میر سعید یکانی نژاد

Patient safety is one of the main pillars of health care and, in other words, avoiding any injury to the patient while providing health care. The study aimed to examine patients' safety from the perspective of medical staff in Ardabil city hospitals.

In this quantitative and applied study, descriptive-analytical data were collected cross-sectionally in public, private, and social security hospitals in Ardabil city in 1400. The study population included 189 medical staff of these hospitals in the medical, nursing, operating room, and anesthesiology groups, who were selected by simple random sampling. Data collection was done by visiting hospitals and completing standard questionnaires. SPSS statistical software was used for data analysis.

The research showed that patients' safety status in hospitals of Ardabil city was favorable, with an average of 88.7. Social Security Hospital, with an average score of 95.92, had the highest patient safety score, and public hospitals, with an average score of 87.93, and private hospitals, with an average score of 39.85, were in the next rank. The safety status of patients was inversely related to the level of education of employees and was not significantly related to employment status, organizational post, and type of hospital ownership.

Overall, the safety status of patients in Ardabil city hospitals was assessed at the desired level based on nine patient safety dimensions. Furthermore, implementing patient safety standards in public, private, and social security hospitals has been done correctly. However, it is recommended to implement patient safety standards as best as possible concerning nurse-to-patient education, patient identification, and infection control.

Currently, utilizing different nutritional indicators to investigate the association between diet and various diseases is considered in previous studies, which is related with some chronic diseases. However, no studies have studied the connection between the indicators with the rate of metabolism at rest (RMR). Therefore, the present study aimed to determine the relationship between dietary index and insulin load with resting metabolic rate (RMR) in overweight and obese women

A total of 280 healthy overweight and obese women (aged 18-50 years) who were referred to community health centers of Tehran University of medical sciences were included. In this study anthropometrics measurements such as weight, height, waist circumference, waist to hip ratio, body mass index, fat percentage, and fat-free mass were evaluated for every participant. Data on dietary intakes were collected using 147 semi-quantitative food frequency questionnaire (FFQ). DII and DIL were calculated using food insulin index values published earlier. To assess the RMR, indirect calorimetry was used. 

Mean age of study participants was 36.4±8.38 years. Although a significant association was seen between DII and RMR in a crude model (P=0.04); adjusting for different confounders made this significant relationship between DII and RMR insignificant. In addition, the dietary insulin index had no significant relationship with the amount of RMR/kg (p=0.63) and RMR/FFM (p=0.73).

Based on the results of this cross-sectional study, it seems that the insulin index and insulin load of the diet are not associated to the rate of resting metabolism. However, due to the limitations of this study, findings can only confirm or reject the hypothesis under further studies. It is also necessary to determine the role of dietary insulin indicators on human health, especially with a Study Prospective Design

Human resources determine the quality of performance of health care organizations and are one of their most important competitive advantages. Also, committing is very important to perform their duties. Therefore, it is necessary to recognize the factors that affect organizational commitment. This study aimed to investigate how organizational transparency could affect organizational trust and commitment from the perspective of hospital staff.

The present study is an applied descriptive-analytical study conducted on 640 staff members in teaching hospitals affiliated to Tehran University of Medical Sciences. The instruments used were: Organizational Transparency and Trust developed by Rawlins (2008) and  Organizational Commitment developed by Meyer and Allen (1997). Data were analyzed using SPSS software version 26 and AMOS.

Organizational transparency dimensions (overall transparency, participation, substantial information, and accountability) had a positive indirect effect on organizational commitment dimensions (affective, continuance, and normative commitment). Additionally, secrecy has a negative indirect effect on organizational commitment dimensions. The relationship between organizational transparency and commitment was also statistically significant, which indicates that organizational trust mediated the relationship between organizational transparency and commitment.

Managers might be able to improve transparency and staff participation in decision-making by taking cognizance of the priorities and information that can be disseminated by hospitals. In fact, increasing organizational transparency expands cooperation and leads to enhancing staff’s organizational trust, and ultimately increases their organizational commitment.

Physical activity and nutrition are important topics in adolescent health. This study aimed to determine the predictors of nutritional knowledge, behaviors, and physical activity in fifth-grade elementary school female students

This cross-sectional descriptive-analytical study was performed on 480 female students in the fifth grade of the elementary school in Gods city in 2020-2021 by cluster random sampling. Data were collected using a researcher-made questionnaire two-part questionnaire of contextual questions and questions about knowledge, nutritional and physical activity, virtual in the Shad messenger. The content validity ratio and content validity index was used to determine validity, and the intra-cluster correlation index to determine the reliability, of the questionnaire. In data analysis, descriptive statistical tests, Pearson         
correlation coefficient, and multiple regression analysis were performed using SPSS 27.

The results of multiple regression analysis showed the effect of nutritional knowledge variables on nutritional behavior (p <0.001, β = 0.159) and physical activity knowledge on nutritional behavior (p = 0.008, β = 0.120) if the Physical activity knowledge variable was not effective on physical activity behavior and also nutritional knowledge variable had no effect on physical activity behavior.

Increasing knowledge of nutrition and physical activity improves students' nutritional behavior, but this increase in knowledge does not affect physical activity behavior. The sedentary lifestyle and the presence of the Covid-19 pandemic appear to have significantly reduced physical activity. By increasing knowledge, nutritional behavior and physical activity can be improved to some extent

Cardiovascular diseases are the most common cause of death in most countries of the world, hypertension being the most important cause of disability. The aim of this study conducted in 2020-2021 was to determine the effect of educational intervention on the nutritional knowledge, illness perception and dietary adherence in hypertensive middle aged women based on the transtheoretical model (TTM).

This was a quasi-experimental study on middle-aged women (30-59 years old) suffering from hypertension referred to the  health centers and health bases in the 21st district of Tehran in 2020-2021. A total of 164 subjects were randomly assigned to the intervention (n=82) or control (n=82) group by randomized quadruple blocks. A multifaceted questionnaire was completed for both the control and intervention groups and their blood pressure measured. This was followed by  a one-month virtual education for the intervention group in the form of a WhatsApp group and designing and developing fifty-six podcasts and educational clips with a maximum duration of four minutes based on the transtheoretical model constructs. After a lapse of one and six months both groups completed the questionnaire again and their blood pressure was measured. Descriptive statistics and general linear model were used for data analysis using the SPSS version 25 (p<0.05).

Before the intervention the mean age of the subjects was 50.16 years and their systolic and diastolic blood pressures were 1.35 and 1.84 mmHg, respectively, and there were no statistically significantly differences between the two groups as regards contextual variables, constructs of nutritional awareness, disease perception, diet adherence, systolic and diastolic blood pressures and body mass index (as an ananthropometric index) and transtheoretical model constructs. Data one month after the intervention revealed significant differences (p<0/001) between the two groups (p <0/001) as regards the constructs of nutritional awareness, disease perception, self-sufficiency construct of the transtheoretical model and systolic blood pressure. Six months after the intervention significant differences were observed between the two groups as regatds  nutritional awareness constructs, disease perception (p<0.007), diet adherence (p<0.001), stages of change constructs (p<0.001) and self-sufficiency (p<0.001) of the transtheoretical model.

The results of this study show that educational intervention based on the transtheoretical model in middle-aged women with hypertension can increase their nutritional knowledge, illness perception, self-sufficiency, self-adequacy and diet adherence.

In recent years, women's experience of disrespect and misconduct during childbirth has been raised as a significant problem around the world. This study aimed to determine the prevalence of disrespectful maternity care and its associated factors.

This is a cross-sectional study conducted in 2019 on 357 mothers who gave birth at hospitals affiliated to TUMS. The data collection tool included socio-demographic characteristics form, and the disrespectful maternity care questionnaire, measuring various domains of abuse. The questionnaire was completed by interviewing mothers. Data was analyzed using descriptive tests, Chi-square test and multivariate logistic regression through the SPSS software version 24.

All participants reported at least one form of disrespect, of which “not allowing for mobility, fluid and companion” was the most prevalent (99.7%) and “stigma and discrimination” was the least prevalent (4.5%). Statistical analysis showed a significant relationship between older age, ethnic minority, primiparity, higher socioeconomic status, delivery time (night, day) and a history of illness with more experience of different forms of disrespect.

This study confirmed a relatively high prevalence of disrespectful maternity care in hospitals based on international standards, which requires serious and prompt attention of top-level managers to take action to eliminate or limit this type of behavior.

In 2020 the rank of Iran in happiness index and gender inequality were reported to be rather low, they being, among 153 countries, 118 and 113, respectively. This study aimed to investigate the relationship between gender inequality and happiness in Iranchr('39')s provinces.

This ecological study was conducted based on secondary analysis of data on happiness index, as the dependent variable, and gender inequality, as the main independent variable, in 31 Iranian provinces, the statistical population being people over 10 years old. The sources of data on other background variables were previous national studies and the national statistical yearbook. Analysis of the data was done using descriptive statistics, Pearson correlation coefficient and multiple linear regression.

No significant relationship was found between gender inequality and happiness (p<0.05) in the provinces. Neither was found any relationship between the background variables and happiness. However, the mean age of the population and gender inequality were inversely associated (p<0.05), meaning that with an increase in the mean age gender inequality would decrease.

The fact that no statistically significant association was found between the various variables and happiness in Iran’s provinces could be due to the small sample size.We would recommend to investigate further this topic at the individual level and with a larger sample size.

Patient education is an essential component of diabetes control, and increasing the health knowledge of diabetic patients based on suitable educational theories is crucial. This study aimed to determine the effect of educational intervention using the Transtheoretical Model (TTM) on improving the nutritional habits among patients with type-2 diabetes mellitus in Maragheh city, Iran during 2017-2018.

This study was a randomized controlled trial conducted on 136 diabetic patients under coverage of Maragheh health centers, Maragheh city, Iran, randomly divided into two groups of intervention and control (68 participants in each group). The data collection tool was a three-part questionnaire with questions/items related to demographic characteristics and nutritional habits, as well as constructs of TTM and HbA1c based on the TTM. The educational program included four weekly sessions of 45-60 minutes each. The data were analyzed using the SPSS16 software, the statistical tests being descriptive and inferential tests such as ANCOVA; the significance level was set as a p-value < 0.05.

Before the intervention, the comparison and control groups did not differ significantly as regards demographic variables, HbA1c, TTM constructs and nutritional habits (p<0.05). After the educational intervention, the mean scores of nutritional habits, constructs of TTM and HbA1c were statistically significant in patients with type 2 diabetes (p <0.01).

The study results reveal that the application of transtheorical model can improve the nutritional habits of diabetic patients.

Osteoporosis is a silent and progressive disease that causes disability in people particularly women, with age and has irreversible consequences in their lives. This study aimed to determine the effect of an educational intervention program based on BASNEF model on prevention of osteoporosis among women referred to health centers in the south of Tehran.

This is a quasi-experimental study with two groups of intervention and control, performed on 162 women (81 in the intervention group and 81 in the control group) aged 30-49 years, referred to health centers in the south of Tehran in 2018. The data collection tool included demographic information, a researcher-made questionnaire based on BASNEF model constructs and another part of the questionnaire was Health Promotion Standards Questionnaire (HPLP II). Questionnaires were completed for both the intervention and control groups before and six months after the intervention. Data were analyzed by the SPSS software using chi-square, t-test, and paired t-test at a significance level of 0.05.

The mean of women’s age in this study was 37.79±5.47 years old. There was no significant difference in demographic variables and BASNEF model constructs before the intervention (P>0.05). After the intervention, the mean score of BASNEF model constructs and the dimensions of health promoting behaviors significantly increased in the intervention group (P<0.001).

The study results revealed a positive effect of the BASNEF model-based educational program on health promoting behaviors regarding osteoporosis prevention among women. It is suggested to use this model as a successful model in educational interventions to prevent osteoporosis in women.

The prevalence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing neurosurgery is reported to be up to 25%. Mortality from this complication has been reported between 9% and 50% due to PE. Even with the use of pneumatic pressure devices, the prevalence of DVT is reported to be up to about 32% in these patients, so prophylactic treatment with heparin is of particular importance. Application of low molecular weight heparin (LMWH) reduces the prevalence of DVT by 40-50% in neurosurgery patients. Our neurosurgeon must strike a balance between the risk of venous thromboembolism (VTE) and the increased risk of bleeding from heparin prophylaxis for DVT and pulmonary embolism. The aim of this study was to provide clinical recommendation for prevention of VTE in neurosurgical cases.

Here we try to review the available scientific sources on the prevalence and risk factors for VTE in neurosurgery patients and up-to-date recommendations and guidelines for mechanical (Intermittent pneumatic compresion and anti-embolic stocking) and pharmacological  (low-dose unfractionated heparin or LMWH) prophylaxis of VTE in patients with neurosurgery.

Strength of panel opinion (including 6 neurosurgeons) assessed by the weights of each risk factor for thromboembolism during and after cranial and spinal surgery was calculated. The risk factors with less than 50% of the panel opinion were excluded. At last the results were inserted within evaluation forms for each risk factor. Measuring level of agreement (kappa coefficient) between 6 persons of expert panel for evaluating risk factors during and after cranial and spine surgery was calculated.

In all neurosurgery patients, mechanical prophylaxis should begin at the time of admission and continue for up to 30 days if immobilized, or until the person is mobilized. Drug prophylaxis also increases the effectiveness of mechanical prevention and should be considered in patients at high risk for VTE.

The health of pregnant mothers is one of the most important health indicators of each country. The midwifery clinic is one of the first places in which pregnant mothers become familiar with at the time they arrive. Providing health services at a desirable level and improving the quality of services in the midwifery clinic require an accurate understanding of the situation and its complications. This study aimed to assess how well pregnant mothers were satisfied with the midwifery services that they have received at midwifery to improve their quality.

This cross-sectional study was performed on 364 pregnant women who were referred to the midwifery clinic of Shariati Hospital in Tehran in August and September in 2018. Data were collected using a validated, pre-designed questionnaire and were analyzed using chi-square and multivariate logistic regression.

Among the pregnant women referred to the clinic, 70.2% were satisfied with the care services received and 29.8% of them were not satisfied. This satisfaction level had a significant relationship with pregnancy (P=0.009) and motherschr('39') age (P<0.001) while decreased by the increment in the number of pregnancies and age. Also, in this study, the least satisfaction was related to the crowds and waste of time and lack of access to the parking spot (P<0.001). In this research, the least satisfaction was due to crowding and waste of time, which can be addressed by improvement in the health services in the residential areas, appropriate referrals, informing about the expected time of arrival, and providing information on the alternative of the new hospitals in areas around the city with less traffic congestion and better parking sites.

 The results of our study showed the detailed patient satisfaction factors of an educational medical hospital. In overall the satisfaction.

The main purpose of this study was to compare the predictive power of the Inequality-adjusted Human Development Index (IHDI) with the Human Development Index (HDI) with regard to the share of deaths caused by Non-Communicable Diseases (NCD) among all deaths in the world and Iran.  

The data required for this cross-sectional ecological study were extracted from the reports of the United Nations Human Development Program and the WHO in 2015. Pearson correlation test was used to investigate the correlation of HDI and IHDI with the share of deaths caused by NCDs and linear regressions models were used to determine the associations of IHDI and HDI with the dependent variable.

At a significant level of P<0.01, the dependent variable showed a strong positive correlation with HDI (0.892) and IHDI (0.899). Simple linear regression showed that HDI alone predicted the dependent variable well (Adj.R2=0.794, P<0.001).However, according to the multivariate linear regression model, when IHDI and HDI were included in the model, IHDI was able to predict the dependent variable well (Adj.R2=0.809, P=0.001), while the relationship between HDI and the dependent variable was no longer significant.

Although HDI alone is an important predictor of NCD status, it loses its influence in the presence of IHDI. Therefore, in addition to HDI, IHDI that illustrates the impact of inequality on human development can provide more information on the status of deaths caused by NCDs.

Today, one of the most important challenges in teaching oral and maxillofacial pathology is how to teach it to dental students. The purpose of this study was to review the implementation and evaluation of the Practical Pathology Curriculum in order to achieve the goals of applied pathology education for dental students.

First, a need assessment was conducted so that the view of students in the faculty of Tehran University of Medical Sciences who had completed the practical oral and maxillofacial pathology unit 2 during the last 2 years were collected using a questionnaire. Then, using the view of faculty members and considering the student opinions and reviewing the texts and similar experiences in other universities in the world, amendments were made to the course mentioned above. After the implementation of the modifications, we gathered the student’s view using the same questionnaire.

In the need assessment phase, 92 students (controls) and after the implementation of the modification, 62 students (cases) completed the questionnaire. A significant improvement in the assessment of students in some items such as their overall assessment of educational quality (p = 0. 008) and the mean score of the questionnaire (p = 0. 00) was observed. Regarding the students grades in the final exam, after the implementation of the modifications, a slight improvement was observed although this was not statistically significant (p = 0. 431).

The above mentioned modifications results an improvement in the overall satisfaction of students with the teaching quality of practical pathology course, although the average score of the final exam did not show a significant increase.

The most important factor in interpersonal relationships is trust. Trust in the physician-patient relationship is key and essential. Understanding the factors that affect trust is a prerequisite for trust. These factors vary in different societies. So we need to identify these factors and provide a single criterion for measuring them. Therefore, because we need a tool to measure these different factors in the context of culture and society, the purpose of this study is to determine the factors that influence public confidence in physicians to provide the necessary evidence for making appropriate instruments in Iran. The first step was to investigate the factors affecting patients' confidence in physicians during a library study. Then, during interviews and numerous discussion sessions, nineteen factors influencing public confidence in physicians were provided. Then, to determine the content validity, twenty experts evaluated the transparency, relevance and importance of the factors. Content validity ratio (CVR) and content validity index (CVI) were measured. CVR value for each of nineteen factors was 0.42, therefore content validity of the tool was significant with P.value 0.05. CVI value was 0.944 and content validity of the tool was confirmed. Factors affecting public confidence in physicians in Iran include 19 factors extracted during this study and can be used as factors for assessment of public confidence in physicians. Factors affecting public confidence in physicians in Iran include 19 factors extracted during this study.