Psychometric properties of the Postgraduate Hospital Educational Environment Measure in an Iranian hospital setting

Background: Students’ perceptions of the educational environment are an important construct in assessing and enhancing the quality of medical training programs. Reliable and valid measurement, however, can be problematic – especially as instruments developed and tested in one culture are translated for use in another. Materials and method: This study sought to explore the psychometric properties of the Postgraduate Hospital Educational Environment Measure (PHEEM) for use in an Iranian hospital training setting. We translated the instrument into Persian and ensured its content validity by back translation and expert review prior to administering it to 127 residents of Urmia University of Medical Science. Results: Overall internal consistency of the translated measure was good (a=0.94). Principal components analysis revealed five factors accounting for 52.8% of the variance. Conclusion: The Persian version of the PHEEM appears to be a reliable and potentially valid instrument for use in Iranian medical schools and may find favor in evaluating the educational environments of residency programs nationwide

Effects of amount of excess solid, the type of stirring and sedimentation time on solubility of sodium phenytoin and lamotrigine

Solubility is the maximum quantity of a drug dissolved in a given volume of solvent at a specific temperature. Several factors affect equilibrium solubility. Therefore, different solubility data have been reported for a solute in a certain solvent and temperature in the literature. These variations in solubility are one of the possible reasons for unsuccessful attempts of medicinal chemists for developing models as well as deviation of experimental works for solubility prediction in aqueous, non-aqueous and solvent mixtures. The present research aim is to investigate the effect of the amount of excess solid and the type of stirring on the solubility of drugs. The solubility of two antiepileptic drugs, namely sodium phenytoin and lamotrigine was determined in water, ethanol, and HCl 0.1 M at 37 °C. Different excess amounts of drugs were added to the constant volume of solvent. Additionally, different stirring methods such as magnetic stirrer and shake-flask and sedimentation time were investigated on the solubility values. Saturation solubility of drugs after dilution with water was measured using a spectrophotometer, and the concentration was calculated according to the calibration curve. Amount of excess solid, especially when the drug is in ionized form, and sedimentation time after 24 h have a significant effect on solubility values

Epidemiologic findings of the patients who attempted suicide and referred to the Shahid Mohammadi hospital of Bandar Abbass in 2009

Objective: Suicide is the 13th leading cause of death worldwide and is influenced by cultural, psychological and social aspects. The aim of this study was to investigate the epidemiology of suicide in Bandar Abbas in 2009.Methods: In a cross-sectional study in 2009, all suicidal patients who were referred to the emergency room (ER) of Shahid Mohammadi Hospital of Bandar Abbass were enrolled. Fully trained medical interns of the ER first collected demographic data of the suicidal patients. Then the data, including their reason for attempting suicide, how they attempted suicide, previous suicide attempts, history of substance use, and the size of the family, were collected by direct interviewing the patient. The collected data were analyzed using SPSS-16 software.Results: About 405 patients were enrolled in the study consisting 172 men (44.2%) and 226 (55.8%) women. Mean age of the participants was 24.29±5.5 years. Most of the suicidal patients were 18 to 26 years old (64.2%). Thirty-eight percent of the women and 62% of the men were addicts. Eleven patients (2.71%) died, including eight men and three women. The most prevalent method of suicide leading to death was drug toxicity. Conclusion: Teaching problem-solving skills is an important way to control suicide. Identifying the risk groups, paying closer attention to the 18-26 age group, and moral support of the patients with previous unsuccessful suicide attempts might decrease the suicide rate

Blind Mothers’ Experiences of Marginalization: A Hermeneutic Phenomenological Qualitative Study

Introduction: Mothering is a precious art with many intricacies. When women experience the phenomenon of mothering, they become vulnerable, and face many challenges. It creates worst conditions, if this experience is combined with a disability such as blindness. This study aimed to determine blind mothers’ experiences of marginalization. Method: The approach used in this study was hermeneutic phenomenology. Sampling was carried out using targeted and snow balling method. Face-to-face interviews were conducted with nine congenitally blind mothers who had child under the age of 8 years old. The interviews were recorded and transcribed verbatim. Interviews continued until data saturation. van Manen method was used for all steps of the study including data collections, data analysis, and interpretation and reporting the findings. Data analysis was performed using MAXQDA software. Results: From 479 initial codes, the main theme of "hermit inevitable", and subthemes of "feelings of shame", "a sense of discrimination", and "obligation in loneliness" were emerged. Conclusion: Blind mothers’ perception of themselves was to be marginalized, and they suffered from shame feeling, discrimination, lack of support, and obligation in loneliness. Blindness affects mothering, and blind mothers are in a unique situation. Keywords: Mothers, Blindness, Hermeneutics, Qualitative research, Experienc

Assessment of Nutritional and Antioxidant Activity of Sport Drink Enriched with Spirulina platensis

In this study, a sports drink was prepared with the addition of different concentrations of Spirulina platensis (0.05%, 0.125%, and 0.25% w/w). Spirulina biomass was extracted by ethanol, ethanol/water, and water and added to a sports drink. During storage time (21 days, 4°C), the chemical properties of these drinks such as antioxidant activity, ascorbic acid, and total sugar were evaluated. The lowest and highest amount of total sugar also was observed in the control sample, and sports drink containing 0.25% aqueous extract, respectively. After 21 days of storage, total sugar decreased by 40%, 27.25% and 38% for samples containing 0.25% alcoholic, water and hydroalcoholic extracts. The ascorbic acid content of sports drinks was significantly higher (p < 0.05) in the treatment sample in the comparison with control sample. Content of ascorbic acid was highest in sports drinks containing 0.25% aqueous extract and decreased (up to 1.3mg/100cc) with storage. The addition of spirulina increased the antioxidant activity of the sports drink. Among the sports drinks containing alcoholic, water and hydroalcoholic extracts, minimum control of free radicals, respectively pertained to the samples containing 0.05% of Spirulina extract (18.31, 23.33 and 22.11) after 21 days of storage. Also, the antioxidant properties of the sports drink samples decreased during storage time. According to the findings of this research, the addition of spirulina extract to sports drinks improves their nutritional and antioxidant characteristics

Drug-based therapeutic strategies for COVID-19-infected patients and their challenges

Emerging epidemic-prone diseases have introduced numerous health and economic challenges in recent years. Given current knowledge of COVID-19, herd immunity through vaccines alone is unlikely. In addition, vaccination of the global population is an ongoing challenge. Besides, the questions regarding the prevalence and the timing of immunization are still under investigation. Therefore, medical treatment remains essential in the management of COVID-19. Herein, recent advances from beginning observations of COVID-19 outbreak to an understanding of the essential factors contributing to the spread and transmission of COVID-19 and its treatment are reviewed. Furthermore, an in-depth discussion on the epidemiological aspects, clinical symptoms and most efficient medical treatment strategies to mitigate the mortality and spread rates of COVID-19 is presented

Motorcyclists' reactions to safety helmet law: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Extensive body of the literature reveals that proper use of helmets is an effective way to reduce the severity of injuries and fatalities among motorcyclists. However, many motorcyclists do not use safety helmet properly. This study aimed to empirically explore reactions of motorcyclists to the safety helmet laws, in Iran.</p> <p>Methods</p> <p>Qualitative data were collected via four focus groups and 11 in-depth interviews. Participants were 28 male motorcyclists who never used a safety helmet during rides, and 4 male police officers. All transcripts, codes and categories were read for several times to exhaust identifiable major themes. During this process data were reduced from text to codes and themes.</p> <p>Results</p> <p>Five major themes emerged from the data analyses, including themes related to the following: (1) circumventing or dodging police officers; (2) simulating a helmet wearing behavior; (3) accepting the probability of receiving a ticket; (4) taking advantage of the police neglect and carelessness; and (5) using a cheap or convenient helmet.</p> <p>Conclusion</p> <p>Our findings suggest certain levels of reckless driving among the participating motorcyclists in this study. They also point to a system of law enforcement that operates haphazardly and fails to consistently penalize those who deviate from it. Further studies are needed to investigate how "risks" are perceived and relate to "reactions", and how a 'culture of masculinity' may encourage risk tolerance and a disposition toward lawlessness and carelessness among male motorcyclists. Also, there is a need for the development and implementation of multidimensional interventions that would offer socio-culturally sensitive educational and motivational messages to the motorcyclists and the in-service traffic-enforcement officers in Iran.</p

Maternal mortality and morbidity burden in the Eastern Mediterranean region : findings from the Global Burden of Disease 2015 study

Assessing the burden of maternal mortality is important for tracking progress and identifying public health gaps. This paper provides an overview of the burden of maternal mortality in the Eastern Mediterranean Region (EMR) by underlying cause and age from 1990 to 2015. We used the results of the Global Burden of Disease 2015 study to explore maternal mortality in the EMR countries. The maternal mortality ratio in the EMR decreased 16.3% from 283 (241-328) maternal deaths per 100,000 live births in 1990 to 237 (188-293) in 2015. Maternal mortality ratio was strongly correlated with socio-demographic status, where the lowest-income countries contributed the most to the burden of maternal mortality in the region. Progress in reducing maternal mortality in the EMR has accelerated in the past 15 years, but the burden remains high. Coordinated and rigorous efforts are needed to make sure that adequate and timely services and interventions are available for women at each stage of reproductive life

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH