Qazvin University of Medical Sciences
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Developing decision model for the outsourcing of medical service delivery in the public hospitals
Get PDFBackground: The decision to outsource an activity is one of the most complex organizational decisions. This decision
is also influenced by several factors and components. In order to facilitate and optimize it, for the first time in this
study, a decision model for outsourcing medical service delivery in public hospitals has been developed.
Methods: We conducted this cross-sectional study in 3 stages: 1) We identified the factors affecting the outsourcing
decisions, 2) an expert panel identified the influential factors. After standardization, we distributed 220 questionnaires
among university staff managers and heads, nursing managers, and managers of the research units, and 3) Structural
Equation Model applied to evaluate the relationship between the variables on AMOS22, at 0.05 significant level.
Results: Findings indicated the optimal level of all fit indices. The path coefficient between all identified factors with
the outsourcing decision was positive (t > 1.96). Factors ranging from the most effective to least effective included
monitoring and control, service type, human resource, economic and financial, executive capability, external environment,
and terms and conditions.
Conclusion: The proposed model provides unit evaluation to make the appropriate decision on outsourcing or
non-outsourcing. Control and monitoring were the most determining factors. We recommend performing monitoring
continuously as a guide and deterrent to error. We also recommend continuous monitoring and control over the
quality of outsourced units and stakeholder satisfaction
A New Insight Into the Anti Proliferative and Apoptotic Effects of Fulvic and Humic Acids as Bio Product of Humus on Breast Cancer Cells, Optimized by Response Surface Methodology
Get PDFToday, plant compounds and substances of natural origin as bio products are strongly
recommended for the prevention and treatment of cancer. In the field of biomedicine antiviral, anti-inflammatory, anti-oxidant properties among the most known activities of
Humus and the products obtained from humus. In this study, the effect of humic and fulvic
acids (HA, FA), bio product of humus, on breast cancer cells (MCF7), the most common
cancer among women, was investigated. To achieve optimum cytotoxic time and determine
the effect of the different parameters the Response Surface Methodology (RSM) was
applied. The main parameters influencing the cytotoxic performance in the MTT assay,
such as time and concentrations were regarded. The cell viability was measured using
different concentrations of HA and FA including 10, 50, 100, and 200 µg/mL for 14, 24,
and 48 h, respectively. Apoptosis, cell cycle, mechanical properties and survivin gene
expression of MCF7 cells treated with HA and FA were analyzed after 14 h. Our results
showed that HA and FA induced apoptosis, reduced cell viability and gene expression in
the cured MCF7 cells. We have seen a dose-dependent behavior of HA in increasing the
cell population in phase Sub-G1. The results of AFM showed that the increasing behavior
of elastic modulus value and cell–cell adhesion forces were dose-dependent in cells treated
with HA and FA. The golden result of this study was the matching of laboratory and
statistical results which confirms the success of the RSM model in biological researches
Screening and molecular characterization of Trichomonas vaginalis genotypes isolated from married women in northern Iran
Get PDF. Trichomonas vaginalis is an anaerobic protozoan parasite that causes trichomonosis in human. It is one
of the most common non-viral sexually transmitted infections. It has been found to be most prevalent in patients referred
to sexually transmitted disease clinics. In recent years, molecular methods have been used to identify genotypes of this
parasite in different parts of the world and so far 6 types of T. vaginalis have identified. The aim of this study was to
investigate the prevalence and genotype identification of T. vaginalis from married women in northern Iran. A total of
450 vaginal specimens were taken from married women, referring to health centers in northern Iran. Demographic
information of women was collected through a questionnaire. The samples were first examined microscopically and
then monitored in Dorsch culture medium for up to 10 days. Actin genes of positive samples were amplified by PCR.
Finally, PCR products were used to determine the sequence and genotype of the parasite. Overall, 0.7% (3/450) samples
were positive for T. vaginalis. All of the three infected women were housewives. After sequencing, the genotype of these
parasites were type H (66.7%) (Accession no; MW414672-MW414673) and type E (33.3%) (Accession no;
MW414671). Low prevalence of T. vaginalis in north of Iran indicate high level of hygiene in sexual intercourse and
avoiding from high risk sexual behaviors, and also it seems that genotype H is dominant type of the parasite in the study
area
Correlation of radiomorphometric indices of the mandible and mandibular angle fractures
Get PDFThis study assessed the correlation of radiomorphometric indices of the mandible and mandibular angle fractures
(MAFs) in an Iranian population. This retrospective study was conducted on 3D computed tomography (CT) scans
of 118 patients between 18 to 60 years. The images were divided into two groups with MAFs and other types of
mandibular fractures (non-MAF). The gonial angle, ramus height, condylar neck width, minimum ramus width,
and mandibular length were all measured using MARCO PACS software. Age, gender, and presence and eruption
status of third molar at the fracture side were all recorded. The correlation between these parameters and MAF
was analyzed using R software (alpha ¼ 0.05). Of all patients, 41 samples had MAF. The two groups were not
significantly different regarding the mean age and gender (P > 0.05). The mean size of gonial angle and ramus
height in the MAF group were significantly larger, and smaller than the corresponding values in the non-MAF
group, respectively (P < 0.001). The median minimum ramus width in the MAF group was significantly
smaller than that in the non-MAF group (P ¼ 0.001). Patients with a large gonial angle had 6.6 times higher odds
of MAF compared with other fracture types (P ¼ 0.046). Condylar neck width, mandibular length, and erupted
third molars had no significant correlation with type of fracture. Presence of impacted third molar increased the
odds of MAF by 5.55 times.
Patients with a large gonial angle, short ramus height, minimum ramus width, and impacted third molar are
more susceptible to MAF. Surgeons can use these indices to predict the risk of MAF in trauma patients with such
facial characteristics, and make a diagnosis by radiographic modalities
Association of rs1800624 Polymorphism in Receptor for Advanced Glycation End Products Gene Promoter with the Risk of Diabetic Nephropathy
Get PDFBackground and Aim: Although the molecular mechanisms involved in the pathogenesis of
diabetic nephropathy are still unclear, the role of advanced glycation end products (AGEs) and
their associated receptors (AGER) in initiating the inflammatory process in this disease has
attracted attention. The aim of this study was to investigate the relationship between rs1800624
polymorphism of AGER gene with risk of diabetic nephropathy in Iranian population.
Materials and Methods: In this case-control study, patients were divided into two groups,
group1 without diabetic nephropathy (n = 71) and group2 with diabetic nephropathy (n = 79).
TETRA-Primer ARMS-PCR technique was used to determine the frequency of genotype and
allele of rs1800624 polymorphism in the promoter region of AGER gene. Using standard
methods, biochemical tests including measurement of glucose, creatinine, glycosylated
hemoglobin and blood urea nitrogen and calculation of eGFR were performed. We used SPSS
and FAMHAP softwares for data analysis.
Results: The results showed that AA genotype rs1800624 polymorphism in the promoter
region of the AGER gene may be associated with an increased risk of diabetic nephropathy.
Allele analysis also showed that allele A of the polymorphism may be associated with an
increased risk of developing nephropathy, although the results were not statistically significant
between the two groups in relation to rs1800624 polymorphism.
Conclusion: The findings of this study showed that there was no statistically significant
relationship between rs1800624 polymorphism in AGER gene with diabetic nephropathy in the
Iranian population, but increase in sample size may result in a tendency to develop diabetic
nephropathy
بررسی میزان فعالیت فاکتور های ویرولانس ایزوله های کاندیدا آلبیکنس و غیر آلبیکنس از نمونه های لاواژ
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زمینه و هدف: از فاکتورهای ویرولانس گونه های کاندیدا ترشح آنزیم های هیدرولیتیک می باشد. هدف از این مطالعه ارزیابی فعالیت پروتئیناز، فسفولیپاز و همولایزین در گونه های کاندیدا جدا شده از نمونه های برونکوآلوئولار در شرایط آزمایشگاهی می باشد.
روش بررسی: این مطالعه بر روی 50 گونه کاندیدا شامل 30 گونه کاندیدا آلبیکنس و 20 گونه کاندیدا غیر آلبیکنس (کاندیدا گلابراتا (9 n=) ، کاندیدا تروپیکالیس (7 n=) و کاندیدا پاراپسیلوزیس (4 n=)) انجام گرفت. گونه های کاندیدا مورد مطالعه از نمونه های لاواژ برونکوآلوئولار جمع آوری شده بودند. جهت ارزیابی فعالیت آنزیم پروتئیناز ، فسفولیپاز و همولایزین به ترتیب از محیط آلبومین سرم گاوی، محیط سابورو دکستروز آگار همراه با امولسیون تخم مرغ و محیط سابورودکستروز آگار حاوی 5 % خون گوسفندی استفاده شد. سپس میانگین فعالیت هر یک از آنزیم ها بررسی گردید.
یافته ها: در مطالعه حاضر، تولید پروتئیناز در 3/93 % از گونه های کاندیدا آلبیکنس و 70 % از گونه های غیر آلبیکنس مشاهده شد. هم چنین، 80 % از گونه های کاندیدا آلبیکنس و غیر آلبیکنس دارای فعالیت فسفولیپازی بودند. علاوه براین، فعالیت همولایزین در گونه های کاندیدا آلبیکنس و غیر آلبیکس به ترتیب در 3/53 % و ۴۰% بود. نتایج آماری نشان داد که ارتباط معنی داری بین فعالیت پروتئیناز با گونه های آلبیکنس و غیر آلبیکنس وجود داشت(P<0.05).
نتیجه گیری: داده ها نشان می دهد که ظرفیت گونه های کاندیدا برای فعالیت آنزیم های خارج سلولی ممکن است بازتابی از توانایی بیماری زایی جدایه ها باشد. بنابراین، تعیین این فاکتورها ممکن است ابزار مفیدی در مورد بیماری زایی احتمالی گونه ها باشد.
کلمات کلیدی: کاندیدا ، فسفولیپاز ، پروتئیناز، همولایزی
بررسی فعالیت آنزیم های هیدرولیتیک در ایزوله های کاندیدا گلابراتا و کاندیدا تروپیکالیس جدا شده از نمونه های عفونت قارچی ناخن
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زمینه: اونیکومایکوزیس عفونت قارچی ناخن می باشد که توسط گونه های مختلف کاندیدا و سایر ساپروفیت ها ایجاد میگردد. تولید آنزیم های خارج سلولی از جمله پروتئیناز، فسولیپاز و همولیزین از عوامل بیماریزایی مهم برای اتصال و حمله بیشتر به سلولهای میزبان هستند. هدف از این مطالعه بررسی فعالیت آنزیم های خارج سلولی در ایزوله های کاندیدا گلابراتا و کاندیدا تروپیکالیس جمع آوری شده از بیماران مبتلا به اونیکومایکوزیس در استان قزوین میباشد.
مواد و روش ها: در این مطالعه فعالیت آنزیم های فسفولیپاز، پروتئیناز و همولیزین بر روی 50 گونه ذخیره شده شامل کاندیدا گلابراتا (22=n) و کاندیدا تروپیکالیس (28=n) جدا شده از نمونه های عفونت قارچی ناخن انجام گردید.. سپس داده ها با نرم افزار SPSS مورد تجزیه و تحلیل قرار گرفت.
یافته ها: در این مطاللعه، میزان فعالیت آنزیم پروتئیناز در کاندیدا گلابراتا و کاندیدا تروپیکالیس به ترتیب 2/68 % و 61 % گزارش شد. درحالیکه فعالیت آنزیم فسفولیپاز و همولیزین در کاندیدا تروپیکالیس بیش از کاندیدا گلابراتا مشاهده شد. همچنین اختلاف معنی داری بین تولید فسفولیپاز در کاندیدا تروپیکالیس و کاندیدا گلابراتا مشاهده گردید (0.05P<).
نتیجه گیری: نتایج این مطالعه اهمیت بالینی فعالیت فسفولیپازی، پروتئیناز و همولیزینی بعنوان فاکتورهای موثر در بیماری زایی گونه های کاندیدا غیر آلبیکنس در بیماران مبتلا به اونیکومایکوزیس را نشان داد.
کلیدواژه ها: آنزیم های هیدرولیتیک، کاندیدا گلابراتا، کاندیدا تروپیکالیس، اونیکومایکوزی
The Effect of Parent-child Interaction Therapy on Separation Anxiety in 3-6-Year-old Children of Nurses
Get PDFBackground: Separation anxiety disorder is considered as the most common anxiety disorder in childhood. Failure to treat this
disorder in early age can be converted into a risk factor for childhood and adolescent psychiatric disorders.
Objectives: This study aimed at investigating the effect of parent-child interaction therapy on reducing the symptoms of separation
anxiety disorder among the nurses’ children aged between 3 and 6 years old working in educational hospitals in Qazvin.
Methods: The intervention was designed as pre- and post-test along with the control group. The sample included 67 children aged 3
- 6 years’ old who were divided into intervention and control groups using the blocking method. The intervention consists of three
steps: child directed interaction, bravery directed interaction and parent directed interaction which was performed for 8 sessions
per weak. No intervention was performed for the control group. The obtained data were collected using the Spence questionnaire
(parents’ version) and the results were evaluated.
Results: Intervention therapy significantly reduced the symptoms of separation anxiety in the intervention group at the post-test
stage compared to the control group. The mean of separation anxiety decreased from 10.82±0.62 to 7.69±0.52 in the intervention
group.
Conclusions: Parent-child interaction therapy can be used as an effective treatment plan to reduce the symptoms of separation
anxiety disorder among preschool children.
Keywords: Children, Nurse, Parent Child Interaction Therapy, Preschool Ages, Separation Anxiety Disorde
