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Background & aim: Several issues cause agitation in patients hospitalized in the Intensive Care Unit (ICU), which in turn causes many complications in patients. For this reason, various methods have been used to reduce agitation, each of which have advantages and problems. The purpose of this study was to investigate the effect of the care plan based on the Roy adaptation model on the level of agitation in patients of the ICUs. Methods: This triple-blind clinical trial study was conducted in 2015 on 100 patients in a ICU. Two ICU wards in Sanandaj Besat Hospital were randomly selected as intervention and control wards, and eligible patients in each ward were assigned to the intervention or control group separately by a simple random method. In the intervention group, care based on Roy adaptation model was performed and in the control group, routine care was performed. The data were collected using Richmond agitation scales. Results: The average agitation at different times did not show a significant difference between the control and intervention groups (P>0.05). Conclusion: Care based on the Roy adaptation model by nurses did not affect the agitation of ICU patients. It is suggested to provide organized nursing care based on other nursing models in order to improve the health of patients in the ICUs. [ABSTRACT FROM AUTHOR]

Background & Aims Nurses are the largest group of healthcare providers, especially during the COVID-19 pandemic. Patients with COVID-19 are in dire need of spiritual care due to being alone in quarantine, away from their families. The present study aims to assess the spiritual care competence of nurses in the special care units for COVID-19 in teaching hospitals in Arak, Iran Materials & Methods This is a descriptive cross-sectional study. Participants were 142 nurses working in the special care units for COVID-19 in hospitals affiliated to Arak University of Medical Sciences in 2022, who were selected by a census method. The data collection tool was the spiritual care competence scale. The data were analyzed in SPSS software, version 16. Results The mean total score of spiritual care competence was 100.71±14.45, which was higher than the median score of 81. The spiritual care competence had a significant relationship with marital status (P=0.044), willingness to work overtime (P<0.001), age (P=0.011), total work experience (P=0.03), and work experience in the special care unit (P=0.025), such that spiritual care competence was higher in older married nurses with a willingness to work overtime and a higher work experience. Conclusion The spiritual care competence of nurses in the study hospitals is at a favorable level. The results of this study can help future studies in improving the quality of nursing care and the competence of nurses in spiritual care. [ABSTRACT FROM AUTHOR]

Background and Aim: One of the best radiotherapy methods that have been suggested for the treatment of cancers such as brain, head and neck, skin, and recently liver is boron neutron capture therapy. Therefore, neutron shielding in the treatment room is important because the absorption of neutrons in the shield may lead to the production of gamma rays, which can have destructive effects. While an increase in density of the elements used in the shield is generally sufficient for gamma radiation shielding, protection against neutrons is more complicated. It is due to variations in neutron interactions with the matter based on their kinetic energy and reaction cross-sections with the shield component atoms. Methods: In this paper, it will be developed a neutron shield that is a proper shield against ionizing radiation, which will be accomplished via the use of experiment-based optimization of materials backed by Monte Carlo simulations. Also, the neutron shielding characteristics of conventional and heavy-weight shields modified with epoxy resin and gadolinium oxide was investigated. The shielding effectiveness against neutrons was initially modelled using the MCNP code. In the end, the comparison of MCNP simulated results and the real experiment was presented. Results: Gadolinium is an efficient additive for weakening low-energy neutrons, but it does not have a good effect in terms of shielding against fast neutrons. Also, Epoxy resin improves the shielding property of the composite against neutron radiation. Conclusion: The results show that the addition of the polymers used in composite shielding and the proposed method for developing the neutron shield can improve the shielding characteristics for neutron beams. [ABSTRACT FROM AUTHOR]

Introduction: Depression in children with cancer can complicate the course of the disease and cause many problems in the treatment process. Aim: The aim of this study was to determine the prevalence of depression in children and adolescents with cancer. Method: This study was a descriptive cross-sectional study. Forty children with cancer admitted to the oncology ward of Besat Hospital, Sanandaj, with an age range of 7- 17 years in 2016, who were selected and assessed using a demographic information checklist and the Children's Depression Inventory (Kovacs, 1979). After collecting data, the data were analyzed by SPSS-20 software using descriptive statistical tests and chi-square. Results: The 15% of the subjects had depressive symptoms and 47.5% were on the verge of depression. The prevalence of depression was 21.1% in girls and 9.5% in boys (p=0.54), and there was no significant difference in terms of cancer type (p=0.99), treatment method (p=0.81) and demographic indicators (p>0.05). Conclusion: Due to the relatively high prevalence of depression in this group of patients, it is recommended that the necessary screenings be performed to identify and refer patients with depression to psychiatric or psychological clinics to receive appropriate and timely treatment to help improve the quality of life of these patients and their families. [ABSTRACT FROM AUTHOR]

Background & Aims The role of the family in the health of the child is very vital because a major part of a child’s development. The present study investigates the health behaviors and related factors in mothers of hospitalized children in Kashan, Iran. Materials & Methods This cross-sectional study was conducted on 216 mothers of children hospitalized in children’s wards of two teaching hospitals in Kashan from November 2019 to March 2021. Meanwhile, sampling was done through continuous sampling. The first author (a nurse in the children’s wards) indirectly observed the mothers’ health-related behaviors toward their children and then immediately recorded them using a checklist. Data were then analyzed in SPSS software (v. 26) using descriptive statistics, Pearson correlation test, one-way ANOVA, independent t-test, and linear regression analysis. Results The mean age of mothers of hospitalized children was 29.27±5.60 years. Based on the results, the following items had the highest compliance scores: “use of fresh and safe drinking water for the child” (97.5%), “washing hands with soap and water in case of clear hand contamination” (95.6%), “Changing the child’s clothes and bedding as soon as they become contaminated with diarrhea, vomit, blood, and other contaminants” (90.7%), and “Washing hands after changing the child’s diaper” (87.3%). On the other hand, some other items, including “washing hands before changing the child’s diaper” (8%), “covering the mobile phone with a plastic to avoid contamination” (8.8%), and “washing hands with soap and water after touching the surrounding surfaces” (15.8%), had the lowest compliance scores. Conclusion The results indicated that mothers failed to comply with behaviors such as washing their children’s hands regularly and washing their own hands before breastfeeding. It is necessary to teach and inform them regarding the observation of behaviors related to the child’s health upon entering the hospital to ensure their child’s safety. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate the satisfaction of patients in the School of Dentistry of Isfahan University of Medical Sciences during the COVID-19 pandemic (Academic Year 2020-2021). Materials & Methods: This is a cross-sectional descriptive-analytical study utilizing a self-made questionnaire with confirmed validity and reliability, comprising 34 questions including demographic details, inter-personal parameters, ease and access to infection control to assess patients'satisfaction in the Dental faculty during the COVID-19 pandemic from 251 patients in the academic year 2020-2021. Finally, the data were analyzed using descriptive statistical methods including mean and standard deviation, frequency distribution tables, and statistical methods including independent t-test, Pearson correlation coefficient and one-way analysis of variance. (p value > 0.005). Results: In the present evaluation, it was observed that most of the patients of the study were from the general endo ward (20 patients - 8%). The highest overall satisfaction of patients was reported at the specialized surgery ward with a mean of 144.25 ± 24.92, the lowest at the specialized prosthesis ward with a mean of 128.41 ± 8.30 and the overall satisfaction of patients had a mean score 136.60 ± 19.32 out of 170 (80.35%). Conclusion: In general, the level of satisfaction of patients referred to Isfahan Dental School during the corona pandemic was relatively good. [ABSTRACT FROM AUTHOR]

Background: This research investigates the possibility of nurses' job autonomy and its effect on job satisfaction of nurse's quality of care. Materials and Method: This study was a practical, descriptive and correlational one. The statistical population was the nursing staff of Imam Khomeini Hospital in Arak, where nurses of intensive care units, internal medicine, surgery, pediatrics and neonatal, gynecology, orthopedics and emergency hospitals were selected as the statistical population and other wards due to differences in performance of out-of-study study. And 101 people were selected. The data collection tool was Moghimi and Kramer and Schmalenberg questionnaires. The results of this study were analyzed by SPSS software. Results: study results revealed that the mean level of nurses 'autonomy was 3.16 with a standard deviation of 0.35, which indicated a desirable level of nurses' autonomy. Limited autonomy applies to all departments. In the internal ward, autonomy is Unsanctioned Autonomy and autonomous in the surgical ward was Autonomous Nursing Care Action. The regression pattern was significant for all wards except the internal ward, with an increase of one unit in "Limited Autonomy in the intensive care unit", " Autonomous Nursing Care Action in the surgical department" and " Limited Autonomy" in the wards of Pediatric and neonatal, gynecology, orthopedics and inpatient emergency among nurses of Imam Khomeini Hospital in Arak in the amount of 0.253, 0.187, 0.522, 0.205, 0.466 and 0.129" Care "has been added. Conclusion: Nursing autonomy as an organizational feature, along with several other factors, leads to an increase in the quality of patient care and to achieve these beneficial results, nursing managers need to empower nurses and provide an environment to apply their knowledge in selfhelp practice [ABSTRACT FROM AUTHOR]

Introduction: The unit dose distribution system ensures the delivery of drugs from the hospital pharmacy to the ward for a specific patient. Facilitating the improvement process of patients and drug safety requires such research. However, two human factors affecting this process, including pharmacists and nurses, and the impact that the drug distribution system in the hospital has on their condition, have been studied as the purpose of this research. Methods: This study was done by descriptive and analytical-comparative method. Data were collected from the staff of Urmia Women's Hospital in 2021, including 76 hospital staff, 11 pharmacists, and 32 nurses as a sample from three groups using three standard questionnaires. Data were analyzed by two dependent samples T-tests in SPSS-24 software. Results: Attention to pharmacists in the implementation of the unit-dose system by stimulating their interest in pharmaceutical sciences, being in the center of attention of colleagues, and increasing their desire to work in the hospital changed the level of job identity and, thus, it explained their appropriate professional position. Time saving, lack of differences in the counting of drugs, and the peace of mind of nurses after the implementation of the unit-dose plan increased the role of nurses in the main task of patient care by obtaining job satisfaction (3.29), which increased to above the average level ( P<0.001). Conclusion: Success in the implementation of this project in the selected hospital is expected to improve the professional position of pharmacists in the hospital and increase the job satisfaction of nurses. [ABSTRACT FROM AUTHOR]

Background & Aims: Negative Affect is an action occurring when an individual is involved in a mutual interaction, triggered by verbal and non-verbal power in order to make the person to comply with the orders and ultimately, it accompanies with gaining benefits. Negative Affect in workplace in recent years has drawn lots of attention because it results in serious consequences for the individuals and the goals of the organization. For this reason, Negative Affect is viewed as one of the severe forms of organizational and interpersonal misbehaviors in organizational environments. Of such Negative Affect behaviors, we can mention some passive behaviors like: negligence, intentional inattention and active behaviors such as: overt and covert threat. Negative Affect at workplace lowers the staff’s efficiency and performance in the organization since this phenomenon is associated with job dissatisfaction, anxiety, depression, burnout and reduced job commitment. Of course, being exposed to bullying is viewed as a critical source of stress. On the one hand, one of the outcomes of bullying is psychosomatic complaint originating from psychological processes of human beings. Negative Affect is also characterized as a threating factor to the nurses’ health in hospital settings. The findings of a study revealed that by strengthening resilience and hope, it’s viable to control the consequences of encountering bullying on the psychosomatic health of the nurses. As the conducted studies suggest, various factors such as: lack of understanding among fellows and manager, personality traits, major changes in practice bring about bullying. The research by Johnson et al. (2019) suggested that Negative Affect outbreak is high among nurses and as Negative Affect increases, the quality of care provided by the nurses decreases and client’s safety declines and job burnout increases. Since one of the tasks in this profession is to maximally maintain people’s health, thus the nursing staff have to be equipped with maximum level of health. In particular, due to the nature of the ward, the nursing working in special wards are more exposed to the situations like the patients on the verge of death, emergencies and unpredictable conditions, noisy monitoring equipment and conducting clinical and drug administration processes with advanced and efficient devices. Despite the studies performed about hospital workplace related Negative Affect, nothing as exclusive has been discovered so far dealing with bullying association with special wards’ nurses’ mental health. This gap emphasizes the necessity for further studying. Consequently, the current study has been designed and performed pursuing the goal to outline the relationship between Negative Affect and special wards’ nurses’ mental health in the educational hospitals affiliated with MazandaranUniversity of Medical Sciences. Methods: This study is a descriptive-analytical research done as cross-sectional in 2020. The statistical community is made up of all (ICUs, CCUs and dialysis wards) nurses from five educational hospitals of Mazandaran University of Medical Sciences. The nurses were selected through proportional and simple random methods, which overall resulted in 195 nurses. The data collection consisted of three questionnaires as the demographics, bullying and mental health. A) The demographics questionnaire including age, gender, hospital, marital status, job status and working history. B) Bullying (Negative Affect) questionnaire developed in 2001 and psychometrically assessed in Iran by Salimi et al. (2017). C) General Health Questionnaire (GHQ) was developed in 1972 and psychometrically assessed by Tehrani et al. (2011) in Iran and its reliability was reported as 0.93 using Alpha-Cronbach. The ethical considerations observed in the present research involved not requiring the name to be mentioned in the questionnaires, giving the samples information about the research objectives and the optional participation in the study. Having acquired the permit from Ethics Committee of Mazandaran University of Medical Sciences, the questionnaires were distributed in Google Form in the social networks of the nurses in the study hospitals and after completing and collecting the questionnaires, the obtained data were analyzed using SPSS -21 and descriptive statistics indices (frequency distribution tables, mean and standard deviation) and and correlation coefficient (predicting the random variable in terms of another variable) was analyzed. Results: The mean and the standard deviation of Negative Affect imposed on the CCU nurses got the max score as 62.53±14.90 and that of the ICU nurses got the min score as 55.68±15.77 and 72.6% of the participants were exposed to moderate rate of bullying. The mean and standard deviation of the mental health of the CCU nurses got the max score as 33.03 ±8.09 and that of the dialysis wards’ nurses got the min score as 29.11±2.61. Regarding the subscales of the General Health Questionnaire, the social area with a frequency of 93% was identified as the most prevalent disorder and depression with a frequency of 1.6% was detected as the least common disorder. According to the study findings, a significant positive correlation was discovered between Negative Affect and its dimensions and mental health and its dimensions (P≤0.00). Besides, in some cases, the correlation between the mental health dimensions and Negative Affect each other was achieved as poor: the correlation coefficient with social area was gained as 0.875 and with depression area as 0.225. Conclusion: The positive correlation between Negative Affect and mental health indicates that as bullying score increases, the nurses' mental health decreases. Moreover, the findings revealed that the mental health of women and single individuals is more exposed to danger. Since one of the obligations in this profession is to maintain and promote people’s health, then the nursing staff have to be at the maximum level of health so that to be less affected by the consequences of this phenomenon when facing Negative Affect. Therefore, it’s imperative for the medical health system management to develop some programs to lower Negative Affect in nurses’ workplace environment. Regarding the significant relationship existing between Negative Affect and mental health, it can be inferred that by workplace bullying increases, the individuals’ mental health gets impaired .According to the study derived findings about the mental health of women and single individuals, it’s recommended to screen the organizational Negative Affect behavior in the professional health services of the organization, or to develop on-the-job training courses or some courses during their studies at university to increase their mental health and preparedness for Negative Affect behaviors among this group of people so that to be equipped with favorable mental health when encountered with Negative Affect behaviors. Moreover, to determine the proposed approaches’ effectiveness, it’s imperative to develop and conduct an intervention study. Of the present study limitations, we can report lack of controlling the confounding factors of Covid-19 pandemic effect on nurses’ mental health which results in being cautious about generalizing and interpreting the study findings. Therefore, it’s required to perform extensive studies about Negative Affect and mental health of the nurses in other province located hospitals and also employ other tools such as qualitative approaches like interview in order to boost the accuracy of post-Covid-19 pandemic study findings. [ABSTRACT FROM AUTHOR]

Background and Objective: Bioaerosols as small particles enter the body by inhalation and lead to respiratory diseases based on type, concentration, and exposure time. In sensitive workplaces such as medical centers, it is necessary to pay attention to the type and population of these pollutants and the possibility of nosocomial infections. In the present study, the population and type of bioaerosols (bacteria and fungi) in the air of different hospital wards under normal conditions, visiting hours, and Covid-19 pandemic was evaluated. Materials and Methods: Air sampling was carried out in different wards and ambient air of Valiasr Hospital of Zanjan during September 2019 (morning and visiting hours) and October 2020 (Corona pandemic) using an air sampling pump (Flite 3- SKC Ltd) with a flow of 14.1 L/min and then cultured in Sabaroud dextrose agar and nutrient agar. Results: The results showed that air pollution in wards such as infectious diseases and clinics in both periods was more than other wards. The microbial density during visiting hours (before the coronavirus outbreak) was almost 30% higher than normal conditions. In October 2020, due to the coronavirus outbreak and reduced traffic, microbial air pollution in the hospital decreased. In both periods of study, the frequency of gram-positive bacteria, especially Staphylococcus species (49%) was higher than other bacteria and among fungal species the frequency of Aspergillus (47%) was higher than others. Conclusion: This study showed that traffic restrictions caused by the coronavirus pandemic reduce microbial density in hospital space and this achievement can be used in the future with the aim of improving air quality and controlling nosocomial infections. [ABSTRACT FROM AUTHOR]

Introduction: Inappropriate admission and inappropriate hospital days are two undesirable indicators in terms of controlling hospital costs. This study was conducted to determine the rate of inappropriate admission and hospital days and related factors in Shohada Hospital in Kermanshah. Methods: This is descriptive-analytical study.The statistical population included patients admitted of Kermanshah shohada Hospital in 1397. 245 Inpatient records were selected using Cochran's formula and stratified random sampling. Appropriateness evaluation protocol was used to evaluate the inappropriate admission and inappropriate hospital days. The relationship between age, sex, type of admission, type of ward, type of treatment, coverage of cost hospitalization, place of residence, with rate of inappropriate admissions and inappropriate hospital days was assessed using spss16 software. Results: 5.7% of admissions and 21.4% of hospital days were inappropriate. Inadequate admission was significantly related to gender, type of surgical or medical treatment, type of hospital ward in chisquare test in contingency tables with 95% confidence. Inappropriate hospital days were related to the type of hospitalization ward in kruskal-Wallis test, type of treatment and place of residence in Mann- Whitney test. Conclusion: By determining the amount of inappropriate admissions and inappropriate hospital days and related factors for policy makers and managers of hospitals and insurance organizations, it is possible to avoid unnecessary costs without reducing the quality of hospital services. [ABSTRACT FROM AUTHOR]

Introduction and purpose: Risk assessment is a necessity in high-risk work environments like hospitals. During epidemics, the need to maintain the health of healthcare staff increases as they are effective people in controlling the spread of the disease. The purpose of this study was to assess the occupational safety of healthcare staff against coronavirus using FMEA in infectious diseases ward of Bu-Ali Hospital in Zahedan. Methodology: Failure modes were identified using brainstorming technique. After scoring them with S, O and D, they were prioritized by calculated RPN. To improve the traditional FMEA, failure modes were prioritized with weighted FMEA and MCDM techniques. After identifying the critical failure modes, the root causes of them were identified and categorized. Finally, corrective solutions were provided to handle them. Results: Three processes including emergency admission, patient visit, and sampling were identified as priority processes. 58 failure modes and their effects were identified in 6 categories. 13 critical failures modes (RPN above 100) equivalent to 22% were identified. Then 42 root causes of them were identified by brainstorming technique and their classifications were done by Eindhoven. Finally, 49 corrective strategies were presented to handle critical risks. Conclusion: Identifying 58 risks and their effects, identifying and classifying root causes and providing corrective solutions indicate the capability of the FMEA to assess the risk of critical departments such as hospitals. As a result, the FMEA is able to detect risks, reduce their consequences and improve quality. Risk assessment techniques along with the commitment of managers and the renewal of organizational policies can ensure the effectiveness of these activities. [ABSTRACT FROM AUTHOR]

Background: External laryngeal trauma is rare. It has a population incidence of 1 in 137,000 in adults. In developing countries blunt trauma is more common than penetrating trauma. Blunt trauma may occur due to accidents, sports injuries or hanging. Laryngeal trauma manifests as a spectrum of symptoms and signs ranging from cardiopulmonary arrest to subtle changes in voice quality. The most common presenting feature of laryngeal trauma is hoarseness, followed by dysphagia and pain. Although blunt laryngeal trauma is rare, but it can be life threatening. So, its early and proper management will remarkably affect the immediate probability of patient’s survival and their long term quality of life. Methods: In this cross-sectional and descriptive study, medical records of 30 patients with blunt laryngeal trauma, who were admitted in ENT ward of Imam Reza hospital over a 10-year period, were evaluated. Results: 30 patients, including 27 (90%) males and 3 (10%) women were studied. Mean age of patients was 36.13±10.53 years. The most common cause of blunt laryngeal trauma was vehicle accidents. The most common presenting symptoms were neck pain and tenderness. Subcutaneous emphysema was the most common radiological finding. The most common laryngoscope findings were swelling and hematoma of true vocal cords. Treatment modalities were supportive therapy performed on 26(86.7%) patients, tracheotomy on 3(10%) patients and open surgery on 1(3.3%) patients. Also 2 (6.7%) patients required intubation. Conclusion: In most patients suffering from mild trauma, conservative therapy is mostly administered. Any delay in early and proper diagnosis and treatment may be life threatening. So in such situations the patient's airway should be evaluated by skillful experts and emergency procedures have to be applied. Also any changes in patient's signs should be monitored frequently and the required diagnostic and therapeutic procedures must be applied. [ABSTRACT FROM AUTHOR]

Background and Objectives: Sick building syndrome (SBS) is a building-related illness in which people in the environment do not experience proper physical and mental well-being. Mental and physical changes include headache, nausea, abnormal fatigue, lack of concentration, sensation of an unpleasant odor. Thus, the aim of this study was to investigate the frequency of SBS and its related factors in nurses at Ali Ibn Abitaleb hospital in Rafsanjan City in 2018. Materials and Methods: This cross-sectional study was performed using standard MM040EA questionnaire related to SBS and indoor air quality at Ali Ibn Abitaleb hospital in Rafsanjan city in 2018. 285 nurses in different wards of the hospital were entered the study using census method. Data were analyzed by descriptive statistics and chi-square test. Results: The mean ± standard deviation of age for participating nurses was 34.04±7.90 years. Fatigue 88 (63.8%), dry hands and itching and red skin 71 (51.4%) were the most frequent symptoms of SBS among the nurses. 68 (49.3%) nurses complained of unpleasant odors of the workplace every week, and 77 (56.2%) nurses felt their workload was sometimes high. Demographic characteristics, work environment and working conditions did not show any statistically significant difference with the frequency of SBS (p>0.05). Conclusion: Due to the high frequency of SBS in hospital nurses and its effects on performance and productivity, it is necessary to re-engineer the hospital environment and improve the work environment, especially ventilation of hospital wards. [ABSTRACT FROM AUTHOR]

Background and Objective:Stress is one of the main problems of nurses, which greatly affects their professional performance and their personal life and causes conflict between work and life. The purpose of this research was to identify the effects of Health Belief model-based training on nurses’ occupational stress. Materials and Methods: This is a Quasi-experimental study conducted on nurses. 45 nurses were randomly selected from special wards of a hospital as the interventional group and also 42 nurses from another hospital were randomly selected as the control group. Data gathering tool was included the Nursing Stress Scale (NSS) for determining nurses’ occupational stress and HBM Model constructs questionnaire to determine the effect of educational intervention. Training program was carried out in three 2-hour sessions. Subjects were monitored for 1 month. Statistical analysis was performed before, and 1 month after training using SPSS software. Statistical tests including Chi- Square, independent t-test, Paired t- test, Kolmogorov- Smirnov were used in this study. Results: Mean NSS score of the intervention group reduced from 107.311 ±20.800 to 89.578 ±23.352 after the training. Moreover, after training, the variables of perceived susceptibility, perceived severity, perceived benefits, cue to action, self-efficacy, and behaviors showed a significant increase and perceived barriers decrease in the intervention group compared to the control group (P < 0.05). Conclusion: Results showed that the Health Belief Model for stress management education was effective in the reduction of nurses’ stress level. Considering that behavioral and non-behavioral factors are effective in reducing stress; as a result, to change behavior of individuals, in addition to themselves, it is necessary to pay attention to the environment surrounding them and others influencing their behavior. [ABSTRACT FROM AUTHOR]

Background: According to the importance of health and treatment, it is necessary to use suitable models for planning and setting surgery time. In this study, a mathematical model is offered for operational scheduling of surgeries at surgery rooms of hospitals. Material and Methods: This is an applied study and its data is related to the surgery rooms of Zahedan Al-Zahra eye hospital. Study population was the surgeries performed in March 2016. The mathematical model of scheduling surgeries at the surgery room was optimized in MATLAB2014. Results: Due to limitations on patient admission capacity in hospital surgery ward, 79 surgeries were called off. In the proposed model, the total waiting time index for performing surgeries was 1547.29, and this index was found to be 1842 without the use of the model. Therefore, the waiting time index was improved by 16%. In accordance with the third purpose (objective) function, the tally of delays for predicted surgery ending time in one month was estimated to be 69.15 hours. The process of each surgery includes four defined activities. The end time of the activities related to each surgery has been examined and it has been optimized according to the existing limitations. Conclusion: The proposed model can improve the waiting time by 16% and makes it possible to choose the surgical procedures that should be canceled and delayed according to medical priorities. [ABSTRACT FROM AUTHOR]

Introduction: Considering the importance of screening for diagnosis of tuberculosis (TB) infection among medical students and the necessity of annual TB tests and effectiveness of preventive programs, there is an ever increasing need for undertaking research to investigate the effect of residence in hospital on the risk of tuberculosis infection among students, and planning strategies for reducing and controlling the risk. Objective: this study was undertaken to investigate the probability of tuberculosis infection in medical students during clinical education at infectious disease wards.. Materials and Methods: This is a cross-sectional comparative study performed on 70 medical students selected via census sampling method during 2015-2017. In this research, Tuberculin skin test was done on the students once in the first week of externship rotation at infectious diseases ward and the second test on that students with negative results in the internships course at the infection diseases ward, with the results analyzed accordingly. Collected data were analyzed using SPSS v.20 Software and investigated based on descriptive statistics (frequency, mean, and standard deviation) and Fisher's exact and logistic regression tests. Results: In the present study, the rate of positive PPD reaction at the first clinical rotation in infectious disease ward was 13% and the rate of PPD conversion during internship was 16% . No significant relationship was found between any of the considered variables and the results of the second tuberculin test. However, a significant relationship was observed between age and positive result of the second tuberculin test (p = 0.01). Conclusion: There is a significant risk of tuberculosis infection in medical students during clinical education. It is recommended not only monitor the students periodically in terms of TB infection but also in case of infection prophylactic interventions to prevent new infection and active TB disease in those with PPD conversion seems necessary. [ABSTRACT FROM AUTHOR]

Introduction: Considering the growth of cancer in the world and also in Iran, the oncology ward is considered as one of the most significant wards in hospitals. Information quality plays a key role in improving the performance of this ward. Dashboards can track the key indicators and improve the performance of oncology wards through transferring information to managers.Therefore, the current study aimed to identify the performance indicators for oncology wards, based on the the needs of decision makers, and then design and evaluate an appropriate dashboard. Method: In the first stage, the key performance indicators were determined using a questionnaire which was completed by all 30 oncology administrators in private hospitals as well as hospitals affiliated with Medical Universities in Tehran. In the second stage, QLIKVIEW software was used to design a dashboard which was evaluated by hospital directors, and directors of the oncology wards in Shohada Haftom Tir and Firouzgar Hospitals. Results: Seven key performance indicators, including the number of patients, days off, hours of training, personnel, complaints, as well as income and expense were identified. The satisfaction mean scores of hospital directors, the technical staff and the internal director of the oncology ward were 7.5±0.32, 7.4±0.39, and 7.3±0.37, respectively. Conclusion: Dashboards can collect data scattered between various depatments, summarize them, and provide key performance indicators. The information available in dashboards in oncology wards can provide a basis for informed decision making to improve the performance of the ward. [ABSTRACT FROM AUTHOR]

Background and Objectives: Colonization of Staphylococcus aureus in the nose of healthcare workers (HCWs) can be considered as the main source of nosocomial infections. The aim of this study was to investigate the frequency of S. aureus nasal carriage among HCWs in Pastor and Aflatoonian hospitals in Bam, its antibiotic resistance patterns, and determine Staphylococcal protein A (spa) typing and staphylococcal cassette chromosome mec (SCCmec) typing of methicillin resistant S. aureus isolate. Materials and Methods: In this cross-sectional study, a total of 258 nasal swabs were collected from HCWs during 2017 and were analyzed to detect methicillin sensitive and resistant S. aureus isolates. Resistance to different antibiotic agents was determined by disk diffusion. The presence of nuc, mecA, pvl genes, and spa and SCCmec types were determined by polymerase chain reaction technique (PCR). The data were analyzed using chi-square and Fisher's exact tests. Results: Thirty seven subjects (14.3%) were nasal carrier of S. aureus and one of them (2.7%) was resistant to methicillin with Sccmec type IV and spa type t608. All of isolates were sensitive to vancomycin, linezolid and mupirocin. The pvl gene was found in 8 (22.2%) isolates. Except with regard to gender (p=0.036), occupation, age, hospital ward, years of healthcare service, previous antibiotic therapy during the last three months, hospitalization and blood group were not significantly associated with nasal carriage (p˃ 0.05). Conclusion: Although according to the results, the frequency of nasal carriage of S. aureus isolates among HCWs at our hospitals compared to the other studies from Iran was low, regular S. aureus carriage screening as well as decolonization strategies is recommended. [ABSTRACT FROM AUTHOR]

Background and Aims: Listeria monocytogenes is one of the most important causes of abortion and postpartum infection in newborns. This study aimed to compare the indirect ELISA and immunofluorescence methods for the detection of anti-Listeria antibodies among women with spontaneous abortion. Materials and Methods: In this study, indirect ELISA and immuno-fluorescence methods were used for the detection of anti-Listeria antibodies. Five milliliters of blood sample were collected from mothers with spontaneous abortion during the third trimester of pregnancy in a ward that examines the diseases of female genital tract in Kamali Hospital of Karaj, Iran. The samples were then transferred to the laboratory for examination using relevant kits. The serum titers of positive samples were also assessed via both ELISA and indirect immunofluorescence for evaluation of IgG and IgM antibodies. The antibodies titers were compared using SPSS software while P values <0.001 were considered as significant. Results: From the 58 evaluated serum samples, 21 were positive for anti-Listeria antibody. Statistical analysis showed that ELISA and indirect immunofluorescence methods had identical sensitivity. Moreover, it was shown that identification of IgG antibody was better performed in both diagnostic methods. Conclusions: Both ELISA and indirect immunofluorescence methods are suitable methods for the detection of antibodies against Listeria. [ABSTRACT FROM AUTHOR]

Background and Objectives Blood Malignancies are the most frequent cancers in children including about 45% of diagnosed cancers in children. Chromosome disorders are found in most of patients with acute lymphoblastic leukemia. These disorders present valuable information for prognostic determinants. Materials and Methods This descriptive study includes all the children with acute leukemia having referred to the oncology ward of Besat Hospital of Sanandaj from 1385 to the end of the first half of 1394. Peripheral blood smear and bone marrow aspirations were taken from the children; RT-PCR method was used for determination of chromosome karyotypes so as to detect chromosome disorders. The data were analyzed by SPSS 11.5 & x2 test. Results Among 75 cases, 12 chromosome genotypes were observed. Normal chromosome genotype has the highest frequency with 41 cases (54.7%). t( 12-21) chromosome disorder observed in 15 cases (20%) was the most frequent disorder. t( 15-17) chromosome disorder observed in 5 cases (6.5%) was the next most frequent disorder. The only chromosome disorder observed in T lymphocyte leukemia was 47xy + 21 with the frequency of 1 case. Conclusions Based on the research findings, 54.7% of the children have no chromosome disorders. Different results are reported in different researches. Due to the importance of finding the types of chromosome translocation for prognostic determinants in children with leukemia, more research is required. [ABSTRACT FROM AUTHOR]

Background and Objectives: Changing the roll of hospital in far future and necessity of long and medium term planning regarding to these changes is undeniable. Evaluation and selection of different approaches to change the hospitals, requires extensive investigations in this area to find the best response, considering the conditions and characteristics of a country. Materials and Methods: This study was conducted in two phases: comparative and interviews with experts. The aim was to gather information about active hospital wards in other countries in the first phase and to obtain expert opinions about the wards needed in the years ahead, in the second phase. Results: The results indicated the necessity of expanding outpatient departments in the field of: chronic diseases and cancer, geriatrics (regarding to population aging trend), Recovery after long-term care, sleep clinics, health infrastructure services such as weight management, management of risk factors, lifestyle modification and in some cases, more specialized inpatient departments such as bone marrow transplantation and toxicity. Conclusion: Based on results obtained, the proposed future structure of the hospitals is divided at four levels, the public and nation-wide wards, specialty and subspecialty wards which is limited to some hospitals in the country, luxury and unnecessary wards services and alternative and complementary medicine wards. [ABSTRACT FROM AUTHOR]

Background: The prediction of death in intensive care units is done by using scoring systems assess the disease severity. This study was performed to compare two scoring systems, Acute Physiology and Chronic Health Evaluation (APACHE) IV and Simplified Acute Physiology (SAPA) III, in predicting mortality rate in intensive care units (ICU). Methods: In this retrospective cross-sectional study, we calculated 60 patient during the year 2012 admitted to ICU wards in Shahid Rajaei hospital, Qazvin, Iran. APACHE IV and SAPA III scores and predicted mortality were calculated. Then, the real mortality in intensive care units were recorded. Using the area under the curve of receiver operating characteristic (ROC), performance and differentiation of these models to predict mortality were assessed. Data were analyzed using Mann- Whitney test at the significant level of P-value of less than 0.05. Findings: Of 74 patients admitted to the intensive care unit, 60 were included in the study, 38 men and 22 women. The mean age of patients was 59.0 years and the average duration of hospital staying was 12.10 days; 11 patients died. The mean scores of APACHE IV and SAPA III were 30.0 ± 3.4 and 15.0 ± 2.0, respectively. The area under ROC curve was 0.990 for APACHE IV with confidence interval of 0.930 to 1.008 and 0.97 for SAPA III with confidence interval 0.97-1.008with a significant difference (P < 0.001). Conclusion: Our study revealed that APACHE IV scoring method predicted the mortality rates in intensive care units better than SAPSIII method. [ABSTRACT FROM AUTHOR]

Background: Patient's self-discharge from the hospital is a process in which a patient leaves the hospital before completing his or her determined treatment period by his own will. This study is aimed to survey the factors affecting patient's self-discharge from the hospital in emergency ward of a referred hospital. Materials and Methods: This is a case-control study. The 280 selected samples were divided to two groups, each with 140 members. The data were gathered using a questionnaire evaluating the scale of patients and their companions' satisfaction of the hospital services. Chi-square test was used for analyzing the relationship between independent variables and the patient discharge type. Moreover logistic regression was used in order to identify the effect of significant independent variables on own will-discharge possibility. Results: Results indicate that there is a meaningful relationship between variables such as age, having supplementary insurance, residency, income rate, reference shift, reference day, satisfaction of the physicians, satisfaction of the physical environment and welfare facilities, the patient's satisfaction, the waiting time, satisfaction of the instructions given by nurses and physicians and total satisfaction with discharge type(p<0.05). Conclusion: The matter of patient's self-discharge is a multi-dimensional phenomenon and depends on patient's characteristics and structural and medical factors. Therefore predicting its scale and determining factors might play an effective role in controlling this phenomenon. [ABSTRACT FROM AUTHOR]

Background and Objectives Blood transfusion plays a critical role in health system. However, one of the main problems is the excessive order of blood in teaching hospitals. The aim of the study was to investigate the current pattern of blood order and consumption at three teaching hospitals in Kerman city. Materials and Methods In a cross-analytical study, blood order forms for 3182 patients were collected from three hospitals from May to July 2010. C/T ratio and TI were analyzed with descriptive statistics and frequency table tests. Results The overall ratios of C/T (Crossmatch/Transfusion) and TI (Transfusion Index) were 1.33 and 1.81, respectively. The results are considered to be desirable as compared with the standard figures of C/T< 2.5 and TI > 0.5. Out of 7731 blood orders, the highest number pertained to heart surgery wards with 1704 (22%), and the least to ophthamology ward with 7 (0.09%). Conclusions Our results show that blood order and consumption in three teaching hospitals in Kerman city during 3 months were desirable. Although in comparison with other studies in Iran inconsistencies in blood order and consumption were seen. In conclusion, it is essential to prepare blood order and consumption protocols according to our regional conditions to improve the blood transfusion status [ABSTRACT FROM AUTHOR]

Background and purpose: Cerebral venous thrombosis (CVT) is the thrombosis affecting cerebral veins and sinus and is a rare condition. The diagnosis may be late or neglected due to the great clinical spectrum of symptoms, various forms of initial presentation and unspecific signs of neuroimaging. Materials and methods: In this descriptive study, the included patients were followed up according to clinical manifestations, diagnostic efforts and clinical suspicions. The information regarding the subjects' age, gender, clinical presentation, diagnostic efforts and classified treatment results were recorded. The data was obtained during a 21 months period and analyzed in SPSS. Results: The most prevalent symptoms among the study population were headache, papillary edema, blurred vision, sensory-motor disorder, disorders of consciousness, double vision, behavioral disorder, speech impairment, focal seizure, and generalized seizure. The most common reasons were taking oral contraceptive pill (OCP), pregnancy, infection, idiopathic, drug abuse, hematologic diseases, trauma, previous cerebrovascular accident, CVT, diabetes, and hypertension. Conclusion: The most prevalent complaint was headache and the most founded neurological sign was papillary edema. In our study, OCP and pregnancy were the greatest etiologies, while infection was the next common etiology. [ABSTRACT FROM AUTHOR]

Introduction: Cancer patients are susceptible to severe parasitic infections particularly Strongyloides stercoralis (S.s) infection. Accordingly, this study aimed to determine the prevalence of parasitic infections with highlighting Strongyloides stercoralis infections in 139 cancer patients admitted to oncology ward of Imam Khomeini hospital of Sari during 2009. Material and Methods: In this descriptive and cross-sectional study, fecal samples (n=139) were collected from different cancer patients. After completing the questionnaires, the samples were examined by direct smear and formalin ether sedimentation methods. Results: In this study, of 139 patients with different types of cancer 53.9 % (n=75) and 46.1% (n=64) were male and female, respectively. In the stool exam, two cases (1.4%) infected with Rhabditiform larvae of S.s were detected while both of them were affected with Multiple Myeloma cancer. Conclusion: This study showed that in endemic areas, three times stool examination by formalin-ether technique for detecting Strongyloides stercoralis must be requested before chemotherapy in cancer patients. [ABSTRACT FROM AUTHOR]

Background: Poisoning with carbamazepine is the third most common reason for status epilepticus seizure in the poisoning ward of Nour Hospital (Isfahan, Iran). No survey has been performed on the frequency of seizure among patients poisoned with carbamazepine. The relationship of such toxicity and other effective variables and treatment outcome have not been studied either. This study aimed to identify factors affecting seizure due to carbamazepine toxicity in order to help physicians make the correct decisions. Methods: In a retrospective study, information of every patient with carbamazepine toxicity who had been admitted in Nour Hospital was collected by census sampling method. Patients were then divided into two groups of with and without seizures. The two groups were compared using independent-t and Fisher's exact tests in SPSS15. Findings: During 1 year, 114 cases were admitted and 7% of cases experienced seizures. The mean dose of drugs and pH levels were significantly different between the two groups. The frequency of patients who were discharged with a complication or died was higher in the seizure group. Conclusion: Using high doses of carbamazepine increases the risk for seizure among poisoned individuals. In addition, patients with seizure are at higher risk for acidosis, complications, and death. [ABSTRACT FROM AUTHOR]

Background: Septic shock is an important and serious disease. The major aim of this research was to find demographic factors and etiology of septic shock in women hospitalized with septic shock diagnosis. Methods: In this retrospective descriptive research, 400 patients with the diagnosis of septic shock who were admitted in obstetric and gynecologic wards of Alzahra (SA) and Beheshti hospitals in Isfahan during ten years were evaluated. The data about age, marital status, etiology, pregnancy status, treatement and death were gathered. Finding: The most prevalent etiology of the disease was septic abortion. Most of the patients were in 25 to 35 years and married. Most of them had 2 or more children, lived in town, are treated by surgical treatment plus medical treatment and 3 antibiotics. The hospitalization stay of most of them was more than 5 days and the mortality was seen in 43% of evaluated patients. Conclusion: This research concluded that etiology of most of the septic shocks was septic abortion that has done illegally and in non sterile condition. This emphasized the importance of people education for have a safe contraception and avoid from illegally induced abortion and septic abortion. [ABSTRACT FROM AUTHOR]

Background and Aim: This study was undertaken to determine the effectiveness of a safe community program, as an international community-based program, for injury prevention and safety promotion, in Kashmar Materials and Methods: In this retrospective study, the data on injured patients consulting hospital emergency wards in Kashmar and 44 other districts (as control) for a period of 3 years (March 20 2005 to March 19, 2008) were analyzed and compared. Results: The number of injuries/100,000 population in Kashmar was 4654.6, 4570.9, and 4949.2 in March 2005-2006, 2006-2007, and 2007-2008, respectively. The corresponding figures (means) for the control districts were 822.7, 1130.0 and 1245.5. The injury- related fatality rate in the emergency ward for the 3 periods was 57.6, 52.9, and 44.2 per 100,000 in Kashmar and 12.2, 13, and 11.9 per 100,000 in the control districts. The injury rate showed an increase and the injury- related fatality rate showed a decrease in both Kashmar and the control districts over the 3 year period, but there was a statistically significant difference between the decreased injury-related fatality rate in Kashmar (p<0.0001). Conclusion: The Kashmar International Safe Community Program resulted in no significant decrease in the rate of injuries in Kashmar. However, as compared to the control distrcts, it caused a decrease in the injury-related fatality rate over the 3-year period. Long-term studies are necessary to confirm these results. [ABSTRACT FROM AUTHOR]