Representing the Unrepresentable: Trauma in Rocketman

Lida Shams-Mostofi’s video essay “Representing the Unpresentable: Trauma in Rocketman” delves into the representation of trauma in the biographical musical film Rocketman (2019), reflecting traumatic flashbacks of disturbing video sequences

Values in Health Policy – A Concept Analysis

Background: Despite the significant role “values” play in decision-making no definition or attributes regarding the concept have been provided in health policy-making. This study aimed to clarify the defining attributes of a concept of value and its irrelevant structures in health policy-making. We anticipate our findings will help reduce the semantic ambiguities associated with the use of “values” and other concepts such as principles, criteria, attitudes, and beliefs. Methods: An extensive search of literature was carried out using electronic data base and library. The overall search strategy yielded about 1540 articles and 450 additional records. Based on traditional qualitative research, studies were purposefully selected and the coding of articles continued until data saturation was reached. Accordingly, 31 articles, 2 books, and 5 other documents were selected for the review. We applied Walker and Avant’s method of concept analysis in studying the phenomenon. Definitions, applications, attributes, antecedents, and consequences of the concept of “value in health policy-making” were extracted. We also identified similarities and differences that exist between and within them. Results: We identified eight major attributes of “value in health policy-making”: ideological origin, affect one’s choices, more resistant to change over time, source of motivation, ability to sacrifice one’s interest, goal-oriented nature for community, trans-situational and subjectivity. Other features pinpointed include alternatives, antecedents, and consequences. Alternative, antecedents and consequences case may have more or fewer attributes or may lack one of these attributes and at the same time have other distinctive ones. Conclusion: Despite the use of the value framework, ambiguities still persist in providing definition of the concept value in health policy-making. Understanding the concept of value in health policy-making may provide extra theoretical support to decision-makers in their policy-making process, to help avoid poor policy formulation and wastage of limited resource

Relationship between Health Care Organization Management Standards of the Joint Commission International and Health Tourism in Selected Hospitals in Tehran

Introduction: Health tourism is an organized travel we make from where we live to another place to keep, regain, and improve physical and mental health. It can be also a national strategy to improve national income and some believe that it can be an integral part of national security. The present study is an attempt to determine the relationship between observance of the standards of international Joint Commission regarding structural-centered fields and number of health tourists attracted to a country. Methods: The study is a descriptive-analytical work of applied type, which was conducted as cross-sectional work in 2012 on some of Tehran-based hospitals. Sampling was carried out randomly and for data gathering the standard checklist of the commission was employed. The tool covered six Health Care Organization Management Standards. Reliability and validity of the checklist have been ascertained by previous works. Data was collected through observing, interviewing, and document reviewing. For data analyses, descriptive and deductive statistics were used in SPSS16. Results: Observance of the standard regarding its different aspects is not equal as regarding infection prevention and control (3.48) we found highest mean point and the lowest position was obtained by improvement of quality and patients’ safety (2.52). A relatively positive correlation (r=0.114) was observed between observance of the standards of the commission and attracting health tourists. Conclusion: Given the results obtained, it is notable that the development and implementation of an accreditation system for health services centers nationwide, which is aimed to improve quality of health services in light of the standards of International Joint Commission is helpful in attracting more health tourists. </span

Surface Coating of Polyurethane Films with Gelatin, Aspirin and Heparin to Increase the Hemocompatibility of Artificial Vascular Grafts

Purpose: A hemocompatible substrate can offer a wonderful facility for nitric oxide (NO) production by vascular endothelial cells in reaction to the inflammation following injuries. NO inhibits platelet aggregation this is especially critical in small-diameter vessels. Methods: The substrate films were made of polyurethane (PU) in a casting process and after plasma treatments, their surface was chemically decorated with polyethylene glycol (PEG) 2000, gelatin, gelatin-aspirin, gelatin-heparin and gelatin-aspirin-heparin. The concentrations of these ingredients were optimized in order to achieve the biocompatible values and the resulting modifications were characterized by water contact angle and Fourier transform infra-red (FTIR) assays. The values of NO production and platelet adhesion were then examined. Results: The water contact angle of the modified surface was reduced to 26±4⸰ and the newly developed hydrophilic chemical groups were confirmed by FTIR. The respective concentrations of 0.05 mg/ml and 100 mg/mL were found to be the IC50 values for aspirin and heparin. However, after the surface modification with aspirin, the bioactivity of the substrate increased in compared to the other experimental groups. In addition, there was a synergistic effect between these reagents for NO synthesis. While, heparin inhibited platelet adhesion more than aspirin. Conclusion: Because of the highly hydrophilic nature of heparin, this reagent was hydrolyzed faster than aspirin and therefore its influence on platelet aggregation and cell growth was greater. Taken together, the results give the biocompatible concentrations of both biomolecules that are required for endothelial cell proliferation, NO synthesis and platelet adhesion

Global respiratory syncytial virus–related infant community deaths

Background Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with >99% of mortality occurring in low- and lower middle-income countries. At least half of RSV-related deaths are estimated to occur in the community, but clinical characteristics of this group of children remain poorly characterized. Methods The RSV Global Online Mortality Database (RSV GOLD), a global registry of under-5 children who have died with RSV-related illness, describes clinical characteristics of children dying of RSV through global data sharing. RSV GOLD acts as a collaborative platform for global deaths, including community mortality studies described in this supplement. We aimed to compare the age distribution of infant deaths <6 months occurring in the community with in-hospital. Results We studied 829 RSV-related deaths <1 year of age from 38 developing countries, including 166 community deaths from 12 countries. There were 629 deaths that occurred <6 months, of which 156 (25%) occurred in the community. Among infants who died before 6 months of age, median age at death in the community (1.5 months; IQR: 0.8−3.3) was lower than in-hospital (2.4 months; IQR: 1.5−4.0; P < .0001). The proportion of neonatal deaths was higher in the community (29%, 46/156) than in-hospital (12%, 57/473, P < 0.0001). Conclusions We observed that children in the community die at a younger age. We expect that maternal vaccination or immunoprophylaxis against RSV will have a larger impact on RSV-related mortality in the community than in-hospital. This case series of RSV-related community deaths, made possible through global data sharing, allowed us to assess the potential impact of future RSV vaccines

Genomic Detection of Coxiella burnetii in Raw and Unpasteurized Cow Milk of Traditional domestic dairy products Vendors in Khorramabad, Lorestan Province in 2015

Background: Q fever is a widespread zoonotic disease that is caused by obligate intracellular bacteria, Coxiella burnetii. Raw milk or dairy products that are produced from unpasteurized milk may contain virulent Coxiella burnetii. The objective of this study was to determine the prevalence rate of C. burnetii in raw and unpasteurized cow bulk tank milk samples of traditional domestic dairy products vendors in Khorramabad, Iran. Materials and Methods: In this cross - sectional study a total of 120 raw and unpasteurized cow bulk tank milk samples in traditional domestic dairy products vendors were collected from October 2015 to November 2015 and tested for C. burnetii used a nested PCR assay. Results: In this survey, 9 out of 120 (7.5%) raw and unpasteurized cow bulk tank milk samples were found PCR positive for C. burnetii. Conclusion: The Results of this study indicate that raw and unpasteurized cow bulk tank milk samples in traditional domestic dairy products vendors are an important source of C. burnetii infection in Khorramabad

Molecular Detection of Brucella abortus and Brucella melitensis in Raw and Unpasteurized Bulk Cow Milk Tanks of Traditional Domestic Dairy Sale Centres in Khorramabad

Background and Aims: Brucellosis or Malta fever is one of the most prevalent zoonotic diseases considered as a health and economic problem in many countries in the Middle East, including Iran. The consumption of contaminated milk, milk products and contact with infected animals are the main transmission ways of pathogenic Brucella strains among human. The aim of the current study was to determine simultaneous detection of Brucella abortus and Brucella melitensis in raw and none-pasteurized bulk cow milk tanks of traditional domestic dairy sale centres in Khorramabad, Iran. Materials and Methods: In this cross-sectional study during October and November 2015, a total of 120 samples from raw and unpasteurized bulk cow milk tanks were collected from traditional domestic dairy sale centres in Khorramabad. To confirm the presence of Brucella genus among the samples, single PCR was carried out using B4 and B5 primers and multiplex PCR was then carried out in order to detect the B. abortus and B. melitensis spp.. Results: The present study revealed that 10% of the bulk milk tank samples in traditional domestic dairy sale centres in Khorramabad were contaminated with Brucella. Conclusions: Results of PCR assay showed that raw and unpasteurized bulk cow milk tanks of traditional domestic dairy sale centres in Khorramabad are the potential cause of human brucellosis in this region

Values in Health Policy – A Concept Analysis

Background Despite the significant role “values” play in decision-making no definition or attributes regarding the concept have been provided in health policy-making. This study aimed to clarify the defining attributes of a concept of value and its irrelevant structures in health policy-making. We anticipate our findings will help reduce the semantic ambiguities associated with the use of “values” and other concepts such as principles, criteria, attitudes, and beliefs. Methods An extensive search of literature was carried out using electronic data base and library. The overall search strategy yielded about 1540 articles and 450 additional records. Based on traditional qualitative research, studies were purposefully selected and the coding of articles continued until data saturation was reached. Accordingly, 31 articles, 2 books, and 5 other documents were selected for the review. We applied Walker and Avant’s method of concept analysis in studying the phenomenon. Definitions, applications, attributes, antecedents, and consequences of the concept of “value in health policy-making” were extracted. We also identified similarities and differences that exist between and within them. Results We identified eight major attributes of “value in health policy-making”: ideological origin, affect one’s choices, more resistant to change over time, source of motivation, ability to sacrifice one’s interest, goal-oriented nature for community, trans-situational and subjectivity. Other features pinpointed include alternatives, antecedents, and consequences. Alternative, antecedents and consequences case may have more or fewer attributes or may lack one of these attributes and at the same time have other distinctive ones. Conclusion Despite the use of the value framework, ambiguities still persist in providing definition of the concept value in health policy-making. Understanding the concept of value in health policy-making may provide extra theoretical support to decision-makers in their policy-making process, to help avoid poor policy formulation and wastage of limited resources

Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS)

Background: Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). Methods: This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research in-strument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Results: Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Conclusions: Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authori-ties in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable frame-work and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning

Effect of group schema therapy on physical self-concept and worry about weight and diet among obese women

Obese women have negative physical self-concept and attitude about self .Schema therapy as a new approach in psychological intervention is effective in reduction of negative beliefs, self-concept and worry. The purpose of this study was to investigate the effect of group schema therapy on physical self-concept and worry about weight and diet in women with obesity. This study was a quasi-experimental design using pretest-posttest and control group. Statistical population consists of 186 women who referred to a nutrition and diet therapy clinic and nutrition counseling center. After screening women with obesity, they were asked to fulfill Physical Self-Description Questionnaire (PSDQ) and Worry about Weight and Diet Scale (WWDS). Those who gained high scores in these questionnaires (40 women) selected for study. Among of them 30 women were selected randomly and placed in two experimental and control groups (15 persons in each group). The experimental group received 15 sessions of group schema therapy with 90 minutes per session and control group was in waiting list. Both groups completed PSDQ and WWDS in baseline and final intervention. The results showed that there is a significant difference in terms of physical self- concept and concern about weight and food diet between experimental and control group. Group schema therapy training for women with obesity can lead to improvement of physical self-concept and reduction of worry about weight and food diet