Heart surgery waiting time: Assessing the effectiveness of an action

Background: Waiting time is an index assessing patient satisfaction, managerial effectiveness and horizontal equity in providing health care. Although heart surgery centers establishment is attractive for politicians. They are always faced with the question of to what extent they solve patient’s problems. Objectives: The objective of this study was to evaluate factors influencing waiting time in patients of heart surgery centers, and to make recommendations for health-care policy-makers for reducing waiting time and increasing the quality of services from this perspective. Patients and Methods: This cross-sectional study was performed in 2013. After searching articles on PubMed, Elsevier, Google Scholar, Ovid, Magiran, IranMedex, and SID, a list of several criteria, which relate to waiting time, was provided. Afterwards, the data on waiting time were collected by a researcher-structured checklist from 156 hospitalized patients. The data were analyzed by SPSS 16. The Kolmogorov Smirnov and Shapiro tests were used for determination of normality. Due to the non-normal distribution, non-parametric tests, such as Kruskal-Wallis and Mann-Whitney were chosen for reporting significance. Parametric tests also used reporting medians. Results: Among the studied variables, just economic status had a significant relation with waiting time (P = 0.37). Fifty percent of participants had diabetes, whereas this estimate was 43.58% for high blood pressure. As the cause of delay, 28.2% of patients reported financial problems, 18.6% personal problem and 13.5% a delay in providing equipment by the hospital. Conclusions: It seems the studied hospital should review its waiting time arrangements and detach them, as far as possible, from subjective and personal (specialists) decisions. On the other hand, ministries of health and insurance companies should consider more financial support. It is also recommend that hospitals should arrange preoperational psychiatric consultation for increasing patients’ emotionally readiness. © 2015, Iranian Red Crescent Medical Journal

Efecto de la presión de confinamiento y el método de deposición sobre la respuesta de corte no drenada de arena de densidad media

This study examines the effects of the confining pressure and sample preparation method on the shearing behavior shown by sand from the Chlef River (Algeria). Undrained monotonic triaxial compression tests were performed on samples with an initial relative density of 50% at initial confining pressures of 50 to 200 kPa. Samples were prepared using two depositional methods: dry funnel pluviation and wet deposition. Our results reveal marked differences in the undrained shearing responses produced under identical conditions of density and stress and therefore determined by the soil fabric. Thus, at low confining pressures, samples prepared by the wet deposition method showed complete static liquefaction (zero effective confining pressure and zero stress difference). For both sample types, as confining pressures increased, effective stress paths exhibited increasing resistance to liquefaction indicated by increasing dilatant tendencies.En este trabajo se han estudiado los efectos de la presión de confinamiento y los métodos de preparación de muestras sobre el comportamiento de rotura de arena Chlef. Los resultados de las pruebas sin escurrir monótona de compresión triaxial realizadas en muestras con una densidad relativa inicial del 50% y presiones de confinamiento inicial variaron desde 50 hasta 200 kPa. Las muestras fueron preparadas por dos métodos de deposición seca con embudo de pluviacion y deposición húmeda. Se encontró que existía una marcada diferencia en el comportamiento sin escurrir a pesar de que las condiciones de la densidad y el estrés eran idénticas. La conclusión fue que la estructura del suelo fue la responsable de este resultado. Los resultados también indicaron que a baja presión de confinamiento, las muestras preparadas mediante un método de deposición húmedo, completan la licuefacción estática (ninguna presión de confinamiento efectiva y ninguna diferencia de estress). Los resultados indicaron también que a bajas presiones de confinamiento, los especímenes reconstituida por el método de deposición húmeda expuesto licuefacción estática completa (cero de la presión efectiva de confinamiento y cero diferencia de estrés). Como las presiones de confinamiento se incrementaron, las trayectorias de tensiones efectivas aumentaron la resistencia a la licuefacción, mostrando aumento de la tendencia dilatante

Airborne Fungi Spores in Different Wards of Hospitals Affiliated to Kerman University of Medical Sciences

Abstract: Introduction: The infections resulting from opportunist invasive fungi, such as Aspergillus, are an increasingly developing problem in hospitalized patients especially those suffering from immunosuppressive deficiencies. Method: In this study, air sampling from selected wards of three hospitals affiliated to Kerman University of Medical Sciences was carried out 2 times/day over 7 months (May – October, 2003) by using 500 plates containing saborodextrose-agar. Results: According to the results, 89% of the plates proved to be positive for fungal growth. Of this pool of fungi plates, 1034 fungal colonies containing 16 different fungi were sorted out which in regard to the frequency were Penicillium, Rhizopus, Aspergillus flavus, yeast, and Alternaria respectively. Higher rate of fungi colonies was observed in Bahonar hospital comparing to the two others. The most contaminated settings were ICU wards in Bahonar and Shafa hospitals, respectively. Comparison of the common wards of Bahonar and Afzalipour hospitals, revealed that the emergency room in Bahonar hospital had the highest rate of contamination. Finally, among the isolated Aspergillus and fungi, Aspergillus flavus and yeast species showed the highest frequencies. Conclusion: Considering the results of the present study, control of fungal contamination in hospital wards, especially those in which patients with immunosuppressive deficiency are hospitalized is highly necessary. Keywords: Airborne fungal spores, Hospita

Nurses' Requirements for Relief and Casualty Support in Disasters: A Qualitative Study

Background: Nurses are among the most important groups engaged in casualty support, regardless of the cause, and they are one of the largest care groups involved in disasters. Consequently, these workers should gain proper support and skills to enable effective, timely, responsible and ethical emergency responses. Objectives: In this study, we investigated the needs of nurses for proper casualty support in disasters, to facilitate better planning for disaster management. Materials and Methods: This was a qualitative content analysis study. Interviews were performed with 23 nurses, at educational hospitals and the Faculty of Nursing at Kerman Medical University, who had a minimum of five years working experience and assisted in an earthquake disaster. Intensity and snowball sampling were performed. Data was collected through semi-structured interviews. Interviews were transcribed and coded into main themes and subthemes. Results: Four major themes emerged from the data; 1) psychological support, 2) appropriate clinical skills education, 3) appropriate disaster management, supervision and programming, and 4) the establishment of ready for action groups and emergency sites. The participants’ comments highlighted the necessity of training nurses for special skills including emotion management, triage and crush syndrome, and to support nurses' families, provide security, and act according to predefined programs in disasters. Conclusions: There are a wide range of requirements for disaster aid. Proper aid worker selection, frequent and continuous administration of workshops and drills, and cooperation and alignment of different governmental and private organizations are among the suggested initiatives

Blood parameters of Caspian brown trout (Salmo trutta caspius) fingerlings affected by dietary L-ascorbyl-2-polyphosphate

This study was aimed to evaluate the effect of L-ascorbyl-2-polyphosphate as a dietary ascorbic acid source on blood parameters of Caspian brown trout (Salmo trutta caspius), including red blood cell (RBC) count, white blood cell (WBC) and WBC differential. A total number of 600 Caspian brown trout (9.6±0.6 g) fingerlings were randomly distributed in triplicates among five treatments each containing 40 specimens. Experimental diets were also prepared by adding 0, 50, 100, 200 and 400 mg kg^-1 L-Ascorbyl-2-Polyphosphate to the basal diet. Feeding was done for nine weeks in each treatment. The survival rate in all treatments was 100%. The results showed a significant increase in RBC, hemoglobin, hematocrit, WBC and lymphocyte (p<0.05) by supplementing L-ascorbyl-2-polyphosphate compared to the control treatment. The fish fed by 200 mg ascorbic acid kg^-1 diet had the maximum hemoglobin and hematocrit in comparison with the other treatments. The current research showed that dietary L-ascorbyl-2-polyphosphate influences the complete blood count of Caspian brown trout while fingerlings fed with the optimum amounts of 200 mg ascorbic acid kg^-1 diet for a period of 9 weeks trail

Transport and Reaction Processes in Soil

In order to register agrochemicals in Europe it is necessary to have a detailed understanding of the processes in the environment that break down agrochemicals. The existing framework for environmental assessment includes a consideration of soil water movement and microbial breakdown of products in soil and these processes are relatively understood and represented in models. However the breakdown of agrochemicals by the action of light incident on the soil surface by a process termed photolysis is not so well represented in models of environmental fate. The problem brought by Syngenta (one of the worlds leading agrochemical companies) to the workshop was how to include the effects of light degradation of chemicals into predictive models of environmental fate. Photolysis is known to occur in a very thin layer at the surface of soil. The workshop was asked to consider how the very rough nature of the upper surface of a ploughed field might affect the degradation of chemicals by sunlight. The discussions were directed down two avenues: - firstly to determine how the very small distances over which photolysis occurs might be adequately incorporated into models of transport in soils and, - secondly to consider how the rough surface might modify the illumination of the surface and hence alter degradation. The rate of degradation by photolysis is measured in the laboratory by illuminating a thin, typically about 1 or 2 mm, layer of soil with very strong xenon lamps. The amount of chemical is measured at various intervals and is fitted to a first-order process. Field experiments where the chemical is sprayed on a bare field show evidence of photolysis indicated by biphasic degradation patterns and the presence of breakdown products only formed by photolysis. This report addresses methods for mathematically modelling the action of photolysis on particular relevant chemical species. We start with a general discussion of mechanisms that transport chemicals within soil §2. There is an existing computational model exploited by Syngenta for such modelling and we discuss how this performs and the predictions that can be derived using it §3. The particular mechanism of photolysis is then considered. One aspect of this mechanism that is investigated is how the roughness of the surface of the soil could be adequately incorporated into the modelling. Some results relating to this are presented §4.2. Some of the original experimental data used to derive aspects of the model of photolysis are revisited and a simple model of the process presented and shown to fit the data very well §5. By considering photolysis with a constant diffusion coefficient various analytical results are derived and general behaviour of the system outlined. This simple model is then applied to real field-based data and shown to give very good fit when simply extended to account for the moisture variations by utilising moisture dependent diffusion coefficients derived from the existing computational model §5.3. Some consequences of the simple model are then discussed §6

Accelerating Universe from an Evolving Lambda in Higher Dimension

We find exact solutions in five dimensional inhomogeneous matter dominated model with a varying cosmological constant. Adjusting arbitrary constants of integration one can also achieve acceleration in our model. Aside from an initial singularity our spacetime is regular everywhere including the centre of the inhomogeneous distribution. We also study the analogous homogeneous universe in (4+d) dimensions. Here an initially decelerating model is found to give late acceleration in conformity with the current observational demands. We also find that both anisotropy and number of dimensions have a role to play in determining the time of flip, in fact the flip is delayed in multidimensional models. Some astrophysical parameters like the age, luminosity distance etc are also calculated and the influence of extra dimensions is briefly discussed. Interestingly our model yields a larger age of the universe compared to many other quintessential models.Comment: 18 pages, 9 figure