Patients' sense of security from clinical factors in Iran: a cross-sectional study.

BACKGROUND: One of the clinical responsibilities and goals of hospitals is to provide patients with comfort and security. The present study aims to assess patients' sense of security among patients in Iranian hospitals. METHODS: The present research employed a cross-sectional design. The sample consisted of 830 patients visiting public, private, and social security hospitals in Mazandaran in the North of Iran. The required data were collected using a questionnaire developed by the researcher of this study.This questionnaire consisted of 4 dimensions:nursing, medical, advanced facilities and patient rights. The participants were selected using a proportional stratified random sampling method. Exploratory factor analysis, confirmatory factor analysis, descriptive statistics, and ANOVA were used for data analysis using SPSS version 22. RESULTS: The mean scores of patients' sense of security in social security, private, and public hospitals were 4.16 ± 0.89, 3.78 ± 0.67, and 3.60 ± 0.89, respectively. Medical factors with a mean and standard deviation of 3.92 ± 0.76, advanced facilities and equipment with 3.89 ± 0.89, nursing factors with 3.87 ± 0.73, and patient rights with 3.71 ± 0.90 were the highest to the lowest scores, respectively. The results showed that the type of hospital significantly affected the mean dimensions of security (p < 0.05). CONCLUSIONS: The study revealed variations in the sense of securityacross the sampled hospitals. Particularly, the sense of security attributed to the patient rights factors was lower than other factors. Therefore, to enhance the sense of security for patients, it is recommended to focus on staff training and fostering a culturethat emphasizes obtaining informed consent, demonstrating respect for the patient, and introducing the medical team to the patient before initiating any treatment.

Psychometric validation of the Persian version of the Mental Health Knowledge Schedule.

Determining the reliability and validity of the Mental Health Knowledge Schedule (MAKS-P) in Iran was the purpose of this study. We translated the MAKS into Persian and back into English. The validation process included linguistic validation, face validity, internal consistency, test-retest reliability, and construct validity. We perform multiple linear regressions to test the association between mental health knowledge and independent variables. A total of 384 people completed the Persian version of the questionnaire. In total, 64.6% of the respondents were women. The majority of respondents (51.6%) were married and did not have a full-time job (67.7%). The linguistic validation was confirmed. All the items of the questionnaire had acceptable face validity, except question number one, which was deleted due to incompatibility with the Iranian culture. Good internal consistency and reliability were shown by an overall Cronbach's alpha coefficient of 0.77. The test-retest approach was performed and the Cronbach's alpha was 0.845. Eigenvalues and the scree plot supported a 2-factorial nature of the translated survey form. The first and the second factors explained 33.14 and 14.92% of the variance, respectively. Age, education, and working status can be considered possible predictors of the MAKS-P score. The MAKS-P is a trustworthy questionnaire to assess stigma-related mental health knowledge in Persian-speaking societies.

A Comprehensive Study on the Antimicrobial Properties of Resveratrol as an Alternative Therapy.

Resveratrol is a polyphenolic antioxidant whose possible health benefits include anticarcinogenic, antiaging, and antimicrobial properties that have gained significant attention. The compound is well accepted by individuals and has been commonly used as a nutraceutical in recent decades. Its widespread usage makes it essential to study as a single agent as well as in combination with traditional prescription antibiotics as regards to antimicrobial properties. Resveratrol demonstrates the action of antimicrobials against a remarkable bacterial diversity, viruses, and fungus. This report explains resveratrol as an all-natural antimicrobial representative. It may modify the bacterial virulence qualities resulting in decreased toxic substance production, biofilm inhibition, motility reduction, and quorum sensing disturbance. Moreover, in conjunction with standard antibiotics, resveratrol improves aminoglycoside efficacy versus Staphylococcus aureus, while it antagonizes the deadly function of fluoroquinolones against S. aureus and also Escherichia coli. The present study aimed to thoroughly review and study the antimicrobial potency of resveratrol, expected to help researchers pave the way for solving antimicrobial resistance.

Ethical predictability of patient safety in Iranian hospitals.

BACKGROUND: Receiving safe health care services is among the first rights of patients. Ethical predictability is influential to identify the patient safety concerns in hospitals. OBJECTIVE: This study aimed to ascertain and compare ethical predictability of patient safety in selected hospitals in Mazandaran Province in Iran. METHODS: A cross-sectional design was applied in the current study. By applying the multistage method for sampling, the statistical population consisted of clinical units of selected public, social security, and private hospitals. Out of the 18 public hospitals, five teaching hospitals, nine private and five social security hospitals, one hospital was randomly selected in Mazandaran Province from each cluster. In total, 938 patients participated in the study. Data entry and analysis was carried out by SPSS version 22 software. RESULTS: The results showed that ethical predictability in social security hospitals was higher than the results in private and public hospitals (p < 0.001). In addition, among the selected dimensions of ethical predictability of patient safety in the selected hospitals, blood management was the highest dimension. Safe drug management, error management, infection control, and safe clinical services were the middle priorities and management and leadership of patient safety had the lowest mean in the ethical predictability of patient safety in the selected hospitals in the province. CONCLUSION: Identifying the factors causing ethical predictability in order to improve patient safety and service quality, is of great help to managers and authorities in the field of health services. Such awareness helps managers to consider these factors in all decision making processes.

Estimating the Survival of Patients With Lung Cancer: What Is the Best Statistical Model?

OBJECTIVES: Investigating the survival of patients with cancer is vitally necessary for controlling the disease and for assessing treatment methods. This study aimed to compare various statistical models of survival and to determine the survival rate and its related factors among patients suffering from lung cancer. METHODS: In this retrospective cohort, the cumulative survival rate, median survival time, and factors associated with the survival of lung cancer patients were estimated using Cox, Weibull, exponential, and Gompertz regression models. Kaplan-Meier tables and the log-rank test were also used to analyze the survival of patients in different subgroups. RESULTS: Of 102 patients with lung cancer, 74.5% were male. During the follow-up period, 80.4% died. The incidence rate of death among patients was estimated as 3.9 (95% confidence [CI], 3.1 to 4.8) per 100 person-months. The 5-year survival rate for all patients, males, females, patients with non-small cell lung carcinoma (NSCLC), and patients with small cell lung carcinoma (SCLC) was 17%, 13%, 29%, 21%, and 0%, respectively. The median survival time for all patients, males, females, those with NSCLC, and those with SCLC was 12.7 months, 12.0 months, 16.0 months, 16.0 months, and 6.0 months, respectively. Multivariate analyses indicated that the hazard ratios (95% CIs) for male sex, age, and SCLC were 0.56 (0.33 to 0.93), 1.03 (1.01 to 1.05), and 2.91 (1.71 to 4.95), respectively. CONCLUSIONS: Our results showed that the exponential model was the most precise. This model identified age, sex, and type of cancer as factors that predicted survival in patients with lung cancer.

Nurses' Perspectives on the Impact of Marketing Mix Elements (7Ps) on Patients' Tendency to Kind of Hospital.

BACKGROUND: Marketing mix (7Ps) is a critical concept in healthcare management and health marketing. Hence, this study was conducted to investigating the role of 7Ps on patients' disposition to the kind of hospital from nurses' perspectives. METHODS: A cross-sectional study design was used in 2015. The study was conducted in one state in Iran (Mazandaran). The statistical population included nurses (n=235) in public and private hospitals were selected randomly through the list. Data were collected by questionnaire and were analyzed using SPSS software (version 22). RESULTS: The results showed that 38.6 percent of nurses were males and the others (61.4 percent) were females. Their mean age was 31.0±7.1 years, and the majority of them belonged to the 30-40 age group. The mean work experience of them was 11.42±6.5 years. The findings showed that there were significant differences between nurses' perspectives in public and private hospitals about the effect of 7Ps elements on patients' tendency to the public and private hospitals (p<0.05). CONCLUSIONS: According to the results, the officials of public hospitals should take more attention to the elements like product, place, promotion, people, physical assets and process management more than the past because these elements cause that the patients are disposed to the private hospitals while the government make more investment in public hospitals.

Nurses' perspectives on the impact of marketing mix elements (7Ps) on patients' tendency to kind of hospital

BACKGROUND: Marketing mix (7Ps) is a critical concept in healthcare management and health marketing. Hence, this study was conducted to investigating the role of 7Ps on patients' disposition to the kind of hospital from nurses' perspectives. METHODS: A cross-sectional study design was used in 2015. The study was conducted in one state in Iran (Mazandaran). The statistical population included nurses (n=235) in public and private hospitals were selected randomly through the list. Data were collected by questionnaire and were analyzed using SPSS software (version 22). RESULTS: The results showed that 38.6 percent of nurses were males and the others (61.4 percent) were females. Their mean age was 31.0±7.1 years, and the majority of them belonged to the 30-40 age group. The mean work experience of them was 11.42±6.5 years. The findings showed that there were significant differences between nurses' perspectives in public and private hospitals about the effect of 7Ps elements on patients' tendency to the public and private hospitals (p<0.05). CONCLUSIONS: According to the results, the officials of public hospitals should take more attention to the elements like product, place, promotion, people, physical assets and process management more than the past because these elements cause that the patients are disposed to the private hospitals while the government make more investment in public hospitals

Prevalence of Blindness and Low Vision in Iran: A Systematic Review and Meta-Analysis.

PURPOSE: Visual impairment is responsible for medical, mental, and socio-economic problems. Several studies have investigated the prevalence of blindness and low vision in different parts of Iran. This study aims to estimate the pooled results of these studies to estimate the total prevalence of this problem in Iran. METHODS: National and international databases were searched using specific keywords. The selected primary studies were quality assessed using STROBE checklist. According to the results of the heterogeneity tests (Cochrane and I-squared indices), fixed- or random-effect models were applied to estimate the pooled results. The factors responsible for the heterogeneity were investigated using meta-regression models. The point and pooled estimates were presented by forest plots, and the presence of publication bias was assessed based on Egger test. RESULTS: Considering the results of 10 eligible studies showed that the prevalence (95% confidence intervals) of blindness among men, women, urban, and rural population as well as total population was 0.96% (0.60-1.31), 1.00% (0.70-1.31), 0.81% (0.19-1.44), 0.89% (0.45-1.32), and 1.02% (0.71-1.34), respectively. Prevalence (95% confidence intervals) of low vision among men, women, urban, and rural populations and also total populations was estimated at 2.19% (1.60-2.79), 2.60% (2.08-3.12), 2.81% (1.26-4.36), 3.67% (2.17-5.17), and 2.85% (2.12-3.58), respectively. CONCLUSION: Our meta-analyses showed that more than 3% of Iranian people are suffering from visual problems. In addition, we found that prevalence of blindness and low vision among Iranian women was more common than that of Iranian men and also was higher in rural areas than urban areas.

Decline in lung function among cement production workers: a meta-analysis.

BACKGROUND: Several studies with different results have been performed regarding cement dust exposure and its pathogenic outcomes during the previous years. This study aims to combine these results to obtain a reliable estimate of the effect of exposure to cement dust. METHODS: PubMed and other data banks were searched to identify required electronic articles. The search was extended interviewing with relevant experts and research centers. Point and pooled estimates of outcome with 95% confidence intervals were estimated. RESULTS: Participants were 5371 exposed and 2650 unexposed persons. Total mean differences (95% confidence intervals) were estimated as of -0.48 (-0.71 to -0.25) L for forced vital capacity (FVC), -0.7 (-0.92 to -0.47) L for forced expiratory volume in the first second (FEV1), -0.43 (-0.68 to -0.19) L for FEV1/FVC%, -0.73 (-1.15 to -0.30) L/min for PEFR and -0.36 (-0.51 to -0.21) L/s for FEF25-75. CONCLUSION: Our meta-analysis showed that cement dust has significant impact on lung function and reduces the indicators of FVC, FEV1, FEV1/FVC, PEFR and FEF25-75.

Awareness and Observance of Patient Rights from the Perspective of Iranian Patients: A Systematic Review and Meta-Analysis.

BACKGROUND: Recipients of healthcare services have rights, which must be acknowledged and protected. Such rights include observance of acceptable patient physical, mental, spiritual, and social needs guided by commonly accepted rules and regulations. The objective of this study was to conduct a systematic review and meta-analysis of awareness rates and observance of patient rights in Iran from the perspective of the patient. METHODS: In this study, various references such as Medline (PubMed), Scopus, Scientific Information Database (SID), Google scholar, Magiran, and IranMedex were searched (from August to December 2015). Heterogeneity was assessed using the Q statistic. English and Persian search keywords and combinations included terms such as "patient bill of rights, patient rights, Iranian patient bill of rights, and Persian patient rights." A meta-analysis of the primary search sources was accomplished using STATA (version 11.0). RESULTS: Initial review included 20 articles of which 12 assessed observance rates of patient rights and three described service awareness rates of recipients concerning their personal rights. Five articles covered both topics and had an estimated 54.2% coverage based on the results of meta-analysis and the random-effects model with the heterogeneity. CONCLUSION: An Observance rate of patient bills of rights was considered somewhat adequate. However, contradictions in findings noted in this study suggest deficiencies do exist and need to be resolved. There appears a need to better describe and increase awareness rates of healthcare services by patients concerning their own bill of rights.

A Systematic Review on the Effects of Polycyclic Aromatic Hydrocarbons on Cardiometabolic Impairment.

BACKGROUND: Various epidemiological studies have shown that exposure to environmental pollutants including polycyclic aromatic hydrocarbons (PAHs) might increase the risk of cardiovascular diseases (CVDs) and their risk factors. This study aims to systematically review the association of PAH exposure with metabolic impairment. METHODS: Data were collected by searching for relevant studies in international databases using the following keywords: "polycyclic aromatic hydrocarbon" + "cardiovascular disease," PAH + CVD, polycyclic aromatic hydrocarbon and "air pollutant" + "CVD," and the desired data were extracted and included in the study according to the systematic review process. RESULTS: From the 14 articles included in the present systematic review, eight articles were conducted on the relationship between PAH and CVDs, four articles were conducted to examine the association of PAH exposure with blood pressure (BP), and two articles investigated the link between PAH and obesity. CONCLUSIONS: Most studies included in this systematic review reported a significant positive association of PAH exposure with increased risk of CVDs and its major risk factors including elevated BP and obesity. These findings should be confirmed by longitudinal studies with long-term follow-up.

Patients' Expectations and Perceptions of Service Quality in the Selected Hospitals.

BACKGROUND: Hospital's success depends on patients' expectations, perceptions, and judgment on the quality of services provided by hospitals. This study was conducted to assess the patients' perceptions and expectations from the quality of inpatient health care in Vali-Asr hospital, Ghaemshahr, and Imam Khomeini and Shafa Hospitals, Sari. MATERIALS AND METHODS: This study is applied regarding the objective of the study. Considering the research methodology, it is a descriptive - analytical study. The sample of this study consists of 600 patients with at least 24 hours of being hospitalized in internal, surgery, women, and children sectors of Vali-Asr, Ghaemshahr, Imam Khomeini, and Shafa Hospitals. Using random sampling method, the classifications relevant to the size of each class were selected. The data required was collected through the standard SERVQUAL questionnaire and then it was analyzed using the SPSS software. RESULTS: The overall mean value and standard deviation of expectations were equal to 10.4 and 28, respectively. The mean value for the field of perception was 69.2 and the relevant standard deviation was 26. In terms of patients and hospital visits in concrete cases, the highest priority is related to empathy. The second priority is related to physical appearance, the third priority is related to responsiveness, the fourth priority is related to assurance, and the lowest priority is related to the reliability of the SERVQUAL approach. Examining the gap between patients' perceptions and expectations, the widest gap was observed in the Vali-Asr Hospital with the mean and SD (-92.0±39.0) and the lowest gap was observed in Shafa Hospital with the mean value of (-39.9±44.0). According to The Kruskal-Wallis test, the difference observed in these three hospitals were significant. CONCLUSION: The results showed that patients' expectations had not been met in any of the examined dimensions and their consent has not been achieved. It seemed that necessary for managers and relevant authorities to plan and pay special attention to this important issue.

First-principles study of terpyrrole as a potential hydrogen cyanide sensor: DFT calculations.

The sensitivity of terpyrrole (TPy; used as a polypyrrole model) to toxic hydrogen cyanide (HCN) adsorption was studied by using DFT to perform geometry optimization and to calculate the adsorption energy of HCN on TPy as well as orbital properties. The interaction of terpyrrole with HCN was studied for different relative orientations of the molecules. The adsorption energy, charge analysis, and the density of states were used to evaluate the ability of TPy to sense HCN in these different relative orientations. The adsorption energy was calculated to be -3.9 and -3.1 kcal mol(-1) for two possible relative orientations. Frontier molecular orbitals and energies indicated that some hybridization occurs during the adsorption of HCN on TPy when the molecules have appropriate relative orientations, resulting in an increase in conductivity. Considering the changes in the HOMO-LUMO energy gap that were calculated to occur during HCN adsorption, it is clear that TPy is sensitive to HCN adsorption, suggesting that TPy has the potential to act as an HCN sensor. Graphical abstract HCN adsorption on TPy.

An investigation into the ancient abortion laws: comparing ancient Persia with ancient Greece and Rome.

Since the dawn of medicine, medical rights and ethics have always been one of mankind's concerns. In any civilisation, attention paid to medical laws and ethics depends on the progress of human values and the advancement of medical science. The history of various civilisations teaches that each had its own views on medical ethics, but most had something in common. Ancient civilisations such as Greece, Rome, or Assyria did not consider the foetus to be alive and therefore to have human rights. In contrast, ancient Persians valued the foetus as a living person equal to others. Accordingly, they brought laws against abortion, even in cases of sexual abuse. Furthermore, abortion was considered to be a murder and punishments were meted out to the mother, father, and the person performing it.

Safety evaluation of nanoliposomes containing cyclosporine a after ocular administration.

AIM: Cyclosporine A (CyA) is an anti inflammatory drug which modulates immune system. We prepared two liposomal formulations of CyA for ophthalmic administration. In the present study, the safety of these formulations was tested in rabbits. MATERIALS AND METHODS: Fusogenic and positively charged liposomes were prepared by solvent evaporation method. CyA concentration in ophthalmic preparations was 0.2% w/v. Twenty New Zealand albino rabbits (40 eyes) were divided into two groups. Right eyes were treated and left eyes served as control. Eyes were examined clinically in 1, 3, 7, 14 and 28th days of the study. Eleven eyes were enucleated for pathological evaluation at the end of the study. RESULTS: Mean size and charge of positively charged and fusogenic liposomes were 110.7 ± 1.5 and 114.9 ± 15.2 nm; 19.0 ± 2.2 and 2.5 ± 0.5 mV, respectively. Clinically, there were transient conjunctival injections and corneal epithelial defects in a few cases which were not limited to the treated eyes. Positively charged liposomes caused conjunctival injection in two cases, while this complication occurred in only one eye after administration of fusogenic liposomes. Histopathological examination revealed the presence of follicular conjunctivitis in two eyes with conjunctival injection. Inflammation in cases received the fusogenic form of the drug was mild and non-specific. CONCLUSIONS: The results of this study suggest that fusogenic liposomal preparation of CyA is safe and can be useful for future studies.