Effectiveness of Blended Instruction on Pain and Requirement for Analgesic after Knee Arthroplasty Surgery

Background and aims: Most patients undergoing knee replacement surgery have pain and limited range of motion during recovery and rehabilitation and due to pain and lack of experience and knowledge are not able to run an effective rehabilitation program. So, this study was aimed to determine the effect of blended instruction on the intensity and the admission palliative of patients undergoing knee surgery. Methods: 64 patients scheduled for knee replacement surgery randomized block Foursome assigned to two experimental and control groups. The training program including film screenings and providing face to face training, manual and training video in the individual manner was implemented days before the surgery for the experimental group. The control group received routine care. Data by demographic and clinical form and pain assessment checklist were collected using a visual analogue scale. Numerical data about the pain from the second to fifth days and one month after surgery were collected and analyzed useing the SPSS software and Independent t-test, Chi-square and Repeated measure tests. Results: The results of this study showed that the experimental group reported significantly less pain than the control group at most times (P=0.012). According to independent t-test statistically significant difference between the 2 groups in terms of the amount of admission palliative at the time was found (P>0.054). However, based on analysis of variance with repeated measures between the admission palliative on study, there was a significant difference in both groups (P<0.001). Conclusion: According to our results, the combined intervention before surgery can reduce the level of pain experienced after surgery and as a training method used to teach these patients after surgery

Proposing a new methodology for prioritising the investment strategies in the private sector of Iran

This article proposes a systematic and organised approach for group decision-making in the presence of the uncertainty involved in expert judgments as used in multi-criteria decision-making (MCDM) issues. This procedure comprises the selection of the optimum alternative with respect to the evaluation criteria under consideration, in particular to select the strategy of investing. However, the selection of the investment strategy is difficult on account of considering the numerous quantitative and qualitative parameters like benefits, opportunities, costs, and risks. However, it is possible that these parameters have a significant influence on each other. A decision-making trial and evaluation laboratory (DEMATEL), used to define the influential network of elements, can be employed to construct a network relationship map (NRM). On the other hand, according to whether the information is incomplete or unavailable, uncertainty is an inseparable part of making decision for solving the MCDM problems. Therefore, this article proposes a new hybrid model based on analytic hierarchical process (AHP), DEMATEL, and echnique for Order of Preference by Similarity to Ideal Solution (TOPSIS) techniques under fuzzy environment to evaluate the problem of the selection of the investment strategy. To achieve the aim, a three-step process is presented to solve a sophisticated problem. First, the AHP method is employed to break down the investment problem into simple structure and calculate the importance weights of criteria by using a pairwise comparison process. Second, the DEMATEL technique is applied for considering interdependence and dependencies and computing the global weights of benefit, opportunities, cost, and risk (BOCR) factors. Finally, the fuzzy TOPSIS methodology is used for prioritising the possible alternatives. To demonstrate the potential application of the proposed model, a numerical example is illustrated and investigated. The results show that the proposed model has a high ability to prioritise the strategies of investing

Assessment of nurses, patient satisfaction, patient attendants in educational hospitals in Ahvaz city health development plan in 2015

زمینه و هدف: طرح تحول نظام سلامت یکی از خدمات ارزنده دولت یازدهم در حوزه سلامت به شمار می&zwnj;رود. هدف این مطالعه، بررسی میزان رضایتمندی پرستاران، بیماران و همراهان از اجرای طرح تحول نظام سلامت در بیمارستان&zwnj;های آموزشی شهر اهواز در سال 1394 بود. روش &zwnj;بررسی: مطالعه حاضر از نوع توصیفی تحلیلی است. جامعه پژوهش شامل 300 نفر از پرستاران، 300 بیمار و 300 همراه بیمار از بیمارستان&zwnj;های آموزشی شهر اهواز بود. نمونه&zwnj;گیری به صورت تصادفی ساده انجام شد. ابزار پژوهش پرسشنامه محقق&zwnj;ساخته بود. نحوه نمره&zwnj;دهی به&zwnj;صورت لیکرت سه گزینه&zwnj;ای (رضایت کامل، رضایت متوسط و ناراضی از اجرای طرح تحول) بود. آنالیز داده&zwnj;ها با استفاده از نرم&zwnj;افزار SPSS و آزمون&zwnj;های آماری توصیفی( میانگین، انحراف معیار)، آزمون&zwnj;های آماری تی&zwnj;مستقل و آنالیز واریانس یکطرفه انجام شد. یافته&zwnj;&zwnj;ها: میانگین نمرات رضایت از طرح تحول سلامت بترتیب در پرستاران، همراهان و بیماران 42/6&plusmn;64/30، 52/7&plusmn;45/29 و 75/5&plusmn;65/26 بود. نتایج نشان داد که 1/83 ناراضی، 4/16 رضایت متوسط و 5/0 کاملاً راضی بودند. میزان رضایت همراهان بیمار 5/35 ناراضی، 4/55 رضایت متوسط و 1/9 کاملاً راضی بودند. میزان رضایت بیماران از طرح، 5/33 ناراضی، 5/57 رضایت متوسط و 9 کاملاً راضی بودند. نتیجه&zwnj;&zwnj;گیری: اکثریت نمونه&zwnj;های پژوهش (بیمار و همراه) از اجرای طرح تحول نظام سلامت راضی بودند، اما غالب پرستاران از اجرای طرح تحول نظام سلامت ناراضی بودند؛ لذا پیشنهاد می&zwnj;شود این پژوهش در سایر بیمارستان&zwnj;ها نیز انجام شود تا نتایج آن&zwnj;ها با هم دیگر مقایسه گردد

Critical factors of the application of nanotechnology in construction industry by using ANP technique under fuzzy intuitionistic environment

Nanotechnology plays a significant role in construction industry. The construction industry has been employed nanomaterials to improve the performance of construction components and the safety of the structure and to reduce the energy consuming and the cost of maintenance. In other words, nanotechnology has a substantial impact on the construc­tion industry. Therefore, it is necessary to identify and evaluate the critical factors of the application of nanotechnology in construction in order to concentrate on the most critical factors. However, several techniques have been developed to prioritize the evaluation criteria. Analytical network process (ANP) technique, a branch of multi criteria decision mak­ing (MCDM) methods, is a powerful tool to rank a limited number of criteria. This technique takes into account both tangible and intangible criteria in the process of formulation of a decision making problem. This method is capable of handling all types of independence and dependence relationships. On the other hand, intuitionistic fuzzy set (IFS) is a well-known technique in considering the inherent uncertainty involved in the process of modelling a decision making problem. In this paper, a new model based on the IFS and ANP technique is proposed to evaluate the critical factors of the application of nanotechnology in the construction industry. The results demonstrate that the proposed model has a high potential for taking into account the uncertainty in the form of a three dimension function, including membership, non-membership, and non-determinacy

Underground mine risk assessment by using FMEA in the presence of uncertainty

Managers always look for systems with minimum hazards, which cause problems for performance of projects. The largest and the most important hazards of working underground mines can be associated with health, safety and environmental Failure mode and effects analysis (FMEA) is a widely used technique to identify the potential failure modes for measuring reliability of a product or a process. FMEA is performed by developing a risk priority number (RPN), which is the product of severity, occurrence, and detection ratings. On the other hand, with regard to uncertainty in the decision-making, fuzzy theory can help model the inherent uncertainty involved in the underground mining projects. Fuzzy FMEA provides a tool that can work in a better way with vague concepts using insufficient information compared with conventional FMEA. The comparison between the results of the conventional FMEA with those of the proposed model shows that the fuzzy model has a high potential to formulate the level of risk

Beneficiation of Low-Grade Phosphate Deposits by a Combination of Calcination and Shaking Tables: Southwest Iran

Three quarters of the world’s phosphate deposits are of sedimentary origin and 75%–80% of those include carbonate gangue. In this study, carbonate sedimentary phosphate deposits of the Lar Mountains of southwest Iran are studied. These deposits consist mainly of calcite, fluorapatite, quartz, kaolinite and illite, with an average P2O5 grade of 9%–10% (low-grade). Various pre-processing and processing methods have been developed for concentrating low-grade phosphate up to marketable grade and this study aims to select the optimal method to produce an economically viable grade of phosphate concentrate from low-grade ore. Different concentration methods, including calcination and gravity separation, were applied on samples at both a laboratory and semi-industrial scale (pilot scale). Using an integrated method of calcination (performed in a rotary kiln) and shaking table for concentrating the low-grade phosphate ore, the results show promise at producing grades of 30.77% P2O5 with 60.7%–63.2% recovery

Assessment of “Improving Productivity of Clinical Staff’s Law” and Clinical Errors in Nurses Working in Night Shift in Ganjavian Hospital of Dezful City, in 2017

Background and Aims One of the goals of "Improving Productivity of Clinical Staffs’ Law" was to reduce the clinical nursing errors. Nurseschr('39') fatigue is one of the most important causes of clinical errors in night shifts. This study aimed to study "Improving Productivity of Clinical Staffs’ Law" and clinical errors in nurses working in night shifts in Ganjavian Hospital of Dezful, Dezful City, Iran, in 2017. Methods In this descriptive-analytical study, records of nurseschr('39') clinical errors in the night shifts from 1992 to 1995 (since the enforcement of the "Improving Productivity of Clinical Staffs’ Law"), as well as the years 1988 to 1991 (before the "Improving Productivity of Clinical Staffs’ Law”) were checked out. The study data were collected using a demographic questionnaire and clinical errors checklist. The obtained data were analyzed using Chi-square test in SPSS version 22. Results The total number of clinical errors recorded in the night shift in terms of drug, diagnostic, care-therapeutic and laboratory aspects was 318 cases before the implementation of the health promotion plan. This figure increased to 746 in 4 years. The total number of clinical errors in comparison with the patientschr('39') numbers showed that the odds ratio before the implementation of the development plan was 0.72 and after the implementation of the plan and the risk of chance after the implementation of the development plan is equal to 1.38 before the implementation of the plan. The total number of clinical errors in relation to the number of nurses showed that the risk of risk before the implementation of the development plan was equal to 0.195 after the implementation of the transformation plan and the risk of the risk after the implementation of the plan to develop before the implementation of the plan is 5.12. Conclusion Results showed that the implementation of the development plan and consideration of the reward for the transparent report of clinical errors increased the number of reports of clinical errors

Proposing a new model for waste dump site selection: case study of ayerma phosphate mine

The purpose of developing a mining project is to meet the demand for metals and minerals resources. This is obviously connected with the generation of a considerable volume of waste. However, one of the most important strategies in waste management is to select the optimum waste dump site. To face with this problem, managers go in search of the techniques that not only can consider the technical and economic factors but also take into account environmental aspects to get a better perspective on the problem under consideration. The merit of using multicriteria decision making (MCDM) model is to consider different criteria. One of the most standard techniques used for the formulation of a complex problem under different criteria is Additive Ratio ASsessment (ARAS). In this paper, the ARAS based group decision making (GARAS) for evaluating the possible alternatives under partial or incomplete information is proposed. The proposed model contains three main stages: (i) identifying the main and sub-criteria, (ii) evaluating the feasible alternative by using fuzzy GARAS technique, and (iii) conducting a sensitivity analysis to determine how the importance weights influence the process of the decision making. To demonstrate the potential application of the proposed model, a real case study is illustrated. The strength of the proposed model is its effectiveness and capability to produce proper solutions under the inherent uncertainty involved in the process of modeling a real-life problem

The effects of diazinon on pituitary-gonad axis and ovarian histological changes in rats

Background: Diazinon is a widely used Organophosphate insecticide, which is applied against plant pests. This compound has various side effects because it acts as an acetyl cholinesterase enzyme inhibitor. Objective: The aim of present study was to investigate the effects of diazinon on pituitary-gonad axis and ovarian histological changes in rats. Materials and Methods: In total, 50 female wistar rats were divided into 5 groups of 10, including control, sham and experimental groups I, II and III which orally received 50, 100 and 150 mg/kg/bw diazinon for 14 days respectively. Diazinon was administered orally, and 24 hours after the last treatment, blood samples were taken from the heart, centrifuged and sera were evaluated for the concentrations of estrogen, progesterone and gonadotropins via RIA method. In addition, ovaries were removed, fixed and studied with steriological methods. Results: The results show no significant changes in body weight among various groups; while, ovarian weight in experimental group III decreased significantly (p<0.05). Also, no significant changes in the levels of LH, FSH and estradiol hormones were observed. In contrast, the concentration of progesterone showed a significant decrease in all experimental groups compared with the control group. The results showed no significance difference in the mean number of primary, secondary and graffian follicles but there was a significant decline in the mean number of corpus luteum in experimental group receiving 150 mg/kg diazinon (p<0.05 ) . Conclusion: One can conclude that oral administration of diazinon could have adverse effect on progesterone hormone level as well as hazardous effects on ovarian tissues and reproductive processes

The Effect of Collaborative Care model on the Fatigue in Patients Undergoing Maintenance Hemodialysis: A Randomized Clinical Trial

Abstract Background and Objectives: Hemodialysis patients suffer from fatigue due to various problems, which negatively affects their quality of life and health status. The present study was performed with the aim of determining the effect of collaborative care model on the fatigue in patients undergoing maintenance hemodialysis. Methods: In this controlled clinical trial study, 52 patients undergoing maintenance hemodialysis were purposively selected and randomly divided into two groups of test and control. Demographic characteristics and Fatigue Severity Scale (FSS) Questionnaires were completed in both groups before intervention and collaborative care model implemented for 3 months in the test group based on motivation, readying, involvement, and evaluation stages in the intervention group. One month after the intervention, frequency and mean of fatigue severity were compared with pre-intervention data using Chi-square, independent t, and repeated measures statistical tests. Results: After the intervention, mild fatigue increased and intense fatigue significantly deceased (p=0.02). Moreover, the results showed that after the intervention, the mean score of fatigue severity decreased in the intervention group (p=0.036). Conclusion: Implementation of collaborative care model has positive effect on decreasing fatigue severity in hemodialysis patients, therefore, use of this model by nurses, improves the patients&rsquo; fatigue. Keywords: Collaborative care; Hemodialysis patients; Fatigue; A randomized clinical trial