Evaluation of the Psychometric Properties of the Persian Version of Spence Children's Anxiety Scale in Iranian Adolescents.

The Spence Children's Anxiety Scale (SCAS) is a tool for measuring anxiety symptoms in children and adolescents. In this study, the psychometric properties of the Persian version of SCAS were investigated in an Iranian adolescents. This study was conducted on a sample of 684 adolescents. For standardization of SCAS, first- and second-order confirmatory factor analyses wereperformed. Also, to evaluate convergent and divergent validity, Fornell and Larcker criteria (1994), along with the Revised Children's Manifest Anxiety Scale (RCMAS)and Children's Depression Inventory (CDI), was used. A receiver operating characteristic (ROC) curve analysis was also performedto determine the cut-off point. The model fit of the correlated six-factor model was good however, a second-order model provided a statistically superior fit to the data. The reliability coefficients for the total scale and its dimensions were satisfactory (α > 0.7). Therefore, it can be concluded that the Persian version of SCAS has acceptable reliability and validity and can be used as a useful tool for early screening of anxiety in Iranian adolescents due to its easy use and specific design for children and adolescents.

Evaluation of the Psychometric Properties of the Persian Version of Children's Depression Inventory in Iranian Adolescents.

Objectives: Children's Depression Inventory (CDI) is a self-report tool for measuring depression in children and adolescents. In this study, the psychometric properties of the Persian version of CDI were investigated in an Iranian adolescent population. Methods: This study was conducted on a sample of 480 adolescent boys and girls in the age range of 12-18 years. The results showed that 23.6% of the study population were 11-13 years old, 62.1% were 14-16 years old, and 14.3% were 17-18 years old. Also, 48.5% of the sample were girls, and 51.5% were boys. To investigate the convergent and divergent validity, Beck's Depression Inventory-Second Edition (BDI-II) and Teenage Inventory of Social Skills were used, respectively. Results: The reliability coefficient of CDI, based on Cronbach's alpha, indicated the relatively high internal consistency of the items (0.907). The results of the exploratory factor analysis showed that CDI has a saturated factor, explaining 50.11% of the variance in the data. Also, goodness-of-fit indices of confirmatory factor analysis showed that the model is well suited for explaining depression. The present results also showed a negative correlation between children's depression and the social skills subscale and a positive correlation between children's depression and BDI-II score. Conclusions: The construct validity of the questionnaire was confirmed. It can be concluded that the Persian version of CDI has adequate reliability and validity. Therefore, it can be used as a useful tool for early screening of depression in adolescents due to its easy use and specific design for children and adolescents.

Investigation of the psychometric properties of children's somatization inventory in Iranian adolescents.

BACKGROUND: This study aimed to investigate the psychometric properties of children's somatization inventory (CSI-24) in a sample of Iranian school adolescents. MATERIALS AND METHODS: In this study, after translating and back-translating CSI-24, comparisons were made with the original version. The study population consisted of 394 school adolescents. Cronbach's alpha method was used to examine the reliability of the scale. Furthermore, the correlation of the scale with the Symptom Checklist-90-Revised was evaluated to determine its criterion validity, using Pearson's correlation coefficient. Exploratory and confirmatory factor analysis methods were applied for construct validity. RESULTS: Investigation of the psychometric properties of the Iranian version of CSI-24 showed its high reliability and confirmatory factor analysis results show the model's satisfactory fitting. CONCLUSION: The Persian version of CSI-24 is a useful self-report tool for evaluating the physical complaints of Iranian school adolescents aged between 12 and 18 years.

Improving the Thermomechanical Properties of Poly(lactic acid) via Reduced Graphene Oxide and Bioderived Poly(decamethylene 2,5-furandicarboxylate).

Polylactide (PLA) is the most widely used biopolymer, but its poor ductility and scarce gas barrier properties limit its applications in the packaging field. In this work, for the first time, the properties of PLA solvent-cast films are improved by the addition of a second biopolymer, i.e., poly(decamethylene 2,5-furandicarboxylate) (PDeF), added in a weight fraction of 10 wt%, and a carbon-based nanofiller, i.e., reduced graphene oxide (rGO), added in concentrations of 0.25-2 phr. PLA and PDeF are immiscible, as evidenced by scanning electron microscopy (SEM) and Fourier-transform infrared (FTIR) spectroscopy, with PDeF spheroidal domains showing poor adhesion to PLA. The addition of 0.25 phr of rGO, which preferentially segregates in the PDeF domains, makes them smaller and considerably rougher and improves the interfacial interaction. Differential scanning calorimetry (DSC) confirms the immiscibility of the two polymer phases and highlights that rGO enhances the crystallinity of both polymer phases (especially of PDeF). Thermogravimetric analysis (TGA) highlights the positive impact of rGO and PDeF on the thermal degradation resistance of PLA. Quasi-static tensile tests evidence that adding 10 wt% of PDeF and a small fraction of rGO (0.25 phr) to PLA considerably enhances the strain at break, which raises from 5.3% of neat PLA to 10.0% by adding 10 wt% of PDeF, up to 75.8% by adding also 0.25 phr of rGO, thereby highlighting the compatibilizing role of rGO on this blend. On the other hand, a further increase in rGO concentration decreases the strain at break due to agglomeration but enhances the mechanical stiffness and strength up to an rGO concentration of 1 phr. Overall, these results highlight the positive and synergistic contribution of PDeF and rGO in enhancing the thermomechanical properties of PLA, and the resulting nanocomposites are promising for packaging applications.

Effect of Ustukhuddus Alavi, a multi-herbal product, on the cognitive performance of adolescent female students.

ETHNOPHARMACOLOGICAL RELEVANCE: Ustukhuddus Alavi is a polyherbal formula which is introduced by Persian medicine scholars. It is traditionally used to treat brain disorders and is claimed to do so by preprocessing and cleansing the waste products from the brain. According to Persian medicine, the disposal of brain waste products is necessary for optimal cognitive performance. AIM OF THE STUDY: Sustaining optimal cognitive performance is crucial for ideal quality of life and higher academic achievements in high school students. The objective of this study was to determine the effects of this multi-component herbal product on the cognitive performance and salivary cortisol levels of adolescent female students. MATERIALS AND METHODS: The effect of a 6-week randomly assigned Ustukhuddus Alavi versus placebo administration on cognitive performance was assessed by the paced auditory serial addition test (PASAT) at the baseline and after the 3- and 6-week intake of Ustukhuddus Alavi or placebo and the one-month follow-up in 86 healthy female high school students in grades 10 and 11. Additionally, we measured the levels of salivary cortisol of the students pre- and post-intervention. RESULTS: Significant mean difference between the Ustukhuddus Alavi and placebo groups in three of the paced auditory serial addition test (PASAT) subscales, namely mental health (p-value = 0.006), sustained attention (p-value = 0.001) and mental fatigue (p-value = 0.001), were observed after six weeks. We also found a significant difference between the mean salivary cortisol level of the two groups after the intervention (p-value = 0.047). CONCLUSIONS: These findings reveal that the intake of the multi-ingredient herbal product Ustukhuddus Alavi for six weeks can be helpful for cognitive function and cortisol levels in female high school students. These positive effects seem to be related to the increase in sustained attention and the decrease in mental fatigue.

The effectiveness of lifestyle training program promoting adolescent health with polycystic ovarian syndrome: A study protocol for a randomized controlled study.

BACKGROUND: Lifestyle training is of a key important in adolescent age for better life in the future. Healthy lifestyle in adolescents can management of any disease such as diabetes and polycystic ovarian syndrome (PCOS). Schools can provide an important environment to identify and change the lifestyle of students. The aim of this protocol is designing and evaluating the effectiveness of school-based lifestyle training program improving the PCOS of adolescents. MATERIALS AND METHODS: A cluster-randomized controlled trial will be conducted to examine the effectiveness of school-based lifestyle training program in 16 to 18 years old adolescent girls. The healthy lifestyle program will be designed by modification of behavioral habit, dietary intake, and physical activity and educated in eight sessions for adolescents and one session for parents in the intervention groups with sixty participants. RESULTS: Changes in primary and secondary outcomes in PCOS and healthy adolescents before and after intervention in the intervention and control groups will be analyzed for evaluation effectiveness by one-way ANOVA or other nonparametric equivalents. CONCLUSION: The current study will provide information on the effectiveness of school-based lifestyle training programs for adolescents. With increasing numbers of PCOS at risk for long-term and/or late effects of treatment and other chronic diseases, efforts for promoting the healthy lifestyle of this important group are urgently needed. This lifestyle program may provide valuable information relating to the development of other healthy lifestyle interventions for PCOS and result in appropriate behavior change and self-management strategies.

Multifunctionality of Reduced Graphene Oxide in Bioderived Polylactide/Poly(Dodecylene Furanoate) Nanocomposite Films.

This work reports on the first attempt to prepare bioderived polymer films by blending polylactic acid (PLA) and poly(dodecylene furanoate) (PDoF). This blend, containing 10 wt% PDoF, was filled with reduced graphene oxide (rGO) in variable weight fractions (from 0.25 to 2 phr), and the resulting nanocomposites were characterized to assess their microstructural, thermal, mechanical, optical, electrical, and gas barrier properties. The PLA/PDoF blend resulted as immiscible, and the addition of rGO, which preferentially segregated in the PDoF phase, resulted in smaller (from 2.6 to 1.6 µm) and more irregularly shaped PDoF domains and in a higher PLA/PDoF interfacial interaction, which suggests the role of rGO as a blend compatibilizer. rGO also increased PLA crystallinity, and this phenomenon was more pronounced when PDoF was also present, thus evidencing a synergism between PDoF and rGO in accelerating the crystallization kinetics of PLA. Dynamic mechanical thermal analysis (DMTA) showed that the glass transition of PDoF, observed at approx. 5 °C, shifted to a higher temperature upon rGO addition. The addition of 10 wt% PDoF in PLA increased the strain at break from 5.3% to 13.0% (+145%), and the addition of 0.25 phr of rGO increased the tensile strength from 35.6 MPa to 40.2 MPa (+13%), without significantly modifying the strain at break. Moreover, rGO decreased the electrical resistivity of the films, and the relatively high percolation threshold (between 1 and 2 phr) was probably linked to the low aspect ratio of rGO nanosheets and their preferential distribution inside PDoF domains. PDoF and rGO also modified the optical transparency of PLA, resulting in a continuous decrease in transmittance in the visible/NIR range. Finally, rGO strongly modified the gas barrier properties, with a remarkable decrease in diffusivity and permeability to gases such as O2, N2, and CO2. Overall, the presented results highlighted the positive and sometimes synergistic role of PDoF and rGO in tuning the thermomechanical and functional properties of PLA, with simultaneous enhancement of ductility, crystallization kinetics, and gas barrier performance, and these novel polymer nanocomposites could thus be promising for packaging applications.

The Prevalence of Addiction to Social Network Among Students in Iran and its Factors Related: A Study Conducted in 2020.

BACKGROUND: In the present era, the prevalence of addiction to social networks has shown that many users, including students, are detaching from the real world. Therefore, this study aims to estimate the prevalence of addiction to the social networks among students in Iran and its related factors. METHODS: This is a cross-sectional study conducted in 2020 on 1000 students in Shahid Beheshti University of Medical Sciences, Tehran, Iran. The data collection tool was a standardized questionnaire about addiction to the social networks distributed online among students. Statistical data were analyzed using Stata software version 14. RESULTS: Generally, 462 students (44%) had addiction to social networks, of which 449 (90.04%) had slight addiction and 13 (9.96%) had severe addiction. The results showed that age (p = 0.001), type of disciplines in the treatment-related subgroup (p = 0.03) and using nerve medicine (p = 0.0001) had significant relationships with addiction to social networks. CONCLUSION: Considering that a high number of students in the present study are at high risk of addiction, it is suggested that educational programs should be implemented to improve the knowledge of parents and students for optimal use of social networks and raise awareness of the harmful consequences of addiction.

A randomized clinical trial of metacognitive therapy and nortriptyline for anxiety, depression, and difficulties in emotion regulation of patients with functional dyspepsia.

Functional Dyspepsia (FD) as a psychosomatic disorder is an upper gastrointestinal tract disease without organic pathogenesis causes. The psychopathological nature of this disease and its high correlation with anxiety and depression implies the need for psychological interventions. The purpose of the present study is to compare the efficacy of Metacognitive Therapy (MCT) and medication for the symptoms of anxiety, depression, and difficulties in emotion regulation in patients with FD. In a randomized clinical trial, 65 patients with FD were recruited during their visit to gastroenterology clinics. These patients were randomly assigned to three groups to receive MCT, nortriptyline treatment, and controls. They were treated for 10 weeks and followed up three months later. The instruments used in this study were Hamilton anxiety and Depression Rating Scale (HAM-A and HDRS) and difficulties in emotion regulation scale. The results were analyzed using repeated measure analysis by SPSS (19- IBM). Data analysis showed statistically significant differences in the variables of depression, anxiety among MCT, nortriptyline treatment, and controls at pre-test, post-test and follow-up phases. Moreover, MCT had a better and more persistent effect on anxiety compared to nortriptyline treatment, as well as a better efficacy in treating anxiety and depression symptoms compared to the controls. MCT demonstrated better efficacy in treating anxiety symptoms compared to nortriptyline treatment and controls.

Effect of lifestyle modifications on anthropometric, clinical, and biochemical parameters in adolescent girls with polycystic ovary syndrome: a systematic review and meta-analysis.

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of childbearing age. This study aimed to compare the effects of lifestyle interventions on anthropometric, clinical, and biochemical parameters in adolescent girls with PCOS. METHODS: PubMed, Scopus, and Web of Science was systematically searched to retrieve studies investigating the effects of lifestyle modifications in adolescent girls with PCOS, which were published up to December 2019. The primary outcome was Body Mass Index (BMI) and secondary outcomes were all manifestations of PCOS, including clinical, metabolic, and hormonal parameters. Random effect meta-analysis was applied for significant results. Publication bias was assessed using the Egger test. RESULTS: This study showed significant improvements in luteinizing hormone (LH) (Pooled SMD = - 0.1.23; 95% CI, - 2.44 to - 0.03), and Free Androgen Index (FAI) levels (Pooled SMD = - 0.78 95% CI, - 0.1.42 to - 0.13) in adolescent girls receiving lifestyle intervention compared to baseline. This study also revealed that diet modifications alone were associated with a significant decrease in Body Mass Index (BMI) (Pooled SMD = - 0.45; 95% CI, - 0.76 to - 0.13), and FG score (Pooled SMD = - 0.81; 95% CI, - 1.33 to - 0.28). Exercise interventions were associated with significant changes in the menstrual cycles (Pooled SMD = 1.16; 95% CI, 0.72 to 1.61), Ferriman-Gallwey (FG) score (Pooled SMD = - 0.57; 95% CI, - 0.99 to - 0.15), LH (Pooled SMD = - 056; 95% CI, - 0.98 to - 0.14), Anti-Müllerian Hormone (AMH) (Pooled SMD = - 0.81; 95% CI, - 0.1.24 to - 0.38), and Triglyceride (TG) levels (Pooled SMD = - 0.32; 95% CI, - 0.62 to - 0.02). CONCLUSION: This meta-analysis concluded lifestyle interventions, such as diet and exercise, can improve some clinical, metabolic, and hormonal parameters in adolescent girls with PCOS.

Psychometric Properties of the Abdominal Pain Index (API) in the Iranian Adolescent Population.

Considering the high prevalence of abdominal pain in children and adolescents in Iran, it is essential to use appropriate screening tools. One of the most comprehensive, yet concise, tools for this purpose is the Abdominal Pain Index (API). This study aimed to investigate the psychometric properties of the Persian version of the self-report API in adolescents. In this descriptive study, A total of 162 Iranian adolescents in the age range of 12 to 18 years were considered as the sample group, which included two groups of school students (n = 125) and adolescent patients with abdominal pain (n = 37). Clinical sample was selected by the available sampling method, and nonclinical sample was selected by the cluster sampling method. Adolescents in the sample group were selected from both clinical and nonclinical groups in order to evaluate differential validity. Instruments, including API, somatic symptoms subscale of the General Health Questionnaire (GHQ), and McGill Pain Questionnaire (MPQ), were also completed for the participants. Also, to evaluate the construct validity of API, exploratory and confirmatory factor analysis methods were applied. The exploratory factor analysis identified one general factor, and the confirmatory factor analysis results show the model's satisfactory fitting. Also, the researchers' hypothesis, i.e., API is a single-factor model (with five items), was approved. The reliability coefficient of the questionnaire was satisfactory for the total scale (α < 0.7). This study showed that API could be used with considerable confidence for Iranian children and adolescents with chronic pain.

Relationship Between Preoperative 25-Hydroxy Vitamin D and Surgical Site Infection.

BACKGROUND: Surgical site infection (SSI) is one of the most important and costly complications of surgical operations. Vitamin D antimicrobial and wound healing effects have been recently shown in animal models and in laboratory settings. Furthermore, potential effects of vitamin D in mitigating nosocomial infections and SSIs have been examined at a limited scale. To our knowledge, no comprehensive study has been performed to show the relationship between preoperative level of vitamin D and incidence of SSI. The present study was designed and implemented to investigate this relationship. MATERIALS AND METHODS: We performed a prospective cross-sectional study involving 300 adult patients who were admitted to undergo surgery in our tertiary care unit from January 2016 to January 2018. Cutoff point was considered at a level of 30 (ng/mL) in defining vitamin D deficiency. The presence of any SSI was investigated and recorded at the time of discharge and at postoperative visits up to 30 d after the surgery. Cross-tabulation and bivariate and multivariate logistic regression with unadjusted and adjusted odd ratio were used to determine the association between dependent and independent variables and to identify factors associated with SSIs. RESULTS: Overall, of 300 patients who were investigated, 39% had preoperative vitamin D deficiency and 11% developed SSI. In univariate logistic regressions, 20 predictors were selected to be included in the multivariate analysis. Finally preoperative level of 25-hydroxy vitamin D, history of recent infection, preoperative and postoperative hospital length of stay, and postoperative blood transfusions were confirmed as statistically significant independent predictors of SSI. CONCLUSIONS: Preoperative 25-hydroxy vitamin D level has a strong effect on postoperative SSI. Prospective double-blinded randomized clinical trials are required to confirm such strong relationship and to settle preoperative vitamin D measurement as a standard approach to reduce postoperative complications including SSI. Preoperative patient optimization, limiting hospital length of stay, and blood transfusion are other strategies to reduce SSI.

Effect of Kangaroo Mother Care on hospital management indicators: A systematic review and meta-analysis of randomized controlled trials.

Results of previous studies about the effect of Kangaroo Mother Care (KMC) on hospital management indicators (HMIs) (length of stay [LOS], readmission to hospital, parent satisfaction, and parent's preference for same postdelivery care) had high confusions. The aim of this study was to conduct a systematic review and meta-analysis of randomized controlled trials on the effect of KMC on HMI in comparison with the conventional neonatal care (CNC). In this systematic review and meta-analysis study, required data were collected by searching the following keywords: "length of stay," "readmission to hospital," satisfaction," same post-delivery," "hospital management," indicators, "skin-to-skin," "Kangaroo Mother Care," randomized trial. The following databases were searched: Google Scholar, PubMed, EMBASE, Scopus, and Cochrane. To estimate the hospital management indicators, computer software Comprehensive Meta-Analysis 2 was used. Finally, 18 articles were included to analysis. The overall LOS standard different between groups (KMC vs. CNC) was - 0.91 days (95% confidence interval [CI], -2.14-0.32, Q = 25.6, df = 10, P = 0.004, I 2 = 60.98). The overall readmission to hospital standard different between groups was - 1.78% (95% CI, -1.21%-0.86%, Q = 0.024, df = 1, P = 0.87, I 2 = 0.00). The overall parent satisfaction standard different between groups was 5.3% (95% CI, -32.4%-43%, Q = 0.052, df = 2, P = 0.97, I 2 = 0.00). The overall standard different between groups was 16.2% (95% CI, -24.7%-57.1%, Q = 0.040, df = 1, P = 0.84, I 2 = 0.00). KMC improves HMI but not significantly. According to the current study result and other studies that report positive effect of KMC on health status of the newborns and parents, implemented of KMC in low- and middle-income countries recommended.

Validity and Reliability of the Persian Version of Leeds Dyspepsia Questionnaire.

BACKGROUND: It is essential in clinical care services to measure the symptoms of functional dyspepsia both in the primary examination and treatment outcomes. No valid assessment tool is already available for functional dyspepsia in Iran. The present study aimed at evaluating the reliability, validity, and responsiveness of the Leeds dyspepsia questionnaire (LDQ). MATERIALS AND METHODS: The LDQ was completed by 67 subjects with no dyspepsia symptoms and 93 subjects with certain functional dyspepsia diagnosed via endoscopy by a gastroenterologist and other clinical assessments. After definite diagnosis of functional dyspepsia, the participants were assessed by the LDQ. The psychometric characteristics of the questionnaire were then documented to investigate its reliability, validity, and responsiveness. RESULTS: The internal consistency of the LDQ ranged from 0.80 to 0.89 and its test-retest reproducibility was 0.96. The LDQ was significantly correlated with all domains of dyspepsia symptom severity index (DSSI) and also with some of the domains of gastrointestinal symptom rating scale (GSRS). The LDQ had a sensitivity of 90.3% with a great specificity and a very good predictive validity. Moreover, a significant responsiveness to changes was observed (P<0.05). CONCLUSION: The LDQ is a valid, reliable, reproducible, and self-rated instrument responsive to change, which can be used to measure the frequency and severity of functional dyspepsia symptoms in clinical trials.

Effect of Stress, Depression and Type D Personality on Immune System in the Incidence of Coronary Artery Disease.

BACKGROUND: Psychoneuroimmunology (PNI) is the study of the interaction between psychological processes and the nervous and immune systems of the human body. The impact of psychological factors on the immune system and the role of this system in Coronary Artery Disease (CAD) are confirmed. Coronary Heart Disease (CHD) is arisen due to the failure of blood and oxygen to the heart tissues. AIM: The present study aimed to describe psychoneuroimmunological processes which contribute to CAD and CHD progression. METHOD: Such psychological risk factors like stress, depression and type D personality were investigated here. Psychoneuroimmunological pathways of all three mentioned risk factors were described for CAD. RESULTS: The studies review indicated that stress could be accompanied with myocardial ischemia and help to rupture. The depression involves in the transfer of stable atherosclerotic plaque to unstable, and type D personality is effective in the initial stages of a CAD. CONCLUSION: As more information on cardiovascular immunity becomes available, this will provide a better understanding and thus act as the foundation for the potential development of new treatment strategies for treatment of cardiovascular disorders.

The role of noninvasive penile cuff test in patients with bladder outlet obstruction.

PURPOSE: The aim of this study was to compare the penile cuff test (PCT) and standard pressure-flow study (PFS) in patients with bladder outlet obstruction. MATERIALS AND METHODS: A total of 58 male patients with moderate to severe lower urinary tract symptoms (LUTS) were selected. Seven patients were excluded; thus, 51 patients were finally enrolled. Each of the patients underwent a PCT and a subsequent PFS. The sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and likelihood ratio were calculated. Chi-square and Fisher exact test were used to evaluate relationships between PCT results and maximal urine flow (Qmax); a p<0.05 was considered statistically significant. RESULTS: The mean (±standard deviation) age of the study group was 65.5±10.4 years. Overall, by use of the PCT, 24 patients were diagnosed as being obstructed and 27 patients as unobstructed. At the subsequent PFS, 16 of the 24 patients diagnosed as obstructed by the PCT were confirmed to be obstructed, 4 were diagnosed as unobstructed, and the remaining 4 patients appeared equivocal. Of the 27 patients shown to be unobstructed by the PCT, 25 were confirmed to not be obstructed by PFS, with 13 equivocal and 12 unobstructed. Two patients were diagnosed as being obstructed. For detecting obstruction, the PCT showed an SE of 88.9% and an SP of 75.7%. The PPV was 66.7% and the NPV was 93%. CONCLUSIONS: The PCT is a beneficial test for evaluating patients with LUTS. In particular, this instrument has an acceptable ability to reject obstruction caused by benign prostatic hyperplasia.

CO2 reforming of CH4 over CeO2-doped Ni/Al2O3 nanocatalyst treated by non-thermal plasma.

Ni/Al2O3 and Ni/Al2O3-CeO2 nanocatalysts have been prepared with impregnation method, treated with non-thermal plasma, characterized and tested for dry reforming of methane. For catalyst characterization, the following techniques have been used: XRD, FESEM, TEM, EDX dot mapping, BET, FTIR, TG-DTG, and XPS techniques. According to XRD and XPS, Ni in all catalysts exists as NiO and NiAl2O4 that existence of NiAl2O4 reveals strong interaction between active phase and support. Catalyst particles had smaller average particle size in plasma treated Ni/Al2O3-CeO2 nanocatalyst with less agglomeration. Homogenous dispersion of active phase, narrower particle size distribution, and uniform morphology has been observed in ceria containing plasma treated catalyst. The plasma treated Ni/Al2O3-CeO2 nanocatalyst showed bigger NiAl2O4/NiO ratio in XPS analysis that is indicative of stronger interaction between Ni and Al2O3 in the presence of CeO2. The dry reforming of methane was carried out at 550-850 degrees C using a mixture of CH4:CO2 (0.5:2). Improved morphology of the plasma treated Ni/Al2O3-CeO2 nanocatalyst, resulted from both CeO2 and plasma treatment, caused higher ability of catalyst in H2 and CO production. Product yield decreased at higher GHSVs, due to the fact that mass transport limitations will be more severe at low residence time, but this reduction would be less noticeable in the plasma treated Ni/Al2O3-CeO2 nanocatalyst. In addition, the plasma treated Ni/Al2O3-CeO2 nanocatalyst can keep the reactivity without deactivation for either CH4 or CO2 conversion better than other investigated catalysts.

Root-cause analysis of a potentially sentinel transfusion event: lessons for improvement of patient safety.

Errors prevention and patient safety in transfusion medicine are a serious concern. Errors can occur at any step in transfusion and evaluation of their root causes can be helpful for preventive measures. Root cause analysis as a structured and systematic approach can be used for identification of underlying causes of adverse events. To specify system vulnerabilities and illustrate the potential of such an approach, we describe the root cause analysis of a case of transfusion error in emergency ward that could have been fatal. After reporting of the mentioned event, through reviewing records and interviews with the responsible personnel, the details of the incident were elaborated. Then, an expert panel meeting was held to define event timeline and the care and service delivery problems and discuss their underlying causes, safeguards and preventive measures. Root cause analysis of the mentioned event demonstrated that certain defects of the system and the ensuing errors were main causes of the event. It also points out systematic corrective actions. It can be concluded that health care organizations should endeavor to provide opportunities to discuss errors and adverse events and introduce preventive measures to find areas where resources need to be allocated to improve patient safety.

Development of an effective risk management system in a teaching hospital.

BACKGROUND: Unsafe health care provision is a main cause of increased mortality rate amongst hospitalized patients all over the world. A system approach to medical error and its reduction is crucial that is defined by clinical and administrative activities undertaken to identify, evaluate, and reduce the risk of injury. The aim of this study was to develop and implement a risk management system in a large teaching hospital in Iran, especially of the basis of WHO guidelines and patient safety context. METHODS: WHO draft guideline and patient safety reports from different countries were reviewed for defining acceptable framework of risk management system. Also current situation of mentioned hospital in safety matter and dimensions of patient safety culture was evaluated using HSOPSC questionnaire of AHRQ. With adjustment of guidelines and hospital status, the conceptual framework was developed and next it was validated in expert panel. The members of expert panel were selected according to their role and functions and also their experiences in risk management and patient safety issues. The validated framework consisted of designating a leader and coordinator core, defining communications, and preparing the infrastructure for patient safety education and culture-building. That was developed on the basis of some values and commitments and included reactive and proactive approaches. RESULTS: The findings of reporting activities demonstrated that at least 3.6 percent of hospitalized patients have experienced adverse events and 5.3 percent of all deaths in the hospital related with patient safety problems. Beside the average score of 12 dimensions of patient safety culture was 46.2 percent that was considerably low. The "non-punitive responses to error" had lowest positive score with 21.2 percent. CONCLUSION: It is of paramount importance for all health organizations to lay necessary foundations in order to identify safety risks and improve the quality of care. Inadequate participation of staff in education, reporting and analyzing, underreporting and uselessness of aggregated data, limitation of human and financial resources, punitive directions and management challenges for solutions were the main executive problems which could affect the effectiveness of system.