal solution cannot be found easily.As an alternative strategy, this paper investigates the application of Checkland‘s Soft System Methodology (SSM) to the course timetabling problem. Besides giving an ideal course timetable, even to large and complex real problems, application of SSM, generates debate, learning, and understanding; enables key changes; facilitates negotiating the actions to be taken and makes possible the meaningful collaboration among concerned stakeholders. This paper also provides an appropriate course timetable for the management faculty at University of Tehran to show the potential of this application to real problems

Improved Gas Separation of PEBAX-CSWCNTs Mixed Matrix Membranes

In the present study, mixed matrix membranes (MMMs) were prepared using PEBAX® 3000 as polymer matrix and single-wall carbon nanotubes (SWCNTs) functionalized with carboxyl groups as nanofillers. The effects of the nanofillers on separation of CO2/N2 and CO2/CH4 were investigated. The pristine PEBAX membrane indicated gas selectivity values of 23 and 13 for CO2/N2 and CO2/CH4, respectively. However selectivity of the modified membrane for gas pairs of CO2/N2 and CO2/CH4 improved to the values of 106.4 and 31.3, respectively. In other words, selectivity of modified membranes compared to those of unmodified ones enhanced greatly. The dramatic increase in gas selectivity of the mixed matrix membranes can be attributed to the polar groups of caboxyl-functionalized single-wall carbon nanotubes (CSWCNTs). While CO2 permeability of MMMs increaesd, permeability of nonpolar gases (N2 and CH4) decreased. FTIR spectra depicted that there were inter/intramolecular forces between ether and amide groups of the polymer chains. For PEBAX membrane filled with 10 wt% CSWCNTs, the peaks of C-O-C، N-H, and H-N-C=O functional groups shifted to lower values due to the formation of hydrogen bonds between polar carboxyl groups of CSWCNTs and amide/ether groups of PEBAX copolymer. Relative crystallinity values of the membranes with various CSWCNTs content were calculated using ΔHf data obtained from DSC measurements. Results demonstared that the rise in content of CSWCNTs brought about the decrement in crystallinity values of polyamide segments. The morphology of the membrane containing 10 wt% CSWCNTs was also investigated emplying AFM images, and a suitable compatability and adhere between PEBAX and CSWCNTs was last confirmed

Randomized double blind clinical trial evaluating the Ellagic acid effects on insulin resistance, oxidative stress and sex hormones levels in women with polycystic ovarian syndrome

Abstract Objective: The design of this study was due to the report of the antioxidant properties of Ellagic acid (EA) for its evaluation on the Insulin resistance (IR), oxidative stress and sex hormones levels in women with polycystic ovarian syndrome (PCOS). Methods: In this randomized, double-blind, placebo-controlled clinical trial, 60 patients were recruited. Patients were randomly allocated consumed a capsule containing 200 mg of EA per day (n = 30) or placebo (n = 30) for 8 weeks. The fasting blood sugar (FBS), insulin, IR, total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), total antioxidant capacity (TAC), Malondialdehyde (MDA), C-reactive protein (CRP), Tumor necrosis factor-alpha (TNF-α), sex hormones and anti-mullerian hormone (AMH) were measured at the beginning and end of the study. Result: At the end of the study, the mean of FBS, insulin, IR, TC, TG, LDL, MDA, CRP, TNF-α, total testosterone, prolactin and AMH were significantly decreased in the intervention group compared to the placebo group (P 0.05). Conclusion: EA supplementation can be helpful as a diet supplement in women with PCOS through improvement in insulin resistance. This supplement may be used to reduce metabolic disorders in women

Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome

STUDY QUESTION What is the recommended assessment and management of those with polycystic ovary syndrome (PCOS), based on the best available evidence, clinical expertise, and consumer preference? SUMMARY ANSWER International evidence-based guidelines address prioritized questions and outcomes and include 254 recommendations and practice points, to promote consistent, evidence-based care and improve the experience and health outcomes in PCOS. WHAT IS KNOWN ALREADY The 2018 International PCOS Guideline was independently evaluated as high quality and integrated multidisciplinary and consumer perspectives from six continents; it is now used in 196 countries and is widely cited. It was based on best available, but generally very low to low quality, evidence. It applied robust methodological processes and addressed shared priorities. The guideline transitioned from consensus based to evidence-based diagnostic criteria and enhanced accuracy of diagnosis, whilst promoting consistency of care. However, diagnosis is still delayed, the needs of those with PCOS are not being adequately met, evidence quality was low and evidence-practice gaps persist. STUDY DESIGN, SIZE, DURATION The 2023 International Evidence-based Guideline update reengaged the 2018 network across professional societies and consumer organizations, with multidisciplinary experts and women with PCOS directly involved at all stages. Extensive evidence synthesis was completed. Appraisal of Guidelines for Research and Evaluation-II (AGREEII)-compliant processes were followed. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was applied across evidence quality, feasibility, acceptability, cost, implementation and ultimately recommendation strength and diversity and inclusion were considered throughout. PARTICIPANTS/MATERIALS, SETTING, METHODS This summary should be read in conjunction with the full Guideline for detailed participants and methods. Governance included a six-continent international advisory and management committee, five guideline development groups, and paediatric, consumer, and translation committees. Extensive consumer engagement and guideline experts informed the update scope and priorities. Engaged international society-nominated panels included paediatrics, endocrinology, gynaecology, primary care, reproductive endocrinology, obstetrics, psychiatry, psychology, dietetics, exercise physiology, obesity care, public health and other experts, alongside consumers, project management, evidence synthesis, statisticians and translation experts. Thirty-nine professional and consumer organizations covering 71 countries engaged in the process. Twenty meetings and five face-to-face forums over 12 months addressed 58 prioritized clinical questions involving 52 systematic and 3 narrative reviews. Evidence-based recommendations were developed and approved via consensus across five guideline panels, modified based on international feedback and peer review, independently reviewed for methodological rigour, and approved by the Australian Government National Health and Medical Research Council (NHMRC). MAIN RESULTS AND THE ROLE OF CHANCE The evidence in the assessment and management of PCOS has generally improved in the past five years, but remains of low to moderate quality. The technical evidence report and analyses (∼6000 pages) underpins 77 evidence-based and 54 consensus recommendations, with 123 practice points. Key updates include: i) further refinement of individual diagnostic criteria, a simplified diagnostic algorithm and inclusion of anti-Müllerian hormone (AMH) levels as an alternative to ultrasound in adults only; ii) strengthening recognition of broader features of PCOS including metabolic risk factors, cardiovascular disease, sleep apnea, very high prevalence of psychological features, and high risk status for adverse outcomes during pregnancy; iii) emphasizing the poorly recognized, diverse burden of disease and the need for greater healthcare professional education, evidence-based patient information, improved models of care and shared decision making to improve patient experience, alongside greater research; iv) maintained emphasis on healthy lifestyle, emotional wellbeing and quality of life, with awareness and consideration of weight stigma; and v) emphasizing evidence-based medical therapy and cheaper and safer fertility management. LIMITATIONS, REASONS FOR CAUTION Overall, recommendations are strengthened and evidence is improved, but remains generally low to moderate quality. Significantly greater research is now needed in this neglected, yet common condition. Regional health system variation was considered and acknowledged, with a further process for guideline and translation resource adaptation provided. WIDER IMPLICATIONS OF THE FINDINGS The 2023 International Guideline for the Assessment and Management of PCOS provides clinicians and patients with clear advice on best practice, based on the best available evidence, expert multidisciplinary input and consumer preferences. Research recommendations have been generated and a comprehensive multifaceted dissemination and translation program supports the Guideline with an integrated evaluation program. STUDY FUNDING/COMPETING INTEREST(S) This effort was primarily funded by the Australian Government via the National Health Medical Research Council (NHMRC) (APP1171592), supported by a partnership with American Society for Reproductive Medicine, Endocrine Society, European Society for Human Reproduction and Embryology, and European Society for Endocrinology. The Commonwealth Government of Australia also supported Guideline translation through the Medical Research Future Fund (MRFCRI000266). HJT and AM are funded by NHMRC fellowships. JT is funded by a Royal Australasian College of Physicians (RACP) fellowship. Guideline development group members were volunteers. Travel expenses were covered by the partnering organizations. Disclosures of interest were strictly managed according to NHMRC policy and are available with the full guideline, technical evidence report, peer review and responses (www.monash.edu/medicine/mchri/pcos). Of named authors HJT, CTT, AD, LM, LR, JBoyle, AM have no conflicts of interest to declare. JL declares grant from Ferring and Merck; consulting fees from Ferring and Titus Health Care; speaker’s fees from Ferring; unpaid consultancy for Ferring, Roche Diagnostics and Ansh Labs; and sits on advisory boards for Ferring, Roche Diagnostics, Ansh Labs, and Gedeon Richter. TP declares a grant from Roche; consulting fees from Gedeon Richter and Organon; speaker’s fees from Gedeon Richter and Exeltis; travel support from Gedeon Richter and Exeltis; unpaid consultancy for Roche Diagnostics; and sits on advisory boards for Roche Diagnostics. MC declares travels support from Merck; and sits on an advisory board for Merck. JBoivin declares grants from Merck Serono Ltd.; consulting fees from Ferring B.V; speaker’s fees from Ferring Arzneimittell GmbH; travel support from Organon; and sits on an advisory board for the Office of Health Economics. RJN has received speaker’s fees from Merck and sits on an advisory board for Ferring. AJoham has received speaker’s fees from Novo Nordisk and Boehringer Ingelheim. The guideline was peer reviewed by special interest groups across our 39 partner and collaborating organizations, was independently methodologically assessed against AGREEII criteria and was approved by all members of the guideline development groups and by the NHMRC

Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome

Study question What is the recommended assessment and management of those with polycystic ovary syndrome (PCOS), based on the best available evidence, clinical expertise, and consumer preference? Summary answer International evidence-based guidelines address prioritized questions and outcomes and include 254 recommendations and practice points, to promote consistent, evidence-based care and improve the experience and health outcomes in PCOS. What is known already The 2018 International PCOS Guideline was independently evaluated as high quality and integrated multidisciplinary and consumer perspectives from 6 continents; it is now used in 196 countries and is widely cited. It was based on best available, but generally very low- to low-quality, evidence. It applied robust methodological processes and addressed shared priorities. The guideline transitioned from consensus-based to evidence-based diagnostic criteria and enhanced accuracy of diagnosis, whilst promoting consistency of care. However, diagnosis is still delayed, the needs of those with PCOS are not being adequately met, the evidence quality was low, and evidence-practice gaps persist. Study design, size, and duration The 2023 International Evidence-based Guideline update re-engaged the 2018 network across professional societies and consumer organizations with multidisciplinary experts and women with PCOS directly involved at all stages. Extensive evidence synthesis was completed. Appraisal of Guidelines for Research and Evaluation II (AGREEII)-compliant processes were followed. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was applied across evidence quality, feasibility, acceptability, cost, implementation, and ultimately recommendation strength, and diversity and inclusion were considered throughout. Participants/materials, setting, and methods This summary should be read in conjunction with the full guideline for detailed participants and methods. Governance included a 6-continent international advisory and management committee, 5 guideline development groups, and paediatric, consumer, and translation committees. Extensive consumer engagement and guideline experts informed the update scope and priorities. Engaged international society-nominated panels included paediatrics, endocrinology, gynaecology, primary care, reproductive endocrinology, obstetrics, psychiatry, psychology, dietetics, exercise physiology, obesity care, public health, and other experts, alongside consumers, project management, evidence synthesis, statisticians, and translation experts. Thirty-nine professional and consumer organizations covering 71 countries engaged in the process. Twenty meetings and 5 face-to-face forums over 12 months addressed 58 prioritized clinical questions involving 52 systematic and 3 narrative reviews. Evidence-based recommendations were developed and approved via consensus across 5 guideline panels, modified based on international feedback and peer review, independently reviewed for methodological rigour, and approved by the Australian Government National Health and Medical Research Council. Main results and the role of chance The evidence in the assessment and management of PCOS has generally improved in the past 5 years but remains of low to moderate quality. The technical evidence report and analyses (∼6000 pages) underpin 77 evidence-based and 54 consensus recommendations, with 123 practice points. Key updates include the following: (1) further refinement of individual diagnostic criteria, a simplified diagnostic algorithm, and inclusion of anti-Müllerian hormone levels as an alternative to ultrasound in adults only; (2) strengthening recognition of broader features of PCOS including metabolic risk factors, cardiovascular disease, sleep apnoea, very high prevalence of psychological features, and high risk status for adverse outcomes during pregnancy; (3) emphasizing the poorly recognized, diverse burden of disease and the need for greater healthcare professional education, evidence-based patient information, improved models of care, and shared decision-making to improve patient experience, alongside greater research; (4) maintained emphasis on healthy lifestyle, emotional well-being, and quality of life, with awareness and consideration of weight stigma; and (5) emphasizing evidence-based medical therapy and cheaper and safer fertility management. Limitations and reasons for caution Overall, recommendations are strengthened and evidence is improved but remains generally low to moderate quality. Significantly greater research is now needed in this neglected, yet common condition. Regional health system variation was considered and acknowledged, with a further process for guideline and translation resource adaptation provided. Wider implications of the findings The 2023 International Guideline for the Assessment and Management of PCOS provides clinicians and patients with clear advice on best practice, based on the best available evidence, expert multidisciplinary input, and consumer preferences. Research recommendations have been generated, and a comprehensive multifaceted dissemination and translation programme supports the guideline with an integrated evaluation programme

The Effect of Educational Intervention Based on Self-efficacy Theory on General Health Status of Women in Chaloos, Iran

Background: Self-efficacy is one of the factors which is effective on promoting general health. The aim of this research was to determine the effect of an educational intervention based on self-efficacy theory on general health status of women. Methods: The study is an interventional study carried out on 130 women visiting a health center who were randomly divided into experimental and control groups of 65 people. The data collection instruments were the standard General Health Questionnaire (GHQ-28) and standard Self-efficacy questionnaire (GSE). The educational intervention was designed based on the results from the initial test and the self-efficacy theory and was performed in two educational sessions lasting 60 and 55 minutes by group discussion, short lecture, questions and answers, demonstration, guidance, consultation and pamphlet. One month after the intervention, post tests were done. Data were analyzed and compared in SPSS 19 software by chi square, Correlation Co-efficient, Independent T and Exact Fisher tests. Results: Before the intervention, there was no significant difference between the mean of general health; self-efficacy and general health dimension scores between groups. But there were significant differences after intervention (respectively P=0.0001, P=0.045 and P=0.0001). There were significant inverse correlations between general health and self-efficacy and self-efficacy and number of children, but direct correlations between general health and number of children, after intervention. Conclusion: In designing interventions for improving women’s general health it is better to focus on their self-efficacy. Keywords: General health, Self-efficacy, Women, Educational interventio

Exploring the Iranian EFL Learners’ Reading Performance: The Effect of Teaching Method

The present study was an attempt to compare the reading achievement of learners who received the jigsaw method of instruction and that of those students who received the traditional teacher-fronted method of teaching. To achieve the purpose of the study, two intact classes were assigned randomly as the control and experimental groups. The experimental group consisted of 40 freshman and sophomore intermediate level male (N=18) and female (N=22) learners and the control group consisted of 38 freshman and sophomore intermediate level male (N=17) and female (N=21) students. The control participants received the traditional teacher-fronted method of teaching while the experimental group participants were exposed to the jigsaw method of teaching. After gathering the required data, the results of independent samples T-test indicated statistically significant differences (P= 0.000) between the experimental and control groups. These positive results attained were attributed to the major specificities of the cooperative teaching such as positive interdependence, group formation, individual accountability, social skills, and structuring and structures. Results are further discussed.

Clinical Pharmacognosy: A New Interesting Era of Pharmacy in the Third Millennium

Pharmacy is known as a branch related to healthcare services [Stubbings, 2011]. According to the features of pharmacognosy and clinical pharmacy two distinctive and important subjects of pharmacy in this editorial it has been introduced as a new integrated and multidisciplinary feature between these two subjects named; "clinical pharmacognosy"