Quality measurement indicators for Iranian Health Centers

Background: Recently, quality is a serious concern in development of organizations. There are various indicators to assess quality and the purpose of this study was to identify the main indicators for quality measurement of Iranian health centers. Methods: This qualitative study was conducted in three stages: first, review of the literature was performed to identify different indicators for quality measurement in health centers; second, a two-round Delphi process was used with participation of 18 experts in both rounds; third, Analytical Hierarchy Process (AHP) method was applied to give weights to each indicator. Results: Twenty-seven indicators were identified from the literature review stage. The Delphi method reduced the list to 4 indicators. Developing a quality plan in the health center had the highest weight (38) and percentage of followed complaints the lowest (12). The consistency rate was 7.2 indicating appropriateness of the data. Conclusion: This list of indicators can be used as a template for measuring quality of health centers in Iran and possibly in other developing countries

Management ofwater content of soil in cultivation of greenhouse cucumber (Cucumis sativus L, Nasim variety) in Isfahan- Iran

Measurement and control of water content of soil is an essential factor in irrigation management, to apply the best management practice for reducing water consumption and improving product quality. The water content of soil is an important factor in greenhouse where it is directly related to the total amount of water consumed for irrigation. Since cucumbers (Cucumis sativus L, Nasim variety) is considered as the main and much used summer crop in Iran, which are extremely sensitive to adverse conditions particularly water stress, determination and supply of water is vital for this plant. To this end, maximum allowable depletion (MAD) should be determined. This experiment was conducted in the research greenhouse (Plastic Covered) of Islamic Azad University in Khorasgan, Isfahan, during a period of five months. This project was implemented in the framework of three 40, 60, and 80 cm bar water suction treatments with three replications using tensiometer. Before treatment application, water content of soil was determined in weight. MAD in 40, 60, and 80 cm bar treatments was 22, 32 and 50%, respectively. Statistical results and mean comparison demonstrated that MAD of 22 and 32% led to a significant yield increase (P<0.001), while MAD of 50% had the least yield. The results reveal that there was a significant difference between MAD of 22 and 32% in increasing leaf area index (LAI) (P<0.001).Key words: Maximum allowable depletion, greenhouse cucumber, tensiometer, leaf area index

The relationship between problem-focused coping strategies and quality of life in schizophrenic patients

Background: Schizophrenia is a disorder with psychotic symptoms that severely affects personal performance. Assessing problem- focused strategies and quality of life (QoL) in patients with schizophrenia may help the clinicians to use appropriate interventions. This study was conducted to find the relationship between problem-focused coping strategies and quality of life in schizophrenic patients who referred to the clinic of Iran University of Medical Sciences in 2013. Methods: Non-random sampling was used in two stages (quota and convenience sampling). Data were collected through Demographic Questionnaire, 5-point Likert-type scale World Health Organization Quality of Life and Problem-Focused Strategies Standard Questionnaire. Four dimensions of QoL which were assessed among schizophrenic patients were as follows: Physical health, mental health, social relationships and environmental factors. Pearson correlation coefficient and regression were used for data analysis. Results: The highest mean score (Mean = 2.7) belonged to environmental factors and the lowest score to social relationships (Mean = 2.55). Overall, there was a significant direct relationship between the QoL and problem-focused coping strategies (p = 0.024, r = 0.319). Conclusion: The Schizophrenic patients who used more problem- focused coping strategies had better QoL. Therefore, it is important to take into account problem- focus coping strategies when treating the patients. The application of this research will be crucial to clinicians and healthcare executives

Effect of tocotrienols enriched canola oil on glycemic control and oxidative status in patients with type 2 diabetes mellitus: A randomized double-blind placebo-controlled clinical trial

Background: Tocotrienols have been shown to improve glycemic control and redox balance in an animal study, but their effects on patients with diabetes are unknown. The study aimed to investigate whether tocotrienols improves glycemic control, insulin sensitivity, and oxidative stress in individuals with type 2 diabetes mellitus (T2DM). Materials and Methods: This study was a double-blinded, placebo-controlled, randomized trial. A total of 50 patients, aged 35-60 years, with T2DM treated by noninsulin hypoglycemic drugs were randomly assigned to receive either 15 mL/day tocotrienols (200 mg) enriched canola oil (n = 25) or pure canola oil (n = 25) for 8 weeks. Fasting blood sugar (FBS), fasting insulin, total antioxidant capacity (TAC), malondialdehyde (MDA), and homeostatic model assessment for insulin resistance (HOMA-IR) were determined before and after the intervention. The data were compared between and within groups, before and after the intervention. Results: Baseline characteristics of participants including age, sex, physical activity, disease duration, and type of drug consumption were not significantly different between the two groups. In tocotrienol enriched canola oil, FBS (mean percent change: �15.4 vs. 3.9; P = 0.006) and MDA (median percent change: �35.6 vs. 16.3; P = 0.003) were significantly reduced while TAC was significantly increased (median percent change: 21.4 vs. 2.3; P = 0.001) compared to pure canola oil. At the end of the study, patients who treated with tocotrienols had lower FBS (P = 0.023) and MDA (P = 0.044) compared to the pure canola oil group. However, tocotrienols had no effect on insulin concentrations and HOMA-IR. Conclusion: Tocotrienols can improve FBS concentrations and modifies redox balance in T2DM patients with poor glycemic control and can be considered in combination with hypoglycemic drugs to better control of T2DM. © 2015 Journal of Research in Medical Sciences

Quantum Black Hole in the Generalized Uncertainty Principle Framework

In this paper we study the effects of the Generalized Uncertainty Principle (GUP) on canonical quantum gravity of black holes. Through the use of modified partition function that involves the effects of the GUP, we obtain the thermodynamical properties of the Schwarzschild black hole. We also calculate the Hawking temperature and entropy for the modification of the Schwarzschild black hole in the presence of the GUP.Comment: 11 pages, no figures, to appear in Physical Review

Containing COVID: the establishment and management of a COVID-19 ward in an adult psychiatric hospital

BACKGROUND: As the coronavirus disease 2019 (COVID-19) epidemic in the UK emerged and escalated, clinicians working in mental health in-patient facilities faced unique medical, psychiatric and staffing challenges in managing and containing the impact of the virus and, in the context of legislation, enforcing social distancing. AIMS: To describe (a) the steps taken by one mental health hospital to establish a COVID-19 isolation ward for adult psychiatric in-patients and (b) how staff addressed the challenges that emerged over the period March to June 2020. METHOD: A descriptive study detailing the processes involved in changing the role of the ward and the measures taken to address the various challenges that arose. Brief clinical cases of two patients are included for illustrative purposes. RESULTS: We describe the achievements, lessons learned and outcomes of the process of repurposing a mental health triage ward into a COVID-19 isolation facility, including the impact on staff. Flexibility, rapid problem-solving and close teamwork were essential. Some of the changes made will be sustained on the ward in our primary role as a triage ward. CONCLUSIONS: Although the challenges faced were difficult, the legacy they have left is that of a range of improvements in patient care and the working environment

The association between empirical dietary inflammatory pattern and metabolic phenotypes in overweight/obese adults

Objectives: The study aimed to investigate whether diet-induced inflammation assessed by Empirical DietaryInflammatory Pattern (EDIP) is associated with odds of unhealthy metabolic phenotype and components of metabolic syndrome (MetS). Methods: This cross-sectional study included 403 overweight/obese individuals recruited from employees of two pharmaceutical companies in Iran. The weighted intake of 15 food groups was summed to construct EDIP and metabolic phenotypes were defined based on MetS criteria. Results: After adjusting for age, sex, BMI, and marital status, the odds of unhealthy phenotype increased significantly from quartile 1 to quartile 4 (P-trend = 0.013). However, the association became non-significant after adjusting for energy intake. Compared to those in the lowest quartile, individuals with higher EDIP scores had higher odds of high fasting blood sugar (FBS) (P-trend = 0.031) and low HDL-C (P-trend = 0.036) after adjusting for all covariates. By adding energy intake into the model, an inverse association was observed between EDIP, waist circumference (WC), and odds of high WC. Conclusions: A higher pro-inflammatory diet was associated with higher odds of unhealthy phenotype, high FBS, and low-HDL-C in overweight/obese individuals. However, the association with unhealthy phenotype seems to be dependent on the energy intake. © 2018, International Journal of Endocrinology and Metabolism

The association between empirical dietary inflammatory pattern and metabolic phenotypes in overweight/obese adults

Objectives: The study aimed to investigate whether diet-induced inflammation assessed by Empirical DietaryInflammatory Pattern (EDIP) is associated with odds of unhealthy metabolic phenotype and components of metabolic syndrome (MetS). Methods: This cross-sectional study included 403 overweight/obese individuals recruited from employees of two pharmaceutical companies in Iran. The weighted intake of 15 food groups was summed to construct EDIP and metabolic phenotypes were defined based on MetS criteria. Results: After adjusting for age, sex, BMI, and marital status, the odds of unhealthy phenotype increased significantly from quartile 1 to quartile 4 (P-trend = 0.013). However, the association became non-significant after adjusting for energy intake. Compared to those in the lowest quartile, individuals with higher EDIP scores had higher odds of high fasting blood sugar (FBS) (P-trend = 0.031) and low HDL-C (P-trend = 0.036) after adjusting for all covariates. By adding energy intake into the model, an inverse association was observed between EDIP, waist circumference (WC), and odds of high WC. Conclusions: A higher pro-inflammatory diet was associated with higher odds of unhealthy phenotype, high FBS, and low-HDL-C in overweight/obese individuals. However, the association with unhealthy phenotype seems to be dependent on the energy intake. © 2018, International Journal of Endocrinology and Metabolism

Aesthetics and Psychological Effects of Fractal Based Design

Highly prevalent in nature, fractal patterns possess self-similar components that repeat at varying size scales. The perceptual experience of human-made environments can be impacted with inclusion of these natural patterns. Previous work has demonstrated consistent trends in preference for and complexity estimates of fractal patterns. However, limited information has been gathered on the impact of other visual judgments. Here we examine the aesthetic and perceptual experience of fractal ‘global-forest’ designs already installed in humanmade spaces and demonstrate how fractal pattern components are associated with positive psychological experiences that can be utilized to promote occupant wellbeing. These designs are composite fractal patterns consisting of individual fractal ‘tree-seeds’ which combine to create a ‘global fractal forest.’ The local ‘tree-seed’ patterns, global configuration of tree-seed locations, and overall resulting ‘global-forest’ patterns have fractal qualities. These designs span multiple mediums yet are all intended to lower occupant stress without detracting from the function and overall design of the space. In this series of studies, we first establish divergent relationships between various visual attributes, with pattern complexity, preference, and engagement ratings increasing with fractal complexity compared to ratings of refreshment and relaxation which stay the same or decrease with complexity. Subsequently, we determine that the local constituent fractal (‘tree-seed’) patterns contribute to the perception of the overall fractal design, and address how to balance aesthetic and psychological effects (such as individual experiences of perceived engagement and relaxation) in fractal design installations. This set of studies demonstrates that fractal preference is driven by a balance between increased arousal (desire for engagement and complexity) and decreased tension (desire for relaxation or refreshment). Installations of these composite mid-high complexity ‘global-forest’ patterns consisting of ‘tree-seed’ components balance these contrasting needs, and can serve as a practical implementation of biophilic patterns in human-made environments to promote occupant wellbeing