Examining the role of export competitive advantages on export performance

This paper investigates the role of export competitive advantage on export performance in food industry. The proposed study designs a questionnaire in Likert scale and distributes it among 280 randomly selected experts in food industry and Cronbach alpha has been calculated as 0.827. The study has applied factor analysis to find important factors influencing export performance. Kaiser-Meyer-Olkin Measure of Sampling Adequacy and Bartlett's Test of Sphericity have been performed to validate the results and they both validated the questionnaire. The results of the survey have determined six effective groups including product development, e-commerce, marketing planning, organizational performance, competitiveness and supply chain management

Educational Costs of Residents in a Teaching Hospital: a case study

Background & Objectives: Residents spend much of their time at the hospitals to earn their required educational skills and although they act as a kind of human resource in the hospital, they increase hospital costs. The present study was designed to calculate the share of educational costs of different medical residents in hospitals. Methods: In this descriptive and applied study performed in one of the hospitals affiliated to Iran University of Medical Sciences, the hospital cost items of education of residents in different medical fields during the academic year of 2017-2018 were identified by use of two scenarios. Results: In short, mean educational cost of one resident in the studied academic year was about 5357$based on the first scenario and about 5404$ according to the second scenario. Based on both scenarios, salaries paid to residents accounted for more than 50% of the costs followed by the cost of consumed materials by residents. Forensic Medicine and Anesthesiology residency programs had respectively the lowest and highest share of costs in both scenarios. Conclusion: The cost of training in the hospital is different among residency fields based on the required tests and errors in each field. But, in order to save hospital costs, the culture of optimal use of materials as well as medical equipment should be taught to residents. Key­words: Education Economics, Costing, Direct Costs, Residents, Teaching hospital ­Citation: Aleboyeh MR, Reza pour A, Meshkani Z, Alipour V, Soleimani movahed M. Educational Costs of Residents in a Teaching Hospital: a case study. Journal of Health Based Research 2019; 5(2): 117-30

The relationship between Nrf2/Keap1 system and endoplasmic reticulum stress and inflammatory markers in peripheral blood mononuclear cells of type 2 diabetic subjects

Background: Oxidative stress, endoplasmic reticulum stress (ER stress), and inflammation are the main leading factors in the pathogenesis of type 2 diabetes. Nuclear factor erythroid 2-related factor 2/ Kelch-like ECH-associated protein 1 (Nrf2/Keap1) is the chief regulator of the antioxidant defense system that protects the cells against reactive oxygen species (ROS). ER stress and inflammatory pathways are involved in the suppression or the activation of the Nrf2/Keap1 system. In this study, we aimed to explore the possible relationships of the main factors contributing to oxidative stress, endoplasmic reticulum stress, and inflammation in peripheral blood mononuclear cells (PBMCs) of diabetic patients. Methods: Levels of biological parameters, oxidative stress markers as well as the gene transcription of Nrf2, Keap1, p22phox, Chop1, Grp78, IL-6, and TNF- were analyzed in the PBMCs of 32 type 2 diabetic and 31 non-diabetic subjects. The correlation analysis was performed for the markers of oxidative stress with selected ER stress-related genes and pro-inflammatory cytokines. Results: Fasting blood sugar (

Actual Costs of Residency Training in Teaching Hospitals: A Case of Iran

Background: There was a challenge for teaching hospitals to accept residents for educational goals due to their training costs. Objectives: The present study aimed to estimate the actual costs of residency training in hospitals for policymaking, budgetary impact, and negotiation. Methods: This retrospective study was performed in eight teaching hospitals affiliated with the Iran University of Medical Sciences, Tehran, Iran, in 2018. Two scenarios were designed to estimate the costs of education per resident. All of the resources used by residents in the hospitals were identified. Cost items attributed to the training goals were allocated to the internal medicine and surgical fields; however, for cost items that were used for treatment and education, such as disposables and consumables and equipment, the cost drivers were used. Therefore, the difference between the scenarios was related to the cost drivers. Results: Overall, the selected hospitals had spent $586,720.35 and$ 572,358.10 based on scenarios 1 and 2, respectively. The residency training per surgical resident in the hospitals was about 1.2 times higher than an internal medicine resident. Surgery, neurology, urology, and anesthesiology were the f ields with the highest costs in the hospitals. Conclusion: Although residency training accounts for a large proportion of hospital costs, employing residents reduces the costs of human resources. Monitoring and controlling costs, as well as resource quotas for resident training, can be a way to reduce educational course costs in hospitals. Universities can cover some parts of the educational costs to motivate hospitals to make an appropriate setting for residents. Keywords: Cost Analyses, Academic Medical Centers, Internship and Residenc

Mechanisms Linking the Metabolic Syndrome and Cardiovascular Disease: Role of Hepatic Insulin Resistance

The worldwide prevalence of insulin resistant states such as the metabolic syndrome has grown rapidly over the past few decades. The metabolic syndrome is a constellation of common metabolic disorders that promote the development of atherosclerosis and cardiovascular disease. Studies in both human and animal models suggest that hepatic inflammation and insulin resistance are key initiating factors in the development of the metabolic syndrome. Chronic inflammation is known to be associated with visceral obesity and is characterized by production of abnormal adipokines and cytokines such as tumor necrosis factor a, interleukin-1 (IL-1), IL-6, leptin, and resistin. These factors inhibit insulin signaling in the liver (hepatocytes) by activating suppressors of cytokine signalling proteins; several kinases such as c-Jun N-terminal kinases, IKK-β, and Protein kinase C; and protein tyrosine phosphatase 1B, that in turn impair insulin signaling at insulin receptor and insulin receptor substrate level. Hepatic insulin resistance in turn causes impaired suppression of glucose production by insulin in hepatocytes leading to hyperglycemia, induction of very low density lipoprotein production, and de novo lipogenesis. Increased production of C-reactive protein (CRP) and plasminogen activator inhibitor-1, both markers of an inflammatory state, is also observed in insulin resistance. All of the above metabolic abnormalities can directly or indirectly promote atherosclerosis. In particular, hyperglycemia induces endothelial dysfunction, cellular proliferation, changes in extracellular matrix conformation, and impairment of low density lipoproteins (LDL)-receptor-mediated lipoprotein uptake. Small dense LDLs have higher affinity to the intimal proteoglycans, leading to the penetration of more LDL particles into the arterial wall. CRP can also accelerate atherosclerosis by increasing the expression of PAI-1 and adhesion molecules in endothelial cells, inhibition of nitric oxide formation, and increasing LDL uptake into macrophages. In summary, hepatic insulin resistance is a critical early event that underlies the development of the metabolic syndrome and progression to atherosclerosis and cardiovascular disease

Distribution of General Practitioners in the Health System of Iran Using Equity Indices (Gini, Atkinson(

Introduction: Although equity is a key motivation for providing hospital services to the public, resource distribution in governments, rarely focus on those who need the resources more. This study was done to investigate the distribution of general practitioners in the health system of Iran using Gini and Atkinson indices. Method: In this cross-sectional study, data were gathered from the Statistics Center of Iran, Medical Council and statistics office of the Ministry of Health and Medical Education. Gini and Atkinson indices have been used to investigate the distribution of human resources. In order to find more accurate estimation of the distribution coefficients, the adjusted index was used. Stata 11 software was applied for data analysis. Results: The range of Gini and Atkinson indices before adjusting needs during 2006-2011were respectively between 0.127-0.204; and 0.018-0.038 that shows a worse status after adjusting needs. Conclusion: Appropriate supply and distribution of medical manpower is the major key for improvement of the countries’ health status. Therefore, accurate estimation of required human resources and population-based distribution help to reduce the cost of health care systems as well as households’ cost. Keywords: General Practitioners, Equity, Lorenz curve, Gini coefficient, Atkinson inde

Identifying and ranking the factors affecting the adoption of biofuels

This paper presents an empirical investigation to determine the important factors influencing on adoption of biofuels from consumer’s perspective. The study designs a questionnaire in Likert scale and distributes it among 211 randomly selected people who use green products in city of Tehran, Iran. Cronbach alpha is calculated as 0.812, which is well above the acceptable level. Using principle component with Varimax rotation, the study has determined five important factors including social commitment, product usefulness, infrastructure, management approach and customer oriented, which influence the most on adaptation of biofuels