Studying three management skills among midwifery managers of Iranian universities of medical sciences in 2015

Introduction: Nowadays, for organizational success, managers should accept multiple roles that each requires trainings for specific skills. This issue especially is much more important in health care systems that are responsible for improving the health of the society. Therefore, this study was aimed to determine three managerial skills among midwifery managers Iranian Medical Sciences Universities.Method: This study was descriptive and data collection method was cross-sectional. The subjects in this study included members of the Board of Midwifery and Reproductive Health, bachelors of midwifery in the field of health care and members of midwifery faculty from eight Iranian universities of medical sciences. Collecting information was performed through demographic characteristics questionnaire and triple skills of management researcher-made questionnaire. Validity and reliability were determined through content validity and Cronbach's alpha coefficient of α = 0.88 and test results were evaluated and analyzed by inferential statistics (ANOVA, Kruskal-Wallis test) which p < 0.05 was considered as the significant level.Results: The results of this study showed that in the field of knowledge, managers prioritized the skills as follows: the human-communicational skills (MR =69.05), technical skills (MR =50.31) and theoretical-cognitive skills (MR =47.57). Also prioritization of skills from the perspective of the study population in the field of importance was human-communicational skills (MR =82.23), technical skills (MR =76.57) and theoretical-cognitive skills (MR =75.47).Discussion: According to the results of this study, the importance of humancommunicational skills in all the hierarchy and categories of management is one of the essential tasks of managers for promoting organizations toward the achievement of their goals efficiently and effectively.Keywords: Managers, Management Skills, Human Skills, Midwive

A retrospective analysis of the causes of postoperative ventral hernia recurrence

Considering the results of surgical treatment of postoperative ventral hernia, a significant number of recurrences of 4.3–46 % should be noted, and in case of large and giant postoperative ventral hernias reaches up to 80 %, which is associated with demographic imbalance that is an increase in the number of persons of old and senile age with comorbidity typical for them. Excessive obesity, especially in women, requires a revision of the main surgical approaches in the choice of methods of hernioplasty. Failure to take into account the present syndrome of undifferentiated connective tissue dysplasia (UCTD) in the performance of hernioplasty and allohernioplasty in 60 % of cases leads to postoperative relapse.Objective. On the basis of the analysis of the performed surgical treatment of patients with ventral and postoperative ventral hernia, to study the main causes of the development of recurrent hernia, which would improve the results of surgical treatment of this category of patients.Materials and methods. The clinical section of the work is based on a retrospective analysis of the results of surgical treatment of 1419 patients who underwent surgery on the anterior abdominal wall for primary ventral and postoperative ventral hernias. The distribution of patients into groups was according to the periods of surgical treatment of patients: from 2001 to 2009 and from 2010 to2017. In the first period, 597 (42.07%) patients who made the comparison group were examined and operated. The main group (2010–2017) amounted to 822 (57.93 %) patients.To determine the localization, size and extent of hernial bulging in defects of the anterior abdominal wall, we used the classification of the European Association of Surgeons-Herniologists (EHS-classification, 2008).In the comparison group, R1 was observed in 123 (93.18 %) patients, R2 – in 6 (4.55 %), R3 – in 2 (1.51%), R4 and more – in 1 (0.76 %). In the main group: R1 was observed in 63 (71.59 %) patients, R2 – in 18 (20.45 %), R3 – in 5 (5.68 %), R4 and more – in 2 (2.28 %).Results. In 250 (17.62 %) patients, recurrent hernia developed after various types of surgery. The highest recurrence rate was observed in patients after own tissue hernioplasty, which was 36.07 % of all operated patients according to this procedure. In second place, by the frequency of relapse were patients after performed allohernioplasty using inlay technique – 19.63 %. The recurrence rate after allohernioplasty by the onlay technique is, according to our study, 10.58 %. After performing the sublay technique, the results obtained differ significantly with a low percentage of relapses compared to other methods of hernioplasty. Thus, the recurrence was only in 6.01 % of cases. The only method of surgical treatment of POVH with no recurrence was the method of hernioplasty with anatomic separation of the components of the anterior abdominal wall (CST), which was performed in two variants – without the use of polypropylene mesh (PPM) by Ramirez and combined one using PPM. Such data may be explained by the small number of completed surgery interventions (45 (3.17%)) and short observation periods (4 years).Conclusions. Analyzing the causes of recurrence, it can be argued that the main ones are the choice of inadequate method of hernioplasty to a specific clinical situation, incomplete revision of the musculo-aponeurotic layer of the anterior wall, especially in patients with postoperative ventral hernias and concomitant undifferentiated connective tissue dysplasia and obesity, the presence of hidden (small in size and clinically intact) defects and weaknesses, incorrect choice of mesh implant type (“light” or “heavy” polypropylene mesh) and its size, choice of inappropriate material thickness

Electrical transport and optical studies of ferromagnetic Cobalt doped ZnO nanoparticles exhibiting a metal-insulator transition

The observed correlation of oxygen vacancies and room temperature ferromagnetic ordering in Co doped ZnO1-o nanoparticles reported earlier (Naeem et al Nanotechnology 17, 2675-2680) has been further explored by transport and optical measurements. In these particles room temperature ferromagnetic ordering had been observed to occur only after annealing in forming gas. In the current work the optical properties have been studied by diffuse reflection spectroscopy in the UV-Vis region and the band gap of the Co doped compositions has been found to decrease with Co addition. Reflections minima are observed at the energies characteristic of Co+2 d-d (tethrahedral symmetry) crystal field transitions, further establishing the presence of Co in substitutional sites. Electrical transport measurements on palletized samples of the nanoparticles show that the effect of a forming gas is to strongly decrease the resistivity with increasing Co concentration. For the air annealed and non-ferromagnetic samples the variation in the resistivity as a function of Co content are opposite to those observed in the particles prepared in forming gas. The ferromagnetic samples exhibit an apparent change from insulator to metal with increasing temperatures for T>380K and this change becomes more pronounced with increasing Co content. The magnetic and resistive behaviors are correlated by considering the model by Calderon et al [M. J. Calderon and S. D. Sarma, Annals of Physics 2007 (Accepted doi: 10.1016/j.aop.2007.01.010] where the ferromagnetism changes from being mediated by polarons in the low temperature insulating region to being mediated by the carriers released from the weakly bound states in the higher temperature metallic region.Comment: 7 pages, 6 figure

The effects of glucan on hematological parameters, immune response and intestinal microbiota of Rutilus frisii kutum fry

The purpose of this study was to determine the effect of dietary glucan on some haematological parameters, immune response and intestinal microbiota of Rutilus frisii kutum. In the present study, various levels of ingredient so called Hoplit (0, 0.5, 1.0, 1.5, and 2.0%) containing glucan was added to a basal formulated diet. Twenty and five kutum fry with a mean (±SD) weight of 1.15±0.06g were stocked in each experimental tank (100 l capacity) filled with 80 liter of water. Fish were fed on experimental diet for 56 days and biometry was performed every 15 days. At the end of the trial blood samples were collected for measurement of haematological parameters including: Red and white blood cells count, differential count of white blood cells, hematocrit and hemoglobin, and innate immune factors (Immunoglobulin and Lysozyme). Fries in 1.5% treatment had highest serum immunoglobins (Ig) and eosinophil, although when compared with control but with no significant differences. Highest MCHC, hematocrit and hemoglobin were observed in the 0.5 and 1% treatments and the highest MCV and red blood cell count were in 0.5 percent treatment. The highest white blood cells count and neutrophils was observed in 2% treatment. The highest and lowest levels of lysozyme activity were observed in 1% and control treatments, respectively. Evaluation of the total bacteria and LAB counts revealed significant increase in 0.5% treatment. According to these results administration of dietary glucan can be considered for stimulation of innate immune response of white fish fry

Duodenal Bulb Mucosa with Hypertrophic Gastric Oxyntic Heterotopia in Patients with Zollinger Ellison Syndrome

Objectives. Zollinger-Ellison Syndrome (ZES) results in hypersecretion of gastric acid (via gastrinoma) leading to peptic ulcers, diarrhea, and abdominal pain. We describe the novel discovery of hypertrophic, heterotopic gastric mucosa in the proximal duodenal bulb in patients with ZES, which we hypothesize results in an increased incidence of postbulbar ulcers in patients with ZES (a mechanism previously unreported). We determined the incidence of the novel finding of duodenal gastric oxyntic hypertrophic heterotopia (GOH) in patients with ZES. Methods. Seven patients with ZES were enrolled. The diagnosis of ZES was established by hypergastrinemia, gastric acid hypersecretion, and a positive secretin test or based on biopsy specimens (evaluated via tissue staining). Basal acid output (BAO) and baseline gastrin secretion were determined by established methods. Endoscopic examinations with methylene blue staining and biopsy of the gastric and duodenal mucosa were conducted in all patients every 3–6 months for an average of 5 years. Results. The duodenal mucosa demonstrated hypertrophic GOH in 5 out of 7 patients with ZES and an intact stomach and duodenum. Biopsies from the bowel mucosa demonstrated patchy replacement of surface epithelium by gastric-type epithelium with hypertrophic oxyntic glands in the lamina propria in 5 patients. Two of the patients had no evidence of GOH in the duodenal bulb. Patients with GOH had an average serum gastrin level of 1245 pg/mL and BAO of 2.92 mEq/hr versus 724 pg/mL and 0.8 mEq/hr in patients without GOH. Conclusions. This study demonstrated the presence of duodenal mucosa with GOH in 5 out of 7 patients with ZES and an intact stomach and duodenum. The presence of hypertrophic and heterotopic gastric mucosa is proposed to result from increased gastrin levels and may contribute to the increased incidence of postbulbar ulcers in these patients

Design and performance of ropes for climbing and sailing

Ropes are an important part of the equipment used by climbers, mountaineers, and sailors. On first inspection, most modern polymer ropes appear similar, and it might be assumed that their designs, construction, and properties are governed by the same requirements. In reality, the properties required of climbing ropes are dominated by the requirement that they effectively absorb and dissipate the energy of the falling climber, in a manner that it does not transmit more than a critical amount of force to his body. This requirement is met by the use of ropes with relatively low longitudinal stiffness. In contrast, most sailing ropes require high stiffness values to maximize their effectiveness and enable sailors to control sails and equipment precisely. These conflicting requirements led to the use of different classes of materials and different construction methods for the two sports. This paper reviews in detail the use of ropes, the properties required, manufacturing techniques and materials utilized, and the effect of service conditions on the performance of ropes. A survey of research that has been carried out in the field reveals what progress has been made in the development of these essential components and identifies where further work may yield benefits in the future

Outreach obstetrics training in Western Australia improves neonatal outcome and decreases caesarean sections

The objective of this study was to determine the effect of a multi-professional outreach obstetric training programme on perinatal and neonatal outcomes. This was a retrospective comparison of 5-min low Apgar scores, stillbirth, perinatal death and moderate/severe hypoxic ischaemic encephalopathy rates in 127,753 infants born in Western Australia before and after the introduction of training in rural and remote areas. Following the introduction of the training programme, there was a highly significant (p0.003) decrease in the rate of infants born with low 5-min Apgar scores (from 20.4 to 15.4/1,000 live births). While the changes in the other three outcomes were not significant, all three demonstrated a trend for improvement in the intervention area. This is the second study of an educational intervention in obstetrics to demonstrate improvement in neonatal outcome and the first to be associated with a decrease in caesarean sections

MoS2 Nanosheets Uniformly Anchored on NiMoO4 Nanorods, a Highly Active Hierarchical Nanostructure Catalyst for Oxygen Evolution Reaction and Pseudo-Capacitors

Hierarchical nanostructures have attracted considerable research attention due to their applications in the catalysis field. Herein, we design a versatile hierarchical nanostructure composed of NiMoO4 nanorods surrounded by active MoS2 nanosheets on an interconnected nickel foam substrate. The as-prepared nanostructure exhibits excellent oxygen evolution reaction per-formance, producing a current density of 10 mA cm−2 at an overpotential of 90 mV, in comparison with 220 mV necessary to reach a similar current den-sity for NiMoO4. This behavior originates from the structural/morphological properties of the MoS2 nanosheets, which present numerous surface-active sites and allow good contact with the electrolyte. Besides, the structures can effectively store charges, due to their unique branched network providing accessible active surface area, which facilitates intermediates adsorptions. Particularly, NiMoO4/MoS2 shows a charge capacity of 358 mAhg−1 at a current of 0.5 A g−1 (230 mAhg−1 for NiMoO4), thus suggesting promising applications for charge-storing devices

Au-Decorated Ce-Ti Mixed Oxides for Efficient CO Preferential Photooxidation

We investigated the photocatalytic behavior of gold nanoparticles supported on CeO2-TiO2 nanostructured matrixes in the CO preferential oxidation in H2-rich stream (photo-CO-PROX), by modifying the electronic band structure of ceria through addition of titania and making it more suitable for interacting with free electrons excited in gold nanoparticles through surface plasmon resonance. CeO2 samples with different TiO2 concentrations (0-20 wt %) were prepared through a slow coprecipitation method in alkaline conditions. The synthetic route is surfactant-free and environmentally friendly. Au nanoparticles (<1.0 wt % loading) were deposited on the surface of the CeO2-TiO2 oxides by deposition-precipitation. A benchmarking sample was also considered, prepared by standard fast coprecipitation, to assess how a peculiar morphology can affect the photocatalytic behavior. The samples appeared organized in a hierarchical needle-like structure, with different morphologies depending on the Ti content and preparation method, with homogeneously distributed Au nanoparticles decorating the Ce-Ti mixed oxides. The morphology influences the preferential photooxidation of CO to CO2 in excess of H2 under simulated solar light irradiation at room temperature and atmospheric pressure. The Au/CeO2-TiO2 systems exhibit much higher activity compared to a benchmark sample with a non-organized structure. The most efficient sample exhibited CO conversions of 52.9 and 80.2%, and CO2 selectivities equal to 95.3 and 59.4%, in the dark and under simulated sunlight, respectively. A clear morphology-functionality correlation was found in our systematic analysis, with CO conversion maximized for a TiO2 content equal to 15 wt %. The outcomes of this study are significant advancements toward the development of an effective strategy for exploitation of hydrogen as a viable clean fuel in stationary, automotive, and portable power generators