Hospital governance accountability structure: a scoping review.

INTRODUCTION: Hospitals, as complex organizations with clinical, financial, and social functions, face different barriers to providing high-quality and safe services at reasonable costs. Various initiatives have been carried out in hospital governance to improve quality, safety, and accountability. This research aims to identify the structures and dimensions that make hospital governance accountable. METHODS: The research used Arksey and O'Malley's scoping review framework to examine the research literature on hospital governance structure and accountability. The literature review included PubMed, Web of Science, Embase, Scopus ProQuest, Google search engine, and Google Scholar databases from 2010 to 2023. Data were analyzed using the content analysis method. RESULTS: Excluding unrelated and duplicate sources, 40 articles and reports were included in the study. The studies were reviewed and analyzed based on organizational type, type of source, year of publication, objectives, and key findings. Accountable governance features were extracted from the selected articles and reports. The four main themes include inclusive governance, commitment to accountability, planning for accountability, and autonomous governance. Thirteen subthemes were extracted from the study literature. CONCLUSION: Various initiatives have been implemented regarding the reform of the governance structure of public hospitals in different countries. Many of these reforms aim to improve financial and clinical accountability. The study results could be used to identify the structures and dimensions that make hospital governance accountable.

Senescence of bone marrow mesenchymal stem cells in Wistar male rats receiving normal chow/high-calorie diets with/without vitamin D.

Bone marrow mesenchymal stem cells (BM-MSCs) have a momentous function in the composition of the bone marrow microenvironment because of their many valuable properties and abilities, such as immunomodulation and hematopoiesis. The features and actions of MSCs are influenced by senescence, which may be affected by various factors such as nutritional/micronutrients status, e.g., vitamin D. This study aimed to examine the effects of a high-calorie diet (HCD) with/without vitamin D on BM-MSCs senescence. In the first phase, 48 middle-aged rats were fed a normal chow diet (NCD, n = 24) and an HCD (n = 24) for 26 weeks. Afterward, the rats in each group were randomly divided into three equal subgroups. Immediately, eight-rat from each diet group were sacrificed to assess the HCD effects on the first phase measurements. In the second phase, the remaining 4 groups of rats were fed either NCD or HCD with (6 IU/g) or without vitamin D (standard intake: 1 IU/g); in other words, in this phase, the animals were fed (a) NCD, (b) NCD plus vitamin D, (c) HCD, and (d) HCD plus vitamin D for 4 months. BM-MSCs were isolated and evaluated for P16INK4a, P38 MAPK, and Bmi-1 gene expression, reactive oxygen species (ROS) levels, SA-ß-gal activity, and cell cycle profile at the end of both phases. After 26 weeks (first phase), the ROS level, SA-ß-gal-positive cells, and cells in the G1 phase were significantly higher in HCD-fed rats than in NCD-fed ones (P < 0.05). HCD prescription did not significantly affect cells in the S and G2 phases (p > 0.05). Compared with the NCD-fed animals, P16INK4a and P38 MAPK gene expression were up-regulated in the HCD-fed animals; also, Bmi-1 gene expression was down-regulated (P < 0.05). BM-MSCs from vitamin D-treated rats (second phase) exhibited reduced mRNA levels of P16INK4a and P38 MAPK genes and increased Bmi-1 mRNA levels (all P < 0.05). Vitamin D prescription also declined the percentage of SA-ß-gal-positive cells, ROS levels, and the cells in the G1 phase and increased the cells in the S phase in both NCD and HCD-fed animals (P < 0.05). The reduction of the cells in the G2 phase in rats fed with an NCD plus vitamin D was statistically non-significant (P = 0.128) and significant in HCD plus vitamin D rats (P = 0.002). HCD accelerates BM-MSCs senescence, and vitamin D reduces BM-MSCs senescence biomarkers.

The effects of cognitive intervention on inter-joint coordination during walking in the older adults with balance impairment.

BACKGROUND: Cognitive interventions are among the effective training-on-gait parameters; however, the effects of such trainings on inter-joints coordination has not been much considered. RESEARCH QUESTION: Can dual task and executive function training affect inter-joint coordination during walking in elderly with poor balance? METHODS: Thirty elderly men were purposefully divided into three groups: 1) dual-task training group (DTG), 2) executive function training group (EFG) and 3) control group. After the pre-test, the experimental groups participated in 24 training sessions while the control group were required to do their normal daily tasks. VICON three-dimensional motion analysis system with four T20 series cameras was used to evaluate inter-joints coordination during the experiment. Participants had to walk a 12-meter path while kinematics of their joints was recorded. The inter-joint coordination at the sagittal plane and in four phases were assessed using the vector coding technique. RESULTS: The findings of this study showed that the greatest effect of the intervention on the coordination between the joints was in the loading and mid-stance phases (p < 0.05). Also, the variability in the coupling angle showed a significant decrease in most phases (p < 0.05). SIGNIFICANCE: Based on the obtained results, it can be argued that the loading and mid-stance are more involved in postural control and balance because the center of gravity is transferred between the legs and the person is normally on single-leg stance in these phases.

The effects of grapes and their products on immune system: a review.

Immune system plays a significant role in preventing and controlling diseases. Some studies reported the beneficial effects of grapes and their products on immunity. However, their results are controversial. This review aimed to discuss the effects of grapes and their products on immune system and their mechanisms of action. Although various in-vio and in-vitro studies and some human studies suggested that grapes and their products may help to improve the immune system's function, clinical trials in this area are limited and inconsistent.In conclusions, although, consumption of grapes and their products may help to having a healthy immune syste, further studies particularly human studies are required to clarify the precise effects of them and their mechanisms regarding immune system.

Protective Effect of Vitamin D Supplementation on Some Hemogram Derived Inflammatory Indices in Normal and High-Fat Diet Fed Male Wistar Rats.

Background: Hematological inflammatory indices are currently suggested to assess systemic inflammation. This study aims to investigate a vitamin D supplementation effect on hematological indices of inflammation in rats. Method: Forty-eight middle-aged male rats were allocated into a normal diet (ND) group (10% fat) and a high-fat diet (HFD) group (60% fat). The animals were fed for 26 weeks. After this period, each group was randomly divided into three subgroups, each of 8 rats: Group (1): animals were fed the ND and HFD containing 1 IU/g vitamin D for 4 months, group (2): animals were fed the ND and HFD containing 6 IU/g vitamin D for 4 months and group (3): animals were euthanized to evaluate the HFD effect. Serum 25-hydroxyvitamin D level, white blood cell count (WBCs), platelet count, platelet crit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) were measured. Results: The HFD, significantly increased body weight, PCT, PDW, PLR, NLR, and MLR and significantly reduced serum vitamin D levels compared to the ND (P < 0.05). There was a significant decrease in food intake, MPV, PDW, and NLR after vitamin D supplementation in the ND-fed group (P < 0.05). A significant reduction in platelet count, PCT, and MLR was observed after vitamin D supplementation in HFD-fed rats (P < 0.05). Conclusions: In our study, some hemogram-derived inflammatory indices were higher in the HFD-fed group, and vitamin D supplementation lowering effects on some hematological indices were seen in both ND and HFD groups.

Pressurized fluid extraction of essential oil from Lavandula hybrida using a modified supercritical fluid extractor and a central composite design for optimization.

Essential oil components were extracted from lavandin (Lavandula hybrida) flowers using pressurized fluid extraction. A central composite design was used to optimize the effective extraction variables. The chemical composition of extracted samples was analyzed by a gas chromatograph-flame ionization detector column. For achieving 100% extraction yield, the temperature, pressure, extraction time, and the solvent flow rate were adjusted at 90.6°C, 63 bar, 30.4 min, and 0.2 mL/min, respectively. The results showed that pressurized fluid extraction is a practical technique for separation of constituents such as 1,8-cineole (8.1%), linalool (34.1%), linalyl acetate (30.5%), and camphor (7.3%) from lavandin to be applied in the food, fragrance, pharmaceutical, and natural biocides industries.

The Effects of 8-week Nigella sativa Supplementation and Aerobic Training on Lipid Profile and VO2 max in Sedentary Overweight Females.

BACKGROUND: Regular moderate intensity physical activity and lipid lowering effects of Nigella sativa (N. sativa) supplementation may be appropriate management for sedentary overweight females. Therefore, the aim of the present study was to examine the effects of long-term N. sativa supplementation and aerobic training on lipid profile and maximal oxygen consumption (VO2 max) in sedentary overweight females. METHODS: In this randomized, double-blind, controlled trial, which was conducted in Kerman city (Iran), 20 sedentary overweight females were divided into two groups and assigned to N. sativa supplementation (N. sativa capsules) or a placebo for the 8 weeks, both groups participated in an aerobic training program (3 times/week). Each N. sativa capsule contained 500 ± 10 mg N. sativa crushed seeds and subjects had to take 2 g N. sativa per day for 8 weeks. Blood lipids and VO2 max were determined at baseline and at the end of 8 weeks. RESULTS: N. sativa supplementation lowered total cholesterol (TC) (P < 0.01), triglyceride (P < 0.001), low-density lipoprotein (LDL) (P < 0.001) and body mass index (P < 0.01) and increased high density lipoprotein (HDL) and VO2 max (P < 0.01). Aerobic training program lowered TC (P < 0.001) and LDL (P < 0.01) and increased VO2 max (P < 0.01). Furthermore, we observed a significant effect of aerobic training program and N. sativa supplementation lowered LDL and HDL (P < 0.05). CONCLUSIONS: The present study demonstrates that 8-week aerobic training plus N. sativa supplementation have a synergistic effect in improve profile lipid parameters.