The effect of job-stress on patient-safety in hospitals affiliated to Alborz University of Medical Sciences, Iran

BACKGROUND: Patient-safety is one of the main pillars of healthcare. Given that nurses are the largest group associated with patients, so with safety harms, job-stress among then can reduce patient-safety in hospitals. The aim of this article was to investigate the effects of job-stress on patient-safety in hospitals affiliated to Alborz University of Medical Sciences, Karaj, Iran. METHODS: In this cross-sectional study, data gathering tools consisted of a reliable researcher-made job-stress questionnaire, and a patient-safety checklist. 320 nurses in hospitals affiliated to Alborz University of Medical Sciences, who were selected using simple randomized sampling method, completed the questionnaire, and the checklist was filled by the researcher. Data were analyzed at two levels of inferential and descriptive statistics. RESULTS: Job-stress and also patient-safety were at average levels in studied hospitals. Among the demographic factors, only the relationship between job-stress and marital status was statistically significant (P < 0.050). There were no significant relationships between different aspects of job-stress among nurses and patient-safety. CONCLUSION: According to average level of job-stress among studied nurses, the quality of offered services would decrease and patient-safety would become undermined, if no action take place to reduce the job-stress among them. Therefore, it is necessary to increase nurses’ physical, psychological, and social health to increase patient-safety

The effect of job-stress on patient-safety in hospitals affiliated to Alborz University of Medical Sciences, Iran

BACKGROUND: Patient-safety is one of the main pillars of healthcare. Given that nurses are the largest group associated with patients, so with safety harms, job-stress among then can reduce patient-safety in hospitals. The aim of this article was to investigate the effects of job-stress on patient-safety in hospitals affiliated to Alborz University of Medical Sciences, Karaj, Iran.METHODS: In this cross-sectional study, data gathering tools consisted of a reliable researcher-made job-stress questionnaire, and a patient-safety checklist. 320 nurses in hospitals affiliated to Alborz University of Medical Sciences, who were selected using simple randomized sampling method, completed the questionnaire, and the checklist was filled by the researcher. Data were analyzed at two levels of inferential and descriptive statistics.RESULTS: Job-stress and also patient-safety were at average levels in studied hospitals. Among the demographic factors, only the relationship between job-stress and marital status was statistically significant (P &lt; 0.050). There were no significant relationships between different aspects of job-stress among nurses and patient-safety.CONCLUSION: According to average level of job-stress among studied nurses, the quality of offered services would decrease and patient-safety would become undermined, if no action take place to reduce the job-stress among them. Therefore, it is necessary to increase nurses’ physical, psychological, and social health to increase patient-safety

Core crosslinked flower-like micelles for systemic and local pharmaceutical applications

This thesis investigates pharmaceutical suitability of core crosslinked flower-like micelles for local and systemic applications. First, we demonstrated crosslinking of micelles composed of hydrophilic PEG shell and hydrophobic N-isopropylacrylamide core using native chemical ligation. In a follow-up study, circulation kinetics, biodistribution, and occurrence of accelerated blood clearance (ABC) phenomenon upon injection of flower-like micelles was compared to star-like micelles. Immunocompetent mice were used for this study and both types of micelles were injected twice and the time interval between the injection was one week. Determination of concentration of micelles and anti-PEG antibodies in plasma samples showed that first, flower-like micelles circulate significantly longer than star-like micelles upon the first injection. Second, both types of micelles induce production of anti-PEG IgM. Third, the anti-PEG IgM induced by injection of star-like micelles cause rapid clearance of the second dose of star-like micelles but not flower-like micelles. Forth, the anti-PEG IgM induced upon injection of flower-like micelles reduced circulation time of the second dose of star-like micelles but not flower-like micelles. Taken together, the results of this study show the great potential of looped PEG in preventing recognition by anti-PEG antibodies and thereby opsonization and clearance of PEGylated nanocarriers. These findings propose that for clinical application of pegylated nanoparticles especially the ones that are repeatedly administered, the surface should be decorated with looped PEG. To investigated suitability of flower-like micelles for local pharmaceutical applications, formulation of flower-like micelles into enzyme-responsive hydrogel were investigated. The target enzyme was matrix metalloproteinase (MMP) which is upregulated in many diseased tissues. Micelles with an excess of thioester functionalities in the core were prepared. Two novel pentablock copolymers having a peptide midblock (consisting of either L- or D- amino acids) and cysteine functionalities in the outer blocks were synthesized by ATRP as linker. Upon mixing the micelles with the linker (either D or L peptide), the excess of thioester functionalities in the micellar cores reacted with cysteine functionalities in the linker resulting in a hydrogel. Both types of hydrogels were incubated with collagenase as a model for MMP’s. Only the gel crosslinked by a L-peptide linker showed degradation upon exposure to collagenase in a concentration dependent manner. Moreover, we investigated the rheological characteristics of dense dispersions of core crosslinked flower-like micelles at a range of temperature from 10 to 40 °C. An effective volume fraction (φ) was defined to compare packing of micelles at different concentrations and temperatures. We observed that for a dense micellar dispersion, φ can be above the maximum random packing fraction for monodisperse hard spheres Φ_rcp≈0.64 possibly due to compressible deformation of the relatively soft micelles. When the storage modulus of different micellar dispersions at different concentrations and temperatures is plotted as a function of φ, the data points collapse on a master curve. This indicates that the effective volume fraction of the micellar dispersions is the main parameter controlling their rheological properties. A glassy state was observed at φ≥ 1.2 independent from temperature which is well described by a disordered lattice model

Core crosslinked flower-like micelles for systemic and local pharmaceutical applications

This thesis investigates pharmaceutical suitability of core crosslinked flower-like micelles for local and systemic applications. First, we demonstrated crosslinking of micelles composed of hydrophilic PEG shell and hydrophobic N-isopropylacrylamide core using native chemical ligation. In a follow-up study, circulation kinetics, biodistribution, and occurrence of accelerated blood clearance (ABC) phenomenon upon injection of flower-like micelles was compared to star-like micelles. Immunocompetent mice were used for this study and both types of micelles were injected twice and the time interval between the injection was one week. Determination of concentration of micelles and anti-PEG antibodies in plasma samples showed that first, flower-like micelles circulate significantly longer than star-like micelles upon the first injection. Second, both types of micelles induce production of anti-PEG IgM. Third, the anti-PEG IgM induced by injection of star-like micelles cause rapid clearance of the second dose of star-like micelles but not flower-like micelles. Forth, the anti-PEG IgM induced upon injection of flower-like micelles reduced circulation time of the second dose of star-like micelles but not flower-like micelles. Taken together, the results of this study show the great potential of looped PEG in preventing recognition by anti-PEG antibodies and thereby opsonization and clearance of PEGylated nanocarriers. These findings propose that for clinical application of pegylated nanoparticles especially the ones that are repeatedly administered, the surface should be decorated with looped PEG. To investigated suitability of flower-like micelles for local pharmaceutical applications, formulation of flower-like micelles into enzyme-responsive hydrogel were investigated. The target enzyme was matrix metalloproteinase (MMP) which is upregulated in many diseased tissues. Micelles with an excess of thioester functionalities in the core were prepared. Two novel pentablock copolymers having a peptide midblock (consisting of either L- or D- amino acids) and cysteine functionalities in the outer blocks were synthesized by ATRP as linker. Upon mixing the micelles with the linker (either D or L peptide), the excess of thioester functionalities in the micellar cores reacted with cysteine functionalities in the linker resulting in a hydrogel. Both types of hydrogels were incubated with collagenase as a model for MMP’s. Only the gel crosslinked by a L-peptide linker showed degradation upon exposure to collagenase in a concentration dependent manner. Moreover, we investigated the rheological characteristics of dense dispersions of core crosslinked flower-like micelles at a range of temperature from 10 to 40 °C. An effective volume fraction (φ) was defined to compare packing of micelles at different concentrations and temperatures. We observed that for a dense micellar dispersion, φ can be above the maximum random packing fraction for monodisperse hard spheres Φ_rcp≈0.64 possibly due to compressible deformation of the relatively soft micelles. When the storage modulus of different micellar dispersions at different concentrations and temperatures is plotted as a function of φ, the data points collapse on a master curve. This indicates that the effective volume fraction of the micellar dispersions is the main parameter controlling their rheological properties. A glassy state was observed at φ≥ 1.2 independent from temperature which is well described by a disordered lattice model

Effect of workload on quality of work life among staff of the teaching hospitals of Shahid Beheshti University of Medical Sciences (2014)

Background: Quality of work life is the reaction of employees to their work specially the individual results at work and mental health that affects their personal experience and work results. Objective: The aim of this study was to determine the effect of workload on quality of work life in staff of the teaching hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran. Methods: This analytical study was conducted in 530 staff of four hospitals affiliated to the Shahid Beheshti University of Medical Sciences that were selected by Cochrane sampling method during 2014. The measurement tools were demographic questionnaire, Walton's quality of work life questionnaire (including 32 questions and eight dimensions), and the NASA TLX workload scale. Data were analyzed using Pearson’s correlation coefficient. Findings: The mean scores of quality of work life and workload were 48.21±13.34 and 64.70±11.44, respectively. There was negative significant correlation between workload and quality of work life (r= -0.0161). Conclusion: With regards to the results, it seems that high workload is one of the most important factors of reduced quality of work life that can be reduced through proper organization and planning. Keywords: Quality of life, Workload, Hospital

The feasibility and optimization of biodiesel production from Celtis australis L. oil using chicken bone catalyst and ultrasonic waves

Biodiesel is a green renewable energy source and an alternative for diesel fuel. The objective of this research was to study the feasibility of biodiesel production from Celtis australis L. oil using an ultrasonic system and CaO derived from chicken bone as a biowaste renewable resource. In this research, the effects of some parameters such as the alcohol-to-oil molar ratio (6:1, 9:1, 12:1), the CaO catalyst concentration (3%, 5% and 7% w/w), and the reaction time using ultrasonication (10, 25, 40 min) on the rate of conversion of fatty acids to methyl ester (biodiesel) were studied. The results showed that by increasing the molar ratio into the range between 6:1 and 9:1, the conversion percentage first increased and then its value followed a fixed trend. By increasing the catalyst concentration to about 5%, the conversion percentage increased significantly, and then remained constant. By increasing the time from 10 to 25 min, the conversion percentage increased by 20.19%, but from 25 to 40 min, no significant difference was observed. Moreover, all of the properties of C. australis methyl ester were found to meet the requirements of EN 14214 (European Committee for Standardization) biodiesel standards

Relationship between behavioral indices of pain during labor pain with pain intensity and duration of delivery

Background: Certain behaviors can be adopted by women to cope with labor pain according to their individual characteristics, which are currently called behavioral indicators during labor pain, and include facial expressions, verbal expressions, tone of voice, body movements, degree of relaxation, and respiratory system functioning during delivery. Moreover, severity of pain and duration of labor can vary due to several factors including individual characteristics. Objective: The purpose of the present study was to determine the relationship between behavioral indicators during labor pain, severity of pain, and delivery duration. Methods: In this cross-sectional study, 120 low risk pregnant women who referred to Omolbanin (AS) Hospital in the city of Mashhad (Iran) for delivery in 2014, were selected via convenience sampling method, which was then followed by completion of demographic information forms. From cervical dilatation of 3-5 centimeters until delivery, the Labor Pain Coping Behavior Observation Form (comprised of 6 sub-groups of facial expressions, verbal expressions, tone of voice, body movements, degree of relaxation, and respiratory function and severity and duration of pain) was completed during uterine contractions and every half an hour. Using the Inventory of Labor Information; vital signs, frequency of contractions, and duration of the first and second stages of labor were measured. Furthermore, the content validity of the questionnaire was determined and its reliability was confirmed by Cronbach’s alpha method. Then, the data were analyzed using the SPSS version 16, through Pearson Product-Moment Correlation and Spearman’s Rank-Order Correlation, Kruskal-Wallis test, and ANOVA. Results: According to the results, 16.2% of the individuals had undesirable behavioral indicators during labor pain, 50% of them were endowed with acceptable behaviors, and 33.8% of these women had desirable behaviors. The findings also revealed that the duration of the active phase of the first stage of labor (p˂0.001 and r=-0.453), the duration of the second stage of labor (p˂0.012 and r=-0.146), and the severity of pain (p˂0.001 and r=-0.450) were significantly and inversely correlated with behavioral indicators during labor pain; i.e. an increase in the mean score of behavioral indicators during labor pain could lead to a decline in the duration of stages of labor and severity of pain. Conclusion: It was concluded that behaviors demonstrated by women in labor had effects on their pains in the course of delivery, and there was also a relationship between the duration of stages of labor and its severity of pain. Therefore, it was recommended to turn attention to behaviors by women in labor in order to achieve a desirable clinical managemen

The role of coping strategies in the academic engagement of students in Bushehr University of Medical Sciences

Introduction: Coping strategies are a set of cognitive and behavioral efforts that are employed to interpret and modify a stressful situation. For students, it seems appropriate to employ coping strategies, which seems to be an important factor for academic achievement. Therefore, this study endeavored to examine the relationship between coping strategies and academic engagement in students of Bushehr University of Medical Sciences in 2017. Methods: This correlational study was performed with 232 undergraduate students of Bushehr University of Medical Sciences through relative stratified random sampling. The instruments were three questionnaires of demographic information and academic achievement of Frederick Bloomfield, as well as a short scale of coping with Andrew Parker's stress conditions. Data analysis was done through independent t-test and Pearson test within the significance level of 0.05. Results: The average age of students was 21.75± 2.72 and most of them were single (86%). The mean score of students' academic motivation was 51/0 2/79 0/51 and the mean score of coping strategies was 2.99 0.43. It was found that there is a direct and significant relationship between the score of coping strategy and the score of academic motivation (p=0. 001). Conclusion: The results reveled that the variable of academic engagement is of special importance in predicting coping strategies in students. As a result, guiding students in the right direction could have positive educational consequences

Review of Nurse per Bed Rate in Iranian hospital compared with selected countries

Background and purpose: One of the main challenges of human resource management in hospitals is the proper distribution of nurses, which is necessary to improve the efficiency and quality of health services. In this review, this rate is compared in selected countries and Iran in order to provide the necessary evidence for managers and policymakers in human resource management Materials and Methods: This study was conducted as a field review in 2019 with the aim of comparing the standards of nurse distribution to beds/wards in selected studies. The search was conducted with related keywords in "Scopus", "Web of Science", "PubMed" databases without a time limit. Results: The distribution of nursing per bed was reported in Australia, England, Northern Ireland, Wales, Israel, America, California, Pennsylvania and New Jersey. In Iran, the rate of nurses to intensive beds was slightly higher than the average and the ratio of nurses to ordinary and emergency beds was lower than the average of selected countries average. Conclusion: Nurses' distribution was generally lower than the average of other countries, and this ratio was lower in some sectors and higher than the average in some sectors. Recruitment and redistribution of the appropriate nurse in different sectors by benchmarking successful countries are suggested

Heterofunctional Poly(ethylene glycol) (PEG) Macroinitiator Enabling Controlled Synthesis of ABC Triblock Copolymers

ABC triblock copolymers with a poly(ethylene glycol) (PEG) midblock have attractive properties for biomedical applications because of PEG's favorable properties regarding biocompatibility and hydrophilicity. However, easy strategies to synthesize polymers containing a PEG midblock are limited. In this study, the successful synthesis of a heterofunctional PEG macroinitiator containing both an azoinitiator and an atom transfer radical polymerization (ATRP) initiator is demonstrated. This novel PEG macroinitiator allows the development of elegant synthesis routes for PEG midblock-containing ABC copolymers that does not require protection of initiating sites or polymer end-group postmodification. Polymers with outer blocks composed of different monomers were synthesized to illustrate the versatility of this macroinitiator. N-Isopropylacrylamide (NIPAM) was included to obtain thermosensitive polymers, 2-(dimethylamino)ethyl methacrylate (DMAEMA) provided pH-sensitive properties, and 2-hydroxyethyl acrylate (HEA) functioned as a noncharged hydrophilic block that also allows for postmodifications reactions. This synthesis approach can further contribute to the design of high-precision polymers with tailorable block compositions and polymer topologies, which is highly attractive for applications in nanotechnology