La prestación del servicio en el sistema público de salud: análisis envolvente de datos

As well as companies that compete in market, in public health system organizations compete to satisfy customer’s need, and therefore identifying those needs and delivering the value is critical in success. Return to Scale and Damage to Scale are measures. In this study data envelopment analysis is developed to measure the Return to Scale and Damage to Scale in public health organization. Two new assumptions for production possibility set are proposed as Weak Natural Disposability and weak managerial disposability. Then three types of models including efficiency evaluation, Return to Scale determination, and Damage to Scale determination are proposed based on radial and non-radial models.A case study is handled using real data of 33 hospitals in Tehran. Each hospital is assumed as a decisionmaking unit with 4 inputs, 2 desirable outputs, and 2 undesirable outputs. The proposed approachesare straightforward and applicable for real world problems.Al igual que las empresas  que compiten en el mercado, las organizaciones del sistema  público de salud compiten para satisfacer las necesidades de los clientes  y, por lo tanto, es fundamental  identificar dichas necesidades y entregar  valor para alcanzar el éxito. Los Rendimiento de Escala y Daños de Escala se utilizan como  medidas.  En este estudio, el análisis envolvente de datos se desarrolla para medir los Rendimientos  y Daños de Escala en una organización pública de salud. Se proponen dos nuevos supuestos para la posibilidad de producción: Baja disponibilidad natural y baja disponibilidad de gestión. Seguidamente, se proponen tres tipos de modelos basados en modelos  radiales  y no radiales que incluyen la evaluación de la eficiencia, la determinación de los rendimientos de escala y la determinación de los daños de escala. Se maneja un estudio de caso que utiliza datos reales de 33 hospitales de Teherán, Irán. Cada hospital se asume como una unidad de toma de decisión de cuatro insumos (inputs), dos productos (outputs) deseables y dos productos (outputs) indeseables.  Los enfoques propuestos  son sencillos y aplicables a los problemas del mundo real

THE EVALUATION OF THE RATE AND THE TYPE OF MEDICATION ERRORS AMONG NURSES

ABSTRACTObjective: Since medication instructions are an important part of patients' treatment process, neglecting the correct principles of medicationinstructions application can result in numerous problems such as unsuccessful treatment or failure and the emergence of lawsuit and complaintissues. The survey and the determination of the medication error types is the first step in preventing them and since the medication errors arecommon among the nurses according to the various studies and due to their importance the researchers decided to perform a study aiming at thesurvey of the rate and the type of the medication errors common among the nurses.Methods: This study is a descriptive research performed on 119 nurses from Zahedan training hospitals all of whom have been selected based on arandom method in 2016. To gather the necessary information required for the current study, a two-part questionnaire was taken advantage of the firstpart of which was related to the demographic characteristics, and the second part was connected to the evaluation of the type of medication errorsand reporting them. Finally, after the questionnaires were collected, the data were analyzed based on SPSS 19 software and descriptive statistics.Results: The participants average age was 28.86±6.45; 101 individuals were women and 87 individuals had passed courses on ethics. Furthermore,86 nurses had had an experience of medication error at least for 1 time. The highest mean score in the type of the medication error was related towrong infusion rate, wrong dosage, and administering several drugs without paying attention to the drug interferences.â€Conclusion: In this study, the results indicated that the rate of the medication errors is a very high among the nurses. Therefore, to reduce themedication errors, there is a need for making serious decisions.Keywords: Medication error, Nurses, Zahedan

A Neglected Case of Wilson’s Disease Presenting as Symptomatic Urolithiasis and Proteinuria: A Case Report and Review of the Literature

We report a short-statured, 39-year-old male presenting with recurrent kidney stones, history of refractory rickets, and bone deformity. He had been consuming multiple doses of calcium supplements and multiple courses of vitamin D over past 30 years before prior to reporting in our clinic without any significant laboratory or clinical improvement. The patient was diagnosed as having Fanconi’s syndrome attributable to Wilson’s disease. This patient highlighted that in case of resistant rickets, a high index of uncertainty must be invoked for Wilson’s disease. Appropriate timely recognition of this entity results in prompt ministrations and prevention of disability. We also presented and discussed reviews on Wilson’s disease from literature

Production of Chitin and Chitosan from Shrimp Shell Wastes Using Co-Fermentation of Lactiplantibacillus plantarum PTCC 1745 and Bacillus subtilis PTCC 1720

Abstract   Background and Objective: Disposal of fishery wastes is one of the environmental challenges. Converting wastes into valuable products is an economical solution to solve this environmental problem. One of the wastes of fishery products is shrimp shell waste, which contains large quantities of chitin. Chitin and its derivative, chitosan, include several uses in various industries, especially the food industry. The aim of the present study was to extract chitin from shrimp shell wastes using co-fermentation with mixed microbial cultures. Chitosan production by deacetylation of chitin using various concentrations of NaOH was another aim of this study. Material and Methods: Batch fermentation was carried out to extract chitin from the shrimp shell using mixed cultures of two microorganisms, Lactiplantibacillus plantarum PTCC 1745 and Bacillus subtilis PTCC 1720. The Logistic model was used to assess the microbial growth rate. To prepare chitosan from chitin, deacetylation was carried out using NaOH solution. Morphological structures of the chitin and chitosan were studied using scanning electron microscopy. Functional groups of the synthesized chitin and chitosan were assessed using Fourier transform infrared spectroscopy. Results and Conclusion: High levels of demineralization and deproteinization were achieved using co-fermentation with the mixed microbial populations at 60 g.l-1 of glucose concentration. Chitin was produced with high purity and the protein and ash contents included 1.43 and 1.26%, respectively. Data predicted by the Logistic model were fairly matched the experimental data. A maximum cell growth rate of 0.065 (h-1) was achieved at 60 g.l-1 of initial glucose concentration at 35 °C. The optimal value of deacetylation (88.2%) was achieved using 50% NaOH solution at 100 °C. The results showed that the use of mixed culture of acid-producing and proteolytic microorganisms is highly effective for extracting chitin from shrimp shell waste. Conflict of interest: The authors declare no conflict of interest