Distribution of socioeconomic factors among the new patients of skin cancer in Iran

Background: The global burden of cancer due to population growth and aging, and various environmental factors is increasing. Skin cancer is the most common cancer among Iranians and among men, is more common. There is strong evidence from Industrialized and less developed countries that cancer incidence and survival is related to socioeconomic factors. The aim of this study was to investigate the relationship between socioeconomic variables including Human Development Index, unemployment rate and Urbanization ratio with the incidence of skin cancer in Iran. Method: The panel data were for 30 provinces for 6 years) 2007 to 2012(. Data of socioeconomic factors were collected from the Statistical Center of Iran and the data related to the incidence of cancer were collected from the reports on cancer registry of Health and Medical Education Ministry. For data analysis Stata11th version was used. Result: There is no relation between unemployment and the incidence of skin cancer. There is negative relationship between urbanization and incidence of skin cancer in both sexes. There is negative relation between HDI and the incidence of skin cancer in both sexes. Conclusion: Among the three variables selected in this study, the human development index and the urbanization, influenced on the cancer incidence. Therefore, in order to prevent skin cancer, paying attention appears to be necessary for policymakers. Key words: Socioeconomic Factors, Skin Neoplasm, Ira

MicroRNA-183 family in inner ear: Hair cell development and deafness

miRNAs are essential factors of an extensively conserved post-transcriptional process controlling gene expression at mRNA level. Varoius biological processes such as growth and differentiation are regulated by miRNAs. Web of Science and PubMed databases were searched using the Endnote software for the publications about the role miRNA-183 family in inner ear: hair cell development and deafness published from 2000 to 2016. A triplet of these miRNAs particularly the miR-183 family is highly expressed in vertebrate hair cells, as with some of the peripheral neurosensory cells. Point mutations in one member of this family, miR-96, underlie DFNA50 autosomal deafness in humans and lead to abnormal hair cell development and survival in mice. In zebrafish, overexpression of the miR-183 family induces extra and ectopic hair cells, while knockdown decreases the number of hair cell. The miR-183 family (miR-183, miR-96 and miR-182) is expressed abundantly in some types of sensory cell in the eye, nose and inner ear. In the inner ear, mechanosensory hair cells have a robust expression level. Despite much similarity of these miRs sequences, small differences lead to distinct targeting of messenger RNAs targets. In the near future, miRNAs are likely to be explored as potential therapeutic agents to repair or regenerate hair cells, cell reprogramming and regenerative medicine applications in animal models because they can simultaneously down-regulate dozens or even hundreds of transcripts. © 2016 The Korean Audiological Society

Innovation in the use of motor ambulance for prehospital emergency care

BACKGROUND: Prehospital emergency care system is one of the important parts of the health system. Heavy traffic, increasing urban population, and growing demands for prehospital emergency services are challenges faced by this section of the health system. One of the approaches to deal with this issue is using motor ambulances. AIMS: This study aims to investigate the missions of motor ambulances, ambulances, and the effects of motor ambulance services on response time and ambulance missions. MATERIALS AND METHODS: This applied research has been designed as a descriptive and cross-sectional study. Overall, 267,836 missions carried out by ambulances and motor ambulances of Tehran emergency medical service (EMS) Center in the years 2014 and 2015 were investigated. The data were gathered personally by visiting Tehran EMS Center. The data were analyzed by Excel (2013) software. RESULTS: The average response time for ambulances and motor ambulances were 16 min and 14 min and 13 s, respectively. Most of the ambulance and motor ambulance missions were reportedly due to weakness (20%) and heart problems (16%). In 57% of ambulance missions and 71.5% of motor ambulance missions, the patients refused to being transferred to the hospital. Most of the transport missions to hospital (24%) were caused by traffic accidents. CONCLUSIONS: According to the results, the response time was higher than the national standards. Locating motor ambulances on the streets and outside emergency stations during peak traffic times decreased the response time by 2 min and by providing the necessary services in the scene and transferring fewer patients to the hospital, it is possible to provide further services by assigning ambulances to more urgent missions. Thus, it is recommended to employ more seasoned staff, multiply motor ambulances, and locate motor ambulances precisely to decrease response time and also at a lower cost more citizens are provided with prehospital care

Training needs assessment of hospital CEOs in a developing country: the example of Iran

Abstract Background It is essential to identify the necessary competencies of hospital CEOs in order to improve the quality and efficiency of services they provide. Expert leadership skills and competencies can have a significant impact on the success of an organization, benefiting both patients and staff. This study aimed to assess the competencies and training needs of hospital CEOs in Iran public hospitals. Methods We conducted this cross-sectional analytical study through a self-assessment questionnaire, which was a web-based platform developed by the WHO country office in Iran, between July 2018 and September 2018. The questionnaire was completed by 180 hospital CEOs and included a core set of 81 items based on Assessing the Competency of Hospital CEO. These items were categorized into five superordinate categories: leadership, personality and quality of individual behavior, knowledge and business skills, social responsibility, and healthcare environment. In addition, we conducted focus groups with 30 hospital CEOs, supervisor assessments with 10 hospital managers, and interviews with 10 supervisors. Results Of the 180 questionnaires distributed, 78% were returned, and most respondents were medical specialists. The need for leadership competencies such as individual behavior skills and change management received the highest priority. Most respondents required training in management skills, including financial management, governance, strategic thinking, quality improvement, and disaster management. Conclusion Providing needs-based education is crucial, especially in developing countries. In this study, leadership and strategic thinking were found to be the most needed competencies among hospital CEOs in Iran. These findings serve as reference points for developing countries with similar backgrounds and healthcare environments as Iran

Education Quality Assessment in the Field of Focus on Workforce: Iranian Education Quality Management (IEQM) Model

Introduction: IEQM Model is a tool for evaluating universities that provides regular, systematic and comprehensive review of university activities. The aim of this study was to evaluate the quality of education in the field of focus on workforce based on IEQM model in Mashhad University of Medical Sciences. Methods: This descriptive cross-sectional study was performed on 150 faculty members and employees of Mashhad University of Medical Sciences in 2014. Subjects were selected through stratified random sampling. Data were collected using Ministry of Health’s IEQM model 5-point Likert scale questionnaire whose validity and reliability were confirmed. The data were analyzed by means of descriptive statistics, one-way ANOVA and independent t-test at the significance level of 0.05. Results: A total of 125 questionnaires were analyzed. The highest and lowest means scores were related to faculties of health and nursing respectively. The best and worst scores were related to the fields of working conditions (82.82±2.0) and employees’ empowerment (65.73±2.0). In general, the score of focus on workforce was 55% of the total points (85). The mean score of this field was not significantly related to education (p=0.5), gender (p=0.6) and the faculties under study (p=0.6). Conclusion: The status of Mashhad University of Medical Sciences in the field of focus on workforce was at an average level. Results indicated that the working condition was almost appropriate from the perspective of faculty members but employees’ empowerment in the faculties was a priority

Analysis of Spatial Distribution of Pre-hospital Emergency Medical Services in Traffic Accidents: Mashhad City, Iran

Background: Physical access to health services is determined by the geographic location of the patient. This study aims to distribute the bases and hospitals of Mashhad City, Iran, and the extent of coverage of the bases in traffic accidents. Materials and Methods: This research is a descriptive cross-sectional and applied study. The study population for high-accident points includes 21142 missions carried out regarding traffic accidents as well as 37 points related to 115 emergency bases in 2014. The information needed by the researcher was collected by receiving the files of the injured from the statistical unit of the center. By forming the database of the road network in Mashhad City in a geographic information system environment as communication links and defining emergency centers as facilities, the radius of emergency centers was drawn using the service area method.  Results: In this study, the areas that needed more services and the number of provider centers was less compared to the covered area were identified. After matching the distribution map of the bases with the distribution of accidents, the areas with the lowest distribution of accidents and the highest service of emergency medical services, as well as high accidents and less service were obtained.  Conclusion: The distribution of bases and hospitals does not have a proper distribution situation, which can lead to the lowering of the desired level and the creation of illogical concentration. To cover the emergency missions, it is necessary to set up emergency bases and complete the existing hospitals in the city

Evaluation of Medication Errors by Nurses in Hospitals Affiliated with Mashhad University of Medical Sciences, Mashhad, Iran

Introduction: Medication error is one of the quality problems in hospitals harming millions of people around the world every year. This study aimed to investigate the occurrence and reporting of medication errors by nurses in hospitals affiliated with Mashhad University of Medical Sciences, Mashhad, Iran. Materials and Methods: This descriptive cross-sectional study was conducted on 530 nurses selected by simple and stratified random sampling in 2014. Data were collected using a survey consisting of four sections and 66 questions, scored based on a Likert scale (87% return rate). Data analysis was performed in SPSS Version 18 using descriptive statistics, ANOVA test, and chi-square test. P-value of less than 0.05 was considered statistically significance. Results: The most prevalent medication errors by nurses was early or late administration of medication (43.7%), which was attributed to individual factors by the managers in the viewpoint of the nurses (mean: 3.66+1.3). In addition, the occurrence of medication error might be due to the hospital ward patient overcrowding (4.29+1.07). No significant relationship was observed between the variables of medication error, the causes, and lack of error report with gender and nursing experience (P=0.6 and P=0.8, respectively). Conclusion: One of the effective methods for prevention of medication error is providing teaching courses for nurses to raise their knowledge in this regard and aware them of the outcomes of wrong medication prescription

Pre-Hospital Emergency Services With Emphasis on Traffic Accidents: A Case Study in Mashhad, Iran

Background: Pre-hospital emergency service is an important part of any health care system. The present study was conducted to evaluate the pre-hospital Emergency Services 115 of Mashhad City, Iran with emphasis on response to traffic accidents during 2012-2013. Materials and Methods: In this descriptive cross-sectional and applied study, 53685 files of traffic accident victims related to 42240 missions accomplished during 2012-2013 were evaluated. The study data were collected by referring to the statistics unit of the Center for Medical Emergencies and Accidents. To determine the services performed for the victims, a researcher-designed checklist was used. Descriptive statistics were performed to analyze the raw data. All analyses were done by Excel 2013. Results: The average (SD) age of traffic accident victims was 29.5(15.69) years. The frequency of accidents was more in September, on Thursdays, and between 6 and 9 PM. About 70% of missions ended with the transfer the injured to hospitals and average (SD) response times were 8:24 (2:35) minutes in 2012 and 9:01 (2:46) minutes in 2013. The frequency of treatment and dispatch to hospitals by the resident physician were reported as 70.51% in 2012 and 69.7% in 2013. The most frequent action taken were injections (96%) and then stabilizing body limbs (60%). Conclusion: Considering the findings of this research, the response time was longer than the standard time. Regarding the performed services, shortcomings in manpower and ambulance equipment can reduce the effectiveness of missions. Therefore, Emergency Center 115 of Mashhad should carry out some interventions to resolve shortages in manpower and equipment to reach standard conditions and provide better services