Approaches and Components of Health Workforce Planning Models: A Systematic Review

Background: To date, there is still no uniformity in forecasting models for health workforce planning (HWFP). Different countries use various HWFP models, some of which are context-specific. The objective of this systematic review is to determine approaches and components of HWFP models.Methods: A systematic review of studies published in English and Persian between 2004 and 2021 was performed by searching PubMed Central, MEDLINE, Web of Science, Scopus, Eric, and Elmnet databases. Articles that assessed HWFP models, focused on health service delivery, used input-output models, and a clear formulation process were included. Articles that scored ≥20 points on the “strengthening the reporting of observational studies in epidemiology” checklist were considered of acceptable quality for inclusion.Results: Twenty articles were included for qualitative synthesis based on the inclusion and exclusion criteria. Most studies used the mixed method approach “supply and demand”, whereas target- and needs-based approaches were used less frequently. The number of components used to estimate supply, demand, needs, and targets were 42, 32, 11, and 6, respectively. In addition, several unique factors used in the various HWFP models were identified.Conclusion: Different approaches are used in HWFP models, which is indicative of the lack of consensus on this topic. High diversity in the identified factors is related to the approach used and the context in which the model is applied

Berberine as a Natural Modifier of Gut Microbiota to Promote Metabolic Status in Animal Studies and Clinical Trials: A Systematic Review

As a phytochemical, berberine can modulate metabolic parameters via altering gut flora. However, findings are conflicting. In the present systematic review, we aimed to summarize the effects of berberine on gut microbiota in the models of metabolic disorders in both animal studies and clinical trials. Publications in five electronic databases including PubMed, SCOPUS, EMBASE, Web of Science, and Cochrane Library were searched systematically up to 31 May 2021 to find relevant articles with English language. Out of 4102 studies (including 2125 duplicates), 35 studies were included. In animal studies, various effects of berberine on beneficial and harmful microbiota were reported. However, findings also indicated that berberine can decrease the Firmicutes to Bacteroidetes (F/B) ratio. Three out of five studies showed positive effects of berberine on the production of short-chain fatty acids (SCFA), particularly butyrate. In three animal studies, Lipopolysacaride (LPS) concentrations decreased with berberine administration. In clinical trials (n=3) positive effects on microbiota and metabolic status were also reported. However, the quality of clinical trials was mainly low.The present systematic review showed that berberine can modulate key metabolic parameters through improving the balance of intestinal microbiome, decreasing the abundance of harmful microbiota and LPS concentrations, and increasing the production of SCFAs, particularly butyrate in animal models. However, there are limited high-quality evidence regarding the effects of berberine on gut flora in clinical trials. Although berberine can be an effective prebiotic supplement to modulate metabolic parameters, further high-quality clinical trials are needed to confirm this potential

Treatment of Wastewater Containing Aniline Using a Moving Bed Biofilm Reactor (MBBR)

In this research, the capability of the moving bed biofilm reactor (MBBR) for the treatment of aniline wastewater has been investigated. This compound is found in effluents from chemical, dye, pigment, herbicide, pharmaceutical, plastic, and paint industries. The moving bed biofilm reactor was developed to adopt the best features of the activated sludge process as well as those of the biofilter processes. In this study, a cylindrical moving bed biofilm reactor with an approximate capacity of 5 liters was used. The effects of LECA (Light Expanded Clay Aggregate) filling ratio and retention times (RT) of 8, 24, 48, and 72 hr were investigated on removal efficiency for different influent COD values. The best removal efficiency of 91% was obtained for a COD level of 2000 mg/L after 72 hour. Other experiments were conducted to evaluate the removal efficiency of the reactor under a decreased carrier volume of 30% and under continuous loading. NMR test results confirmed the capability of the reactor in the biodegradation of aniline. The capability of the reactor was also evaluated by feeding an organic shock that resulted in satisfactory performance of MBBR. The results showed that Grau and Stover-Kincannon were the best models to describe the biological kinetic data in this study

Anatomical Features of the Interscapular Area Where Wet Cupping Therapy Is Done and Its Possible Relation to Acupuncture Meridians

Although wet cupping has been a treatment for centuries, its mechanism of action is not well understood. Because the anatomical features of the wet-cupping area might play a role in its mechanism, we focus on the features of the interscapular area in which a common type of wet-cupping therapy (WCT), called Hijamat-e-Aam in Iranian medicine, is usually applied and discuss the possible relation of those features to the acupuncture meridians. We gathered and analyzed data from reliable textbooks on modern medicine with a focus on the anatomical features of the interscapular area, topics related to WTC in Iranian medicine, and acupuncture sources obtained by searching PubMed, Google-Scholar, and Science Direct. The interscapular area used for WCT was found to have special features: brown adipose tissue, immediate proximity to sympathetic ganglia, passage of the thoracic duct, two important acupuncture meridians, and proximity to the main vessel divisions carrying blood from the heart and the brain. These features indicate that the interscapular application of WCT not only discharges waste materials through a shifting of blood to the site after application of a traction force but also invigorates the body’s metabolism, increases immunity, and regulates blood biochemistry, which are desired therapeutic effects of WCT

The Effects of Oral Consumption of Honey on Key Metabolic Profiles in Adult Patients with Type 2 Diabetes Mellitus and Nondiabetic Individuals: A Systematic Review of Clinical Trials

Objectives. Although several clinical trials have revealed the beneficial effects of honey on metabolic profiles, the results are conflicting. The aim of this study was to systematically summarize the effects of oral consumption of honey on key metabolic profiles in adult patients with type 2 diabetes mellitus (T2DM) and nondiabetic individuals. Methods. In total, four electronic databases, including PubMed/Medline, Web of Science, Scopus, and Cochrane library, were searched from 2000 to 31 July 2019 to identify all English language studies that would meet the eligibility criteria. Clinical trials which have examined the effects of oral consumption of any types of honey on anthropometric indices, glycemic status, lipid profiles, and blood pressure in both diabetic and nondiabetic adult subjects were included in the study. Results. Of the 7769 possible relevant studies (including 3547 duplicates) identified in the initial search, finally, 13 clinical trials were included in the systematic review. All studies except three had a parallel design. Of 13 studies, 8 trials did not have placebo/control groups. The included studies examined the impact of oral consumption of honey on glycemic status (n = 12), anthropometric indices (n = 6), lipid profiles (n = 10), and blood pressure (n = 3). Based on the Jadad scale, 5 studies had acceptable methodological quality, and the remaining (n = 8) had low methodological quality. Conclusion. The current systematic review showed that oral consumption of honey might have no significant effects on the modulation of metabolic profiles in nondiabetic subjects. In addition, a high intake of honey might increase glucose levels and worsen other metabolic parameters in patients with T2DM. Due to substantial heterogeneity in study design and limited clinical trials, results, however, should be interpreted with great caution

Spatial Planning, a Necessity of Designing Unified Policy Structure and National Document for Higher Education in second Step of Islamic Revolution

Letter to edito

Safety Evaluation of Crocin (a constituent of saffron) Tablets in Healthy Volunteers

Objective(s): Crocin is the chemical ingredient primarily responsible for the color of saffron. It has different pharmacological effects such as antioxidant, anticancer and memory improving activities. Crocin tablets were evaluated for short-term safety and tolerability in healthy adult volunteers. Materials and Methods: The study was a randomized, double-blind, placebo-controlled design consisting of one month treatment of crocin tablets. Volunteers who fulfilled inclusion and exclusion criteria were randomized into 2 groups of 22 each (males and females) and received 20 mg crocin tablets or placebo. General measures of health were recorded during the study such as hematological, biochemical, hormonal and urinary parameters in pre and post-treatment periods. Results: No major adverse events were reported during the trial. Crocin tablets did not change the above parameters except that it decreased amylase, mixed white blood cells and PTT in healthy volunteers after one month. Conclusion: This clinical safety evaluation showed a relatively safe and normal profile for crocin in healthy volunteers at the given doses within the trial period

The roles of quercetin in diabetes mellitus and related metabolic disorders; special focus on the modulation of gut microbiota: A comprehensive review

Quercetin is a dietary flavonoid that can affect the balance between anti-oxidant defense system and oxidative stress. A number of studies showed the positive effects of quercetin on diabetes mellitus and related metabolic disorders through different pathways such as gut flora. However, findings are conflicting. In addition, it seems no studies have summarized all potential mechanisms of quercetin in diabetes mellitus, so far. Therefore, the aims of the present comprehensive review were to provide an overview on biological and biochemical characteristics of quercetin and investigate the effect of quercetin on diabetes mellitus and related metabolic disorders by focusing on its effects on the modulation of gut microbiota. For this purpose, findings of In vitro, animal studies, clinical trials, and review studies with the English language published until January 2021 were summarized. They were identified through electronic databases (PubMed, Scopus, and Cochrane Library) and Google Scholar. Findings showed that quercetin can be an effective component for improving glycemic status and other metabolic disorders related to diabetes mellitus based on In vitro and animal studies. However, environmental factors, food processing and using nanoformulations can affect its efficacy in human studies. Several potential mechanisms, including the modulation of gut flora are proposed for its actions. However, due to limited clinical trials and contradictory findings, more high-quality clinical trials are needed to make a decision on the efficacy of supplementation with quercetin as a complementary therapy for the management of diabetes mellitus, metabolic disorders, and modulating gut flora

The roles of quercetin in diabetes mellitus and related metabolic disorders; special focus on the modulation of gut microbiota: A comprehensive review

Quercetin is a dietary flavonoid that can affect the balance between anti-oxidant defense system and oxidative stress. A number of studies showed the positive effects of quercetin on diabetes mellitus and related metabolic disorders through different pathways such as gut flora. However, findings are conflicting. In addition, it seems no studies have summarized all potential mechanisms of quercetin in diabetes mellitus, so far. Therefore, the aims of the present comprehensive review were to provide an overview on biological and biochemical characteristics of quercetin and investigate the effect of quercetin on diabetes mellitus and related metabolic disorders by focusing on its effects on the modulation of gut microbiota. For this purpose, findings of In vitro, animal studies, clinical trials, and review studies with the English language published until January 2021 were summarized. They were identified through electronic databases (PubMed, Scopus, and Cochrane Library) and Google Scholar. Findings showed that quercetin can be an effective component for improving glycemic status and other metabolic disorders related to diabetes mellitus based on In vitro and animal studies. However, environmental factors, food processing and using nanoformulations can affect its efficacy in human studies. Several potential mechanisms, including the modulation of gut flora are proposed for its actions. However, due to limited clinical trials and contradictory findings, more high-quality clinical trials are needed to make a decision on the efficacy of supplementation with quercetin as a complementary therapy for the management of diabetes mellitus, metabolic disorders, and modulating gut flora