Ardabil University of Medical Sciences
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Psychometric Properties and Dimension Analysis of the Hospital Survey On Patient Safety Culture Questionnaire (HSOPSC)
No full textObjectives: Medical errors are known as one of the five main causes of mortality. In response to this mortality rate, over two decades, global efforts have been made to increase patient safety and reduce unwanted accidents in health centers. One of the priorities is the development of research to measure the attitudes and beliefs of patient safety from the perspective of health care workers. So, the main goal of this study is to investigate the possible alternative factorial structure of the patient safety culture model in Iran.
Methods: The HSOPSC "Hospital Survey on Patient Safety Culture" questionnaire was translated into Persian during the forward-backward translation technique and with the necessary corrections on the items. The validity of the questionnaire was assessed using face and content validity methods. Content validity ratio (CVR) and content validity index (CVI) were calculated. In order to evaluate the internal consistency of the questionnaire, Cronbach's alpha was calculated and to evaluate test-retest reliability, Intraclass Correlation Coefficient (ICC) was calculated. Data were collected from 420 staff members in 4 educational hospitals of Ardabil University of Medical Sciences by HSOPSC questionnaire. Exploratory factor analysis was used to investigate the possible alternative factorial structure. Confirmatory factor analysis and structural equation modeling was used to examine and confirm obtained structure. To perform exploratory and confirmatory factor analysis, the data were divided into two halves (210 items per analysis). SPSS 24 and Amos 24 softwares were used for the analysis.
Results: The content validity index (CVI) was 0.92 and the content validity ratio (CVR) was higher than the standard value (0.51) in all items. Internal consistency (∝=0.8) and good test-retest reliability (ICC=0.791) were obtained for HSOPSC questionnaire items. Exploratory factor analysis identified 12 dimensions with Cronbach's alpha range of 0.57 to 0.86, which included “sense of altruism”, “teamwork
to maintain and enhance patient safety”, “teamwork, handoffs and transitions across units”, “frequency of events reported”, “non-punitive response to errors”, “effective and fair care and monitoring to improve patient safety”, “management support for patient safety”, “freedom of expression and communication openness”, “requesting to do things irresponsibly and against the patient safety”, “threats to patient safety”, “preventing errors” and “Identification of the errors before patient injury”. The distribution of items in all dimensions differed from the original HSOPSC questionnaire except the two dimensions “management support for patient safety”, “frequency of events reported”. Based on the CFA and SEM, the structure obtained in this study was a proportional model. The best fitness in CFA analysis indicated an acceptable fit for the Persian version of HSOPSC (χ2/df =1.063 0.90, AGFI = 0.902 > 0.90, NFI = 0.901 > 0.91, CFI = 0.993 > 0.90, RFI= 0.91 > 0.90, IFI=0.99 > 0.90). The critical ratios in all items were acceptable, so it can be said that all factors affect the patient safety culture.
Conclusion: Based on CFA and SEM, the model obtained in this study is a proportional model and the composition of the items in the dimensions had a relative stability.The structure of the dimensions obtained in this study was not consistent with the structure of the original HSOPSC model. Considering the importance of the patient safety, it is suggested that future researches in Iran be carried out in several provinces and cities at a national level.
Keywords: Patient safety culture, Hospital Survey on Patient Safety Culture (HSOPSC), Psychometric properties, Dimensions Analysis, Structural Equation Modelin
Serotonin depletion during the postnatal developmental period causes behavioral and cognitive alterations and decreases BDNF level in the brain of rats
No full textA survey of the literature indicates that the developmental disruptions in serotonin (5‐HT) levels can influence the brain development and the function. To the best of our knowledge, so far, there are a few studies about the effects of developmental period 5‐HT depletion on cognition and behavior of adult male and female rats. Therefore, in the present study, we examined the effects of postnatal days (PND 10–20) administration of para‐chlorophenylalanine (PCPA, 100 mg/kg, s.c) a 5‐HT synthesis inhibitor, on anxiety‐related behaviors, pain sensitivity, short‐term recognition memory, and hippocampal and prefrontal cortex (PFC) brain‐derived neurotrophic factor (BDNF) mRNA expression in adult male and female rats. Novel object recognition memory (NORM) and behavioral parameters (anxiety‐like behaviors and pain sensitivity) were evaluated in early adulthood and after that, the hippocampi and PFC of the rat's brain were removed for the determination of BDNF mRNA expression. Our results indicated that the postnatal period administration of PCPA impaired short‐term NORM. The postnatal developmental period treatment with PCPA also increased anxiety‐like behaviors in the open field and elevated plus maze (EPM) tests. Postnatal PCPA treatment increased pain sensitivity in the hot plate test in both male and female rats, especially in female animals. In addition, postnatal days serotonin depletion decreased BDNF level in the hippocampus and PFC of both male and female rats. These findings demonstrate that serotonin plays the main role in neurodevelopment, cognitive functions, and behavior. Therefore, serotonergic system dysregulation during the developmental periods may have more adverse influences on the brain development of rats
The effects of eugenol nanoemulsion on pain caused by arteriovenous fistula cannulation in hemodialysis patients: A randomized double-blinded controlled cross-over trial
No full textObjectives: Local anesthetic and antinociceptive activity of eugenol, as the main ingredient of clove, was determined in previous researches. This study aimed to assess the efficacy of its topical nanoemulsion gel vs. placebo in controlling pain caused by arteriovenous fistula (AVF) needling in patients undergoing hemodialysis (HD). Design: In this double-blinded cross-over trial, the patients were randomly allocated to eugenol gel 4% (n=34) and placebo gel (n =34) groups. For each patient, a tip of finger unit of gel was applied 2cm around the insertion site of hemodialysis needles. After 10min, AVF needling was done. AVF needling-related pain was assessed using visual analogue scale (VAS) immediately after the puncture. All patients were tested at three different states: (1) before using any intervention; (2) after using either the eugenol or placebo gel; and (3) after crossing over the groups. Results: There was a significant difference between the mean of patients’ pain severity score in the three states (p=0.001). It was reported as low as 3.29 ± 0.67 in patients who received eugenol nanoemulsion. Also, the highest pain severity score (5.03 ± 0.57) was reported at the no-intervention state. Conclusions: It seems that topical application of eugenol nanoemulsion may significantly decrease AVF cannulation related pain intensity score in patients undergoing HD. However, further studies with larger sample size and longer intervention period should be done for better judgment on its efficiency and safety
Evaluation of correlation between serumic Vitamin D3 level and jaws bone density in posterior edentulous area of candidates for dental implants
No full textBackground: only a few information exists about the role of Vitamin D on jaws’ bone density, and the number of human studies is scarce. Vitamin D deficiency is considered to diminish bone regeneration, and raising the serum level might take months. Hence, the primary aim of this study is to determine whether the vitamin D level in the chosen candidates is related to their jaw bone density.
Methods: In the period of 6 months, 50 candidates for dental implants with the ages of 20 to 60 have randomly chosen at implantology department of Tabriz dental faculty. 15 of which were males and 35 females, and They were examined for their vitamin D3 level in the same specific laboratory. As the patients were registered to get implants, all of them already had their cone beam computed tomography (CBCT) radiographic images taken from same CBCT system before the procedure. They were divided into 3 groups based on their Vit D3 level; deficient, insufficient, and sufficient and their bone density at posterior edentulous areas were evaluated using mean calculated Hounsfield unit from the same software called Planeca Romexis.
Result: Although in the mandibles of both males and females the minimum bone density was found in the vitamin D3 deficient group, but neither in maxilla nor mandible there was not any significant statistical relationship between vitamin D3 level and bone density.
Conclusion: This study was unable to find an effective link between low serum levels of vitamin D3 and jaws’ bone density. Further studies should be taken to investigate this topic
Evaluation of dental students and dentists knowledge about oral cancer symptoms in Ardabil
No full textIntroduction: Given the incidence of oral cancer and demographic changes in Iran, planning to encourage dentists to perform and follow the protocol of oral cancer screening to reduce existing barriers is crucial. One of the underlying factors is to measure their awareness of oral cancer. Therefore, this study was conducted to investigate the familiarity of dental students and dentists in Ardabil with the symptoms of oral cancer.
Materials and Methods: In this descriptive-analytical study, 48 dental students and 66 general dentists were studied randomly. Azad and colleagues Standard Questionnaire (2015) were used to collect information and answer the questions and hypotheses. After collecting information, questionnaires related to knowledge were first corrected; After determining the level of knowledge of dentists and dental students and the relationship between the level of knowledge of dentists and their demographic characteristics (gender, work experience, duration of graduation) using two-way analysis of variance and one-way analysis of variance using Spss software version 22 Analyzed, P less than 0.05 was considered significant.
Results: The results showed that the mean and standard deviation of knowledge about the symptoms of oral cancer in senior dental students (7.52 ± 1.5) and general dentists (8± 1.62); So that the level of knowledge of senior dental students and general dentists in Ardabil about the symptoms of oral cancer was moderate. There was no significant difference in the knowledge of senior dental students and general dentists in Ardabil about the symptoms of oral cancer based on gender and work experience (P> 0.05). But the level of awareness of students and graduates of public universities was higher than foreign universities (P <0.05).
Conclusion: The awareness of senior dental students and general dentists in Ardabil about the symptoms of oral cancer is moderate and there is a need to hold retraining courses for dentists and senior dental students
Comparison of tooth discoloration induced by calcium-enriched mixture, mineral trioxide aggregate, and endocem
No full textAim: Dental discoloration after the application of endodontic materials has become a primary cause of concern for many dental patients in recent times. Regarding this, the present in vitro study was performed to evaluate tooth discoloration induced by calcium-enriched mixture (CEM) cement, mineral trioxide aggregate (MTA), and Endocem. Materials and methods: This study was conducted on 54 healthy central incisors extracted due to orthodontic treatment or periodontal disease. The samples were assigned into three groups in which the pulp chambers were filled with Endocem (group I), CEM cement (group II), and MTA (group III). The samples were sealed by glass ionomer cement. Color change was measured using the Vita Easyshade spectrophotometer at the baseline as well as 30 and 90 days after the application of cements. Data analysis was performed using SPSS software (version 23). Results: A visible color change with a delta of >3.3 was observed in all groups 1 month postintervention. The results revealed a significant difference among the three groups in terms of color change 1 month after the intervention (p value <0.001). In this regard, group I and group II showed the highest and lowest color change, respectively. However, there was no significant difference 3 months after the application of the cements. Conclusion: As the findings indicated, tooth discoloration was similarly detectable 1 month after the application of CEM cement, MTA, and Endocem. Clinical significance: CEM cement, MTA, and Endocem showed similar tooth discoloration after 3 months placement
Evaluation of Medication errors in intensive care unit (ICU) of Imam Khomeini Hospital, Ardabil, Iran During the second half of the year 1398
No full textIntroduction: Medication errors (ME) as a one of the major inevitable life threatening problems could occur in any health care setting in all countries. Most of ME can be prevented. ME more likely happens in hospitalized patients specially in critically ill ones and patients with several comorbidity and taking a large number of drugs. Therefore for the first time in this study ME were evaluated in the Intensive Care Unit (ICU) of Imam Khomeini Hospital, Ardabil, Iran.
Methods: This prospective study was performed on 200 Hospital admitted patients during the second half of 1398. Patients' information including demographic findings (age, sex) complete patient history, clinical and para-clinical data were collected. Detected ME were also recorded in the relevant checklists and analyzed after transfer to SPSS21 software.
Discussion: High prevalence of preventable medication errors in this hospital, highlight the urgent need to establish pharmaceutical care unite to improve the health care system service quality .
Results: Out of 200 recruited patients, 68 were female (34%) and 132 were male (66%). The mean age of enrolled patients was 50.8 ±19.3 in total, 1753 cases of medication errors were identified, (8.765 cases per patient). 171 people (85.5%) had at least one medication error. No medication errors were observed in 29 patients (14.5%). The most common type of error 396 (22.6%) was inappropriate dose
Investigation of apoptosis-related genes expression levels in the KG-1a cell line following exposure to Thymus fallax nanoparticles
No full textOver the past 40 years, many plants have been reported as cytotoxic substances. Thyme (T. fallax Fisch Mey), belonging to the family Lamiaceae, is a fragrant perennial plant that grows in several regions, including the Mediterranean Sea, southern Italy, Iran and Turkey. Thyme and its oil have been used as disinfectants and antioxidants. Acute myeloid leukemia (AML) is characterized by abnormal proliferation of myeloid cells in the bone marrow. Leukemia is caused by somatic mutations, translocation, and mutations in the germ cell line. Among the genes whose mutations are involved in AML leukemia genes are DNMT3A, GATA2, KIT, FLT3 and RUNX1, which are located on different chromosomes. KG-1a cell line that is very similar to leukemic stem cells. Therefore, it is used as a model to study the characteristics of leukemia stem cells. In this study, the effect of Thymus fallax extract and nanoparticles on KG-1a cell line was first investigated. Silver nanoparticles were synthesized by green synthesis method and its specificity was investigated by physical and chemical tests including SEM imaging, FTIR analysis, and D.L.S. Concentration and time-dependent graphs were drawn for the effect of the extract and its nanoparticles on KG-1a cells after cytotoxicity test, determination of MTT and IC50 values in each group. Then, apoptotic genes including hCASP3, Bax, Bcl-2, Caspase9, Caspase8 and GAPDH were examined by PCR. Stages of cell death including primary apoptosis, late apoptosis and cell necrosis were analyzed using acridine orange and ethidium bromide staining and phase contrast microscope. The results indicate the presence of silver extract and its nanoparticles in the death of KG-1a cells. Nanoparticles were more effective than Thymus fallax extract, and both agents caused apoptosis in internal and external pathways. The stages of early and late apoptosis and necrosis are concentration dependent and these stages were different in KG-1a cells treated with nanoparticles and extracts. These results suggest the benefits of using plants in the production of nanoparticles as a new way of treating or complementing a cancer treatmen
Frequency of sexual violence and its relation to sexual satisfaction in married women in Ardebil
No full textBackground: Considering that no such study has been conducted in Ardabil, especially in the suburbs, in this study we aimed to investigate the frequency of sexual violence and its relationship with marital satisfaction in married women on the outskirts of Ardabil.
Aim: To determine the frequency of sexual violence and its relationship with sexual satisfaction in married women on the outskirts of Ardabil.
Methods and material: In this study, the statistical population was all women living on the outskirts of Ardabil who referred to rural urban health centers. The sampling method was stratified, during which we selected a number from each health unit as a sample and entered the study. Finally, 200 people were selected from 20 health centers. The Larson Sexual Satisfaction Questionnaire and the Sexual Violence Researcher Questionnaire were used to collect information. Due to the normality of data distribution, the Pearson Correlation Test (Pearson Correlation Test) was used to determine the relationship between quantitative variables.
Results: The present study was performed on 200 married women on the outskirts of Ardabil. In this study, a researcher-made questionnaire was used and its validity and reliability were assessed before sampling. Summarizing the results showed that in our study, 84.5% reported sexual violence as moderate and 10.5% as high. 5% also described this index as low. The results of our study showed that sexual violence has a positive and statistically significant relationship with all sub-criteria as well as the total score of sexual satisfaction. In other words, as sexual satisfaction increases, so does sexual violence. The frequency of moderate sexual violence was the highest in all age groups. In the 26 to 30 age group, 24.4% of women reported severe sexual violence. This study showed that in couples with an age difference of 5 to 10 years, sexual violence has a positive and significant relationship with sexual adjustment, quality of life and sexual attitude (P <0.05) and also in couples with more than 10 years of sexual violence with Sexual compatibility and quality of life show a positive and significant relationship (P <0.05). Women with university education also reported 78% moderate sexual violence and 17.1% severe sexual violence.
Conclusion: In the present study, we showed that most of the women in the suburbs of the city face moderate sexual violence. Sexual violence also increases with increasing sexual satisfaction
Evaluation of water quality parameters of distribution network, water output from domestic water purifier and bottled water for high consumption in Ardabil city and its comparison with drinking water standards in 1398
No full textIntroduction: The health of drinking water is very important for people, and today there are few people who do not have an accurate view about their drinking water and consumption. Increasing public awareness of the consequences of drinking water pollutants and the demand for better water quality has led most people to use bottled water and household water purifiers to compensate for the shortcomings that they suspect there are in tap water. Therefore, it is necessary to be aware of the quality of such waters in order to maintain public health. Some of the components and contaminants in water may have adverse effects on human health. Physical, chemical, and microbial factors can affect water quality, so we must make the necessary arrangements for water so that it does not exceed the set quality standards. The purpose of this study is to determine the water quality parameters of the distribution network, effluent from the domestic water purifier and bottled water distributed in Ardabil city and compares them with the drinking water standards in 1398.
Method: This is a descriptive-cross-sectional study in which the most widely used brands of bottled bottled water in Ardabil city were identified and 30 bottles as a sample of bottled water were randomly purchased from 10 brands in the city. Also, 30 samples were randomly selected from the water of the distribution network and the water from the household water treatment device.
Results: Average concentrations of nitrate, nitrite, fluoride, chloride, total hardness, calcium, sodium, sulfate, TDS, electrical conductivity and pH in the inlet and outlet water of domestic water purifiers and widely used bottled water in Ardabil, respectively 3.94-0.72-5.71, 0.0073-0.0066-0.0007, 0.41-0.16-.41, 49.95-10.023-3.41, 76.038-8.58-78.048, 52.36-5.128-17.71, 79.96-5.45-7.53, 71.85-9.25-32.99, 878.44-151.148-227.44 mg /l, 1254.91-215.925-32.191 μg/cm and 7.668, 6.599, 7.628 were obtained. Microbial contamination was not observed in any of the studied samples the highest efficiency of parameter removal by household water treatment device is related to sodium 92.34% and the lowest removal efficiency is related to nitrite 8.82%.
Conclusion: Distributed bottled water in Ardabil has no health problems in terms of chemical and microbial quality. And the average values obtained for cations and anions are much lower than the desired standard for bottled and drinking water. Regarding the use of home water purifiers, considering that the concentration of most urban physicochemical parameters is below the standard limit of 1053 drinking water, the use of these devices is not necessary for the city of Ardabil because it often reduces the concentration of parameters below the standard level. And somehow reduce the taste of water. On the other hand, they also eliminate high levels of useful salts, so users of home water purifiers should be aware of the low intake of minerals from purified water. It is suggested that in addition to the use of these devices, adequate supervision be provided to provide quality and standard products in the market