Presenting Modified Servqual Model to Evaluate Flight Attendant Services: Iran Air case study

Purpose: The investigation of the customer`s viewpoints and utilizing their ideas and expectations in improving the quality of the products, has turned out to be one of the key concerns of the companies working in all fields. Airline industry as one of the most extensive modes of transportation should be strictly accurate in providing services to their customers. This article attempts to investigate important dimensions from passengers' point of view and present a model which would evaluate the flight attendant's performance. Design/methodology: In order to achieve this purpose, on the basis of the literature and experts' and passengers' point of view, the SERVQUAL model has been modified with 26 factors in 6 dimensions. Then 300 data have been gathered for the Factor Analysis Model. Findings: As a result, a model with high goodness of fit has been developed which could be used as a tool of measuring quality of service with a high degree of certainty. In the end, running the model in Iran air, most differences were as below: 1-Improvement 2-Responsiveness 3-Empathy 4-Assurance 5-Tangibles 6-Reliability. Originality/value: In general, in this model, all services with which employees are involved are observed. However, the main issue in this research is related to attendant team. Consequently, considering that many of these indicators have different meanings in assessing customer satisfaction in relation to the performance of flight attendant; modifications should be made to the dimensions of the SERVQUAL model.Peer Reviewe

Exploring barriers and challenges in protecting residential fire - related injuries: a qualitative study

Background: Building fires can be a great threat to the safety of residents, and can lead to economic and social damage. Exploring the views of stakeholders is a great source for understanding the factors that affect fires. The purpose of this study was to explore stakeholders’ experiences of unintentional fire-related injuries in residential buildings in Iran. Methods: This qualitative study was carried out using grounded theory. The study was conducted in Iran, in 2017. The study participants consisted of 25 people including stakeholders who had practical experience/or were knowledgeable in the field of preventing and fighting building fires. Purposeful and theoretical sampling were used for data collection. Data were analyzed based on constant comparative analysis and according to recommendations by Strauss and Corbin. Results: "Lack of a comprehensive approach to prevention of fire-related injury" emerged as a core variable which impacted on residents' safety against fires. The findings were classified into four groups of challenges related to the structure of building, socio-economic challenge, residents of the building and rescue services. Conclusions: Based on participants` experiences, unintentional fire-related injuries in residential buildings are affected by cultural context and economic, social and geographical factors. Improving the safety against unintentional fire-related injuries in residential buildings requires multidisciplinary operations including both change and improvement of the building construction and change in the beliefs and practices of residents to increase safety against fires

The effect of low- dose tranexamic acid on postoperative blood loss in patients treated with clopidogrel and aspirin

Background: Clopidogrel in combination with aspirin increases bleeding, allogeneic red cell transfusion and reoperation rates after CABG. Tranexamic acid, an antifibrinolytic agent, has been approved for use in cardiac surgery to reduce bleeding. In the present study, we evaluated the impact of tranexamic acid on the transfusion and post-operative blood loss after CABG in patients treated with clopidogrel less than 5 days before surgery. Methods: This study was a prospective, randomized, double-blinded clinical trial. Patients undergoing on-pump CABG with their last dose of clopidogrel and aspirin less than 5 days preoperatively were randomly assigned to receive tranexamic acid (10 mg/kg before surgical incision and 10 mg/kg after protamine neutralization) or a corresponding volume of saline solution. The incidence of allogeneic red cell transfusion and 48h postoperative blood loss were recorded. Results: The average volume of blood loss was 776.92±459.81mL for the TXA group and 1075.00±670.91mL for the control group (P=0.03) in the patients with clopidogrel exposure within 48 h before surgery. The average volume of blood loss was not different between two groups in the patients with clopidogrel exposure within 5 days before surgery and also transfusion rate. Conclusion: The result of this study shows that tranexamic acid reduced blood loss in the patients with clopidogrel exposure within 48 h before surgery. So, it is better that we use tranexamic acid before surgery in all patients

Continuous post-disaster physical rehabilitation: a qualitative study on barriers and opportunities in Iran

Background: Internationally, inclusion of physical rehabilitation services during early disaster response is relatively new. The aim of the study was to gain an understanding of disaster relief physical rehabilitation in Iran. Methods: A qualitative study design was employed and sixteen semi-structured interviews were conducted for data collection. Content analysis was used for data analysis. The participants in this study were purposively selected among people who experienced the Bam (2003) and Varzaghan (2012) earthquakes. Results: Three main themes were explored including: indispensable intervention, barriers to continuous intervention and opportunities for intervention. Almost all participants reiterated the importance of effective physical rehabilitation services during disasters. Some participants mentioned significant barriers for delivering such services in the context of Iran. The lack of an effective responsible body, weak disaster-related competencies and under-prioritization by government were among other barriers. On a more positive note, some interviewees talked about national programs that could facilitate service delivery. Conclusions: Providing disaster relief physical rehabilitation has faced many barriers in Iran. However, there are some facilitators in the country that could help provide these services. Finally, the feasibility of post-disaster physical rehabilitation services delivery completely depends on the current national rehabilitation system

Preventive measures for fire-related injuries and their risk factors in residential buildings: a systematic review

Abstract: Background: Every year, a large number of people lose their lives or become injured seriously as a result of fires. Fires in buildings pose a great threat to resident safety. The aim of this systematic review is to identify preventive measures for fire-related injuries in residential buildings, taking into account associated risk factors. Methods: In this study, a systematic review was performed of all studies conducted in the field of residential building fires, influencing factors and available safety procedures. From the earliest record up to 7 July 2017, databases of PubMed, Web of Science/Knowledge, and Scopus were searched and selected articles included in the study. Results: A total of 5,613 published articles were examined, of which 30 were finally found to meet the inclusion criteria. The findings of the study were included in two main groups of preventive measures and risk factors for residential building fires and related injuries. Regarding preventive measures, the factors to reduce the risk of fire-related injuries raised in the studies under review included rule amendments, changes and modification of the environment, behavior change such as emergency evacuation during fire occurrence, improvements to emergency medical services, and awareness-raising. Also, many of the studies showed that areas with a large number of young children, older people, people with physical and mental disabilities, alcohol and drug addicts, smokers, single-family households and low-income families were particularly at risk of fire-related injuries and deaths. Conclusions: There are features in residential buildings and attributes among residents that can be related to fire hazard and fire-related injuries and deaths. The most important point of this study is to focus on preventive strategies including environmental modification, promotion of safety rules and changes in risk behavior among residents. Policy makers should pay more attention to these important issues in order to promote safety and injury prevention in relation to building fires

Benefits of Zataria multiflora Boiss in Experimental Model of Mouse Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a chronic condition of the intestine with unknown etiology involving multiple immune, genetic and environmental factors. We were interested to examine the effect of total extract from Zataria multiflora Boiss, a folk medicinal plant on prevention and treatment of experimental IBD. Z. multiflora was administered (400, 600, 900 p.p.m.) through drinking water to IBD mice induced by intrarectal administration of acetic acid. Prednisolone was used as the standard drug for comparison. Biochemical, macroscopic and microscopic examinations of colon were performed. Biochemical evaluation of inflamed colon was done using assay of myeloperoxidase (MPO) activity and thiobarbituric acid reactive substances (TBARS) concentration as indicators of free radical activity and cell lipid peroxidation. The activity of MPO and lipid peroxidation products (TBARS) increased in acetic acid-treated groups while recovered by pretreatment of animals with Z. multiflora (400–900 p.p.m.) and prednisolone. Z. multiflora (600 and 900 p.p.m.) and prednisolone-treated groups showed significantly lower score values of macroscopic and microscopic characters when compared with the acetic acid-treated group. The beneficial effect of Z. multiflora (900 p.p.m.) was comparable with that of prednisolone. The antioxidant, antimicrobial and anti-inflammatory potentials of Z. multiflora might be the mechanisms by which this herbal extract protects animals against experimentally induced IBD. Proper clinical investigation should be carried out to confirm the activity in human

Barriers and facilitators to provide effective pre-hospital trauma care for road traffic injury victims in Iran: a grounded theory approach

BACKGROUND: Road traffic injuries are a major global public health problem. Improvements in pre-hospital trauma care can help minimize mortality and morbidity from road traffic injuries (RTIs) worldwide, particularly in low- and middle-income countries (LMICs) with a high rate of RTIs such as Iran. The current study aimed to explore pre-hospital trauma care process for RTI victims in Iran and to identify potential areas for improvements based on the experience and perception of pre-hospital trauma care professionals. METHODS: A qualitative study design using a grounded theory approach was selected. The data, collected via in-depth interviews with 15 pre-hospital trauma care professionals, were analyzed using the constant comparative method. RESULTS: Seven categories emerged to describe the factors that hinder or facilitate an effective pre-hospital trauma care process: (1) administration and organization, (2) staff qualifications and competences, (3) availability and distribution of resources, (4) communication and transportation, (5) involved organizations, (6) laypeople and (7) infrastructure. The core category that emerged from the other categories was defined as "interaction and common understanding". Moreover, a conceptual model was developed based on the categories. CONCLUSIONS: Improving the interaction within the current pre-hospital trauma care system and building a common understanding of the role of the Emergency Medical Services (EMS) emerged as key issues in the development of an effective pre-hospital trauma care process

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe