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Background: One of the most important effective factors in increasing patient satisfaction and improving health and treatment results is proper communication between physician and nurse, and the patient. The present study was conducted with the aim of determining the relationship between the communication skills of the medical staff and patient’s safety culture. Methods: This was an analytical study conducted among 277 working medical staff including nurses, paramedics, full-time geographical employment doctors and anesthesia, and operating room technicians in Shahid Sadoughi Hospital in Yazd by stratified random sampling in 2022. The instrument used was the safety culture standard questionnaire made by the health care quality and research agency and communication skills of Barton J. Data analysis was done with SPSS 25 software, Mann-Whitney, Kruskal-Wallis, and multiple linear regression tests. Results: The overall mean and standard deviation of patient safety culture was 3.04 ± 0.23, which indicates the average status of safety culture in the studied hospital, and the overall mean of communication skills among medical staff was 3.36 ± 0.40. Which reports a relatively strong level of this skill. The results of linear regression showed that 2 components of communication skills (listening and feedback) have a positive and significant effect on the improvement of patient safety culture, so that they are able to explain 33 percent of the variance of patient safety culture changes. Conclusion: Based on the findings of the research, the communication skills of the medical staff have a significant effect on patient's safety culture. Therefore, in order to improve the patient’s safety culture among them, special attention should be paid to communication skills because effective communication is considered a vital element in effective care, and in the medical system it has a significant effect on the quality of care and consequently increases the satisfaction of patients.

Objective (s): Considering the role of self-care in reducing the burden of non-communicable diseases and in order to properly increase the importance of health to society, paying attention to the self-care is a priority. This study was conducted with the aim of investigating the effect of an educational intervention in the context of social messengers on the awareness of the health workers regarding the self-care program. Methods: This semi-experimental study was conducted on 705 employees (doctors, nurses, midwives, health care workers) of health centers in Ilam province, Iran during 2020 and 2021. To collect data, a self-designed questionnaire containing 330 questions related to the 22 educational packages of the national self-care program provided by the Ministry of Health was used. The questionnaire was completed before an educational intervention and 9-months follow-up. The data was analyzed with SPSS version 24 software and through paired t-test and chi-square test. Results: The results indicated a significant increase in the awareness of health workers in the field of self-care program during a period of nine months after the educational intervention using the virtual educational method. A statistically significant relationship was observed between increasing the level of awareness of health workers with variables such as age (0.01), education level (0.05), gender (0.01) and organizational position (0.01). Conclusion: Considering the important and fundamental role of health workers in improving the level of health literacy of the society and on the other hand the growing trend of access to social messengers, it is suggested with a cascade approach and based on social accountability, suitable educational programs to improve the awareness of health workers and subsequently health ambassadors at the household level should be prioritized.

Background and Purpose: Organizational commitment among nurses, a critical aspect of hospital workforce management, is influenced by various factors, including job attachment. This attachment fosters motivation and commitment, which ultimately enhances the quality of healthcare services. This study investigates the relationship between organizational commitment and job attachment among nurses working in selected teaching hospitals affiliated with Shahid Sadoughi University of Medical Sciences in Yazd in 2022. Methods: This descriptive-analytical study involved all nurses at Shahid Sadoughi Hospital in Yazd. A sample size of 298 nurses was determined using Cochran's formula. Data collection was conducted using the Job Descriptive Index (JDI) by Edwards and Kilpatrick (1984) and the Organizational Commitment Questionnaire (OCQ) by Allen and Meyer (1990). The data were analyzed using the Chi-square test with SPSS version 21 software and structural equation modeling via LISREL software. Results: Among the nurses surveyed, 43.17% reported being satisfied with their jobs, while 40.17% exhibited organizational commitment. The findings revealed a significant relationship between job attachment and organizational commitment (P

Benyamin Netanyahu has been the main figure in the Israeli political scene for the past decade. Since he has played a major role in shaping the Israeli foreign policy in the international arena, this study seeks to examine his leadership style and personality traits as an influential and at the same time a neglected factor in the foreign policy behavior of the state of Israel. Hence, the main hypothesis is the fact that Israel’s foreign policy behavior has been more influenced by Netanyahu’s cognitive system and leadership style. The conceptual/methodological framework used in this paper is Leadership Traits Analysis (LTA) proposed by Margaret G. Hermann with a focus on the Conceptual Complexity variable in this regard. The results of this study, which itself are the quantitative content analysis of Netanyahu’s verbal material from 2009 to 2019; suggest that BIBI’s low conceptual complexity and his black and white thinking to foreign policy with high belief in ability to control events, a high desire for power, and a strong distrust to others have shaped Netanyahu’s aggressive and hawkish approach to Israeli foreign policy, which can be seen in exaggerating the Iranian threat and opposing to the idea of a Palestinian independent state.

In recent months, the spread of Coronavirus encountered us with a contretemps situation. An event occurred in the guise of a virus that was beyond modern life imagination. Due to a virus, the defects and inadequacies of the mechanisms that govern human societies have once again found the opportunity to outbreak. What seems impossible in coordinates of the history of present of international relations, was realized in the disguise of a contretemps event. In these circumstances, nation-states, in confrontation with new-found events like Coronavirus, entangled in some kind of distress, insolvency, and lack of preparation. Considering these circumstances, we would face different questions; what are the roots of the insolvency of nation-states in the confrontation of these new-found challenges? What are the consequences of handling the contretemps events such as Coronavirus in a traditional method based on survival and security of state? In this regard, we argue that the nature of new-found challenges like Coronavirus is as if the nation-state and the international order based on it, has birth defects in face of these kinds of events; On the other hand, it seems that the learning process and adaptation of nation-states has been frozen decades ago. In this paper, The way of information analysis is the explanatory method of research.

Aims & Backgrounds: The US and the Soviet Union led the east and the west camps during the cold war and the geopolitical order was laid on the foundation of the rivalries between these two superpowers. But, after the collapse of the bipolar system, the US became the undisputed power in the international arena and the geopolitical order underwent changes during three decades after that and the conflicts between the superpowers was continued. Based thereon, the current study aims at explaining the geopolitical structure after the cold war and the method of power distribution in the situation after the collapse of Soviet Union up to the present time. Methodology: The present study makes use of a descriptive-analytical method using qualitative content analysis and reviewing literature and the theories presented through reasoning and inference to find answers to three key questions in line with perceiving the relations between the superpowers after the cold war. The method of data and information Collectionis library and documentary. Findings: The present study will show that the world witnessed a geopolitical transition after cold war and that no power is in a hegemonic position currently and the world is bearing witness to a spectrum of unipolar, bipolar and multipolar fluid powers. The conflict between the superpowers can be explained based on subjective and objective geopolitical factors. Conclusion: Powers have chosen such strategies as withdrawal, bandwagoning and, balance of power which is including soft and hard in respect to one another according to the type of conflicts

Civil war is a complex event affected by numerous factors. Recent research is intended to concentrate on poor governance as a cause of civil war. Despite the various way in which civil war can be addressed, the article shows that governance provide a strong framework to study civil war. Civil war in Syria which was started in 2011 provide an important and rich area of investigation into the study of civil war. The findings support the theoretical argument that poor governance paved the way to civil war in Syria. Governance indicators would be more meaningful when are investigated considering the factors like ethic and religious diversity, and the nature of regional and international systems.

Background and purpose: Since a large proportion of fetal mortality is associated with low birth weight (LBW) and considering the fact that fetal development is a vulnerable process influenced by maternal risk factors, this study examined some maternal risk factors associated with LBW infants. Materials and Methods: This cross-sectional study was conducted based on the medical records of 250 infants born in Zeynabeieh Hospital. The required data were registered in a pre-developed checklist. Then, the collected data were analyzed by Chi-square in SPSS Software using descriptive and inferential statistics. Results: The mean weight of the sample was 3.2 ± 0.25 (1.5-4.7) kg. About 18% of the infants had birth weight of 2500 g or less. The most frequent educational level among the mothers was illiteracy and elementary education (60%), and the least was secondary education (9.2%). There was found a significant correlation between the mothers’ education and low birth weight (P < 0.001). Regarding the association between the mothers’ age and low birth weight, 18- to 35-year-old mothers comprised the highest number of mothers (75%), and upper 35-year-old mothers did the lowest (11.2%). Based on chi-square test, a significant correlation was observed between the mothers’ ages and low birth weight (p

Objective: To evaluate the feasibility and results of using serosal patch of small bowel for repair and replacement of inferior vena cava (IVC) after resection of a part of infra-renal IVC in an animal model, as it may be encountered in extensive tumors of retroperitoneal and trauma patients.Methods: Five healthy sheep of both sexes were prepared. After general anesthesia and laparotomy, a defect with 1 cm width and 4cm length was made on anterior aspect of infra-renal IVC, and then an adjacent loop of small bowel was brought and sutured continuously to cover the defect of IVC as a patch graft. The observation period was two months.Results: Three of five IVCs were macroscopically patent without stenosis and thrombosis. Pathologic assay revealed complete endothelialization of serosal surface of the patch of small bowel loop. One of IVCs was completely occluded in gross evaluation and fibrous formation in pathologist review. The sheep had no sign of venous hypertension and edema of limbs. One sheep died at the night of first operation due to internal bleeding.Conclusion: Serosal patch of small bowel is an accessible and feasible alternative in repair and reconstruction of IVC especially when there is restriction for use of prosthetic material in a contaminated space of abdomen.

Background: The aim of this study was to determine the occurrence of virulence determinants and vancomycin- resistant genes among Enterococcus faecalis and E. faecium obtained from various clinical sources.Methods: The study was performed on the 280 enterococcal isolated from clinical specimens in Hamadan hospitals, western Iran in 2012-14. Antibiotic susceptibility testing was performed using disk diffusion and Minimal Inhibitory Concentration (MIC) methods. The presence of vancomycin-resistant genes and virulence genes was investigated using PCR.Results: Totally 280 enterococcal isolates were identified as follows: E. faecalis (62.5%), E. faecium (24%) and Enterococcus spp (13.5%). The results of antibiotic susceptibility testing showed that resistance rates to vancomycin and teicoplanin in E. faecalis and E. faecium isolates were 5% and 73%, respectively. Of Sixty vancomycin-resistant Enterococci strains, fifty-one isolates were identified as E. faecium (VREfm) and nine as E. faecalis (VREfs). Prevalence of esp, hyl, and asa1 genes were determined as 82%, 71.6%, and 100%, respectively in E. faecium strains; and 78%, 56/6%, and 97%, respectively in E. faecalis strains.Conclusion: The increased frequency of VREF, as seen with rapid rise in the number of vanA isolates should be considered in infection control practices. Keywords: E. faecalis, E. faecium, Vancomycin-resistant enterococci, Minimum inhibitory concentration

Streptococcus agalactiae is acommensalorganism, but it may cause infection in susceptible hosts. The aim of this study was to evaluate PCR assay compared with conventional culture method for direct detection of Streptococcus agalactiae. Total of 203 paired low vaginal swabs were collected from women at 35-37 weeks of pregnancy from June 2013 through February 2014 for detection of Streptococcus agalactiae using PCR assay targeting 16S rRNA, cfb, scpB, and atr genes and culture method following broth enrichment. The results were recorded and evaluated for determining of sensitivity, specificity, positive and negative predictive values of PCR assaycompared with culture method. Prevalence of Streptococcus agalactiae was determined as 7.39% (n=15) using culture method; 19.70% (n=40) by PCR targeting 16S rRNA gene; 18.23% (n=37) by targeting atr gene; 17.24% (n=35) by cfb gene; and 8.87% (n=18) by scpB gene. Generally, a total of 49 specimens were considered true positive (27 samples by PCR assay using the four genes in sum, 4 samples only by atr gene PCR, 3 samples only by cfb gene PCR, 2 samples only by culture method, and 13 samples by PCR assay and culture method in common) and prevalence of Streptococcus agalactiae determined 24.14% in Hamadan. The current data demonstrated that performing only culture method for detecting GBS from pregnant women leads to missed false negative carrier individuals. Thus, it is recommended that both the PCR assay and conventional culture method to be performed in order to detect Streptococcus agalactiae.

Sepsis is a leading cause of morbidity and mortality in hospitalized patients worldwide and based on studies, 30-40% of all cases of severe sepsis and septic shock results from the blood stream infections (BSIs). Identifying of the disease, performing laboratory tests, and consequently treatment are factors that required for optimum management of BSIs. In addition, applying precise and immediate identification of the etiologic agent is a prerequisite for specific antibiotic therapy of pathogen and thereby decreasing mortality rates. The diagnosis of sepsis is difficult because clinical signs of sepsis often overlap with other noninfectious cases of systemic inflammation. BSIs are usually diagnosed by performing a series of techniques such as blood cultures, polymerase chain reaction-based methods, and biomarkers of sepsis. Extremely time-consuming even to take up to several days is a major limitation of conventional methods. In addition, yielding false-negative results due to fastidious and slow-growing microorganisms and also in case of antibiotic pretreated samples are other limitations. In comparison, molecular methods are capable of examining a blood sample obtained from suspicious patient with BSI and gave the all required information to prescribing antimicrobial therapy for detected bacterial or fungal infections immediately. Because of an emergency of sepsis, new methods are being developed. In this review, we discussed about the most important sepsis diagnostic methods and numbered the advantage and disadvantage of the methods in detail.

Background and Aim: General anesthesia (GA) is commonly used for spine surgery but this operation can be performed under regional anesthesia. The advantages of regional anesthesia (RA), as compared to GA in regard to the optimum choice of anesthesia for spine surgery have been a matter of controversy. The aim of this study was to compare GA with RA in regard to the intraoperative events, incidence of postoperative complications, and the recovery time in the patients undergoing spine surgery. Material and Methods: This prospective comparative study included 80 patients in ASA 1 and 2 who had referred to Kwosar Hospital in Sanandaj for spinal and lower thoracic surgery. After random allocation of the patients into two equal groups, general anesthesia or epidural anesthesia was adminstered in the same manner to the patients of each group. Demographic characteristics, vital signs, the severity of pain, agitation, urinary retention, nausea, and vomiting, number of times needed to administer analgesics, the time of request for the first dose of analgesia, the time to start walking, and the time of discharge from the hospital were recorded in the patients׳ records. Using SPSS software version 23, data were analyzed by average statistical test, standard deviation, independent t-test, and chi-square test. Results: There was no significant differences between the two groups in terms of gender, age, and type of surgery (P >0.05). The severity scores of pain based on the VAS scale at 2, 4, and 6 hours after surgery in the GA group were higher than those in the epidural group (P

Environmental security is one of the most important aspects of human security, which puts emphasis on sustainability of the developmental policies and that they should adjust with the environment as well as rights of future generations. Since threats to the human security mainly occur within environmental issues, this research- highlighting the relationship between human security and environmental security and pointing out the threatening causes and factors to the human security - has replied to the question that how has the environmental degradation endangered human security in Iran? This study shows adoption of policies like 1- Expansion of urbanization, 2- Population growth, 3- Consumerism and stressing the production increase, disregarding its consequences, and 4- Development of environmentally incompatible technologies have led to further utilization of fossil fuels as well as uncontrollable use of various environmental resources, increased pollution, and extensively damaged the environment which consequently endangered human security due to the severe dependence of human being to the environment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Hypofibrinogenemia is an independent factor of excessive bleeding after congenital cardiac surgeries. Fresh frozen plasma (FFP) and fibrinogen concentrate are examples of recommended products for management of hypofibrinogenemic bleedings. Unfortunately, there is no study to compare these treatments in pediatric cardiac surgeries. Therefore, this study aimed to compare the effect of fibrinogen concentrate with FFP on postoperative bleeding and clinical outcome after congenital cardiac surgeries in pediatric population.METHODS: Phis prospective clinical trial study was carried out on 90 consecutive pediatric patients who underwent congenital cardiac surgeries. The eligible pediatrics who met our study criteria, randomly received FFP (10 ml/kg) or fibrinogen concentrate (70 mg/kg) to assess postoperative bleeding and blood-products requirements.RESULTS: Each of FFP and fibrinogen concentrate significantly reduced total chest tube drainage (CTD) at 3, 6, 12, and 24 postoperative hours (P = 0.04). The analysis of time*intervention revealed that our intervention (fibrinogen group) significantly reduced CTD more (P = 0.01). Moreover, fibrinogen group had a significantly higher plasma fibrinogen level in first 24 hours (P = 0.02).CONCLUSION: Nowadays, both of fibrinogen concentrate and FFP product are widely used for management of hypofibrinogenic bleedings after cardiac surgeries. According to our results, we concluded that although the both product had a comparable effect on management of hypofibrinogenemic bleeding in pediatrics undergoing congenital cardiac surgeries, choosing better product depended on general condition of patients such as their body fluid status.

Analyzes the impact of globalization on the gap between official rhetoric and the legitimate demands of Iran. Participation of the Iranian people in the presidential elections of 1997 and 2001; Problem of legitimacy; Percentage of Iranian high school students who do not say their daily prayers according to social survey research; Discussion on the concept of globalization.

مقدمه: یکی از مشکلات مهم جراحی قلب اطفال، خونریزی پس از بای‌پاس قلبی- ریوی است و تزریق پلاسمای تازه منجمد شده (FFP یا Fresh frozen plasma) جهت جبران خون از دست رفته و پیش‌گیری از اختلالات انعقادی، به طور معمول اولین اقدامی است که برای بیمار انجام می‌گیرد، اما برخی مطالعات نشان داده است تزریق فیبرینوژن و آلبومین می‌تواند در جبران خون از دست رفته و پیش‌گیری از اختلالات انعقادی مؤثر باشد. از این رو، مطالعه‌ی حاضر با هدف تعیین تأثیر ترکیب فیبرینوژن سنتتیک و آلبومین با پلاسمای تازه منجمد شده، در پیش‌گیری از اختلالات انعقادی در جراحی قلب اطفال بستری در بیمارستان چمران اصفهان طی سال 1393 انجام شد. روش‌ها: طی یک مطالعه‌ی کارآزمایی بالینی، 90 بیمار دارای معیارهای ورود به مطالعه به روش تصادفی‌سازی بلوکی در دو گروه تقسیم شدند. گروه اول، تحت تزریق پلاسمای تازه منجمد شده و گروه دوم تحت تزریق فیبرینوژن سنتتیک و آلبومین قرار گرفتند. قبل و بعد از عمل در تمام بیماران، مقدار پلاکت (Plt یا Platelet)، زمان پروترومبین (PT یا Prothrombin time)، زمان ترومبوپلاستین نسبی (PTT یا Partial thromboplastin time)، زمان انعقاد فعال (ACT یا Activated clotting time)، گازهای خون شریانی (ABG یا Arterial blood gas)، هموگلوبین (Hb یا Hemoglobin) و سطح فیبرینوژن خون بررسی و مقایسه شد. یافته‌ها: بررسی سطح هموگلوبین بیماران در قبل از عمل در دو گروه دریافت کننده‌ی پلاسمای تازه منجمد شده و فیبرینوژن و آلبومین، به ترتیب 9/1 ± 6/10 و 3/3 ± 9/11 (290/0 = P)، در یک ساعت بعد از عمل 2/2 ± 9/12 و 3/2 ± 3/12 و در 24 ساعت بعد از عمل 7/1 ± 9/12 و 6/2 ± 1/13 بود (750/0 = P) و تفاوت معنی‌داری بین دو گروه مشاهده نشد. همچنین، روند تغییرات سطح هموگلوبین بین دو گروه اختلاف معنی‌دار نداشت (690/0 = P). سطح فیبرینوژن در قبل از عمل در دو گروه متفاوت بود، اما در بعد از عمل اختلاف معنی‌داری بین دو گروه مشاهده نشد. نتیجه‌گیری: استفاده از ترکیب فیبرینوژن و آلبومین در بیماران تحت اعمال جراحی قلب حداقل به اندازه‌ی پلاسمای تازه منجمد شده از اختلالات انعقادی و میزان نیاز به تزریق پلاسمای تازه منجمد شده می‌کاهد. از این رو، استفاده از این ترکیب در کودکانی که تحت عمل جراحی قلبی قرار می‌گیرند، طبق نظر پزشک جراح و در صورت عدم وجود کنترا اندیکاسیون، توصیه می‌گردد.

این پژوهش در برگیرنده مطالعات چینه‏نگاری سنگی، زیستی و توصیف رخساره‌های رسوبی سازند شاه کوه به سن کرتاسه پیشین در جنوب غرب شهرستان خور در شرق ایران مرکزی می باشد. بدین منظور یک برش چینه­شناسی در کوه تنگل بالا اندازه‏گیری، نمونه‏برداری و مطالعه شده است. سازند شاه کوه در این برش 950 متر ضخامت داشته و به طور عمده از سنگ آهک­های ضخیم لایه تا توده‌ای فسیل‏دار تشکیل شده است. مرز زیرین این سازند با سازند نقره تدریجی و مرز بالائی آن با یک ناپیوستگی فرسایشی در زیرسازند بیابانک قرار می‏گیرد. بر اساس گسترش چینه‌شناسی اربیتولیند‌های شناسائی شده دو زون زیستی Palorbitolina lenticularis Taxon Range Zone و Praeorbitolina cormyi Subzone در نهشته­های سازند شاه کوه تشخیص داده شده است. زون‌های زیستی شناسائی شده مؤید سن بارمین پسین- آپسین پیشین برای سازند شاه‏کوه در برش مورد مطالعه می­باشند. مطالعه رخساره‌های میکروسکوپی نهشته‌های سازند شاه‏کوه نشان می‏دهد که این رسوبات در چهار کمربند رخساره‌ای ساحلی، لاگون، سدو دریای باز کم عمق ته‌نشست یافته‏اند.