Service quality of private hospitals: The Iranian Patients' perspective

<p>Abstract</p> <p>Background</p> <p>Highly competitive market in the private hospital industry has caused increasing pressure on them to provide services with higher quality. The aim of this study was to determine the different dimensions of the service quality in the private hospitals of Iran and evaluating the service quality from the patients' perspective.</p> <p>Methods</p> <p>A cross-sectional study was conducted between October and November 2010 in Tehran, Iran. The study sample was composed of 983 patients randomly selected from 8 private general hospitals. The study questionnaire was the SERVQUAL questionnaire, consisting of 21 items in service quality dimensions.</p> <p>Results</p> <p>The result of factor analysis revealed 3 factors, explaining 69% of the total variance. The total mean score of patients' expectation and perception was 4.91(SD = 0.2) and 4.02(SD = 0.6), respectively. The highest expectation and perception related to the tangibles dimension and the lowest expectation and perception related to the empathy dimension. The differences between perception and expectation were significant (p < 0.001). There was a significant difference between the expectations scores based on gender, education level, and previous hospitalization in that same hospital. Also, there was a significant difference between the perception scores based on insurance coverage, average length of stay, and patients' health conditions on discharge.</p> <p>Conclusion</p> <p>The results showed that SERVQUAL is a valid, reliable, and flexible instrument to monitor and measure the quality of the services in private hospitals of Iran. Our findings clarified the importance of creating a strong relationship between patients and the hospital practitioners/personnel and the need for hospital staff to be responsive, credible, and empathetic when dealing with patients.</p

Active removal of waste dye pollutants using Ta[sub]3N[sub]5/W[sub]18O[sub]49 nanocomposite fibres

A scalable solvothermal technique is reported for the synthesis of a photocatalytic composite material consisting of orthorhombic Ta3N5 nanoparticles and WOx≤3 nanowires. Through X-ray diffraction and X-ray photoelectron spectroscopy, the as-grown tungsten(VI) sub-oxide was identified as monoclinic W18O49. The composite material catalysed the degradation of Rhodamine B at over double the rate of the Ta3N5 nanoparticles alone under illumination by white light, and continued to exhibit superior catalytic properties following recycling of the catalysts. Moreover, strong molecular adsorption of the dye to the W18O49 component of the composite resulted in near-complete decolourisation of the solution prior to light exposure. The radical species involved within the photocatalytic mechanisms were also explored through use of scavenger reagents. Our research demonstrates the exciting potential of this novel photocatalyst for the degradation of organic contaminants, and to the authors’ knowledge the material has not been investigated previously. In addition, the simplicity of the synthesis process indicates that the material is a viable candidate for the scale-up and removal of dye pollutants on a wider scale

Genetic drivers of heterogeneity in type 2 diabetes pathophysiology.

Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes1,2 and molecular mechanisms that are often specific to cell type3,4. Here, to characterize the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study data from 2,535,601 individuals (39.7% not of European ancestry), including 428,452 cases of T2D. We identify 1,289 independent association signals at genome-wide significance (P < 5 × 10-8) that map to 611 loci, of which 145 loci are, to our knowledge, previously unreported. We define eight non-overlapping clusters of T2D signals that are characterized by distinct profiles of cardiometabolic trait associations. These clusters are differentially enriched for cell-type-specific regions of open chromatin, including pancreatic islets, adipocytes, endothelial cells and enteroendocrine cells. We build cluster-specific partitioned polygenic scores5 in a further 279,552 individuals of diverse ancestry, including 30,288 cases of T2D, and test their association with T2D-related vascular outcomes. Cluster-specific partitioned polygenic scores are associated with coronary artery disease, peripheral artery disease and end-stage diabetic nephropathy across ancestry groups, highlighting the importance of obesity-related processes in the development of vascular outcomes. Our findings show the value of integrating multi-ancestry genome-wide association study data with single-cell epigenomics to disentangle the aetiological heterogeneity that drives the development and progression of T2D. This might offer a route to optimize global access to genetically informed diabetes care

Reducing the induction to abortion interval in termination of second trimester pregnancies: A comparison of mifepristone with laminaria tent

Objective: To determine whether mifepristone (RU486) is more effective than laminaria tent in shortening the induction-abortion interval in termination of second trimester pregnancies with gemeprost. Design: Prospective randomised comparative trial. Setting: Department of Obstetrics and Gynaecology in a University teaching hospital. Subjects: Sixty-two women undergoing termination of pregnancy in the second trimester. Interventions: The women were allocated at random to one of the two treatment groups. The first group received 600 mg of mifepristone 36 h before administration of gemeprost. In the second group, a medium-sized laminaria tent was inserted 12 h before gemeprost. The pregnancies in both groups were terminated with vaginal gemeprost, 1 mg every 3 h up to a maximum of 5 mg/day. Main outcome measures: Induction-abortion intervals, amount of gemeprost required, and incidence of side effects. Results: The median induction-abortion interval in the mifepristone group (7.5 h) was significantly shorter than that in the laminaria tent group (11 h) and significantly fewer gemeprost pessaries were required. There was no significant difference in the amount of narcotic analgesics required or the incidence of side effects between the two groups. Conclusions: Mifepristone is more effective than laminaria tent in shortening the induction-abortion interval in termination of second trimester pregnancies.link_to_subscribed_fulltex