Estimation of Nursing Staff in Selected Hospitals of Ilam and Ahvaz Provinces, Western Iran

Background: The nurses as the largest group among different groups of hospital workforce play a crucial role in success of the hospital activities and promotion of community health. Objectives: This study aimed to obtain an estimation of the necessary nursing workforce status in educational hospitals affiliated to Ilam and Ahvaz University of Medical Sciences based on the scientific formula. Materials and Methods: This research was a cross sectional-descriptive study, which was done in hospitals affiliated to Ilam and Ahvaz University of Medical Sciences during 2010. Using three researcher-made forms, data was collected from all clinical, para-clinical, financial, administrative and support departments of hospitals. Data was analyzed in accordance to the standards of Iran's Ministry of Health and Medical Education using the Excel software. Results: The results showed that the nursing staffs in the 42 wards (89.5 %) were lower than the standards, only one ward (2 %) matched the standards and the rest of the wards (8.5%) were higher than the standards. The organizational dislocation (utilization of nurses in non-related jobs) of nursing staffs obtained for Imam Khomeini of Ilam, Mostafa Khomeini, Taleghani, Razi and Imam Khomeini of Ahvaz Hospitals were 8, 5, 3, 8 and 21, respectively. Conclusion: Generally, the studied hospitals were faced with a lack of nursing manpower and distribution of manpower was not appropriate. Proper planning and management of manpower in accordance with the lack of personnel, compensates and achieves the standards required for hospital’s nursing manpower and this would lead to an increase in the efficiency of hospitals activities and can provide satisfaction for the nursing staff

Relationship between urbanization and cancer incidence in Iran using quantile regression

Quantile regression is an efficient method for predicting and estimating the relationship between explanatory variables and percentile points of the response distribution, particularly for extreme percentiles of the distribution. To study the relationship between urbanization and cancer morbidity, we here applied quantile regression. This cross-sectional study was conducted for 9 cancers in 345 cities in 2007 in Iran. Data were obtained from the Ministry of Health and Medical Education and the relationship between urbanization and cancer morbidity was investigated using quantile regression and least square regression. Fitting models were compared using AIC criteria. R (3.0.1) software and the Quantreg package were used for statistical analysis. With the quantile regression model all percentiles for breast, colorectal, prostate, lung and pancreas cancers demonstrated increasing incidence rate with urbanization. The maximum increase for breast cancer was in the 90th percentile (β=0.13, p-value < 0.001), for colorectal cancer was in the 75th percentile (β=0.048, p-value < 0.001), for prostate cancer the 95th percentile (β=0.55, p-value < 0.001), for lung cancer was in 95th percentile (β=0.52, p-value=0.006), for pancreas cancer was in 10th percentile (β=0.011, p-value < 0.001). For gastric, esophageal and skin cancers, with increasing urbanization, the incidence rate was decreased. The maximum decrease for gastric cancer was in the 90th percentile(β=0.003, p-value < 0.001), for esophageal cancer the 95th (β=0.04, p-value=0.4) and for skin cancer also the 95th (β=0.145, p-value=0.071). The AIC showed that for upper percentiles, the fitting of quantile regression was better than least square regression. According to the results of this study, the significant impact of urbanization on cancer morbidity requirs more effort and planning by policymakers and administrators in order to reduce risk factors such as pollution in urban areas and ensure proper nutrition recommendations are made. © 2016, Asian Pacific Journal of Cancer Prevention

The relationship between learning style preferences and gender, educational major and status in first year medical students: A survey study from Iran

Background: Identifying and employing appropriate learning styles could play an important role in selecting teaching styles in order to improve education. Objectives: This study aimed to determine the relationship between learning styles preferences and gender, educational major and status in first year students at Isfahan University of Medical Sciences. Patients and Methods: A cross-sectional study employing the visual-aural-read/write-kinesthetic (VARK) learning style's questionnaire was done on 184 first year students of medicine, pharmacy, dentistry, nursing and health services management at Isfahan University of Medical Sciences in 2012. The validity of the questionnaire was assessed through experts' views and reliability was calculated using Cronbach's alpha coefficients (α = 0.86). Data were analyzed using the SPSS ver.18 software and x2 test. Results: Out of 184 participants who responded to and returned the questionnaire, 122 (66.3) were female; more than two-thirds (68.5) of the enrolled students were at the professional doctorate level (medicine, pharmacy, dentistry) and 31.5 at the undergraduate level (nursing and health services management). Eighty-nine (48.4) students preferred a single-modal learning style. In contrast, the remaining 95 students (51.6) preferred multi-modal learning styles. A significant relationship between gender and single modal learning styles (P = 0.009) and between status and learning styles (P = 0.04) was observed. Conclusions: According to the results, male students preferred to use the kinesthetic learning style more than females, while, female students preferred the aural learning style. Knowledge about the learning styles of students at educational institutes is valuable and helps solve learning problems among students, and allows students to become better learners. © 2015, Iranian Red Crescent Medical Journal

Assessing quality of healthcare service by the SERVQUAL model: A case study of a field hospital

Aims: Identifying quality gap of services provided by hospital lead to preparing improvement projects and programs. This study intends to determine the quality gap in healthcare services provided by Shahid Elmi Field Hospital from the view point of Patients. Methods: In this cross-sectional study, 100 patients admitted to the hospital in 2011 were selected randomly for the study. The data gathered through SERVQUAL Standard Questioner. The content validity and reliability was confirmed by specialist opinions and Cronbach's alpha coefficient, respectively. Data analysis was conducted using descriptive statistics and two-sample t, Pearson correlation and ANOVA tests, using SPSS version 18. Results: According to the patients' views, there is a positive quality gap in delivered services. The highest mean score of the negative and positive quality gap were related to Responsiveness (-0.02) and access (0.035) respectively. There was a significant relation between the frequency of referral and the quality empathy (p=0.05). Conclusion: According to the results, the delivered services of the studied Field hospital is higher than the expectations of patients. It is recommended that processes related to delivery of services, in all dimensions of services' quality particularly responsiveness and assurance, should be identified and reengineered

Assessing health inequalities in Iran: a focus on the distribution of health care facilities

BACKGROUND AND OBJECTIVE: Equality in distribution of health care facilities is the main cause for access and enjoyment to the health. The aim of this study was to examine the regional disparities in health care facilities across the Markazi province. METHODS: This was a cross-sectional study. Study sample included the cities of Markazi province, ranked based on 15 health indices. Data was collected by a data collection form made by the researcher using statistical yearbook. The indices were weighted using Shannon entropy. Finally, technique for order preference by similarity to ideal solution (TOPSIS) was used to rank the towns of the province in terms of access to health care facilities. RESULTS: There is a large gap between cities of Markazi province in terms of access to health care facilities. Shannon entropy introduced the number of urban health centers per 1000 people as the most important indicator and the number of rural active health house per 1000 people as the less important indicator. According to TOPSIS, the towns of Ashtian and Shazand ranked the first and last (10th) respectively in access to health services. CONCLUSION: There are significant inequalities in distribution of health care facilities in Markazi province. We propose that policy makers determine resource allocation priorities according to the degree of development for a balanced and equal distribution of health care facilities

Determination of hydroxyl groups in biorefinery resources via quantitative 31P NMR spectroscopy

The analysis of chemical structural characteristics of biorefinery product streams (such as lignin and tannin) has advanced substantially over the past decade, with traditional wet-chemical techniques being replaced or supplemented by NMR methodologies. Quantitative 31P NMR spectroscopy is a promising technique for the analysis of hydroxyl groups because of its unique characterization capability and broad potential applicability across the biorefinery research community. This protocol describes procedures for (i) the preparation/solubilization of lignin and tannin, (ii) the phosphitylation of their hydroxyl groups, (iii) NMR acquisition details, and (iv) the ensuing data analyses and means to precisely calculate the content of the different types of hydroxyl groups. Compared with traditional wet-chemical techniques, the technique of quantitative 31P NMR spectroscopy offers unique advantages in measuring hydroxyl groups in a single spectrum with high signal resolution. The method provides complete quantitative information about the hydroxyl groups with small amounts of sample (~30 mg) within a relatively short experimental time (~30-120 min)

The Chromatin Remodelling Complex B-WICH Changes the Chromatin Structure and Recruits Histone Acetyl-Transferases to Active rRNA Genes

The chromatin remodelling complex B-WICH, which comprises the William syndrome transcription factor (WSTF), SNF2h, and nuclear myosin 1 (NM1), is involved in regulating rDNA transcription, and SiRNA silencing of WSTF leads to a reduced level of 45S pre-rRNA. The mechanism behind the action of B-WICH is unclear. Here, we show that the B-WICH complex affects the chromatin structure and that silencing of the WSTF protein results in a compaction of the chromatin structure over a 200 basepair region at the rRNA promoter. WSTF knock down does not show an effect on the binding of the rRNA-specific enhancer and chromatin protein UBF, which contributes to the chromatin structure at active genes. Instead, WSTF knock down results in a reduced level of acetylated H3-Ac, in particular H3K9-Ac, at the promoter and along the gene. The association of the histone acetyl-transferases PCAF, p300 and GCN5 with the promoter is reduced in WSTF knock down cells, whereas the association of the histone acetyl-transferase MOF is retained. A low level of H3-Ac was also found in growing cells, but here histone acetyl-transferases were present at the rDNA promoter. We propose that the B-WICH complex remodels the chromatin structure at actively transcribed rRNA genes, and this allows for the association of specific histone acetyl-transferases

Applications of lignin in the agri-food industry

Of late, valorization of agri-food industrial by-products and their sustainable utilization is gaining much contemplation world-over. Globally, 'Zero Waste Concept' is promoted with main emphasis laid towards generation of minimal wastes and maximal utilization of plantbased agri-food raw materials. One of the wastes/by-products in the agri-food industry are the lignin, which occurs as lignocellulosic biomass. This biomass is deliberated to be an environmental pollutant as they offer resistance to natural biodegradation. Safe disposal of this biomass is often considered a major challenge, especially in low-income countries. Hence, the application of modern technologies to effectively reduce these types of wastes and maximize their potential use/applications is vital in the present day scenario. Nevertheless, in some of the high-income countries, attempts have been made to efficiently utilize lignin as a source of fuel, as a raw material in the paper industry, as a filler material in biopolymer based packaging and for producing bioethanol. However, as of today, agri-food industrial applications remains significantly underexplored. Chemically, lignin is heterogeneous, bio-polymeric, polyphenolic compound, which is present naturally in plants, providing mechanical strength and rigidity. Reports are available wherein purified lignin is established to possess therapeutic values; and are rich in antioxidant, anti-microbial, anti-carcinogenic, antidiabetic properties, etc. This chapter is divided into four sub-categories focusing on various technological aspects related to isolation and characterization of lignin; established uses of lignin; proved bioactivities and therapeutic potentials of lignin, and finally on identifying the existing research gaps followed by future recommendations for potential use from agri-food industrial wastes.Theme of this chapter is based on our ongoing project- Valortech, which has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 810630

An assessment of implementation and evaluation phases of strategic plans in Iranian hospitals

Objectives: To assess the implementation and evaluation phases of strategic plans in selected hospitals. Methods: We conducted a cross-sectional study of implementation and evaluation of strategic plan in 24 hospitals in 2015, using a questionnaire which consisted of two separate sections for strategic implementation and strategic evaluation. Data were analyzed with SPSS version 18. Results: Nearly one-third of hospitals claimed that they allocate their budget based on priorities and strategic goals. However, it turned out that although goals had been set, no formal announcements had been made. Most of the hospitals stated that they used measures when evaluating the plan. For hospital staff, clarifying the hospital's priorities was the most important advantage of a strategic plan. Conclusion: There is no clear definition for strategic management in Iranian hospitals, which results in chaotic implementation and control of strategic planning

The relationship between teachers' evaluation scores and the students' academic performance: a case study in Iran

Background and Aims: Identifying factors that affect the students' evaluation of teachers' performance, allows for proper planning and provides for earning real results of the faculty performance. This study was undertaken aimed at determining the relationship between teachers' evaluation scores and the students' academic performance in Ilam University of Medical Sciences. Methods and Material: This descriptive-analytical study was undertaken throughout the school year of 2009-2010 in the Ilam University of Medical Sciences. All the faculty members (110 teachers) and all the medical and basic sciences students (1250 people) studying in this university during the mentioned time span were considered using the census method. Collection of the faculty evaluation data was carried out using a valid and reliable questionnaire including 14 questions, where as the data on academic performance of the students was gathered via the Educational Management System (Sama). Normalization of the variables was executed using the Kolmorogrove-Smirnove test and data analysis was performed based on Pearson correlation coefficient test and linear regression. Findings: The teachers' performance evaluation mean score during the first and second semester was 4.28 and 4.17 respectively, and the students' grade point average during the first and second semester was 15.11 and 15.48 respectively. The Pearson con-elation coefficient showed that there is a negative relationship between the number of units (number of credit hours per each course) a professor should teach and the mean score of the class performance, which was statistically significant (r=0.28, P=0.031). Also, the linear regression equation showed that by increasing the number of the units each professor should teach only by one unit, the mean score of the grade point average (GPA) of the class will decrease by 22. However, there were no significant relationship between the class performance mean (the class average GPA) scores and teachers' evaluations scores mean (p=0.94). Conclusion: Considering the insignificance of the relationship between the classroom performance (mean GPA score) and the teachers' evaluation mean score -having been confirmed by similar studies- this variable should not be considered as a biased factor in evaluation of the professors, given the fact that No significant relationship was observed between the class average exam marks and the classroom evaluation mean scores (P=0.54, r=0.057). The findings of the current study have shed some light on the subject matter by providing insights from a non-western background and would help to fill up the lack of studies in this context