"I Love Foreigners' Attitudes towards Life": Reproducing Lifestyles in an Iranian English Language Teaching Context

ERIC Educational Resources Information Center

Mirhosseini, Seyyed-Abdolhamid; Sazvar, Azam; Rashed, Farnoosh

2017-01-01

An important aspect of learning a foreign language is encountering the sociocultural orientations associated with it. The present qualitative study focuses on an Iranian setting of English language teaching (ELT) to explore the potential reflection and reproduction of certain cultural attitudes and lifestyles in this context. A total of 200 hours…

The Impact of Task-Based Language Teaching on the Development of Iranian EFL Learners' ESP Reading Comprehension Skills

ERIC Educational Resources Information Center

Setayesh, Mahnam; Marzban, Amin

2017-01-01

The present study primarily aimed at investigating the effect of Task-Based Language Teaching (TBLT) on development of the Iranian EFL learners' ESP Reading Comprehension Skills. Moreover, it was aimed at investigating the probable difference between the TBLT-instructed students of Law and Mechanical Engineering with respect to their ESP reading…

Conflict management styles among Iranian critical care nursing staff: a cross-sectional study.

PubMed

Ahanchian, Mohammad Reza; Emami Zeydi, Amir; Armat, Mohammad Reza

2015-01-01

Conflict among nurses has been recognized as an extremely important issue within health care settings throughout the world. Identifying the conflict management style would be a key strategy for conflict management. The aim of this study was to evaluate the prevalence of conflict management styles and its related factors among Iranian critical care nursing staff. In a descriptive cross-sectional study, a total of 149 critical care nurses who worked in the critical care units of 4 teaching hospitals in Sari (Iran) were evaluated. A 2-part self-reported questionnaire including personal information and Rahim Organizational Conflict Inventory II was used for data collection. Although Iranian critical care nurses used all 5 conflict management styles to manage conflict with their peers, the collaborating style was the most prevalent conflict management style used by them, followed by compromising, accommodating, avoiding, and competing. Male gender was a predictor for both compromising and competing styles, whereas position and shift time were significant predictors for compromising and competing styles, respectively. Based on the results of this study, nurse managers need to take these factors into account in designing programs to help nurses constructively manage unavoidable conflicts in health care setting.

A Comparative Study of the Use of Persian vs. English in Teaching English Grammar to Iranian Students in Junior High School

ERIC Educational Resources Information Center

Mehrseresht, Kowsar; Gowhary, Habib; Azizifar, Akbar

2015-01-01

This study compared the relationship between the use of Persian vs. English in teaching English grammar to Iranian students and their achievement in learning English grammar. The participants of this study include 50 female students from a junior high school in Mehran. The researcher randomly selected 2 groups, one group was taught through the…

Pre-Hospital Emergency in Iran: A Systematic Review.

PubMed

Bahadori, Mohammadkarim; Ghardashi, Fatemeh; Izadi, Ahmad Reza; Ravangard, Ramin; Mirhashemi, Sedigheh; Hosseini, Seyed Mojtaba

2016-05-01

Pre-hospital care plays a vital role in saving trauma patients. This study aims to review studies conducted on the pre-hospital emergency status in Iran. Data were sourced from Iranian electronic databases, including SID, IranMedex, IranDoc, Magiran, and non-Iranian electronic databases, such as Medline, Embase, Cochrane Library, Scopus, and Google Scholar. In addition, available data and statistics for the country were used. All Persian-language articles published in Iranian scientific journals and related English-language articles published in Iranian and non-Iranian journals indexed on valid sites for September 2005 - 2014 were systematically reviewed. To review the selected articles, a data extraction form developed by the researchers as per the study's objective was adopted. The articles were examined under two categories: structure and function of pre-hospital emergency. A total of 19 articles were selected, including six descriptive studies (42%), four descriptive-analytical studies (21%), five review articles (16%), two qualitative studies (10.5%), and two interventional (experimental) studies (10.5%). In addition, of these, 14 articles (73.5%) had been published in the English language. The focus of these selected articles were experts (31.5%), bases of emergency medical services (26%), injured (16%), data reviews (16%), and employees (10.5%). A majority of the studies (68%) investigated pre-hospital emergency functions and 32% reviewed the pre-hospital emergency structure. The number of studies conducted on pre-hospital emergency services in Iran is limited. To promote public health, consideration of prevention areas, processes to provide pre-hospital emergency services, policymaking, foresight, systemic view, comprehensive research programs and roadmaps, and assessments of research needs in pre-hospital emergency seem necessary.

Investigating the Relationship between Multiple Intelligences and Professional Identity of Iranian EFL Teachers

ERIC Educational Resources Information Center

Alaee, Mitra

2015-01-01

The main purpose of the study was to investigate the relationship between Iranian EFL teachers' Professional Identity and their types of Multiple Intelligences. Moreover, it aimed to see the extent to which their multiple intelligences can predict their professional identity. The participants of the study were 137 Iranian EFL teachers teaching in…

Iranian Critical ELT: A Belated but Growing Intellectual Shift in Iranian ELT Community

ERIC Educational Resources Information Center

Aghagolzadeh, Ferdows; Davari, Hossein

2014-01-01

Reviewing and discussing the development of critical studies in the field of applied linguistics in general and English language teaching (ELT) in particular in Iran, this paper attempts to highlight the main contributions in this field. Introducing a new growing critical-oriented shift in Iranian ELT community as the one which has been mostly…

How Creative Are Iranian EFL Teachers?

ERIC Educational Resources Information Center

Khany, Reza; Boghayeri, Mahnaz

2014-01-01

The study of creativity has been of great interest to educationalists in general and language teaching practitioners in particular. With all these, very little if any has been reported on the issue in Iranian EFL context. Having this in mind and drawing on the latest profile of creativity, effort was made to see how creative Iranian EFL teachers…

The Effect of Educational Computerized Games on Learning English Spelling among Iranian Children

ERIC Educational Resources Information Center

Mehrpour, Saeed; Ghayour, Maaedeh

2017-01-01

The present study investigated the effects of educational computerized games on learning English spelling among Iranian children. In doing so, 66 young Iranian English learners with the average age of 9.5, attending the children's branch of Iran Language Institute (ILI), the most well-established state-run language teaching institute in Iran,…

Nutritional Care in Iranian Intensive Care Units

PubMed Central

2018-01-01

Intensive care units (ICUs) provides intensive treatment medicine to avoid complications such as malnutrition, infection and even death. As very little is currently known about the nutritional practices in Iranian ICUs, this study attempted to assess the various aspects of current nutrition support practices in Iranian ICUs. We conducted a cross-sectional study on 150 critically ill patients at 18 ICUs in 12 hospitals located in 2 provinces of Iran from February 2015 to March 2016. Data were collected through interview with supervisors of ICUs, medical record reviews and direct observation of patients during feeding. Our study showed that hospital-prepared enteral tube feeding formulas are the main formulas used in Iranian hospitals. None of the dietitians worked exclusively an ICU and only 30% of patients received diet counselling. Regular monitoring of nutritional status, daily energy and protein intake were not recorded in any of the participating ICUs. Patients were not monitored for anthropometric measurements such as mid-arm circumference (MAC) and electrolyte status. The nasogastric tube was not switched to percutaneous endoscopic gastrostomy or jejunostomy (PEG/PEGJ) in approximately 85% of patients receiving long-term enteral nutrition (EN) support. Our findings demonstrated that the quality of nutritional care was inappropriate in Iranian ICUs and improvement of nutritional care services within Iranian ICUs is necessary. PMID:29713622

Nutritional Care in Iranian Intensive Care Units.

PubMed

Shabanpur, Maryam; Nachvak, Seyed Mostafa; Moradi, Shima; Hedayati, Safora; Hosseinikia, Mahboobe; Pasdar, Yahya; Gholizadeh, Shahrbanoo; Samadi, Mehnoosh

2018-04-01

Intensive care units (ICUs) provides intensive treatment medicine to avoid complications such as malnutrition, infection and even death. As very little is currently known about the nutritional practices in Iranian ICUs, this study attempted to assess the various aspects of current nutrition support practices in Iranian ICUs. We conducted a cross-sectional study on 150 critically ill patients at 18 ICUs in 12 hospitals located in 2 provinces of Iran from February 2015 to March 2016. Data were collected through interview with supervisors of ICUs, medical record reviews and direct observation of patients during feeding. Our study showed that hospital-prepared enteral tube feeding formulas are the main formulas used in Iranian hospitals. None of the dietitians worked exclusively an ICU and only 30% of patients received diet counselling. Regular monitoring of nutritional status, daily energy and protein intake were not recorded in any of the participating ICUs. Patients were not monitored for anthropometric measurements such as mid-arm circumference (MAC) and electrolyte status. The nasogastric tube was not switched to percutaneous endoscopic gastrostomy or jejunostomy (PEG/PEGJ) in approximately 85% of patients receiving long-term enteral nutrition (EN) support. Our findings demonstrated that the quality of nutritional care was inappropriate in Iranian ICUs and improvement of nutritional care services within Iranian ICUs is necessary.

The Association between Life Satisfaction and the Extent of Depression, Anxiety and Stress among Iranian Nurses: A Multicenter Survey

PubMed Central

Yazdanshenas Ghazwin, Manijeh; Kavian, Mohammad; Ahmadloo, Mohsen; Jarchi, Alemeh; Golchin Javadi, Shaghayegh; Latifi, Sahar; Ghajarzadeh, Mahsa

2016-01-01

Objective: The determinants of satisfaction of life (SWL) are poorly described among Iranian employed nurses. This study aimed to assess the effect of various factors including age, gender, marital status, depression, anxiety and stress on SWL among Iranian nurses. Method: Employed nurses in three teaching hospitals were invited to participate in this study. Ninety-four nurses (65 women and 29 men) participated in this study. Depression, anxiety, stress scale (DASS-21) was used to measure the related variables. Satisfaction with Life Scale (SWLS) was used to assess SWL. Multivariate analysis was utilized to examine the relationship between multiple variables. Results: A noticeable proportion of Iranian employed nurses were either dissatisfied or extremely dissatisfied with life (45%). Severe depression was related to lower scores of SWLS (P: 0.001, r = −0.32). The similar outcomes were detected between anxiety and stress scales, and SWLS (P: 0.023, r = −0.23 and P: 0.008, r = −0.27 for anxiety and stress, respectively). Although females were more vulnerable to depression (P: 0.010) and stress (P: 0.013), the overall effect of gender on SWL was insignificant (0.41). Satisfactions with financial power and work environment were associated with higher scores of SWLS (P: 0.030 and 0.042, respectively). Marital status was not related to severity of depression, anxiety, stress and SWLS (P: 0.39, 0.38, 0.80, and 0.61, respectively). Conclusion: This study revealed that poor satisfaction with financial status and work environment, depression, anxiety and stress are the major determinants of satisfaction with life among Iranian employed nurses. PMID:27437009

The dysfunctional consequences of a performance measurement system: the case of the Iranian national hospital grading programme.

PubMed

Aryankhesal, Aidin; Sheldon, Trevor A; Mannion, Russell; Mahdipour, Saeade

2015-07-01

Performance measurement systems are increasingly used to reward and improve provider performance. However, such initiatives may also inadvertently induce a range of unintended and dysfunctional side-effects. This study explores the unintended and adverse consequences induced by the Iranian national hospital grading programme, which incorporates financial incentives for meeting nationally defined standards. We interviewed key informants across four key groups with a legitimate interest in healthcare performance: four purposively selected hospitals; four health insurance organizations; the Iranian hospital accreditation body; and one grading agency. The transcribed interviews and field notes were analysed thematically, and subsequently, member checking was conducted. Seven dysfunctional consequences were identified: misrepresentation of data by hospitals; increased anxiety and stress among hospital employees; tunnel vision; financial pressures on poorly graded hospitals; incentives to purchase unnecessary equipment; erosion of public trust; and restricting access to hospital services by patients. These were caused by the way the grading system was implemented: poor standards of audit; the way in which the audit process was conducted; and the timing of audits. The pay for performance element of the grading system and the focus on structural aspects in the standards made improvement in grading particularly difficult for those hospitals that had been assessed as under-performing. Although the Iranian hospital grading system has resulted in a significant increase in the adoption of national standards, it has nevertheless induced a range of perverse outcomes. To mitigate these requires further refinement and recalibration of the system. © The Author(s) 2015.

Awareness and Performance of Iranian Nurses with Regard to Health Economics: A Cross-Sectional Study.

PubMed

Heydari, Abbas; Mazloom, Reza; Najar, Ali Vafaee; Bakhshi, Mahmoud

2015-09-01

Health costs have risen everywhere, worldwide, and nurses play a pivotal role in cost savings and in contributing to the financial stability of hospitals. This study evaluated the awareness and performance of Iranian nursing staff, with regard to health economics. A total of 175 nurses who worked in three teaching hospitals in Mashhad (Iran) were selected for this descriptive cross-sectional study, and data were gathered via a 27-item questionnaire. Statistical analysis was performed using one-way analysis of variance, multiple regression analysis, and Pearson's correlation coefficient. A total of 78% (n = 39) of nurses did not have a good awareness of health economics. The overall mean score for economic awareness was 5.9 ± 2.1 (possible range, 0-16), and for economic performance was 26.6 ± 4 (possible range, 0-44). There was a significant relationship between the economic awareness and performance of nurses, and nurses in higher positions had a greater awareness of health economics. Considering the inadequacy of the health economics awareness and performance of nurses, it is essential that efforts are made to enhance their knowledge and behavior with regard to economic issues and cost saving in all the fields of nursing, through the use of continuing education courses and workshops.

Perceived Quality of Informed Refusal Process: A Cross-Sectional Study from Iranian Patients' Perspectives.

PubMed

Farzandipour, Mehrdad; Sheikhtaheri, Abbas; Sadeqi Jabali, Monireh

2015-12-01

Patients have the right to refuse their treatment; however, this refusal should be informed. We evaluated the quality of the informed refusal process in Iranian hospitals from patients' viewpoints. To this end, we developed a questionnaire that covered four key aspects of the informed refusal process including; information disclosure, voluntariness, comprehension, and provider-patient relationship. A total of 284 patients who refused their treatment from 12 teaching hospitals in the Isfahan Province, Iran, were recruited and surveyed to produce a convenience sample. Patients' perceptions about the informed refusal process were scored and the mean scores of the four components were calculated. The findings showed that the practice of information disclosure (9.6 ± 6.4 out of 22 points) was perceived to be moderate, however, comprehension (2.3 ± 1.4 out of 4 points), voluntariness (8.7 ± 1.5 out of 12 points) and provider-patient relationship (10.2 ± 5.2 out of 16 points) were perceived to be relatively good. We found that patients, who refused their care before any treatment had commenced, reported a lower quality of information disclosure and voluntariness. Patients informed by nurses and those who had not had a previous related admission, reported lower scores for comprehension and relationship. In conclusion, the process of obtaining informed refusal was relatively satisfactory except for levels of information disclosure. To improve current practices, Iranian patients need to be better informed about; different treatment options, consequences of treatment refusal, costs of not continuing treatment and follow-ups after refusal. Developing more informative refusal forms is needed. © 2014 John Wiley & Sons Ltd.

Hospital enterprise Architecture Framework (Study of Iranian University Hospital Organization).

PubMed

Haghighathoseini, Atefehsadat; Bobarshad, Hossein; Saghafi, Fatehmeh; Rezaei, Mohammad Sadegh; Bagherzadeh, Nader

2018-06-01

Nowadays developing smart and fast services for patients and transforming hospitals to modern hospitals is considered a necessity. Living in the world inundated with information systems, designing services based on information technology entails a suitable architecture framework. This paper aims to present a localized enterprise architecture framework for the Iranian university hospital. Using two dimensions of implementation and having appropriate characteristics, the best 17 enterprises frameworks were chosen. As part of this effort, five criteria were selected according to experts' inputs. According to these criteria, five frameworks which had the highest rank were chosen. Then 44 general characteristics were extracted from the existing 17 frameworks after careful studying. Then a questionnaire was written accordingly to distinguish the necessity of those characteristics using expert's opinions and Delphi method. The result showed eight important criteria. In the next step, using AHP method, TOGAF was chosen regarding having appropriate characteristics and the ability to be implemented among reference formats. In the next step, enterprise architecture framework was designed by TOGAF in a conceptual model and its layers. For determining architecture framework parts, a questionnaire with 145 questions was written based on literature review and expert's opinions. The results showed during localization of TOGAF for Iran, 111 of 145 parts were chosen and certified to be used in the hospital. The results showed that TOGAF could be suitable for use in the hospital. So, a localized Hospital Enterprise Architecture Modelling is developed by customizing TOGAF for an Iranian hospital at eight levels and 11 parts. This new model could be used to be performed in other Iranian hospitals. Copyright © 2018 Elsevier B.V. All rights reserved.

Evaluating teaching effectiveness in nursing education: an Iranian perspective.

PubMed

Salsali, Mahvash

2005-07-27

The main objective of this study was to determine the perceptions of Iranian nurse educators and students regarding the evaluation of teaching effectiveness in university-based programs. An exploratory descriptive design was employed. 143 nurse educators in nursing faculties from the three universities in Tehran, 40 undergraduate, and 30 graduate students from Tehran University composed the study sample. In addition, deans from the three nursing faculties were interviewed. A researcher-developed questionnaire was used to determine the perceptions of both faculty and students about evaluating the teaching effectiveness of nurse educators, and an interview guide was employed to elicit the views of deans of faculties of nursing regarding evaluation policies and procedures. Data were analyzed using parametric and nonparametric statistics to identify similarities and differences in perceptions within the Iranian nurse educator group and the student group, and between these two groups of respondents. While faculty evaluation has always been a major part of university based nursing programs, faculty evaluation must be approached more analytically, objectively, and comprehensively to ensure that all nursing educators receive the fairest treatment possible and that the teaching-learning process is enhanced. Educators and students stressed that systematic and continuous evaluation as well as staff development should be the primary goals for the faculty evaluation process. The ultimate goals is the improvement of teaching by nurse educators.

Studying the Impacts of Globalization on Iranian Education System

ERIC Educational Resources Information Center

Chahardahcheriki, Mitra Abdolahi; Shahi, Sakine

2012-01-01

The purpose of this study is to analyze the degree of globalization of important indicators of education system in Iran including teaching approaches, educational tools and facilities, curriculums and contents, and education management. Findings suggest that the situation of Iranian education system has some distance with the globalized level and…

Hepatitis A Is a Health Hazard for Iranian Pilgrims Who Go to Holly Karbala: A Preliminary Report

PubMed Central

Ghasemian, Roya; Babamahmoodi, Farhang; Ahangarkani, Fatemeh

2016-01-01

Background Iraq is a highly endemic area for the prevalence of hepatitis A and annually hosts a large number of Iranian pilgrims, most of whom are susceptible to infection with the hepatitis A virus (HAV). Objectives This study reports the health hazard of hepatitis A for Iranian pilgrims who go to holly Karbala from the Mazandaran province. Patients and Methods In this cross-sectional study, the data of all patients with acute hepatitis A admitted in the Razi teaching hospital from November 23, 2014 to January 24, 2015, with a history of recently returning from holly Karbala or being exposed to Karbala pilgrims, were registered. Results A total number of nine patients were registered. Seven patients were male and two were female. The mean age was 30.11 ± 10.09.Two patients were from the same family. All patients had typical symptoms of acute hepatitis A. None of the patients died nor did fulminant occur in any patients. In addition, all patients were treated with supportive treatment and subsequently recovered. Conclusions This number of pilgrim patients with acute hepatitis A from a single province compels us to conduct more evaluations and follow up monitoring on all persons travelling to Karbala and be sensitive to early diagnoses of the pilgrims. In the future, it is important to be mindful of administering the HAV vaccine and Ig. PMID:27630729

Psychometric properties of the Postgraduate Hospital Educational Environment Measure in an Iranian hospital setting.

PubMed

Shokoohi, Shahrzad; Emami, Amir Hossein; Mohammadi, Aeen; Ahmadi, Soleiman; Mojtahedzadeh, Rita

2014-01-01

Background Students' perceptions of the educational environment are an important construct in assessing and enhancing the quality of medical training programs. Reliable and valid measurement, however, can be problematic - especially as instruments developed and tested in one culture are translated for use in another. Materials and method This study sought to explore the psychometric properties of the Postgraduate Hospital Educational Environment Measure (PHEEM) for use in an Iranian hospital training setting. We translated the instrument into Persian and ensured its content validity by back translation and expert review prior to administering it to 127 residents of Urmia University of Medical Science. Results Overall internal consistency of the translated measure was good (a=0.94). Principal components analysis revealed five factors accounting for 52.8% of the variance. Conclusion The Persian version of the PHEEM appears to be a reliable and potentially valid instrument for use in Iranian medical schools and may find favor in evaluating the educational environments of residency programs nationwide.

Psychometric properties of the postgraduate hospital educational environment measure in an Iranian hospital setting.

PubMed

Shokoohi, Shahrzad; Hossein Emami, Amir; Mohammadi, Aeen; Ahmadi, Soleiman; Mojtahedzadeh, Rita

2014-01-01

Students' perceptions of the educational environment are an important construct in assessing and enhancing the quality of medical training programs. Reliable and valid measurement, however, can be problematic - especially as instruments developed and tested in one culture are translated for use in another. This study sought to explore the psychometric properties of the Postgraduate Hospital Educational Environment Measure (PHEEM) for use in an Iranian hospital training setting. We translated the instrument into Persian and ensured its content validity by back translation and expert review prior to administering it to 127 residents of Urmia University of Medical Science. Overall internal consistency of the translated measure was good (a=0.94). Principal components analysis revealed five factors accounting for 52.8% of the variance. The Persian version of the PHEEM appears to be a reliable and potentially valid instrument for use in Iranian medical schools and may find favor in evaluating the educational environments of residency programs nationwide.

Iranian EFL Teachers' Effectiveness of Instructional Behavior in Public and Private High Schools

ERIC Educational Resources Information Center

Rahimi, Mehrak; Nabilou, Zahra

2011-01-01

Over recent decades, educators have recognized the crucial importance of teaching environment and contextual factors in teaching and learning outcomes. Public and private schools are among those teaching contexts that have been in competition for teaching quality and effectiveness for many years. This study investigated the effectiveness of some…

Teachability of Communication Strategies: An Iranian Experience

ERIC Educational Resources Information Center

Maleki, Ataollah

2007-01-01

The possibility of teaching communication strategies and the feasibility of incorporating them into school syllabi have been a controversial issue. In the current study, 60 Iranian students were divided into two thirty-member classes; then two different textbooks, one with specific CS and the other without them, were chosen to be taught in the…

Submission Letters across English Language Teaching and Mathematics: The Case of Iranian Professionals

ERIC Educational Resources Information Center

Jalilifar, Alireza

2009-01-01

Submitting an article to an English journal for publication requires enclosing an accompanying cover letter. Yet, the phraseology and rhetorical conventions of such letters are not comprehensively documented in literature. This article investigates two English corpora of genuine electronic submission letters to journal editors by Iranian English…

Integrating CALL into an Iranian EAP Course: Constraints and Affordances

ERIC Educational Resources Information Center

Mehran, Parisa; Alizadeh, Mehrasa

2015-01-01

Iranian universities have recently displayed a growing interest in integrating Computer-Assisted Language Learning (CALL) into teaching/learning English. The English for Academic Purposes (EAP) context, however, is not keeping pace with the current changes since EAP courses are strictly text-based and exam-oriented, and little research has thus…

Self-, Peer-, and Teacher-Assessment: An Investigation into Iranian EFL Students' Attitudes

ERIC Educational Resources Information Center

Abolfazli Khonbi, Zainab; Sadeghi, Karim

2013-01-01

Student-directed teaching and assessment techniques are gradually dominating educational systems almost all over the world. This study investigated a cohort of male and female Iranian EFL students' attitudes toward self-, peer-, and teacher-assessment experiences. Sixty three students at Urmia University and Tabriz Islamic Azad University, in the…

An assessment of implementation and evaluation phases of strategic plans in Iranian hospitals.

PubMed

Sadeghifar, Jamil; Tofighi, Shahram; Roshani, Mohamad; Toulideh, Zahra; Mohsenpour, Seyedramezan; Jafari, Mehdi

2017-01-01

To assess the implementation and evaluation phases of strategic plans in selected hospitals. We conducted a cross-sectional study of implementation and evaluation of strategic plan in 24 hospitals in 2015, using a questionnaire which consisted of two separate sections for strategic implementation and strategic evaluation. Data were analyzed with SPSS version 18. Nearly one-third of hospitals claimed that they allocate their budget based on priorities and strategic goals. However, it turned out that although goals had been set, no formal announcements had been made. Most of the hospitals stated that they used measures when evaluating the plan. For hospital staff, clarifying the hospital's priorities was the most important advantage of a strategic plan. There is no clear definition for strategic management in Iranian hospitals, which results in chaotic implementation and control of strategic planning.

Rate and Causes of Discharge against Medical Advice in Iranian Hospitals: A Systematic Review and Meta-Analysis

PubMed Central

MOHSENI, Mohammad; ALIKHANI, Mahtab; TOURANI, Sogand; AZAMI-AGHDASH, Saber; ROYANI, Sanaz; MORADI-JOO, Mohammad

2015-01-01

Background: Discharge against Medical Advice (DAMA) is a problem for hospitals which may result in increasing readmissions, morbidities, inabilities, deaths and health care costs. This study, aimed to investigate the rate and causes of DAMA in Iranian hospitals. Methods: A systematic review and meta-analysis study was conducted in 2014. Required data were collected through searching for key words included: “Discharge Against Medical Advice”, “Leaving against medical advice”, “causes*”, “hospital” and their Persian equivalents, over databases including PubMed, OVID, Google Scholar, Embase, Scopus, Magiran, scientific information database (SID). The reference lists of the articles, certain relevant journals and web sites in this field were also searched. Results: Out of 913 articles initially retrieved, finally 17 articles were incorporated into the study. There were 244858 individuals studied in the articles. Using a random effects model, the rate of DAMA in Iranian hospitals was estimated at 7.9% (6.3%–9.8%). While the highest rate of DAMA was associated with patients in departments of psychiatry (12%), the lowest rate was related to patients in departments of pediatrics (3.7). DAMA was in men more than women (P<0.05) Patient’s perception of feeling of wellbeing, financial problems, family problems, the lack of attention from physicians and nurses, inappropriate behavior with patients by hospital team and the lack of timely care were mentioned as main causes for DAMA. Conclusion: The rate of DAMA in Iranian hospitals is relatively high. Thus effective initiatives in this area are required. PMID:26576368

The Relationship between Teaching Styles and Autonomy among Iranian Female EFL Teachers, Teaching at Advanced Levels

ERIC Educational Resources Information Center

Baradaran, Abdollah

2016-01-01

The current research aimed at inspecting the existence of a significant relationship between teachers' teaching styles and their Autonomy. For this reason, two questionnaires with regard to the main variables were given to 175 female English language teachers, teaching at advanced levels. Moreover, non-parametric Mann Whitney and Kruskal Wallis…

Improving Iranian High School Students' Reading Comprehension Using the Tenets of Genre Analysis

ERIC Educational Resources Information Center

Adelnia, Rezvan; Salehi, Hadi

2016-01-01

This study is an attempt to investigate impact of using a technique, namely, genre-based approach on improving reading ability on Iranian EFL learners' achievement. Therefore, an attempt was made to compare genre-based approach to teaching reading with traditional approaches. For achieving this purpose, by administering the Oxford Quick Placement…

Surviving as an English Teacher in the West: A Case Study of Iranian English Teachers in Australia

ERIC Educational Resources Information Center

Fotovatian, Sepideh

2010-01-01

This paper provides an account of social integration and professional recognition of non-English-speaking-background (NESB) teachers of English in Australia. The case study profiles two Iranian postgraduate students of English teaching in an Australian university and describes their struggle to construct a social and professional identity. The…

The Effect of Implementation of TBLT in Reading Comprehension Classes of Iranian EFL Learners

ERIC Educational Resources Information Center

Madhkhan, Mozhgan; Mousavi, Seyed Mojtaba

2017-01-01

The present study investigates the impact of Task-Based Language Teaching (TBLT) on Iranian EFL learners' reading comprehension performance. Seventy participants were assigned randomly to the experimental and control groups. Having instructed the two groups with the same texts but different task types and activities (i.e., tasks in 4 types) during…

The Relationship between Iranian EFL Teachers' Collective Efficacy Beliefs, Teaching Experience and Perception of Teacher Empowerment

ERIC Educational Resources Information Center

Baleghizadeh, Sasan; Goldouz, Elnaz

2016-01-01

The present study aimed to contribute to the current findings of the relationship between collective efficacy perceptions of EFL teachers and their perception of teacher empowerment. To this end, 147 Iranian EFL teachers from a well-known institute in Tehran participated in the study. The instruments used were two questionnaires: Collective…

Developing an Instrument for Iranian EFL Learners' Listening Comprehension Problems and Listening Strategies

ERIC Educational Resources Information Center

Noroozi, Sara Sara; Sim, Tam Shu; Nimehchisalem, Vahid; Zareian, Gholamreza

2014-01-01

In the body of literature on listening strategies to EFL learners, what seems to be lacking is that the focus is on teaching listening strategies to learners with little attention to their listening comprehension problems. No local research has been conducted on the nature of the Iranian tertiary level students' EFL listening comprehension…

Ideologies "of" English Language Teaching in Iranian Academic Research: Mainstream, Alternative, and Beyond

ERIC Educational Resources Information Center

Mirhosseini, Seyyed-Abdolhamid; Ghafar Samar, Reza

2015-01-01

Mainstream trends of English language teaching (ELT) are predominantly constructed within the epistemological boundaries shaped by the traditional conceptions of linguistics, learning, and teaching as well as positivist research methodology. What tends to be overshadowed by such conceptions is the underlying foundational belief structure of ELT…

Investigating the Relationship between Critical Thinking Skills and the Quality of Iranian Intermediate TEFL Students' Writing

ERIC Educational Resources Information Center

Nikou, Farahnaz Rimani; Bonyadi, Alireza; Amirikar, Negin

2015-01-01

The current study intended to find out the relationship between critical thinking skills and the quality of Iranian TEFL (Teaching English as a Foreign Language) students' writing. One-hundred forty students who were homogeneous in their language proficiency were selected non-randomly. The researcher asked students to take part in a proficiency…

Promoting Civic Engagement in Schools in Non-Democratic Settings: Transforming the Approach and Practices of Iranian Educators

ERIC Educational Resources Information Center

Abolfazli, Maryam; Alemi, Maryam

2013-01-01

Established in 2011, the Online School of Civic Education (the Online School) is intended to give Iranian teachers and educators the opportunity to reflect, experiment, and create classroom experiences aimed at teaching their students how to think, rather than what to think. The Online School was developed to provide teachers and educators inside…

The Application of Podcasting as a Motivational Strategy to Iranian EFL Learners of English: A View toward Listening Comprehension

ERIC Educational Resources Information Center

Shiri, Saeed

2015-01-01

This study was conducted in order to inspect the impact of podcasts as learning and teaching tools on Iranian EFL learners' motivation for listening as well as on their listening comprehension ability. It also investigated the learners' perception towards podcasts. 34 intermediate learners who were homogeneous in terms of listening ability were…

Proletarianization of English Language Teaching: Iranian EFL Teachers and Their Alternative Role as Transformative Intellectuals

ERIC Educational Resources Information Center

Safari, Parvin

2017-01-01

In the field of English Language Teaching (ELT), attention has been shifted toward the alternative role of teachers as transformative intellectuals whereby transformation in teaching occurs from control and technical operations to criticism and intellectual reflection. This role enables teachers to focus on marginalized students' lived experiences…

Teacher's Personality Type and Techniques of Teaching Pronunciation

ERIC Educational Resources Information Center

Shabani, Karim; Ghasemian, Atefeh

2017-01-01

The purpose of this study was twofold: (1) to identify the most frequent techniques of teaching pronunciation used by Iranian EFL teachers and, (b) to find out any relationship between teacher's extroversion/introversion personality type and their techniques of teaching pronunciation. To this end, following an online survey a cohort of 60 teachers…

Quantum leadership: the implication for Iranian nursing leaders.

PubMed

Dargahi, Hossein

2013-07-13

Quantum organizations are referred where stakeholders know how to access the infinite potential of the quantum field. Viewing healthcare organizations from perspective of quantum theory suggest new approaches into management techniques for effective and efficient delivery of healthcare services. This research is aimed to determine the quantum skills, quantum leadership characteristics and functions of Tehran University of Medical Sciences hospitals' nursing administrators. A cross-sectional, descriptive and analytical study was conducted among 25 nursing administrators of Tehran University of Medical Sciences (TUMS) hospitals, Tehran, Iran. The research tool for data collection was a self-constructed questionnaire that measured the quantum skills, quantum leadership characteristics and functions of TUMS hospitals' nursing administrators. The validity of questionnaire was confirmed by 5 management science experts and its reliability was performed by using test-retest method yielded a Cronbach's alpha coefficient of 0.90. Data were collected and analyzed by SPSS software and t-test statistical methods. The results of this research showed that all respondents had desired quantum skills (75.71±5.98), quantum leadership characteristics (82.01±6.77), and quantum leadership functions (78.57±6.28) and total quantum leadership (78.76±4.50). Also, passing management training courses of the respondents was significantly correlated with their quantum leadership. Iranian healthcare organizations require quantum leadership that provides an important resource to advance Iranian nursing leadership to the organizational excellence. We hope Iranian hospitals' nursing leaders who have quantum skills potentially, present a highly developed sense of self and the ability to improve nursing care outcomes in these hospitals.

An assessment of implementation and evaluation phases of strategic plans in Iranian hospitals

PubMed Central

Sadeghifar, Jamil; Tofighi, Shahram; Roshani, Mohamad; Toulideh, Zahra; Mohsenpour, Seyedramezan; Jafari, Mehdi

2017-01-01

Objectives: To assess the implementation and evaluation phases of strategic plans in selected hospitals. Methods: We conducted a cross-sectional study of implementation and evaluation of strategic plan in 24 hospitals in 2015, using a questionnaire which consisted of two separate sections for strategic implementation and strategic evaluation. Data were analyzed with SPSS version 18. Results: Nearly one-third of hospitals claimed that they allocate their budget based on priorities and strategic goals. However, it turned out that although goals had been set, no formal announcements had been made. Most of the hospitals stated that they used measures when evaluating the plan. For hospital staff, clarifying the hospital’s priorities was the most important advantage of a strategic plan. Conclusion: There is no clear definition for strategic management in Iranian hospitals, which results in chaotic implementation and control of strategic planning. PMID:29085637

Effects of Using Instructional Video Games on Teaching English Vocabulary to Iranian Pre-Intermediate EFL Learners

ERIC Educational Resources Information Center

Salehi, Hadi

2017-01-01

This study aims to investigate whether there is any benefit in using IVGs among the Iranian pre-intermediate EFL learners or not. Therefore, 60 EFL learners from Padideh Derakhshan Institute in Sahinshahr, Isfahan, Iran were chosen as the sample. First, a test of novelty was administered at the early stage to ensure the novelty of to-be-instructed…

The Role of WhatsApp in Teaching Vocabulary to Iranian EFL Learners at Junior High School

ERIC Educational Resources Information Center

Jafari, Sanaz; Chalak, Azizeh

2016-01-01

The availability and the use of mobile messaging applications are increasingly widespread among the new generation of students in Iran. The present study aimed to investigate the role of WhatsApp in the vocabulary learning improvement of Iranian junior high school EFL students. Using a mixed method design, a group of 60 students including 30 male…

The Effect of Explicit Affective Strategy Training on Iranian EFL Learners' Oral Language Proficiency and Anxiety Reduction

ERIC Educational Resources Information Center

Mostafavi, Fatemeh; Vahdany, Fereidoon

2016-01-01

The current study aimed at investigating the possible effects of explicit teaching of affective strategies on Iranian EFL learners' oral language proficiency and the extent of their anxiety in EFL classroom. First, PET test was administered to a total number of 120 female third grade high school EFL students. Then, 60 participants whose score fell…

A Comparative Analysis of Educational Teaching in Shahnameh and Iliad

ERIC Educational Resources Information Center

Shahverdi, Elham; Sepahvandi, Masood

2018-01-01

Ferdowsi's Shahnameh and Homer's Iliad are among the first literary masterpieces of Iran and Greece. These teachings include the educational teachings of Zal and Roudabeh, and Paris and Helen. This paper presents a comparative look at the immortal effect of this Iranian poet with Homer's poem--the Greek blind poet. In this comparison, using a…

The Status of Hospital Information Systems in Iranian Hospitals

PubMed Central

Jahanbakhsh, Maryam; Sharifi, Mohammed; Ayat, Masar

2014-01-01

Background: The area of e-Health is broad and has an excellent growth potential. An increasing number of experts believe that e-Health will fuel the next breakthroughs in health system improvements throughout the world, but there is frequent evidence of unsustainable use of e-Health systems in medical centres, particularly hospitals, for different reasons in different countries. Iran is also a developing country which is presently adopting this promising technology for its traditional healthcare delivery but there is not much information about the use of e-Health systems in its hospitals, and the weakness and opportunities of utilization of such Hospital Information Systems (HIS). Methods: For this research, a number of Hospitals from Isfahan, Iran, are selected using convenient sampling. E-health research professionals went there to observe their HIS and collect required data as a qualitative survey. The design of interview questions was based on the researchers’ experiences and knowledge in this area along with elementary interviews with experts on HIS utilization in hospitals. Results: Efficient administration of e-health implementation improves the quality of healthcare, reduces costs and medical errors, makes healthcare resources available to rural areas, etc. However, there are numerous issues affecting the successful utilization of e-health in Hospitals, such as a lack of a perfect HIS implementation plan and well-defined strategy, inadequate IT-security for the protection of e-health-related data, improper training and educational issues, legal challenges, privacy concerns, improper documentation of lessons learned, resistance to the application of new technologies, and finally a lack of recovery plan and disaster management. These results along with some informative stories are extracted from interview sessions to uncover associated challenges of HIS utilization in Iranian hospitals. Conclusion: The utilization of e-health in Iranian hospitals, particularly those in Isfahan, is subject to several challenges and there is no proper long-term strategy plans for HIS initiation, development, and improvement in Iranian hospitals. In order to address these problems, six recommendations are provided. Hence, human resource and e-health professionals from third party consultancy companies along with medical university scholars have to assist such hospitals to undertake the proposed solutions in order to provide proper plans to overcome future challenges and have a mature HIS in accordance with expected HIS utilization from hospitals and medical universities. PMID:25395731

Comparison of Direct and Indirect Methods of Teaching Breast Self-Examination – Influence on Knowledge and Attitudes of Iranian Nursing and Midwifery Personnel

PubMed

Shahbazi, Sara; Heidari, Mohammad; Ghafourifard, Mansour

2017-04-01

Background: Breast cancer is the most common cancer in women. Monthly breast self-examination (BSE) has been presented as one of the best screening methods available. The aim of this study was to compare effects of both direct and indirect methods of teaching of BSE on knowledge and attitudes of nursing and midwifery personnel. Materials and Methods: The present study was performed on 89 nursing and midwifery personnel in Valiasr hospital of Borujen city. Participants were randomly divided into a direct and an indirect training group. Researcher-designed BSE knowledge and attitude and demographic information questionnaires were used for data collection. Results: Before the education intervention, the mean levels of knowledge and attitude were 9.82±2.79 and 56.5±6.21 in the direct training group and 9.59±2.71 and 54.5±4.51 in the indirect training group; after the intervention, they reached 19.2±0.96 and 62.9±4.21, and 11.0±2.58 and 59.0±3.44, respectively. The difference in the mean levels of knowledge and attitude were significantly higher in the direct training group post intervention (P<0.05). Conclusion: It appears that educational planners and hospital personnel education officials should seek to teach aspects of crucial health behavior to female personnel using cooperative and direct training methods. Creative Commons Attribution License

EFL Teachers' Creativity and Their Teaching's Effectiveness: A Structural Equation Modelling Approach

ERIC Educational Resources Information Center

Khodabakhshzadeh, Hossein; Hosseinnia, Mansooreh; Moghadam, Hossein Abedi; Ahmadi, Fatemeh

2018-01-01

Due to the importance of creativity in teaching and learning, this study was conducted to study teachers' creativity and its relationship with their teaching's effectiveness. Another aim of this study was to measure the creativity among men and women teachers at English institutions in Iran. A sample of 325 EFL Iranians' teachers was randomly…

Nurses' autonomy level in teaching hospitals and its relationship with the underlying factors.

PubMed

Amini, Kourosh; Negarandeh, Reza; Ramezani-Badr, Farhad; Moosaeifard, Mahdi; Fallah, Ramezan

2015-02-01

This study aimed to determine the autonomy level of nurses in hospitals affiliated to Zanjan University of Medical Sciences, Iran. In this descriptive cross-sectional study, 252 subjects were recruited using systematic random sampling method. The data were collected using questionnaire including Dempster Practice Behavior Scale. For data analysis, descriptive statistics and to compare the overall score and its subscales according to the demographic variables, t-test and analysis of variance test were used. The nurses in this study had medium professional autonomy. Statistical tests showed significant differences in the research sample according to age, gender, work experience, working position and place of work. The results of this study revealed that most of the nurses who participated in the study compared with western societies have lower professional autonomy. More studies are needed to determine the factors related to this difference and how we can promote Iranian nurses' autonomy. © 2013 Wiley Publishing Asia Pty Ltd.

Examining Factor Structure and Validating the Persian Version of the Pregnancy's Worries and Stress Questionnaire for Pregnant Iranian Women.

PubMed

Navidpour, Fariba; Dolatian, Mahrokh; Yaghmaei, Farideh; Majd, Hamid Alavi; Hashemi, Seyed Saeed

2015-04-23

Pregnant women tend to experience anxiety and stress when faced with the changes to their biology, environment and personal relationships. The identification of these factors and the prevention of their side effects are vital for both mother and fetus. The present study was conducted to validate and to examine the factor structure of the Persian version of the Pregnancy's Worries and Stress Questionnaire. The 25-item PWSQ was first translated by specialists into Persian. The questionnaire's validity was determined using face, content, criterion and construct validity and reliability of questionnaire was examined using Cronbach's alpha. Confirmatory factor analysis was performed in AMOS and SPSS 21. Participants included healthy Iranian pregnant women (8-39 weeks) who refer to selected hospitals for prenatal care. Hospitals included private, social security and university hospitals and selected through the random cluster sampling method. The results of validity and reliability assessments of the questionnaire were acceptable. Cronbach's alpha calculated showed a high internal consistency of 0.89. The confirmatory factor analysis using the c2, CMIN/DF, IFI, CFI, NFI and NNFI indexes showed the 6-factor model to be the best fitted model for explaining the data. The questionnaire was translated into Persian to examine stress and worry specific to Iranian pregnant women. The psychometric results showed that the questionnaire is suitable for identifying Iranian pregnant women with pregnancy-related stress.

The Effect of Data-Driven Approach to Teaching Vocabulary on Iranian Students' Learning of English Vocabulary

ERIC Educational Resources Information Center

Barabadi, Elyas; Khajavi, Yaser

2017-01-01

Corpus-based data-driven learning (DDL) is an innovation in teaching and learning new vocabulary for EFL students. Using teacher-prepared materials obtained from COCA corpus, the goal of the present study is to compare DDL and traditional methods of teaching vocabulary like consultation of dictionary or a grammar book. As such, two intact classes…

The Evaluation of a Teaching Intervention in Iranian EFL Writing

ERIC Educational Resources Information Center

Naghdipour, Bakhtiar; Koç, Sabri

2015-01-01

The curriculum for teaching undergraduate university students in Iran majoring in English generally includes paragraph writing in the second year and essay writing (4-5 paragraphs) in the third year. The first-year course 'Grammar and Writing (I & II)' offered in two consecutive semesters covers grammar only, despite the inclusion of writing…

Authenticity in Teaching: A Constant Process of Becoming

ERIC Educational Resources Information Center

Ramezanzadeh, Akram; Zareian, Gholamreza; Adel, Seyyed Mohammad Reza; Ramezanzadeh, Ramin

2017-01-01

This study probed the conceptualization of (in)authenticity in teaching and the way it could be enacted in pedagogical practices. The participants were a purposive sample of 20 Iranian university teachers. Data were collected using in-depth interviews, field notes, and observation. The collected data were analyzed through the lens of hermeneutic…

Beliefs on Learning and Teaching Language Components: The Case of Iranian EAP and EFL Learners

ERIC Educational Resources Information Center

Parsi, Gholamreza

2017-01-01

The present study intended to investigate the possible difference between EAP and EFL learners' beliefs concerning learning and teaching of language components, namely, vocabulary, pronunciation and grammar. Furthermore, this study examined the association between EAP and EFL learners' beliefs and their language components' development. To this…

Homeland In/Security: A Discussion and Workshop on Teaching Marjane Satrapi's "Persepolis"

ERIC Educational Resources Information Center

Botshon, Lisa; Plastas, Melinda

2009-01-01

One of the great challenges of teaching in the post-9/11 United States is contending with persistent stereotypes and misinformation about Islam, "Arabs," "Arab Americans," and the "Middle East" within student bodies. Since 2003 the authors have been employing Iranian author Marjane Satrapi's work in the classroom as a…

Frontier-based techniques in measuring hospital efficiency in Iran: a systematic review and meta-regression analysis

PubMed Central

2013-01-01

Background In recent years, there has been growing interest in measuring the efficiency of hospitals in Iran and several studies have been conducted on the topic. The main objective of this paper was to review studies in the field of hospital efficiency and examine the estimated technical efficiency (TE) of Iranian hospitals. Methods Persian and English databases were searched for studies related to measuring hospital efficiency in Iran. Ordinary least squares (OLS) regression models were applied for statistical analysis. The PRISMA guidelines were followed in the search process. Results A total of 43 efficiency scores from 29 studies were retrieved and used to approach the research question. Data envelopment analysis was the principal frontier efficiency method in the estimation of efficiency scores. The pooled estimate of mean TE was 0.846 (±0.134). There was a considerable variation in the efficiency scores between the different studies performed in Iran. There were no differences in efficiency scores between data envelopment analysis (DEA) and stochastic frontier analysis (SFA) techniques. The reviewed studies are generally similar and suffer from similar methodological deficiencies, such as no adjustment for case mix and quality of care differences. The results of OLS regression revealed that studies that included more variables and more heterogeneous hospitals generally reported higher TE. Larger sample size was associated with reporting lower TE. Conclusions The features of frontier-based techniques had a profound impact on the efficiency scores among Iranian hospital studies. These studies suffer from major methodological deficiencies and were of sub-optimal quality, limiting their validity and reliability. It is suggested that improving data collection and processing in Iranian hospital databases may have a substantial impact on promoting the quality of research in this field. PMID:23945011

The Attitude of Iranian Nurses About Do Not Resuscitate Orders

PubMed Central

Mogadasian, Sima; Abdollahzadeh, Farahnaz; Rahmani, Azad; Ferguson, Caleb; Pakanzad, Fermisk; Pakpour, Vahid; Heidarzadeh, Hamid

2014-01-01

Background: Do not resuscitate (DNR) orders are one of many challenging issues in end of life care. Previous research has not investigated Muslim nurses’ attitudes towards DNR orders. Aims: This study aims to investigate the attitude of Iranian nurses towards DNR orders and determine the role of religious sects in forming attitudes. Materials and Methods: In this descriptive-comparative study, 306 nurses from five hospitals affiliated to Tabriz University of Medical Sciences (TUOMS) in East Azerbaijan Province and three hospitals in Kurdistan province participated. Data were gathered by a survey design on attitudes on DNR orders. Data were analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL) software examining descriptive and inferential statistics. Results: Participants showed their willingness to learn more about DNR orders and highlights the importance of respecting patients and their families in DNR orders. In contrast, in many key items participants reported their negative attitude towards DNR orders. There were statistical differences in two items between the attitude of Shiite and Sunni nurses. Conclusions: Iranian nurses, regardless of their religious sects, reported negative attitude towards many aspects of DNR orders. It may be possible to change the attitude of Iranian nurses towards DNR through education. PMID:24600178

The attitude of Iranian nurses about do not resuscitate orders.

PubMed

Mogadasian, Sima; Abdollahzadeh, Farahnaz; Rahmani, Azad; Ferguson, Caleb; Pakanzad, Fermisk; Pakpour, Vahid; Heidarzadeh, Hamid

2014-01-01

Do not resuscitate (DNR) orders are one of many challenging issues in end of life care. Previous research has not investigated Muslim nurses' attitudes towards DNR orders. This study aims to investigate the attitude of Iranian nurses towards DNR orders and determine the role of religious sects in forming attitudes. In this descriptive-comparative study, 306 nurses from five hospitals affiliated to Tabriz University of Medical Sciences (TUOMS) in East Azerbaijan Province and three hospitals in Kurdistan province participated. Data were gathered by a survey design on attitudes on DNR orders. Data were analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL) software examining descriptive and inferential statistics. Participants showed their willingness to learn more about DNR orders and highlights the importance of respecting patients and their families in DNR orders. In contrast, in many key items participants reported their negative attitude towards DNR orders. There were statistical differences in two items between the attitude of Shiite and Sunni nurses. Iranian nurses, regardless of their religious sects, reported negative attitude towards many aspects of DNR orders. It may be possible to change the attitude of Iranian nurses towards DNR through education.

A Comparative Washback Study of IELTS and TOEFL iBT on Teaching and Learning Activities in Preparation Courses in the Iranian Context

ERIC Educational Resources Information Center

Erfani, Shiva Seyed

2012-01-01

One consequence of test use in the English-language teaching community is the negative washback of tests on teaching and learning. Test preparation courses are often seen as part of the more general issue of washback. IELTS and TOEFL iBT tests, focusing on communicative competence, are anticipated to have positive washback effect on how English is…

Being at peace as an important factor in acquiring teaching competency by Iranian nurse teachers: a qualitative study.

PubMed

Emamzadeh Ghasemi, Hormat Sadat; Rafii, Forough; Farahani, Mansoureh A; Mohammadi, Nooreddin

2014-02-24

It is imperative to understand the factor that influence teaching competency. Therefore, it is necessary to study those that have an impact on the process of acquiring teaching competency. Competent nurse teachers have an important role in the achievement of nursing students and improving the quality of nursing education. However, few researches have focused specifically on the process of acquiring teaching competency in nurse teachers and its related factors. This study as a part of more extensive research aims to explore the factors influencing acquisition of teaching competency by Iranian nurse teachers. Grounded theory was chosen as the method. Eleven teachers from three nursing schools in Tehran were recruited. Data was generated by semi structured interviews during May 2011 to March 2013 and was analyzed through using constant comparison. Three main categories were emerged including "individual characteristics" (spirituality, professional interest, ethical conducts, knowledge expansion and reflective practice), "organizational factors" (management of educational systems, solidarity culture, student characteristics) and "socio-cultural factors" (social situations, and public definition of nursing). Nurse teachers who deal peacefully with the nursing profession and colleagues are responsible and committed to acquiring teaching competency. A suitable organization in nursing educational systems that is structured and ordered also encourages a peaceful approach by nurse teachers.

Being at Peace as an Important Factor in Acquiring Teaching Competency by Iranian Nurse Teachers: A Qualitative Study

PubMed Central

ghasemi, Hormat Sadat Emamzadeh; Rafii, Forough; Farahani, Mansoureh A.; Mohammadi, Nooreddin

2014-01-01

It is imperative to understand the factor that influence teaching competency. Therefore, it is necessary to study those that have an impact on the process of acquiring teaching competency. Competent nurse teachers have an important role in the achievement of nursing students and improving the quality of nursing education. However, few researches have focused specifically on the process of acquiring teaching competency in nurse teachers and its related factors. This study as a part of more extensive research aims to explore the factors influencing acquisition of teaching competency by Iranian nurse teachers. Grounded theory was chosen as the method. Eleven teachers from three nursing schools in Tehran were recruited. Data was generated by semi structured interviews during May 2011 to March 2013 and was analyzed through using constant comparison. Three main categories were emerged including “individual characteristics” (spirituality, professional interest, ethical conducts, knowledge expansion and reflective practice), “organizational factors” (management of educational systems, solidarity culture, student characteristics) and “socio-cultural factors” (social situations, and public definition of nursing). Nurse teachers who deal peacefully with the nursing profession and colleagues are responsible and committed to acquiring teaching competency. A suitable organization in nursing educational systems that is structured and ordered also encourages a peaceful approach by nurse teachers. PMID:24762353

Preferences of Iranian patients about style of labelling and calling of their physicians.

PubMed

Najafi, Mostafa; Khoshdel, Abolfazl; Kheiri, Soleiman

2012-07-01

To document the performance of patients regarding label styles of their doctors and modes of addressing them. In this descriptive survey, 400 patients, at two teaching hospitals--Hajar and Kashani--with a mean age of 40.5 +/- 19.5 years were enrolled. Their demographic data, disorder type and duration were recorded. Photos demonstrating different label and attire styles based on Iranian culture were shown to the patients and they were asked to mark their performances about the necessity of wearing name badge. They were also requested to nominate the way they preferred to be addressed by the doctors. Of the participants, 180 (45%) were men; 307 (76.8%) were married; and the mean duration of hospitalisation was 2.5 +/- 2.1 days. Most of the patients, (n = 320; 80%) stated that the doctor should always wear a name badge; 301 (75.3%) preferred to call their physicians by title; and 227 (56.8%) preferred to be called by their surnames. Patients preferred to have female physicians wearing white coat, shirt and trousers as the preferred dress code. Patients in the study preferred to have the physicians professionally attired, with the only difference being the dark veil for female physicians. Name badge and white coat were also preferred by the patients.

Examining Factor Structure and Validating the Persian Version of the Pregnancy’s Worries and Stress Questionnaire for Pregnant Iranian Women

PubMed Central

Navidpour, Fariba; Dolatian, Mahrokh; Yaghmaei, Farideh; Majd, Hamid Alavi; Hashemi, Seyed Saeed

2015-01-01

Background and Objectives: Pregnant women tend to experience anxiety and stress when faced with the changes to their biology, environment and personal relationships. The identification of these factors and the prevention of their side effects are vital for both mother and fetus. The present study was conducted to validate and to examine the factor structure of the Persian version of the Pregnancy’s Worries and Stress Questionnaire. Materials and Methods: The 25-item PWSQ was first translated by specialists into Persian. The questionnaire’s validity was determined using face, content, criterion and construct validity and reliability of questionnaire was examined using Cronbach’s alpha. Confirmatory factor analysis was performed in AMOS and SPSS 21. Participants included healthy Iranian pregnant women (8-39 weeks) who refer to selected hospitals for prenatal care. Hospitals included private, social security and university hospitals and selected through the random cluster sampling method. Findings: The results of validity and reliability assessments of the questionnaire were acceptable. Cronbach’s alpha calculated showed a high internal consistency of 0.89. The confirmatory factor analysis using the χ2, CMIN/DF, IFI, CFI, NFI and NNFI indexes showed the 6-factor model to be the best fitted model for explaining the data. Conclusion: The questionnaire was translated into Persian to examine stress and worry specific to Iranian pregnant women. The psychometric results showed that the questionnaire is suitable for identifying Iranian pregnant women with pregnancy-related stress. PMID:26153186

The Usefulness of Pictorial Aids in Developing Female Iranian Intermediate EFL Learners' Speaking Proficiency

ERIC Educational Resources Information Center

Afraz, Shahram; Taghizade, Leila; Taghinezhad, Ali

2018-01-01

Speaking is a crucial form of communication in language learning settings. Through speaking skill, ESL/EFL language learners can communicate and convey information. Pictorial aids have been deployed as efficacious mediatory tools in teaching various disciplines such as language teaching. Still, to the best of the researchers' knowledge, a direct…

Evaluation of English Results Course Books at Upper-Intermediate Level

ERIC Educational Resources Information Center

Haghi, Eshrat Bazarmaj

2013-01-01

The importance of the course books in language teaching leads the way to the evaluation of them. Evaluating the teaching materials specially course books can help teachers to understand more about language learning. The purpose of the present study is to evaluate English Results course books which are widely used at Iranian institutes. The focus…

The Effectiveness of Social Media Network Telegram in Teaching English Language Pronunciation to Iranian EFL Learners

ERIC Educational Resources Information Center

Xodabande, Ismail

2017-01-01

In recent years, the expansion of digital technologies, multimedia, and social networks, dramatically transformed our lives. Education in general and the area of foreign language teaching and learning have also benefited hugely from those developments and advances. As a result, the face of language learning is changing and new technologies provide…

The Effect of Transcribing on Elementary Iranian EFL Learners' Listening Comprehension

ERIC Educational Resources Information Center

Afsharrad, Mohammad; Nafchi, Asghar Moulavi

2015-01-01

This study is motivated by the gap existing between theory and practice in teaching listening. Most of the techniques used to teach listening put more emphasis on top-down processing while listeners' problems are more of perceptive ones (bottom-up). In order to address the pervasive decoding problem in listening, this study suggests using…

The Impact of Teaching Communication Strategies on EFL Learners' Willingness to Communicate

ERIC Educational Resources Information Center

Mesgarshahr, Abulfazl; Abdollahzadeh, Esmaeel

2014-01-01

One of the pedagogical implications of the research on the Willingness to Communicate (WTC) might be to propose practical ways of making language learners more willing to communicate in the classroom. This study investigated the impact of teaching communication strategies (CSs) on Iranian EFL learners' WTC. To this end, 8 intact classes were…

Secondary EFL School Teachers' Perceptions of CLT Principles and Practices: An Exploratory Survey

ERIC Educational Resources Information Center

Anani Sarab, Mohammad Reza; Monfared, Abbas; Safarzadeh, Mohammad Meisam

2016-01-01

Communicative Language Teaching (CLT) is advocated by many applied linguists as a common vehicle to curriculum innovation in many ELT contexts. It represents a change of focus in language teaching from linguistic structures to learners' need for developing communication skills. In recent years, the Iranian Ministry of Education has introduced the…

A Move Towards Postmethod Pedagogy in the Iranian EFL Context: Panacea or More Pain?

ERIC Educational Resources Information Center

Safari, Parvin; Rashidi, Nasser

2015-01-01

Kumaravadivelu's (2003) introduction and development of "postmethod" led to the demise of methods and a dramatic change in the language teaching profession. In fact, it can be claimed that the arrival of postmethod pedagogy in language teaching might be the reason for the abandonment and replacement of method by context sensitive,…

MA TESOL Dissertations in a Changing Global Landscape: A Case from Iran

ERIC Educational Resources Information Center

Tavakoli, Parvaneh; Hasrati, Mostafa

2018-01-01

This paper has investigated the way the dissertation writing component of MA TESOL (Teaching English to Speakers of Other Languages) programmes in Iran has changed over the past decade in relation to globalization. The data, collected from 40 questionnaires completed by Iranian academic staff teaching these programmes, suggest that while change in…

An Investigation of Tensions between EFL Teachers' Beliefs and Practices about Teaching Culture

ERIC Educational Resources Information Center

Baleghizadeh, Sasan; Moghadam, Maryam Saneie

2013-01-01

This study explores tensions between three Iranian EFL teachers' beliefs and practices with respect to teaching culture. The teachers were observed and interviewed over a period of eight weeks. The observations provided insight into how they taught culture in practice, while the interviews tried to elicit their beliefs. Drawing on the distinction…

Safety and efficacy of terbinafine in a pediatric Iranian cohort of patients with Tinea capitis

PubMed Central

Sabzghabaee, Ali M.; Mansouri, Parwin; Mohammadi, Mahboobeh

2009-01-01

Background and objectives Tinea capitis is a common infection of the scalp and hair shaft caused by dermatophyte fungi that mainly affects prepubescent children. Systemic therapy is required for treatment and to prevent spread. The aim of present study was to assess the effect of terbinafine for Tinea capitis treatment in children. Methods Thirty Iranian pediatric patients with a clinical diagnosis of Tinea capitis were enrolled in the study. The Study was conducted in a general and referral teaching hospital (Imam Medical Centre – Tehran, Iran) from 2006 to 2007. Eligible patients with less than 20 kg of body weight were given 62.5 mg terbinafine, and for patients between 20 and 40 kg the dose was 125 mg, on the first visit. All patients had the second clinical visit and second samples for microscopic study were taken. For each patient, direct mycology test (KOH test) and mycological culture were carried out before the study was started and after second, fourth, fifth, sixth and eighth weeks. Probable drug’s adverse effects were also recorded. Results Based on the results of mycological culture of patients’ lesions, Microsporum canis and Trichophyton sheonlini were considered as major causes of Tinea capitis in these children. Out of 30 study patients, KOH test of 93% in the 5th week and 100% in the 6th week was negative. All patients healed completely from signs of infection, after six weeks. Also, no severe side effects were seen in any patients. Conclusion According to the results of this study, the use of terbinafine is an effective therapy in Iranian cases of Tinea capitis in children without severe side effects. PMID:23964167

The status of Iranian hospital pharmacies according to age-friendly pharmacies criteria

PubMed Central

Bastani, Peivand; Marzaleh, Milad Ahmadi; Dehghani, Mina; Falahatzadeh, Maryam; Rahmati, Elahe; Tahernezhad, Ali

2017-01-01

Due to the increasing elderly population and the subsequent increase in their need for medication and more referrals to the pharmacy, this study was conducted to investigate the Iranian hospital pharmacies in terms of age-friendliness criteria. This was a cross-sectional study conducted in 2017. The study population included 3 metropolitan hospital pharmacies selected through clustered sampling, and all their 67 pharmacies were included by census. Data collection tool was a reliable researcher-made checklist (t = 0.85, α = 0.9) Data analysis was performed using Kruskal–Wallis test and Mann–Whitney test through SPSS version 24. The results in these three cities showed that only two pharmacies were in a high level of age-friendly. The relationship between type of pharmacy and the final score of age-friendly situation in these cities showed no significant relationship. There was no significant relationship among the average of the final score of the age-friendly situation in three studied cities. Due to the increasing elderly population and the aging society, readiness of Iranian hospital pharmacies to provide services to the elderly will be one of the most challenging issues in the long term. With proper legislation and policies on health-care systems, especially pharmacies, physical and psychological problems in elderly can be reduced in the future. Furthermore, with advancing toward age-friendly pharmacies, the community can be empower and become ready encountering elderly problems. PMID:29184842

Supporting adolescents with type 1 diabetes mellitus: a qualitative study.

PubMed

Rostami, Shahnaz; Parsa-Yekta, Zohreh; Najafi Ghezeljeh, Tahereh; Vanaki, Zohreh

2014-03-01

Without sufficient support, type 1 diabetes mellitus often disturbs patients' normal lives. This study describes and explores the support that Iranian adolescents with type 1 diabetes mellitus experienced. Semistructured interviews were conducted with ten adolescents, seven family members, one dietitian, one nurse, and one school nurse. Participants were chosen using purposive sampling from two teaching hospitals and one high school in two urban areas of Iran. Using standard procedures for content analysis, three main themes were identified: maintaining a normal life; receiving tangible, informational, and emotional support from the family and society; and advancement of life toward normalization. The cornerstone of maintaining a normal life for adolescents with type 1 diabetes mellitus is to adopt an active role in taking care of themselves within their systems of support. © 2013 Wiley Publishing Asia Pty Ltd.

Cancer Patients' Informational Needs: Qualitative Content Analysis.

PubMed

Heidari, Haydeh; Mardani-Hamooleh, Marjan

2016-12-01

Understanding the informational needs of cancer patients is a requirement to plan any educative care program for them. The aim of this study was to identify Iranian cancer patients' perceptions of informational needs. The study took a qualitative approach. Semi-structured interviews were held with 25 cancer patients in two teaching hospitals in Iran. Transcripts of the interviews underwent conventional content analysis, and categories were extracted. The results came under two main categories: disease-related informational needs and information needs related to daily life. Disease-related informational needs had two subcategories: obtaining information about the nature of disease and obtaining information about disease prognosis. Information needs related to daily life also had two subcategories: obtaining information about healthy lifestyle and obtaining information about regular activities of daily life. The findings provide deep understanding of cancer patients' informational needs in Iran.

Comparison of Efficacy of Eye Movement, Desensitization and Reprocessing and Cognitive Behavioral Therapy Therapeutic Methods for Reducing Anxiety and Depression of Iranian Combatant Afflicted by Post Traumatic Stress Disorder

NASA Astrophysics Data System (ADS)

Narimani, M.; Sadeghieh Ahari, S.; Rajabi, S.

This research aims to determine efficacy of two therapeutic methods and compare them; Eye Movement, Desensitization and Reprocessing (EMDR) and Cognitive Behavioral Therapy (CBT) for reduction of anxiety and depression of Iranian combatant afflicted with Post traumatic Stress Disorder (PTSD) after imposed war. Statistical population of current study includes combatants afflicted with PTSD that were hospitalized in Isar Hospital of Ardabil province or were inhabited in Ardabil. These persons were selected through simple random sampling and were randomly located in three groups. The method was extended test method and study design was multi-group test-retest. Used tools include hospital anxiety and depression scale. This survey showed that exercise of EMDR and CBT has caused significant reduction of anxiety and depression.

Teaching New Vocabulary to Iranian Young FL Learners: Using Two Methods Total Physical Response and Keyword Method

ERIC Educational Resources Information Center

Toghyani Khorasgani, Amir; Khanehgir, Mansour

2017-01-01

Early language learning for children is increasingly common, and the majority of parents and the public do not see it as superfluous or overburdening children. Moreover, teaching a foreign language to very young children has been an increasingly dominant trend in most globalized societies. While there is abundant literature that supports teaching…

Effects of Explicit Instruction in Cognitive and Metacognitive Reading Strategies on Iranian EFL Students' Reading Performance and Strategy Transfer

ERIC Educational Resources Information Center

Aghaie, Reza; Zhang, Lawrence Jun

2012-01-01

This study explored the impact of explicit teaching of reading strategies on English-as-a-foreign-language (EFL) students' reading performance in Iran. The study employed a questionnaire adapted from Chamot and O'Malley's (1994) cognitive and metacognitive strategies framework. To test the effects of explicit teaching of cognitive and…

Critical Thinking and Social Interaction in Active Learning: A Conceptual Analysis of Class Discussion from Iranian Students' Perspective

ERIC Educational Resources Information Center

Hajhosseini, Mansoureh; Zandi, Saeid; Hosseini Shabanan, Sediqeh; Madani, Yaser

2016-01-01

Following the failures in traditional methods of teaching, theorists have recently emphasized students' active role in education in which the teacher is no longer a mere transmitter of knowledge. Discussion-based teaching has been regarded as a route to improving students' active role. The current study intended to discover the benefits of using…

Teachers' Sense of Self-Efficacy, English Proficiency, and Instructional Strategies: A Study of Nonnative EFL Teachers in Iran

ERIC Educational Resources Information Center

Eslami, Zohreh R.; Fatahi, Azizullah

2008-01-01

This study examined the efficacy beliefs of nonnative English speaking (NNES) Iranian EFL teachers. EFL teachers' perceptions of their teaching efficacy in terms of personal capabilities to teach English as a Foreign Language (EFL) and their perceived English language proficiency level were examined. A modified version of the Teacher Sense of…

A Comparative Study of Iranian EFL Teachers' versus Learners' Perceptions of High School English Textbooks

ERIC Educational Resources Information Center

Aghazadeh, Zahra; Ajideh, Parviz

2014-01-01

Textbooks play a very crucial role in the process of language teaching and learning. They affect the whole language learning/teaching process. The purpose of this study was to carry out an evaluation of English textbooks currently in use at high schools in Iran from teachers' and learners' points of view in a comparative way. To this end, the…

The Pedagogy of Visibility: Constructs and Contests of Iranianness in a Community-Organized School in a Large Southern U.S. City

ERIC Educational Resources Information Center

Shirazi, Roozbeh

2014-01-01

This article highlights how a community-organized language school that teaches Persian serves as a site of diasporic cultural production. Specifically, I examine how the school serves as a site to teach the Persian language, delimit cultural meanings, and facilitate a sense of belonging and community membership among a diverse group of parents and…

A case-control study on red meat consumption and risk of stroke among a group of Iranian adults.

PubMed

Saneei, Parvane; Saadatnia, Mohammad; Shakeri, Forough; Beykverdi, Masumeh; Keshteli, Ammar Hassanzadeh; Esmaillzadeh, Ahmad

2015-04-01

We aimed to examine the association between red meat consumption and stroke in a group of Iranian adults. A hospital-based case-control study. The study included stroke patients and hospital-based controls. Usual dietary intakes of participants were assessed by means of a validated 168-item semi-quantitative FFQ. Total red meat consumption was calculated by summing up the consumption of red, processed and visceral meats. One hundred and ninety-five cases were stroke patients hospitalized in the neurology ward and 195 controls were recruited from patients hospitalized in other wards with no history of cerebrovascular diseases or neurological disorders. Participants with stroke were older, more likely to be male and less likely to be obese. Individuals in the highest tertile of red meat intake were 119 % more likely to have stroke (OR=2·19; 95% CI 1·33, 3·60) compared with those in the lowest tertile. After controlling for age, sex and total energy intake, the association between red meat consumption and stroke was strengthened (OR=2·72; 95% CI 1·53, 4·83). This association remained significant even after further controlling for physical activity and smoking as well as dietary intakes. Additional adjustments for BMI, diabetes, hypertension and hyperlipidaemia did not influence the association significantly (OR=2·51; 95 % CI 1·19, 5·09). Consumption of red meat was associated with greater odds of having stroke in a group of Iranian adults.

Validation of Medical Tourism Service Quality Questionnaire (MTSQQ) for Iranian Hospitals.

PubMed

Qolipour, Mohammad; Torabipour, Amin; Khiavi, Farzad Faraji; Malehi, Amal Saki

2017-03-01

Assessing service quality is one of the basic requirements to develop the medical tourism industry. There is no valid and reliable tool to measure service quality of medical tourism. This study aimed to determine the reliability and validity of a Persian version of medical tourism service quality questionnaire for Iranian hospitals. To validate the medical tourism service quality questionnaire (MTSQQ), a cross-sectional study was conducted on 250 Iraqi patients referred to hospitals in Ahvaz (Iran) from 2015. To design a questionnaire and determine its content validity, the Delphi Technique (3 rounds) with the participation of 20 medical tourism experts was used. Construct validity of the questionnaire was assessed through exploratory and confirmatory factor analysis. Reliability was assessed using Cronbach's alpha coefficient. Data were analyzed by Excel 2007, SPSS version18, and Lisrel l8.0 software. The content validity of the questionnaire with CVI=0.775 was confirmed. According to exploratory factor analysis, the MTSQQ included 31 items and 8 dimensions (tangibility, reliability, responsiveness, assurance, empathy, exchange and travel facilities, technical and infrastructure facilities and safety and security). Construct validity of the questionnaire was confirmed, based on the goodness of fit quantities of model (RMSEA=0.032, CFI= 0.98, GFI=0.88). Cronbach's alpha coefficient was 0.837 and 0.919 for expectation and perception questionnaire. The results of the study showed that the medical tourism SERVQUAL questionnaire with 31 items and 8 dimensions was a valid and reliable tool to measure service quality of medical tourism in Iranian hospitals.

Emergence of community-acquired methicillin-resistant Staphylococcus aureus in an Iranian referral paediatric hospital.

PubMed

Mamishi, S; Mahmoudi, S; Bahador, A; Matini, H; Movahedi, Z; Sadeghi, R H; Pourakbari, B

2015-01-01

The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals has been changed in recent years due to the arrival of community-associated MRSA (CA-MRSA) strains into healthcare settings. The aim of this study is to investigate the distribution of staphylococcal cassette chromosome mec (SCCmec) type V as well as SCCmec IV subtypes, which have been associated with community-acquired infection among healthcare-associated MRSA (HA-MRSA) isolates. Antimicrobial susceptibility, SCCmec type, spa type and the presence of Panton-Valentine leukocidin (PVL) genes were determined for all HA-MRSA isolates in an Iranian referral hospital. In this study of 48 HA-MRSA isolates, 13 (27%), three (6.2%), five (10.4%) and one (2%) belonged to SCCmec subtypes IVa, IVb, IVc and IVd, respectively. Only two isolates (4.2%) belonged to SCCmec types V Notably, one isolate was found to harbour concurrent SCCmec subtypes IVb and IVd. MRSA containing SCCmec subtype IVb, IVc and IVd as well as type V isolates were all susceptible to chloramphenicol, clindamycin and rifampicin, while the sensitivity to these antibiotics was lower among MRSA containing SCCmec subtype IVa. The most frequently observed spa ttype was t037, accounting for 88% (22/25). Three other spa type was t002, t1816 and t4478. Large reservoirs of MRSA containing type IV subtypes and type V now exist in patients in this Iranian hospital. Therefore, effective infection control management in order to control the spread of CA-MRSA is highly recommended.

The prevalence of tuberculosis among Iranian elderly patients admitted to the infectious ward of hospital: A systematic review and meta-analysis.

PubMed

Azami, M; Sayehmiri, K; YektaKooshali, M H; HafeziAhmadi, M R

2016-12-01

Age increasing is caused physiological changes in the human body, such as reducing the power of the immune system. Weakened immune systems are more susceptible to bacterial infections like tuberculosis. So, this present study was performed for evaluating the prevalence of tuberculosis among Iranian elderly patients admitted to the infectious ward of a hospital. This systematic review and meta-analysis study has been done based on PRISMA guidelines. A comprehensive search was conducted in Iranian and International databases included: Magiran, Iranmedex, IranDoc, SID, Medlib, Scopus, PubMed, Science Direct, Cochrane, Web of Science, Springer, Wiley Online Library as well as the Google Scholar search engine in the period 1990-2016 by two independent researchers using the Mesh keywords. All of the reviewed studies that had inclusion criterion were been evaluated. The diagnosis of tuberculosis were considered results of physical examination, PPD (Purified Protein Derivative) test, Blood tests, Imaging tests and sputum test. The data were analyzed by using random effects model with the software Stata-Ver.11.1. Five studies with a total number of 2,956 elderly patients were included. The prevalence of tuberculosis among Iranian elderly patients admitted to the infectious ward of the hospital was estimated to be 15% (95%CI: 1-30). The relationship between prevalence of tuberculosis with a year of study was not statistically significant (P=0.371). This will be the first systematic review of tuberculosis prevalence among elderly patients admitted to the infectious ward in Iran. This study showed a high prevalence of Tuberculosis and it is recommended considering tuberculosis as a differential diagnosis in elderly patients with infectious symptoms. Copyright © 2016.

The impact of psychological capital on mental health among Iranian nurses: considering the mediating role of job burnout.

PubMed

Estiri, Mehrdad; Nargesian, Abbas; Dastpish, Farinaz; Sharifi, Seyed Mahdi

2016-01-01

The role of nurses in providing high quality healthcare to patients is so important that creating a desirable working environment to enhance their overall performance is unavoidable. This paper aimed to explore the impact of psychological capital on mental health by investigating the mediating effects of job burnout on this relationship. The data used in this research was obtained via a survey conducted among selected Iranian nurses in public hospitals. In total, 450 questionnaires were distributed and 384 were completed and returned. Collected data was analysed using Structural Equation Modelling (SEM). Findings showed that there is a significant relationship between psychological capital, job burnout and mental health; also, there is a significant negative relationship between psychological capital and job burnout, and a significant positive relationship between psychological capital and mental health. The results have several important practical implications for human resource management in Iranian public hospitals. According to the results of this study, reducing job burnout is an important factor in enhancing psychological capital and can positively enhance nurses' mental health.

Strategic planning, implementation, and evaluation processes in hospital systems: a survey from Iran.

PubMed

Sadeghifar, Jamil; Jafari, Mehdi; Tofighi, Shahram; Ravaghi, Hamid; Maleki, Mohammad Reza

2014-09-28

Strategic planning has been presented as an important management practice. However, evidence of its deployment in healthcare systems in low-income and middle-income countries (LMICs) is limited. This study investigated the strategic management process in Iranian hospitals. The present study was accomplished in 24 teaching hospitals in Tehran, Iran from September 2012 to March 2013. The data collection instrument was a questionnaire including 130 items. This questionnaire measured the situation of formulation, implementation, and evaluation of strategic plan as well as the requirements, facilitators, and its benefits in the studied hospitals. All the investigated hospitals had a strategic plan. The obtained percentages for the items "the rate of the compliance to requirements" and "the quantity of planning facilitators" (68.75%), attention to the stakeholder participation in the planning (55.74%), attention to the planning components (62.22%), the status of evaluating strategic plan (59.94%) and the benefits of strategic planning for hospitals (65.15%) were in the medium limit. However, the status of implementation of the strategic plan (53.71%) was found to be weak. Significant statistical correlations were observed between the incentive for developing strategic plan and status of evaluating phase (P=0.04), and between status of implementation phase and having a documented strategic plan (P=0.03). According to the results, it seems that absence of appropriate internal incentive for formulating and implementing strategies led more hospitals to start formulation strategic planning in accordance with the legal requirements of Ministry of Health. Consequently, even though all the investigated hospital had the documented strategic plan, the plan has not been implemented efficiently and valid evaluation of results is yet to be achieved.

Strategic Planning, Implementation, and Evaluation Processes in Hospital Systems: A Survey From Iran

PubMed Central

Sadeghifar, Jamil; Jafari, Mehdi; Tofighi, Shahram; Ravaghi, Hamid; Maleki, Mohammad Reza

2015-01-01

Aim & Background: Strategic planning has been presented as an important management practice. However, evidence of its deployment in healthcare systems in low-income and middle-income countries (LMICs) is limited. This study investigated the strategic management process in Iranian hospitals. Methods: The present study was accomplished in 24 teaching hospitals in Tehran, Iran from September 2012 to March 2013. The data collection instrument was a questionnaire including 130 items. This questionnaire measured the situation of formulation, implementation, and evaluation of strategic plan as well as the requirements, facilitators, and its benefits in the studied hospitals. Results: All the investigated hospitals had a strategic plan. The obtained percentages for the items “the rate of the compliance to requirements” and “the quantity of planning facilitators” (68.75%), attention to the stakeholder participation in the planning (55.74%), attention to the planning components (62.22%), the status of evaluating strategic plan (59.94%) and the benefits of strategic planning for hospitals (65.15%) were in the medium limit. However, the status of implementation of the strategic plan (53.71%) was found to be weak. Significant statistical correlations were observed between the incentive for developing strategic plan and status of evaluating phase (P=0.04), and between status of implementation phase and having a documented strategic plan (P=0.03). Conclusion: According to the results, it seems that absence of appropriate internal incentive for formulating and implementing strategies led more hospitals to start formulation strategic planning in accordance with the legal requirements of Ministry of Health. Consequently, even though all the investigated hospital had the documented strategic plan, the plan has not been implemented efficiently and valid evaluation of results is yet to be achieved. PMID:25716385

Prophylaxis against Deep Venous Thrombosis in Patients Hospitalized in Surgical Wards in One of the Hospitals in Iran: Based on the American College of Chest Physician's Protocol.

PubMed

Shohani, Masoumeh; Mansouri, Akram; Norozi, Siros; Parizad, Naser; Azami, Milad

2018-01-01

There is not enough studies to determine the frequency of using the prophylaxis against deep venous thrombosis (DVT) based on the American College of Chest Physician's (ACCP) guidelines in Iran. Thus, providing such statistics is essential to improve thromboprophylaxis in hospital. The present study aimed to determine the frequency of using the prophylaxis against DVT based on ACCP guidelines in patients hospitalized in surgical wards in one of teaching hospital in Ilam, Iran. In a cross-sectional, the samples were selected among medical records of patients who were hospitalized and underwent surgery in surgical wards of the hospital from April 2012 to September 2013. Type of prophylaxis was determined based on ACCP guidelines. After reviewing inclusion and exclusion criteria, patients' data were extracted from medical records based on required variables. In reviewing 169 qualified samples, 46.2% (78 patients) were women. Of these, 132 patients were at risk of DVT and needed prophylaxis, only 39 patients (29.5%) received prophylaxis. Thromboprophylaxis based on ACCP guidelines had been fully implemented only in 30 cases (22.7%) of patients with the risk of DVT.. The highest thromboprophylaxis was in the intensive care unit (46.6%) and neurosurgery (37.5%), and the least rate was in urology (0%). As the results of this study, there are differences between clinical practice and the ACCP guidelines recommendation in prophylaxis against DVT. Thromboprophylaxis has not been implemented based on ACCP guidelines in more than 75% of patients with the risk of DVT. Thus, new strategies are needed to implement thromboprophylaxis against DVT in Iranian hospitals.

Comparing the Effect of Blogging as well as Pen-and-Paper on the Essay Writing Performance of Iranian Graduate Students

ERIC Educational Resources Information Center

Kashani, Hajar; Mahmud, Rosnaini Binti; Kalajahi, Seyed Ali Rezvani

2013-01-01

In today's world, there are lots of methods in language teaching in general and teaching writing in particular. Using two different tools in writing essays and conducting a study to compare the effectiveness of these two tools namely blog and pen-and-paper was the basis of this study. This study used a quantitative true experimental design aimed…

Validation of Medical Tourism Service Quality Questionnaire (MTSQQ) for Iranian Hospitals

PubMed Central

Qolipour, Mohammad; Torabipour, Amin; Khiavi, Farzad Faraji; Malehi, Amal Saki

2017-01-01

Introduction Assessing service quality is one of the basic requirements to develop the medical tourism industry. There is no valid and reliable tool to measure service quality of medical tourism. This study aimed to determine the reliability and validity of a Persian version of medical tourism service quality questionnaire for Iranian hospitals. Methods To validate the medical tourism service quality questionnaire (MTSQQ), a cross-sectional study was conducted on 250 Iraqi patients referred to hospitals in Ahvaz (Iran) from 2015. To design a questionnaire and determine its content validity, the Delphi Technique (3 rounds) with the participation of 20 medical tourism experts was used. Construct validity of the questionnaire was assessed through exploratory and confirmatory factor analysis. Reliability was assessed using Cronbach’s alpha coefficient. Data were analyzed by Excel 2007, SPSS version18, and Lisrel l8.0 software. Results The content validity of the questionnaire with CVI=0.775 was confirmed. According to exploratory factor analysis, the MTSQQ included 31 items and 8 dimensions (tangibility, reliability, responsiveness, assurance, empathy, exchange and travel facilities, technical and infrastructure facilities and safety and security). Construct validity of the questionnaire was confirmed, based on the goodness of fit quantities of model (RMSEA=0.032, CFI= 0.98, GFI=0.88). Cronbach’s alpha coefficient was 0.837 and 0.919 for expectation and perception questionnaire. Conclusion The results of the study showed that the medical tourism SERVQUAL questionnaire with 31 items and 8 dimensions was a valid and reliable tool to measure service quality of medical tourism in Iranian hospitals. PMID:28461863

Allocation of health resources according to the type and size of Iranian governmental hospitals.

PubMed

Hassani, Sa; Abolhallaje, M; Inanlo, S; Hosseini, H; Pourmohammadi, K; Bastani, P; Ramezanian, M; Marnani, A Barati

2013-01-01

Due to consuming about 50%-80% of health resources, hospitals are the greatest and costly operational units in Iranian Health system. so allocation of resources specially human and space resources as the most expensive ones is really important for further controlling of costs, analysis of costs and making suitable policies for increasing the profitability and allocation of resources and improvement of quality. This paper intends to describe and analyze any allocation of resources in 530 university hospitals in Iran. The final goal of this research is to provide a data bank according which there is a basis for more scientific budget allocation of state's hospitals from the size and type of application points of view. The relevant index of person to bed was 2.04 for human resources. All hospitals more than 300 beds are located in benefiting areas from which 17 cases are educational and 2 cases are therapeutic. This is necessary to mention that the rate of management group forces to total personnel at deprived areas is about 2.5% more than benefiting areas. Because 60-80% of hospital costs are applied for human forces, all managers of hospitals are obliged to revise their policies in attraction and employment of human force in order to benefit from such a valuable resource and prevent from expensive costs. So any employment of personnel should be based upon real needs of hospital.

Detection of Hepatozoon sp. in a Persian leopard (Panthera pardus ciscaucasica).

PubMed

Khoshnegah, Javad; Mohri, Mehrdad; Mirshahi, Ali; Mousavi, Seyed Javad

2012-07-01

A free-ranging, adult, male Persian leopard (Panthera pardus ciscaucasica) was found at Geloul-Sarani protected zone, province of North-Khorasan, Iran and transported to the Ferdowsi University of Mashhad Veterinary Teaching Hospital. The leopard had normal temperature and respiratory and cardiac frequency, but was significantly dehydrated and had elevated capillary perfusion. The animal also was cachectic, with pale mucus membranes, third-eyelid protrusion, and bilaterally enlarged submandibular lymph nodes. The leopard was stabilized by intensive fluid and electrolyte therapy and hospitalized. In 2 days, the leopard had improved clinically but had severe ataxia and head pressing. Blood smears revealed gamonts of Hepatozoon sp. within some neutrophils. Hematologic and plasma chemistry abnormalities included moderate anemia, leukocytosis, hypocholestrolemia, and hypophosphatemia. In radiographic evaluations, no sign of periosteal reactions or new bone formation was seen on the skull, spine, long bones, pelvis, or vertebrae. The leopard was treated successfully with Tazocin and clindamycin for 1 mo. This is the first detection of a Hepatozoon sp. in wild Felidae in Iran. Because most Iranian wild felids and canids are endangered, knowing whether Hepatozoon infection represents a threat for these animals is important.

Implementing hospital quality assurance policies in Iran: balancing licensing, annual evaluation, inspections and quality management systems.

PubMed

Aghaei Hashjin, Asgar; Delgoshaei, Bahram; Kringos, Dionne S; Tabibi, Seyed Jamaladin; Manouchehri, Jila; Klazinga, Niek S

2015-01-01

The purpose of this paper is to provide an overview of applied hospital quality assurance (QA) policies in Iran. A mixed method (quantitative data and qualitative document analysis) study was carried out between 1996 and 2010. The QA policy cycle forms a tight monitoring system to assure hospital quality by combining mandatory and voluntary methods in Iran. The licensing, annual evaluation and grading, and regulatory inspections statutorily implemented by the government as a national package to assure and improve hospital care quality, while implementing quality management systems (QMS) was voluntary for hospitals. The government's strong QA policy legislation role and support has been an important factor for successful QA implementation in Iran, though it may affected QA assessment independency and validity. Increased hospital evaluation independency and repositioning, updating standards, professional involvement and effectiveness studies could increase QA policy impact and maturity. The study highlights the current QA policy implementation cycle in Iranian hospitals. It provides a basis for further quality strategy development in Iranian hospitals and elsewhere. It also raises attention about finding the optimal balance between different QA policies, which is topical for many countries. This paper describes experiences when implementing a unique approach, combining mandatory and voluntary QA policies simultaneously in a developing country, which has invested considerably over time to improve hospital quality. The experiences with a mixed obligatory/voluntary approach and comprehensive policies in Iran may contain lessons for policy makers in developing and developed countries.

Moral distress and burnout in Iranian nurses: The mediating effect of workplace bullying.

PubMed

Ajoudani, Fardin; Baghaei, Rahim; Lotfi, Mojgan

2018-01-01

Moral distress and workplace bullying are important issues in the nursing workplace that appear to affect nurse's burnout. To investigate the relationship between moral distress and burnout in Iranian nurses, as mediated by their perceptions of workplace bullying. Ethical considerations: The research was approved by the committee of ethics in research of the Urmia University of Medical Sciences. This is a correlation study using a cross-sectional design with anonymous questionnaires as study instruments (i.e. Moral Distress Scale-Revised, Maslach Burnout Inventory and The Negative Acts Questionnaire-Revised). Data were collected from 278 nurses from five teaching hospitals in Urmia, the capital of Western Azerbaijan, northwest of Iran. Structural equation modeling and bootstrapping procedures were employed to recognize the mediating role of their perceptions of workplace bullying. The mean score of moral distress, burnout, and the Negative Acts Questionnaire-Revised Scale among the participants were 91.02 ± 35.26, 79.9 ± 18.27, and 45.4 ± 15.39, respectively. The results confirmed our hypothesized model. All the latent variables of study were significantly correlated in the predicted directions. The moral distress and bullying were significant predictors of burnout. Perception of bullying partially mediated the relationship between moral distress and burnout. The mediating role of the bullying suggests that moral distress increases burnout, directly and indirectly. Nursing administrators should be conscious of the role of moral distress and bullying in the nursing workplace in increasing burnout.

Knowledge and practice of iranians toward colorectal cancer, and barriers to screening.

PubMed

Salimzadeh, Hamideh; Delavari, Alireza; Montazeri, Ali; Mirzazadeh, Ali

2012-01-01

Colorectal cancer (CRC) is the third most common malignancy in Iran. Limited data are available on knowledge and barriers in regard to CRC and screening tests in Iran. The aim of the study was to characterize knowledge, practice, and barriers toward CRC and its screening tests among an Iranian at-risk population. This cross-sectional study was conducted with participation of 200 individuals of both genders aged 50 years or older in a teaching hospital in Tehran, Iran. Data were collected via face-to-face interviews. A questionnaire containing demographics; knowledge about CRC and screening tests; screening practice; and reasons for not being screened was administered. The reliability alpha for knowledge items was 0.52. The age of the participants ranged from 50 to 83 years (mean 60.13). Overall, 11% of the respondents reported prior screening by either fecal occult blood test (6.5%) or colonoscopy (4.5%). The majority of individuals had poor knowledge although respondents with prior screening obtained slightly higher score in comparison with nonparticipants in screening (26.74 vs. 23.24; P<0.05). Four commonly cited reasons for not having CRC tests were "doctor did not recommend the test," "did not think it was needed," "never think of the test," and "no symptoms/problems" which were reported by 29%, 26%, 20%, and 17% of the participants, respectively. It is necessary to design appropriate educational interventions to increase the general population's knowledge about CRC and screening before implementing preventive programs in Iran.

The Status of Information Technology in Iranian Hospital Libraries: A Comparative Study of Managers' Attitude

ERIC Educational Resources Information Center

Isfandyari-Moghaddam, Alireza; Sedehi, Maryam; Dehghani, Mozhdeh; Nemati-Anaraki, Leila; Hasanzadeh-Dizaji, Elaheh

2013-01-01

Purpose: The purpose of this paper is to compare the attitude of the managers of libraries located at Iran, Tehran and Shahid Beheshti Medical Sciences Universities' training hospitals, on the status of information technology (IT) in the mentioned libraries. Design/methodology/approach: This study employed a researcher-made questionnaire. The…

A Comparison between Roles of Professors Teaching English Literature or TEFL at B.A Level and Professors Teaching TEFL at M.A Level in the Light of Goffman's Footing Theory

ERIC Educational Resources Information Center

Ghapanchi, Zargham; Talebi, Farima

2012-01-01

This study aims to examine the metaphors selected by two hundred and forty Iranian B.A and eighty eight M.A students about their professors' roles. The participants were asked to select their preferred metaphors among twenty one metaphors of the checklist about their professors. The metaphors were then categorized based on Goffman's Footing…

Association Between Teaching Status and Mortality in US Hospitals

PubMed Central

Burke, Laura G.; Frakt, Austin B.; Khullar, Dhruv; Orav, E. John

2017-01-01

Importance Few studies have analyzed contemporary data on outcomes at US teaching hospitals vs nonteaching hospitals. Objective To examine risk-adjusted outcomes for patients admitted to teaching vs nonteaching hospitals across a broad range of medical and surgical conditions. Design, Setting, and Participants Use of national Medicare data to compare mortality rates in US teaching and nonteaching hospitals for all hospitalizations and for common medical and surgical conditions among Medicare beneficiaries 65 years and older. Exposures Hospital teaching status: major teaching hospitals (members of the Council of Teaching Hospitals), minor teaching hospitals (other hospitals with medical school affiliation), and nonteaching hospitals (remaining hospitals). Main Outcomes and Measures Primary outcome was 30-day mortality rate for all hospitalizations and for 15 common medical and 6 surgical conditions. Secondary outcomes included 30-day mortality stratified by hospital size and 7-day mortality and 90-day mortality for all hospitalizations as well as for individual medical and surgical conditions. Results The sample consisted of 21 451 824 total hospitalizations at 4483 hospitals, of which 250 (5.6%) were major teaching, 894 (19.9%) were minor teaching, and 3339 (74.3%) were nonteaching hospitals. Unadjusted 30-day mortality was 8.1% at major teaching hospitals, 9.2% at minor teaching hospitals, and 9.6% at nonteaching hospitals, with a 1.5% (95% CI, 1.3%-1.7%; P < .001) mortality difference between major teaching hospitals and nonteaching hospitals. After adjusting for patient and hospital characteristics, the same pattern persisted (8.3% mortality at major teaching vs 9.2% at minor teaching and 9.5% at nonteaching), but the difference in mortality between major and nonteaching hospitals was smaller (1.2% [95% CI, 1.0%-1.4%]; P < .001). After stratifying by hospital size, 187 large (≥400 beds) major teaching hospitals had lower adjusted overall 30-day mortality relative to 76 large nonteaching hospitals (8.1% vs 9.4%; 1.2% difference [95% CI, 0.9%-1.5%]; P < .001). This same pattern of lower overall 30-day mortality at teaching hospitals was observed for medium-sized (100-399 beds) hospitals (8.6% vs 9.3% and 9.4%; 0.8% difference between 61 major and 1207 nonteaching hospitals [95% CI, 0.4%-1.3%]; P = .003). Among small (≤99 beds) hospitals, 187 minor teaching hospitals had lower overall 30-day mortality relative to 2056 nonteaching hospitals (9.5% vs 9.9%; 0.4% difference [95% CI, 0.1%-0.7%]; P = .01). Conclusions and Relevance Among hospitalizations for US Medicare beneficiaries, major teaching hospital status was associated with lower mortality rates for common conditions compared with nonteaching hospitals. Further study is needed to understand the reasons for these differences. PMID:28535236

Allocation of Health Resources According To the Type and Size of Iranian Governmental Hospitals

PubMed Central

Hassani, SA; Abolhallaje, M; Inanlo, S; Hosseini, H; Pourmohammadi, K; Bastani, P; Ramezanian, M; Marnani, A Barati

2013-01-01

Background: Due to consuming about 50%–80% of health resources, hospitals are the greatest and costly operational units in Iranian Health system. so allocation of resources specially human and space resources as the most expensive ones is really important for further controlling of costs, analysis of costs and making suitable policies for increasing the profitability and allocation of resources and improvement of quality. Method: This paper intends to describe and analyze any allocation of resources in 530 university hospitals in Iran. The final goal of this research is to provide a data bank according which there is a basis for more scientific budget allocation of state’s hospitals from the size and type of application points of view. Results: The relevant index of person to bed was 2.04 for human resources. All hospitals more than 300 beds are located in benefiting areas from which 17 cases are educational and 2 cases are therapeutic. This is necessary to mention that the rate of management group forces to total personnel at deprived areas is about 2.5% more than benefiting areas. Conclusion: Because 60–80% of hospital costs are applied for human forces, all managers of hospitals are obliged to revise their policies in attraction and employment of human force in order to benefit from such a valuable resource and prevent from expensive costs. So any employment of personnel should be based upon real needs of hospital. PMID:23865036

Performance Analysis of Hospital Managers Using Fuzzy AHP and Fuzzy TOPSIS: Iranian Experience.

PubMed

Shafii, Milad; Hosseini, Seyed Mostafa; Arab, Mohammad; Asgharizadeh, Ezzatollah; Farzianpour, Fereshteh

2015-06-12

Hospitals are complex organizations that require strong and effective management. The success of such organizations depends on the performance of managers. This study provides a comprehensive set of indicators to assess the performance of hospital managers in Iranian Ministry of Health owned hospitals. This research was a cross-sectional study. First, reviewing the literature and using experts' viewpoints and convening a panel of experts, the dimensions of performance have been selected and came in the form of a performance model. Then, using Fuzzy Analytic Hierarchy Process (FAHP), the chosen dimensions were weighted. Finally, based on the weighted performance dimensions, a questionnaire was designed and after confirming the reliability and validity, through a census, 407 senior and middle managers from 10 hospitals in Yazd, Iran completed it and performance of CEOs in these hospitals was evaluated using the Fuzzy Technique for Order Preference by Similarity Ideal Solution (FTOPSIS). To measure the performance of hospital managers, a performance assessment model consisted of 19 sub-dimensions in 5 main dimensions (Functional, Professional, Organizational, Individual and Human) was developed. The functional area had the most weight and the individual area had the least weight, as well. The hospital managers had different performance levels in each category and sub-dimensions. In terms of overall performance, the hospital managers C and H had the best and the worst performance, respectively. The use of appropriate dimensions for performance, prioritizing them and evaluating the performance of hospital managers using appropriate techniques, can play an effective role in the selection of qualified managers, identifying strengths and weaknesses in performance and continuous improvement of them.

The Incidence, Nature and Consequences of Adverse Events in Iranian Hospitals.

PubMed

Akbari Sari, Ali; Doshmangir, Leila; Torabi, Fereshteh; Rashidian, Arash; Sedaghat, Mojtaba; Ghomi, Robabeh; Prasopa-Plaizier, Nittita

2015-12-01

Adverse events are relatively common in healthcare, leading to extensive harm to patients and a significant drain on healthcare resources. Identifying the extent, nature and consequences of adverse events is an important step in preventing adverse events and their consequences which is the subject of this study. This is a retrospective review of medical records randomly selected from patients admitted to 4 general hospitals, staying more than 24 hours and discharged between April and September 2012. We randomly selected 1200 records and completed the record review for 1162 of these records. Standard forms (RF1 and RF2) were used to review medical records in two stages by nurses and medical doctors. Eighty-five (7.3%) of the 1162 records had an adverse event during the admission; and in 43 (3.7%) of the 1162 records, the patient was admitted to the hospital due to an adverse event that occurred before the admission. Therefore, a total of 128 (11.0%) adverse events occurred in 126 (10.9) records as two patients had more than one adverse event. Forty-four (34.3%) of these 128 adverse events were considered preventable. This study confirms that adverse events, particularly adverse drug reactions, post-operative infections, bedsore and hospital acquired infections are common and potentially preventable sources of harm to patients in Iranian hospitals.

Structural equation model of interactions between risk factors and work-related musculoskeletal complaints among Iranian hospital nurses.

PubMed

Mehralizadeh, Semira; Dehdashti, Alireza; Motalebi Kashani, Masoud

2017-01-01

Statistics indicate a high risk of developing work-related musculoskeletal disorders among hospital nurses. The challenge is to understand the associations between musculoskeletal symptoms and various individual and occupational risk factors. This study examined the direct and indirect interactions of various risk factors with musculoskeletal complaints in hospital nurses. In a cross-sectional design, Iranian hospital nurses from Semnan University of Medical Sciences participated in a questionnaire survey reporting their perceived perceptions of various work-related risk factors and musculoskeletal symptoms. We tested our proposed structural equation model to evaluate the relations between latent and observed concepts and the relative importance and strength of exogenous variables in explaining endogenous musculoskeletal complaints. Measurement model fits the data relatively acceptable. Our findings showed direct effects of psychological, role-related and work posture stressors on musculoskeletal complaints. Fatigue mediated the adverse indirect relations of psychological, role-related, work posture and individual factors with musculoskeletal complaints. Structural equation modeling may provide methodological opportunities in occupational health research with a potential to explain the complexity of interactions among risk factors. Prevention of work-related musculoskeletal disorders among nurses must account for physical and psychosocial conditions.

A holistic approach to ward design.

PubMed

Mozaffar, Farhang; Jamaleddin, Seyyed; Khakzand, Mehdi

2009-06-01

Three Iranian academics examine how existing experience in inpatient and other ward design can be harnessed to ensure the creation of comfortable, relaxing and, as far as is possible, individually "tailored" hospital accommodation in the future.

Resisting Magic Waves: Ideologies of "English Language Teaching" in Iranian Newspaper Advertisements

ERIC Educational Resources Information Center

Mirhosseini, Seyyed-Abdolhamid

2015-01-01

Discourse practices play crucial roles in shaping the cultural environment of social events and, therefore, influence how they actually take place. Promotional materials and media advertisements are significant instances of such discourses through which understandings of social practices, including language education, are both reflected and…

The Relationship between EFL Teachers' Beliefs and Actual Practices of Classroom Management

ERIC Educational Resources Information Center

Aliakbari, Mohammad; Heidarzad, Mohsen

2015-01-01

This study aimed at analyzing Iranian EFL teachers' beliefs toward classroom management and the relationship between teachers' beliefs and their actual practices of classroom management in regard with individual variables such as gender, education degree, and teaching experience. The data were collected using a behavior and instructional…

Improving English Speaking Fluency: The Role of Six Factors

ERIC Educational Resources Information Center

Shahini, Gholamhossein; Shahamirian, Fatemeh

2017-01-01

This qualitative study, using an open interview, set out to investigate the roles six factors, including age, university education, teachers of English Language institutes, teaching English, dictionary, and note-taking, played in improving English speaking fluency of seventeen fluent Iranian EFL speakers. The participants were chosen purposefully…

Coping Work Strategies and Job Satisfaction Among Iranian Nurses

PubMed Central

Ghiyasvandian, Shahrzad; Adera Gebra, Addis

2014-01-01

Context: Nursing is a stressful job that could create physical and psychological disorders. Many studies presented information on stress, effects of coping strategies, and job satisfaction of nurses within health setting. We aimed to identify and describe nursing stresses, coping strategies and job satisfaction of Iranian nurses who are working or worked in different wards. Evidence Acquisition: In this review, we studied peer-reviewed journal articles on the field of stress, coping strategies and job satisfaction in nursing practice, especially Iranian nurses, which were published between 2000 and 2013. In this regard, we searched databases of PubMed, Elsevier, Google, BMJ, PMC, and MEDLINE. Results: The majority of the studies (60%) had analyzed the effect of coping strategies, experiences and perception of job-related stresses in Iranian nurses working in hospitals. In some of the reviewed studies (60%), the majority of the samples enrolled Iranian nurses. Forty percent of studies selected a maximum sample size of 565 (44%) participants in 2011. Nursing stress scale employed at 30% of the studies was the most commonly used strategy. This reviewed studies also revealed a combined measurement (60% of studies), based on categorical stress measurement, effects of coping strategies, and job satisfaction methods. Three studies explored the relationship between job stress and job satisfaction. For instance, the majority (74.4%) of nurses reported job satisfaction. Conclusions: Effect of coping strategies and job satisfaction on Iranian nurses is a well-accepted issue and has important positive outcomes on several areas of health discipline. PMID:25068050

The diversity of Iranian nursing students' clinical learning styles: a qualitative study.

PubMed

Baraz, Shahram; Memarian, Robabeh; Vanaki, Zohreh

2014-09-01

Numerous factors, including learning styles, affect the learning process of nursing students. Having insights about students' learning styles helps promoting the quality of education. The aim of this study was to explore the Iranian baccalaureate nursing students' learning styles in clinical settings. A qualitative design using a content analysis approach was used to collect and analyze data. Semi-structured interviews were conducted with fifteen Iranian baccalaureate nursing students selected using a purposive sample method. During data analysis, it was found that nursing students employed different clinical learning styles such as 'thoughtful observation,' 'learning by thinking,' and 'learning by doing'. Students adopt different learning strategies in clinical practice. Designing teaching strategies based on students' learning styles can promote students' learning and maximize their academic and clinical practice success. Nursing educators, curriculum designers, and students can use the findings of this study to improve the quality of nursing education in both the classroom and clinical settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Similarities and differences in cultural values between Iranian and Malaysian nursing students

PubMed Central

Abdollahimohammad, Abdolghani; Jaafar, Rogayah; Rahim, Ahmad F. Abul

2014-01-01

Background: Cultural values are invisible and relatively constant in societies. The purpose of the present study is to find diversities in cultural values of Iranian and Malaysian nursing students. Materials and Methods: Convenience sampling method was used for this comparative-descriptive study to gather the data from full-time undergraduate degree nursing students in Iran and Malaysia. The data were collected using Values Survey Module 2008 and were analyzed by independent t-test. Results: The means of power distance, individualism, and uncertainty avoidance values were significantly different between the two study populations. Conclusions: The academics should acknowledge diversities in cultural values, especially in power distance index, to minimize misconceptions in teaching-learning environments. PMID:25400685

Religious Practices and Self-Care in Iranian Patients with Type 2 Diabetes.

PubMed

Heidari, Saeide; Rezaei, Mahboubeh; Sajadi, Mahbobeh; Ajorpaz, Neda Mirbagher; Koenig, Harold G

2017-04-01

This study aimed to examine the relationship between religious practices and self-care of patients with type 2 diabetes. A descriptive cross-sectional survey was conducted on 154 diabetic patients who were referred to two general teaching hospitals in Qom City (Iran). Data were collected using demographic questionnaire, private and public religious practices, and summary of diabetes self-care activities questionnaires. Data were analyzed using descriptive statistics and statistical tests including independent t test, and Pearson correlation coefficient. Significant positive correlations were observed between religious practices and self-care activities in diabetic patients (p < 0.05). Significant positive correlations were also found between some religious practices and self-care activities subscales (p < 0.05). Healthcare providers should be aware of the role that religion plays in the lives of diabetic patients and be able to take religious factors into account when developing care plans. Doing so will enhance a more patient-centered approach and thereby support patients in their role as self-care decision-makers.

Neonatal seizures in a rural Iranian district hospital: etiologies, incidence and predicting factors.

PubMed

Sadeghian, Afsaneh; Damghanian, Maryam; Shariati, Mohammad

2012-01-01

Current study determined the overall incidence, common causes as well as main predictors of this final diagnosis among neonates admitted to a rural district hospital in Iran. This study was conducted on 699 neonates who were candidate for admission to the NICU. Study population was categorized in the case group, including patients exposed to final diagnosis of neonatal seizures and the control group without this diagnosis. Neonatal seizure was reported as final diagnosis in 25 (3.6%) of neonates. The most frequent discharge diagnosis in the seizure group was neonatal sepsis and in the non-seizure group was respiratory problems. No significant difference was found in early fatality rate between neonates with and without seizures (8.0% vs. 10.1%). Only gestational age <38 week had a relationship with the appearance of neonatal seizure. Low gestational age has a crucial role for predicting appearance of seizure in Iranian neonates.

Effectiveness of Integrating Simulation with Art-Based Teaching Strategies on Oncology Fellows' Performance Regarding Breaking Bad News.

PubMed

Yakhforoshha, Afsaneh; Emami, Seyed Amir Hossein; Shahi, Farhad; Shahsavari, Saeed; Cheraghi, Mohammadali; Mojtahedzadeh, Rita; Mahmoodi-Bakhtiari, Behrooz; Shirazi, Mandana

2018-02-21

The task of breaking bad news (BBN) may be improved by incorporating simulation with art-based teaching methods. The aim of the present study was to assess the effect of an integrating simulation with art-based teaching strategies, on fellows' performance regarding BBN, in Iran. The study was carried out using quasi-experimental methods, interrupted time series. The participants were selected from medical oncology fellows at two teaching hospitals of Tehran University of Medical Sciences (TUMS), Iran. Participants were trained through workshop, followed by engaging participants with different types of art-based teaching methods. In order to assess the effectiveness of the integrating model, fellows' performance was rated by two independent raters (standardized patients (SPs) and faculty members) using the BBN assessment checklist. This assessment tool measured seven different domains of BBN skill. Segmented regression was used to analyze the results of study. Performance of all oncology fellows (n = 19) was assessed for 228 time points during the study, by rating three time points before and three time points after the intervention by two raters. Based on SP ratings, fellows' performance scores in post-training showed significant level changes in three domains of BBN checklist (B = 1.126, F = 3.221, G = 2.241; p < 0.05). Similarly, the significant level change in fellows' score rated by faculty members in post-training was B = 1.091, F = 3.273, G = 1.724; p < 0.05. There was no significant change in trend of fellows' performance after the intervention. Our results showed that using an integrating simulation with art-based teaching strategies may help oncology fellows to improve their communication skills in different facets of BBN performance. Iranian Registry of Clinical Trials ID: IRCT2016011626039N1.

Assertiveness process of Iranian nurse leaders: a grounded theory study.

PubMed

Mahmoudirad, Gholamhossein; Ahmadi, Fazlollah; Vanaki, Zohreh; Hajizadeh, Ebrahim

2009-06-01

The purpose of this study was to explore the assertiveness process in Iranian nursing leaders. A qualitative design based on the grounded theory approach was used to collect and analyze the assertiveness experiences of 12 nurse managers working in four hospitals in Iran. Purposeful and theoretical sampling methods were employed for the data collection and selection of the participants, and semistructured interviews were held. During the data analysis, 17 categories emerged and these were categorized into three themes: "task generation", "assertiveness behavior", and "executive agents". From the participants' experiences, assertiveness theory emerged as being fundamental to the development of a schematic model describing nursing leadership behaviors. From another aspect, religious beliefs also played a fundamental role in Iranian nursing leadership assertiveness. It was concluded that bringing a change in the current support from top managers and improving self-learning are required in order to enhance the assertiveness of the nursing leaders in Iran.

Performance Analysis of Hospital Managers Using Fuzzy AHP and Fuzzy TOPSIS: Iranian Experience

PubMed Central

Shafii, Milad; Hosseini, Seyed Mostafa; Arab, Mohammad; Asgharizadeh, Ezzatollah; Farzianpour, Fereshteh

2016-01-01

Background and Objectives: Hospitals are complex organizations that require strong and effective management. The success of such organizations depends on the performance of managers. This study provides a comprehensive set of indicators to assess the performance of hospital managers in Iranian Ministry of Health owned hospitals. Methods: This research was a cross-sectional study. First, reviewing the literature and using experts’ viewpoints and convening a panel of experts, the dimensions of performance have been selected and came in the form of a performance model. Then, using Fuzzy Analytic Hierarchy Process (FAHP), the chosen dimensions were weighted. Finally, based on the weighted performance dimensions, a questionnaire was designed and after confirming the reliability and validity, through a census, 407 senior and middle managers from 10 hospitals in Yazd, Iran completed it and performance of CEOs in these hospitals was evaluated using the Fuzzy Technique for Order Preference by Similarity Ideal Solution (FTOPSIS). Results: To measure the performance of hospital managers, a performance assessment model consisted of 19 sub-dimensions in 5 main dimensions (Functional, Professional, Organizational, Individual and Human) was developed. The functional area had the most weight and the individual area had the least weight, as well. The hospital managers had different performance levels in each category and sub-dimensions. In terms of overall performance, the hospital managers C and H had the best and the worst performance, respectively. Conclusions: The use of appropriate dimensions for performance, prioritizing them and evaluating the performance of hospital managers using appropriate techniques, can play an effective role in the selection of qualified managers, identifying strengths and weaknesses in performance and continuous improvement of them. PMID:26383216

Nurses' attitudes towards euthanasia: a cross-sectional study in Iran.

PubMed

Naseh, Ladan; Rafiei, Hossein; Heidari, Mohammad

2015-01-01

Nurses have an important role in caring for terminally ill patients. They are often confronted with euthanasia but little is known about their attitudes towards it. The present study aimed to examine Iranian Muslim nurses' attitudes towards euthanasia. In this exploratory cross-sectional study, all qualified registered nurses working in two teaching hospitals (Kashani and Hajar hospitals) in Iran were invited to participate. The Euthanasia Attitude Scale (EAS) was used to assess the nurses' attitude towards euthanasia. Of 266 nurses who fit the criteria, 190 participated in the study (response rate 72.9%); 91.1% (n=173) were female and 8.9% (n=17) were male. In total, 57.4%, 3.2% and 39.5% of nurses reported a negative, neutral and positive attitude to euthanasia respectively. Nurses reported their most negative attitude to the domain 'practical consideration' with mean of 2.36±0.9 and most positive attitude to the domain 'treasuring life' with a mean EAS score of 2.85±0.4. The majority of Muslim nurses were found to have negative attitudes to euthanasia. We recommend that future studies should be conducted to examine Muslim nurses' attitudes to euthanasia in different cultures to determine the role of culture and religious beliefs in attitude to euthanasia.

On the Relationship of Multiple Intelligences with Listening Proficiency and Attitudes among Iranian TEFL University Students

ERIC Educational Resources Information Center

Naeini, Ma'ssoumeh Bemani; Pandian, Ambigapathy

2010-01-01

Gardner's (1983) Multiple Intelligences Theory (MIT) has been found to have profound implications in teaching English as a foreign language (TEFL) in that it provides a way for teachers to recognize learners' individual cognitive and affective differences by providing favorable motivational conditions for learning. However, little investigation…

Iranian EFL Learners' Vocabulary Development through Wikipedia

ERIC Educational Resources Information Center

Khany, Reza; Khosravian, Fereshteh

2014-01-01

Language teaching has passed through a long way in search of a remedy for language learners and teachers. Countless theories, approaches, and methods have been recommended. With all these, however, more inclusive L2 theories and models ought to be considered to come up with real classroom practices. One of such crucial practices is authenticity,…

Teaching and Learning Vocabulary: What English Language Learners Perceive to Be Effective and Ineffective Strategies

ERIC Educational Resources Information Center

Sa'd, Seyyed Hatam Tamimi; Rajabi, Fereshte

2018-01-01

Vocabulary constitutes an essential part of every language-learning endeavour and deserves scholarly attention. The objective of the present study was three-fold: 1) exploring Iranian English language learners' Vocabulary Learning Strategies (VLSs), 2) examining language learners' perceptions of vocabulary learning, and 3) exploring Iranian…

Language Educators' Understanding of Authenticity in Teaching and Its Impacts on Their Practices

ERIC Educational Resources Information Center

Ramezanzadeh, Akram

2017-01-01

This grounded theory study explored the conceptualization of authenticity in language education. The participants were 30 Iranian English language educators, who were studied as adult learners. The findings revealed that authenticity was conceptualized by language educators as a social and reflective practice under the influence of the…

EFL Teachers' Beliefs/Practices Correspondence in Reading Instruction: Does Language Teacher Education Make a Difference?

ERIC Educational Resources Information Center

Karimi, Mohammad Nabi; Dehghani, Asieh

2016-01-01

The present study examined EFL teachers' theoretical orientations towards reading, their reading instructional practices and the correspondence between the theoretical orientations/practices. The study participants were 80 male and female Iranian EFL teachers teaching at a number of private English language institutes. Half of the teachers were…

Does Project-Based Learning Enhance Iranian EFL Learners' Vocabulary Recall and Retention?

ERIC Educational Resources Information Center

Shafaei, Azadeh; Rahim, Hajar Abdul

2015-01-01

Vocabulary knowledge is an integral part of second/foreign language learning. Thus, using teaching methods that can help learners retain and expand their vocabulary knowledge is necessary to facilitate the language learning process. The current research investigated the effectiveness of an interactive classroom method, known as Project-Based…

English Teachers' Research Engagement: Level of Engagement and Motivation

ERIC Educational Resources Information Center

Mehrani, Mehdi B.

2015-01-01

The gap between research and practice has been an endemic feature of the Iranian English language teaching profession. This concern has recently received major attention by the call for empirical investigations to be conducted in order to improve the relationship between research and practice. The purpose of the present study was to investigate…

Motivating factors among Iranian nurses

PubMed Central

Negarandeh, Reza; Dehghan-Nayeri, Nahid; Ghasemi, Elham

2015-01-01

Background: One of the most important challenges of Iranian health care system is “quality of care,” and it is assumed that motivated nurses are more ready to provide better care. There are limited studies investigating Iranian nurses’ motivations; however, factors which motivate them have not been studied yet. Identifying the motivating factors enables nurse managers to inspire nurses for continuous quality improvement. The aim of this study was to identify motivating factors for Iranian hospital nurses. Materials and Methods: This is a cross-sectional descriptive study in which 310 nurses working at 14 hospitals of Tehran University of Medical Sciences were selected by proportionate stratified random sampling. Data were collected in 2010 by a researcher-developed questionnaire. Descriptive statistics and independent t-test, analysis of variance, Tukey post-hoc test, Chi-Square and Fisher's exact test were used for statistical analysis by Statistical Package for Social Sciences (SPSS) version 16. Results: The mean score of motivation was 90.53 ± 10.76 (range: 59–121). Four motivating factors including “career development” (22.63 ± 5.66), “job characteristics” (34.29 ± 4), “job authority” (18.48 ± 2.79), and “recognition” (15.12 ± 2.5) were recognized. The least mean of the motivation score, considering the number of items, was 3.23 for career development, while the highest mean was 3.81 for job characteristics. Conclusions: The findings showed that motivation of nurses was at a medium level, which calls for improvement. The factors that have the greatest potential to motivate nurses were identified in this study and they can help managers to achieve the goal of continuous quality improvement. PMID:26257797

Hospital incident command system (HICS) performance in Iran; decision making during disasters

PubMed Central

2012-01-01

Background Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS) is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises. Methods This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as < 40%; intermediate as 41-70%; high as 71-100% of the maximum score of 192. Descriptive statistics, T-test, and Univariate Analysis of Variance were used. Results None of the participating hospitals had a hospital disaster management plan. The performance according to HICS was intermediate for 83% (n = 19) of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04). Conclusions The decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with outcome remains to be studied. PMID:22309772

Incidence of iatrogenic pneumothorax in the United States in teaching vs. non-teaching hospitals from 2000 to 2012.

PubMed

John, Jason; Seifi, Ali

2016-08-01

Iatrogenic pneumothorax is a patient safety indicator (PSI) representing a complication of procedures such as transthoracic needle aspiration, subclavicular needle stick, thoracentesis, transbronchial biopsy, pleural biopsy, and positive pressure ventilation. This study examined whether there was a significant difference in rate of iatrogenic pneumothorax in teaching hospitals compared to non-teaching hospitals from 2000 to 2012. We performed a retrospective cohort study on iatrogenic pneumothorax incidence from 2000 to 2012 using the Healthcare Cost and Utilization Project (HCUP) database. Pairwise t tests were performed. Odds ratios and P values were calculated, using a Bonferroni-adjusted α threshold, to examine differences in iatrogenic pneumothorax incidence in teaching vs. non-teaching hospitals. Our study revealed that after the year 2000, teaching hospitals had significantly greater iatrogenic pneumothorax incidence compared to non-teaching hospitals in every year of the study period (P<.001). Iatrogenic pneumothorax occurred with significantly greater incidence in teaching hospitals compared to non-teaching hospitals from 2000 to 2012. This trend may have been enhanced by the residency duty-hour regulations implemented in 2003 in teaching institutions, or due to higher rates of procedures in teaching institutions due to the nature of a tertiary center. Iatrogenic pneumothorax was more prevalent in teaching hospitals compared to non-teaching hospitals after the year 2000. Further randomized control studies are warranted to evaluate the etiology of this finding. Published by Elsevier Inc.

Is Hospital Teaching Status a Key Factor in Hospital Charge for Children with Hip Fractures?

PubMed Central

Gao, Yubo; Pugely, Andrew; Karam, Matthew; Phisitkul, Phinit; Mendoza, Sergio; Johnston, Richard C.

2013-01-01

OBJECTIVE Proximal femur fractures cause significant pain and economic cost among pediatric patients. The purposes of this study were (a) to evaluate the distribution by hospital type (teaching hospital vs non-teaching hospital) of U.S. pediatric patients aged 1-20 years who were hospitalized with a closed hip fracture and (b) to discern the mean hospital charge and hospital length of stay after employing propensity score to reduce selec-tion bias. METHODS The 2006 Healthcare Cost and Uti-lization Project (HCUP) Kids’ Inpatient Database (KID) was queried for children aged up to 20 years that had principle diagnosis of hip fracture injury. Hip fractures were defined by International Classifi-cation of Diseases, 9th Revision, Clinical Modifica-tion codes 820.0, 820.2 and 820.8 under Section “Injury and Poisoning (800-999)” with principle internal fixation procedure codes 78.55, 79.15 and 79.35. Patient demographics and hospital status were presented and analyzed. Differences in mean hospital charge and hospital length of stay by hospital teaching status were assessed via two propensity score based methods. RESULTS In total, 1,827 patients were nation-ally included for analysis: 1,392 (76.2%) were treated at a teaching hospital and 435 (23.8%) were treated at a non-teaching hospital. The average age of the patients was 12.88 years old in teaching hospitals vs 14.33 years old in nonteaching hospitals. The propensity score based ad-justment method showed mean hospital charge was $34,779 in teaching hospitals and $32,891 in the non-teaching hospitals, but these differences were not significant (p=0.2940). Likewise, mean length of hospital stay was 4.1 days in teaching hospitals and 3.89 days in non-teaching hospitals, but these differences were also not significant (p=0.4220). Conclusions Hospital teaching status did not affect length of stay or total hospital costs in children treated surgically for proximal femur fractures. Future research should be directed at identifying factors associated with variations in hospital charge and length of stay. PMID:24027472

Is hospital teaching status a key factor in hospital charge for children with hip fractures?: preliminary findings from KID database.

PubMed

Gao, Yubo; Pugely, Andrew; Karam, Matthew; Phisitkul, Phinit; Mendoza, Sergio; Johnston, Richard C

2013-01-01

Proximal femur fractures cause significant pain and economic cost among pediatric patients. The purposes of this study were (a) to evaluate the distribution by hospital type (teaching hospital vs non-teaching hospital) of U.S. pediatric patients aged 1-20 years who were hospitalized with a closed hip fracture and (b) to discern the mean hospital charge and hospital length of stay after employing propensity score to reduce selection bias. The 2006 Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) was queried for children aged up to 20 years that had principle diagnosis of hip fracture injury. Hip fractures were defined by International Classification of Diseases, 9th Revision, Clinical Modification codes 820.0, 820.2 and 820.8 under Section "Injury and Poisoning (800-999)" with principle internal fixation procedure codes 78.55, 79.15 and 79.35. Patient demographics and hospital status were presented and analyzed. Differences in mean hospital charge and hospital length of stay by hospital teaching status were assessed via two propensity score based methods. In total, 1,827 patients were nation-ally included for analysis: 1,392 (76.2%) were treated at a teaching hospital and 435 (23.8%) were treated at a non-teaching hospital. The average age of the patients was 12.88 years old in teaching hospitals vs 14.33 years old in nonteaching hospitals. The propensity score based adjustment method showed mean hospital charge was $34,779 in teaching hospitals and $32,891 in the non-teaching hospitals, but these differences were not significant (p=0.2940). Likewise, mean length of hospital stay was 4.1 days in teaching hospitals and 3.89 days in non-teaching hospitals, but these differences were also not significant (p=0.4220). Hospital teaching status did not affect length of stay or total hospital costs in children treated surgically for proximal femur fractures. Future research should be directed at identifying factors associated with variations in hospital charge and length of stay.

A comparison of medical students' perceptions of their initial basic clinical training placements in 'new' and established teaching hospitals.

PubMed

Mathers, Jonathan; Parry, Jayne; Scully, Edward; Popovic, Celia

2006-05-01

This study has examined students' perceptions of the factors influencing learning during initial hospital placements and whether differences in perceived experiences were evident between students attending new and established teaching hospitals. Five focus groups were conducted with Year III students at the University of Birmingham Medical School (UBMS): three with students attending three established teaching hospitals and two with students attached to a new teaching hospital (designated as part of the UBMS expansion programme). Extensive variation in student perception of hospital experiences was evident at the level of teaching hospital, teaching firm and individual teacher. Emergent themes were split into two main categories: 'students' perceptions of teaching and the teaching environment' and 'the new hospital learner'. Themes emerging that related to variation in student experience included the amount of structured teaching, enthusiasm of teachers, grade of teachers, specialty of designated firms and the number of students. The new teaching hospital was generally looked upon favourably by students in comparison to established teaching hospitals. Many of the factors influencing student experience relate to themes grouped under the 'new hospital learner', describing the period of adjustment experienced by students during their first encounter with this new learning environment. Interventions to improve student experience might be aimed at organisations and individuals delivering teaching. However, factors contributing to the student experience, such as the competing demand to teaching of heavy clinical workloads, are outside the scope of medical school intervention. In the absence of fundamental change, mechanisms to equip students with 'survival skills' as self-directed hospital learners should also be considered.

Phytochemistry and biological activities of Heracleum persicum: a review.

PubMed

Majidi, Zahra; Sadati Lamardi, S N

2018-05-24

Heracleum persicum Desf. ex Fisch is used in Iranian traditional medicines, for the treatment of various diseases including neurological, gastrointestinal, respiratory, rheumatological and urinary tract diseases. In phytochemical analysis of H. persicum, several classes of natural chemicals including volatile (aliphatic esters, carbonyls, phenyl propenes and terpenes) and nonvolatile (flavonoids, furanocoumarins, tannins and alkaloids) constituents as well as different minerals have been identified. Scientific studies on H. persicum proved that it has a wide range of biological and pharmacological activities. This article has provided comprehensive information on Iranian traditional uses, phytochemistry and pharmacological activities of H. persicum. Copyright © 2018 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.

Pakistan-U.S. Relations

DTIC Science & Technology

2009-02-06

Peshawar. Days later, an Iranian diplomat in Peshawar was kidnaped by suspected Sunni militants, and a Japanese journalist and his Afghan colleague were...center, a café frequented by foreigners, a cinema house, and two hospitals. Six American citizens were among the 26 foreigners reported dead. Indian

Did recent changes in Medicare reimbursement hit teaching hospitals harder?

PubMed

Konetzka, R Tamara; Zhu, Jingsan; Volpp, Kevin G

2005-11-01

To inform the policy debate on Medicare reimbursement by examining the financial effects of the Balanced Budget Act of 1997 (BBA) and subsequent adjustments on major academic medical centers, minor teaching hospitals, and nonteaching hospitals. The authors simulated the impacts of BBA and subsequent BBA adjustments to predict the independent effects of changes in Medicare reimbursement on hospital revenues using 1997-2001 Medicare Cost Reports for all short-term acute-care hospitals in the United States. The authors also calculated actual (nonsimulated) operating and total margins among major teaching, minor teaching, and nonteaching hospitals to account for hospital response to the changes. The BBA and subsequent refinements reduced Medicare revenues to a greater degree in major teaching hospitals, but the fact that such hospitals had a smaller proportion of Medicare patients meant that the BBA reduced overall revenues by similar percentages across major, minor, and nonteaching hospitals. Consistently lower margins may have made teaching hospitals more vulnerable to cuts in Medicare support. Recent Medicare changes affected revenues at teaching and nonteaching hospitals more similarly than is commonly believed. However, the Medicare cuts under the BBA probably exacerbated preexisting financial strain on major teaching hospitals, and increased Medicare funding may not suffice to eliminate the strain. This report's findings are consistent with recent calls to support needed services of teaching hospitals through all-payer or general funds.

Iranian Pre-University Student's Retention of Collocations: Implicit Exposure or Explicit Instruction

ERIC Educational Resources Information Center

Gheisari, Nouzar; Yousofi, Nouroldin

2016-01-01

The effectiveness of different teaching methods of collocational expressions in ESL/EFL contexts of education has been a point of debate for more than two decades, with some believing in explicit and the others in implicit instruction of collocations. In this regard, the present study aimed at finding about which kind of instruction is more…

Cooperative Learning: Homogeneous and Heterogeneous Grouping of Iranian EFL Learners in a Writing Context

ERIC Educational Resources Information Center

Zamani, Mona

2016-01-01

One of the important aspects of learning and teaching through cooperation is the group composition or grouping "who with whom". An unresolved issue is that of the superiority of heterogeneity or homogeneity in the structure of the groups. The present study was an attempt to investigate the impact that homogeneous and heterogeneous…

EFL Learners' Use of Direct Strategies in Competitive and Cooperative Learning Contexts

ERIC Educational Resources Information Center

Zarei, Abbas Ali; Layeq, Hamide

2016-01-01

This study investigated the effects of competitive and cooperative teaching techniques on Iranian adult EFL learners' use of direct strategies. To this end, a sample of 88 non-English major university students at Sohrevardi Nonprofit College in Qazvin were assigned to two groups, and each group received instruction under one of the treatment…

Toward a Systematic Framework for an Entrepreneurial University: A Study in Iranian Context with IPOO Model

ERIC Educational Resources Information Center

Salamzadeh, Aidin; Salarnzadeh, Yashar; Daraei, Mohammad Reza

2011-01-01

Purpose - The present paper aims to elaborate and consolidate the existing knowledge of the entrepreneurial university domain, and also seeks to provide a framework for the third generation of universities, i.e. Entrepreneurial Universities. In this research the third mission of universities is considered alongside traditional teaching and…

Social and Cultural Capital: Underlying Factors and Their Relationship with the School Achievement of Iranian University Students

ERIC Educational Resources Information Center

Khodadady, Ebrahim; Zabihi, Reza

2011-01-01

This study explored the relationship between social and cultural capital and school achievement by developing, administering and validating a 35-statement questionnaire to 403 undergraduate and graduate students majoring in Teaching English as a foreign language and Persian Language and Literature and correlating their extracted factors with the…

The Effect of Asynchronous/Synchronous Approaches on English Vocabulary Achievement: A Study of Iranian EFL Learners

ERIC Educational Resources Information Center

Khodaparast, Fatemeh; Ghafournia, Narjes

2015-01-01

The contribution of computer-assisted instructional programs to language learning process has been the focus of researchers for about two decades. However, the effect of synchronous and asynchronous computer-assisted approaches of language teaching on improving L2 vocabulary has been scarcely investigated. This study explored whether synchronous,…

The Impact of Computer-Based Instruction on the Development of EFL Learners' Writing Skills

ERIC Educational Resources Information Center

Zaini, A.; Mazdayasna, G.

2015-01-01

The current study investigated the application and effectiveness of computer assisted language learning (CALL) in teaching academic writing to Iranian EFL (English as a Foreign Language) learners by means of Microsoft Word Office. To this end, 44 sophomore intermediate university students majoring in English Language and Literature at an Iranian…

Is Ethical Sensitivity in Teaching Culturally Bound? Comparing Finnish and Iranian Teachers' Ethical Sensitivity

ERIC Educational Resources Information Center

Gholami, Khalil; Kuusisto, Elina; Tirri, Kirsi

2015-01-01

In this study, we investigated the culture-invariant and culture-dependent nature of teachers' ethical sensitivity in two countries. Our case study involves teachers from Finland (n = 864) representing Western culture, and from Iran (n = 556) representing Eastern culture. Culturally bound elements of ethical sensitivity were studied with the…

Reciprocal Teaching and Emotional Intelligence: A Study of Iranian EFL Learners' Reading Comprehension

ERIC Educational Resources Information Center

Izadi, Mehri; Nowrouzi, Hossein

2016-01-01

The present study aimed at exploring the effect of reciprocal reading strategies instruction on reading comprehension of EFL learners. Emotional intelligence, another variable of interest, was assessed to indicate whether it plays a role in learners' comprehension. In a pre- and post-test study, forty-two learners went through a reciprocal reading…

The Effect of Using Video Technology on Improving Reading Comprehension of Iranian Intermediate EFL Learners

ERIC Educational Resources Information Center

Mohammadian, Amir; Saed, Amin; Shahi, Younes

2018-01-01

With the development of educational technology, the concept of technology-enhanced multimedia instructions is using widely in the educational settings. Technology can be employed in teaching different skills such as listening, reading, speaking and writing. Among these skills, reading comprehension is the skill in which EFL learners have some…

Instrumental and Integrative Orientations: Predictors of Willingness to Communicate in the Iranian EFL Context

ERIC Educational Resources Information Center

Ghanbarpour, Mahsa

2014-01-01

Given that promoting learners' communicative competence in a second language (L2) is one of the primary foci of communicative language teaching approaches, the late 1980s saw an expansion in research into willingness to communicate (WTC), which is deemed to affect individuals' predisposition towards the initiation of L2 communication. The…

ESP Practitioner Professionalization through Apprenticeship of Practice: The Case of Two Iranian ESP Practitioners

ERIC Educational Resources Information Center

Ghanbari, Batoul; Rasekh, Abbas Eslami

2012-01-01

English for specific purposes (ESP), the popular catchphrase of presently English language teaching programs, has been investigated from different perspectives. However, there have been occasional forays in to the role of ESP practitioner as one of the most distinctive features in the literature. In addition to fulfilling the usual role of a…

A Survey on the Iranian ELT Community's Attitudes to Critical Pedagogy

ERIC Educational Resources Information Center

Davari, Hossein; Iranmehr, Abutaleb; Erfani, Seyyed Mahdi

2012-01-01

Critical pedagogy (CP) as one of the most radical changes in English language teaching (ELT) has turned into a common theme of research and discussion in recent years. Despite its practical implications, however, most of the research on this issue has been limited to its theoretical and conceptual dimensions. Conceiving the importance of this…

Humorous Videos and Idiom Achievement: Some Pedagogical Considerations for EFL Learners

ERIC Educational Resources Information Center

Neissari, Malihe; Ashraf, Hamid; Ghorbani, Mohammad Reza

2017-01-01

Employing a quasi-experimental design, this study examined the efficacy of humorous idiom video clips on the achievement of Iranian undergraduate students studying English as a Foreign Language (EFL). Forty humorous video clips from the English Idiom Series called "The Teacher" from the BBC website were used to teach 120 idioms to 61…

Process of Implementing Critical Reading Strategies in an Iranian EFL Classroom: An Action Research

ERIC Educational Resources Information Center

Nasrollahi, Mohammad Ali; Krishnasamy, Pramela Krish N.; Noor, Noorizah Mohd

2015-01-01

Action research designs are systematic procedures used by teachers to gather quantitative and qualitative data to address improvements in their educational setting, their teaching, and the learning of their students. Action research enables teachers to keep track and take account of the many aspects of their work with students through a systematic…

Implementing Mobile-Assisted Language Learning (MALL) in an EFL Context: Iranian EFL Teachers' Perspectives on Challenges and Affordances

ERIC Educational Resources Information Center

Dashtestani, Reza

2013-01-01

The implementation of computer-assisted language learning (CALL) has provided tremendous opportunities for language teachers to promote their computer literacy and adopt a learner-centered approach to teaching. Accordingly, with the rising advent of language learning technologies, language teachers would occupy a fundamental role in preparing and…

Collocational Differences between L1 and L2: Implications for EFL Learners and Teachers

ERIC Educational Resources Information Center

Sadeghi, Karim

2009-01-01

Collocations are one of the areas that produce problems for learners of English as a foreign language. Iranian learners of English are by no means an exception. Teaching experience at schools, private language centers, and universities in Iran suggests that a significant part of EFL learners' problems with producing the language, especially at…

A Comparative Revolution? An Argument for In-Depth Study of the Iranian Revolution in a Familiar Way

ERIC Educational Resources Information Center

White, Jonathan

2011-01-01

Although the curriculum changes of 2008 brought with them new GCSE specifications, Jonathan White was disappointed by the dated feel of some "Modern World" options, particularly the depth studies on offer. Drawing on his experience of teaching comparative history within the International Baccalaureate, and building on previous arguments…

They're Why We're Here

ERIC Educational Resources Information Center

Razook, Nim

2009-01-01

The author began teaching at the University of Oklahoma in the late 1970s. In this article, the author shares two memories of those times on campus. The first was looking out his office window and seeing Iranian students marching on campus, shouting, "The Shah is a Fascist Pig." The second memory provoked this paper. It made the author…

The Epidemiology of Primary and Revision Total Hip Arthroplasty in Teaching and Nonteaching Hospitals in the United States.

PubMed

Kowalik, Thomas D; DeHart, Matthew; Gehling, Hanne; Gehling, Paxton; Schabel, Kathryn; Duwelius, Paul; Mirza, Amer

2016-06-01

The purpose of this study was to examine the epidemiology of primary and revision total hip arthroplasty (THA) in teaching and nonteaching hospitals. The Healthcare Cost and Utilization Project Nationwide Inpatient Sample was queried from 2006 to 2010 to identify primary and revision THAs at teaching and nonteaching hospitals. A total of 1,336,396 primary and 223,520 revision procedures were identified. Forty-six percent of all primary and 54% of all revision procedures were performed at teaching hospitals. Teaching hospitals performed 17% of their THAs as revisions; nonteaching hospitals performed 12% as revisions. For primary and revision THAs, teaching hospitals had fewer patients aged >65 years, fewer Medicare patients, similar gender rates, more nonwhite patients, and more patients in the highest income quartile compared with nonteaching hospitals. Costs, length of stay, and Charlson Comorbidity Index scores were similar; however, the mortality rate was lower at teaching hospitals. This study found small but significant differences in key epidemiologic and outcome variables in examining primary and revision THA at teaching and nonteaching hospitals. Level III.

Health consequences of shift-work: the case of iranian hospital security personnel.

PubMed

Abedini, Roghayeh; Soltanzadeh, Ahmad; Faghih, Mohammad Amin; Mohammadi, Heidar; Kamalinia, Mojtaba; Mohraz, Majid Habibi; Arassi, Maziyar; Veyseh, Peyman Piran; Aghaei, Hamed; Hosseini, Seyed Younes

2015-01-01

Shift-work, which is an ergonomics issue in workplaces, can negatively affect workers. The security personnel of medical centers in Iran have multiple responsibilities and consequently are exposed to such unwanted situations as observing patients, disputing with patient's attendants, unwanted shift schedules, and being away from family for long periods. This study assessed health problems of Iranian hospital security personnel (shift-worker personnel) using the Survey of Shift-workers (SOS) questionnaire (Persian version). This cross-sectional study was conducted in seven medical centers (4 hospitals and 3 clinics). A total of 416 workers were surveyed: shift-workers (exposed group) (n=209) and non-shift-workers (unexposed group) (n=207). The prevalence of adverse health effects was higher in shift-workers than day-workers. The level of education and mean Body Mass Index (BMI) in shift-workers were significantly higher compared with day-workers. The prevalence of gastrointestinal disorders, cardiovascular and psychological problems were also significantly higher in shift-workers compared with day-workers. Overall, the prevalence of health problems among the security personnel of medical centers was high. Hence, it is recommended that personnel be put under periodic monitoring and receive medical counseling and treatment if there is any disorder.

Forceps Delivery Volumes in Teaching and Nonteaching Hospitals: Are Volumes Sufficient for Physicians to Acquire and Maintain Competence?

PubMed Central

Kyser, Kathy L.; Lu, Xin; Santillan, Donna; Santillan, Mark; Caughey, Aaron B.; Wilson, Mark C.; Cram, Peter

2015-01-01

Purpose The decline in the use of forceps in operative deliveries over the last two decades raises questions about teaching hospitals' ability to provide trainees with adequate experience in the use of forceps. The authors examined: (1) the number of operative deliveries performed in teaching and nonteaching hospitals, and (2) whether teaching hospitals performed a sufficient number of forceps deliveries for physicians to acquire and maintain competence. Method The authors used State Inpatient Data from nine states to identify all women hospitalized for childbirth in 2008. They divided hospitals into three categories: major teaching, minor teaching, and nonteaching. They calculated delivery volumes (total operative, cesarean, vacuum, forceps, two or more methods) for each hospital and compared data across hospital categories. Results The sample included 1,344,305 childbirths in 835 hospitals. The mean cesarean volumes for major teaching, minor teaching, and nonteaching hospitals were 969.8, 757.8, and 406.9. The mean vacuum volumes were 301.0, 304.2, and 190.4, and the mean forceps volumes were 25.2, 15.3, and 8.9. In 2008, 31 hospitals (3.7% of all hospitals) performed no vacuum extractions, and 320 (38.3%) performed no forceps deliveries. In 2008, 13 (23%) major teaching and 44 (44%) minor teaching hospitals performed five or fewer forceps deliveries. Conclusions Low forceps delivery volumes may preclude many trainees from acquiring adequate experience and proficiency. These findings highlighted broader challenges, faced by many specialties, in ensuring that trainees and practicing physicians acquire and maintain competence in infrequently performed, highly technical procedures. PMID:24280847

Posttraumatic growth in Iranian cancer patients.

PubMed

Rahmani, A; Mohammadian, R; Ferguson, C; Golizadeh, L; Zirak, M; Chavoshi, H

2012-01-01

To investigate the level and determinants of posttraumatic growth in Iranian cancer patients. This descriptive-correlational design study was conducted within a university-affiliated oncology hospital in Iran. A convenience sample of 450 patients with a definitive diagnosis of cancer of any type completed a demographic questionnaire and a posttraumatic growth inventory. Some disease-related information was obtained from patients' medical records. The mean of posttraumatic growth reported by participants was 76.1. There was a statistically significant association between experience of posttraumatic growth and age (r = - 0.21, P=0.001), education at university level (F = 8.9, P=0.001) and history of treatment by radiotherapy (t = 2.1, P=0.03). The findings of this study suggest that Iranian cancer patients experience a moderate to high level of posttraumatic growth and confirm the hypothesis that the level of posttraumatic growth in non-Western cancer patients is more than that of Western cancer patients. Although, assessing the reasons for this difference needs more investigations.

Iranian entrepreneur nurses' perceived barriers to entrepreneurship: A qualitative study.

PubMed

Jahani, Simin; Abedi, Heidarali; Elahi, Nasrin; Fallahi-Khoshknab, Masoud

2016-01-01

To respond efficiently to the increasing and new needs of people in health issues, it is necessary for nurses to develop their knowledge from hospital to society and to be equipped to play entrepreneur role in different levels of care. The present study was conducted to describe Iranian entrepreneur nurses' perceived barriers to entrepreneurship, in order to identify the existing barriers. This is a qualitative study in which Graneheim and Lundman's content analysis method was employed. Thirteen entrepreneur nurses were chosen purposively, and data were gathered by unstructured interviews. As a result of the data analysis, five major themes were extracted: Traditional nursing structure, legal limitations, traditional attitudes of governmental managers, unprofessional behaviors of colleagues, and immoral business. The findings of the present study show that Iranian nurses are confronted with various problems and barriers to enter entrepreneur nursing and keep going in this area. By focusing on such barriers and applying appropriate changes, policymakers and planners in health can facilitate nurses entering into this activity.

A qualitative difference. Patients' views of hospital food service in Iran.

PubMed

Jessri, Mahsa; Mirmiran, Parvin; Jessri, Maryam; Johns, Nick; Rashidkhani, Bahram; Amiri, Parisa; Barfmal, Nasrin; Azizi, Fereidoun

2011-10-01

Undernutrition and food acceptability in hospitals form a worldwide problem, but existing studies offer a predominantly Western perspective. This research investigated inpatients' satisfaction with meals in five Iranian hospitals, using focus group discussions, interviews and meal observations. The main problem areas included food quality and quantity, nutritional control, meal arrangements and staff attitudes. Iran's hospitals follow a Western model, which may be appropriate for medical systems, but is less so for patient feeding, due to budgetary constraints and cultural factors. Understanding patients' experience makes it possible to improve feeding arrangements, with a positive impact upon patients' nutrition. Copyright © 2011 Elsevier Ltd. All rights reserved.

On the Efficiency of Text Production in Vocabulary Learning: An Empirical Study on Iranian GFL-Learners

ERIC Educational Resources Information Center

Haghani, Nader; Kiani, Samira

2018-01-01

The concept of text-oriented vocabulary exercises is based on Kühn's (2000) three-step model of vocabulary teaching--receptive, reflective and productive vocabulary exercises--which focuses on working with texts. Since the production is in principle more exhausting than the reception--as can be seen from the Levels of Processing Effect--one can…

The Effect of Dynamic Assessment on L2 Grammar Acquisition by Iranian EFL Learners

ERIC Educational Resources Information Center

Kamali, Mojtaba; Abbasi, Mehdi; Sadighi, Firooz

2018-01-01

This study investigated the effect of dynamic Assessment (DA) on the acquisition of L2 grammar by EFL learners. The focus was on teaching Conditional Type II, or Unreal Conditional, which is a difficult structure for language learners to acquire. To this end, two intact classes of intermediate EFL learners, each consisting of 23 male students were…

A Story-Telling Approach to Teaching English to Young EFL Iranian Learners

ERIC Educational Resources Information Center

Kalantari, Farzaneh; Hashemian, Mahmood

2016-01-01

This study investigated the effects of the storytelling approach on improving of EFL learners' vocabulary knowledge. To this end, 30 upper-beginner EFL learners (out of a population of 134) were selected by means of an OPT test and were assigned to 2 groups: 1 experimental and 1 group. The participants were selected from among young EFL learners…

Efficiency of Using a Web-Based Approach to Teach Reading Strategies to Iranian EFL Learners

ERIC Educational Resources Information Center

Dehghanpour, Elham; Hashemian, Mahmood

2015-01-01

Applying new technologies with their effective potentials have changed education and, consequently, the L2 teacher role. Coping with online materials imposes the necessity of employing Web-based approaches in L2 instruction. The ability to use reading strategies in a Web-based condition needs sufficient skill which will be fulfilled if it is…

The Effect of Context on Iranian EFL Students' Amount of Speech Production of English Language and Their Ways of Using Hedging Devices

ERIC Educational Resources Information Center

Mostofee, Saheb; Pour, Samane Raeis

2016-01-01

Socioculturally and sociolinguistically, gender can have a profound effect on learning and teaching English language as a foreign language. Also learning cooperatively in which both female and male students are involved seems to play a constructive role in creating and enhancing students' performance, achievement and competence of a foreign…

A Comparative Study between Iranian and Japanese Students' Conceptions of "Ideal English Lesson"

ERIC Educational Resources Information Center

Jafari, Sakineh; Ketabi, Saeed

2014-01-01

With the shift in language teaching towards a more learner-centered approach, there is now an emphasis on considering learners' views on what goes on in the classroom. Involving learners in selecting and evaluating classroom activities as well as listening to their voices and preferences can be helpful for teachers in planning lesson and designing…

The Relationship between Anxiety and Test-Taking C-Test and Cloze-Test

ERIC Educational Resources Information Center

Azimi, Mozhgan

2016-01-01

Anxiety has an important role in teaching and learning. If teachers can recognize which kind of tests create high anxiety then they will be able to omit these kinds of tests. Then, the results of test can probably show the students' knowledge more carefully. The subjects of the present study were sixty Iranian female junior university students.…

Iranian Language Teachers' and Students' Perspectives on Top Notch Series (2nd Edition) at Intermediate Level

ERIC Educational Resources Information Center

Azadsarv, Mehdi; Tahriri, Abdorreza

2014-01-01

As the means of transferring knowledge between teachers and students, coursebooks play a significant role in educational practices all over the world. Evaluation of coursebooks is also of great significance as it manages to a better understanding of the nature of a specific teaching/learning situation. The present study is an attempt to evaluate…

The Application of Corpora in Teaching Grammar: The Case of English Relative Clause

ERIC Educational Resources Information Center

Sahragard, Rahman; Kushki, Ali; Ansaripour, Ehsan

2013-01-01

The study was conducted to see if the provision of implementing corpora on English relative clauses would prove useful for Iranian EFL learners or not. Two writing classes were held for the participants of intermediate level. A record of 15 writing samples produced by each participant was kept in the form of a portfolio. Participants' portfolios…

The Effect of Teachers' Beliefs and Sense of Self-Efficacy on Iranian EFL Learners' Satisfaction and Academic Achievement

ERIC Educational Resources Information Center

Rashidi, Nasser; Moghadam, Meisam

2014-01-01

The purpose of this study was to investigate the relationship between teachers' beliefs about their teaching methods and their sense of self-efficacy. The study also examined the effects of these characteristics on students' satisfaction and academic achievement. Participants included 16 instructors and 255 intermediate students (121 males and 127…

Iranian nurses' professional competence in spiritual care in 2014.

PubMed

Adib-Hajbaghery, Mohsen; Zehtabchi, Samira; Fini, Ismail Azizi

2017-06-01

The holistic approach views the human as a bio-psycho-socio-spiritual being. Evidence suggests that among these dimensions, the spiritual one is largely ignored in healthcare settings. This study aimed to evaluate Iranian nurses' perceived professional competence in spiritual care, the relationship between perceived competence and nurses' personal characteristics, and barriers to provide spiritual care. A cross-sectional study was conducted in the year 2014. Participants and research context: The study population consisted of nurses working in teaching hospitals in Kashan city. Using a stratified, systematic random method, 250 samples were selected from a total of 1400 nurses. An indigenous instrument was used to assess the nurses' competencies in spiritual care. Ethical considerations: A research ethics committee approved the study. All the participants were briefed on the study aims, were assured of the confidentiality of their personal information, and signed a written informed consent. Among a total of 250 nurses, 239 answered the questionnaire completely, and in total, 23%, 51%, and 26% had poor, moderate, and favorable competence in spiritual care, respectively. No significant differences were found between the mean competence scores of spiritual care in terms of gender, marital status, employment status, and level of qualification. Significant difference was found between nurses' overall score of competence in spiritual care and receiving training on spiritual care, nurses' position, and the ward they worked in. Confirming the findings of the international literature, this study puts light on the situation of nurses' perceived competence and barriers to providing spiritual care in Iran as an eastern and Islamic context. Three-quarters of the nurses had moderate or unfavorable competence in spiritual care. Due to the crucial role of spiritual care in quality of care and patient satisfaction, nurses should be trained and supported to provide spiritual care.

Pregnancy through the Lens of Iranian Women with HIV: A Qualitative Study.

PubMed

Behboodi-Moghadam, Zahra; Khalajinia, Zohre; Nasrabadi, Ali-Reza Nikbakht; Mohraz, Minoo; Gharacheh, Maryam

2016-01-01

To explore the experience of pregnancy among Iranian women with HIV, 12 HIV-infected pregnant women who referred to counseling center for behavioral diseases in Imam Khomeini Hospital were recruited through purposive sampling. Data were collected by face-to-face, semi-structured interview and were analyzed using conventional content analysis method. Four main themes emerged from the data: fear and hope, stigma and discrimination, marital life stability, and trust in God. Despite concerns about mother-to-child transmission of HIV, and uncertain life span, HIV-infected women tended to continue their pregnancy, and having children was viewed as a window of hope for them. © The Author(s) 2015.

The leadership concept in Iranian nursing.

PubMed

Memarian, R; Ahmadi, F; Vaismoradi, M

2008-03-01

Although greater emphasis has been placed on leadership skills in nursing management in the last decade, the concepts are often confused or used erroneously by Iranian nurses. At the same time we have observed that wide variations in nurses' clinical practice appeared to be related to the presence or absence of leadership skills among senior nurses. To begin to identify the concepts used for expressing leadership in nursing within the Iranian cultural context. A qualitative approach was adopted using content analysis of semi-structured interviews carried out with 10 nurse managers from hospitals in Teheran. The data were analysed using the constant comparative method. Fifty-five primary codes were identified from the respondents' experiences and from these three main themes were abstracted for describing the leadership concept. These were 'personality traits', 'being a model', and 'being a spiritual guide for the nursing profession'. Implementing the culture of patient safety and dignity needs leadership. From Iranian nurse managers' perspectives a leader as a spiritual guide should empower nurses spiritually; it means he/she has a vision for nursing; has clear and explicit objectives; and has a commitment to nursing. Nurses who are confident about the underlying concepts of leadership in their culture can help to adapt nursing to an ever-changing healthcare environment.

Double-stranded RNA viral infection of Trichomonas vaginalis (TVV1) in Iranian isolates.

PubMed

Khanaliha, Khadijeh; Masoumi-Asl, Hossein; Bokharaei-Salim, Farah; Tabatabaei, Azardokht; Naghdalipoor, Mehri

2017-08-01

The Totiviridae family includes a number of viruses that can infect protozoan parasites such as Leishmania and Giardia and fungi like Saccharomyces cerevisiae. Some isolates of Trichomonas vaginalis are also infected with one or more double-stranded RNA (dsRNA) viruses. In this study, the frequency of Trichomonas vaginalis virus (TVV1) was evaluated in Iranian isolates of T. vaginalis in Tehran, Iran. One thousand five hundred vaginal samples were collected from patients attending obstetrics and gynaecology hospitals associated with Iran University of Medical Sciences in Tehran, Iran from October 2015 to September 2016. Trichomonas vaginalis isolates were cultured in Diamond's modified medium. Nucleic acids were extracted using a DNA/RNA extraction kit and RT-PCR was performed. Among 1500 collected vaginal samples, 8 (0.53%) cases of T. vaginalis infection were found. Half (4/8) of the T. vaginalis positive cases were infected with TVV1. Phylogenetic mapping indicated that the Iranian isolates were most closely related to TVV1-OC5, TVV1-UR1. Iranian isolates of T. vaginalis were infected with TVV1. The frequency of viral infection (TVV1) in T. vaginalis isolates found in this study is higher than previously reported in Iran. Copyright © 2017 Elsevier Ltd. All rights reserved.

First report of OXA-143-lactamase producing Acinetobacter baumannii in Qom, Iran.

PubMed

Sarikhani, Zohreh; Nazari, Razieh; Nateghi Rostami, Mahmoud

2017-11-01

Antibiotic resistance in Acinetobacter baumannii and outbreaks caused by this organism have been reported from several areas of the world. The present study aimed at determining the antibiotic susceptibility profiles and the distribution of OXA-type beta-lactamases among Iranian Acinetobacter baumannii isolates from Qom of Iran. For this study, 108 non-duplicate A. baumannii isolates were obtained from clinical specimens in four teaching hospitals in Qom in the central of Iran. The antimicrobial susceptibility of isolates was tested by standard disk diffusion and prevalence of bla OXA genes was investigated by PCR method. Among 97 carbapenem non-susceptible isolates of A. baumannii , 90.72% (88 isolates) isolates showed extensive drug resistance to multiple antibiotics. Among carbapenem resistant isolates, 100% carried bla OXA-51-like , 82.47% carried bla OXA-23-like , 55.67% carried bla OXA-58-like , 22.68% carried bla OXA-40-like and 14.43% had bla OXA-143-like resistance genes. This study demonstrated high genetic diversity of OXA genes among isolates of A. baumannii in Qom, Iran.

First report of OXA-143-lactamase producing Acinetobacter baumannii in Qom, Iran

PubMed Central

Sarikhani, Zohreh; Nazari, Razieh; Nateghi Rostami, Mahmoud

2017-01-01

Objective(s): Antibiotic resistance in Acinetobacter baumannii and outbreaks caused by this organism have been reported from several areas of the world. The present study aimed at determining the antibiotic susceptibility profiles and the distribution of OXA-type beta-lactamases among Iranian Acinetobacter baumannii isolates from Qom of Iran. Materials and Methods: For this study, 108 non-duplicate A. baumannii isolates were obtained from clinical specimens in four teaching hospitals in Qom in the central of Iran. The antimicrobial susceptibility of isolates was tested by standard disk diffusion and prevalence of bla OXA genes was investigated by PCR method. Results: Among 97 carbapenem non-susceptible isolates of A. baumannii, 90.72% (88 isolates) isolates showed extensive drug resistance to multiple antibiotics. Among carbapenem resistant isolates, 100% carried blaOXA-51-like, 82.47% carried blaOXA-23-like, 55.67% carried blaOXA-58-like, 22.68% carried blaOXA-40-like and 14.43% had blaOXA-143-like resistance genes. Conclusion: This study demonstrated high genetic diversity of OXA genes among isolates of A. baumannii in Qom, Iran. PMID:29299207

Evaluation of Factors Influencing Accuracy of Principal Procedure Coding Based on ICD-9-CM: An Iranian Study

PubMed Central

Farzandipour, Mehrdad; Sheikhtaheri, Abbas

2009-01-01

To evaluate the accuracy of procedural coding and the factors that influence it, 246 records were randomly selected from four teaching hospitals in Kashan, Iran. “Recodes” were assigned blindly and then compared to the original codes. Furthermore, the coders' professional behaviors were carefully observed during the coding process. Coding errors were classified as major or minor. The relations between coding accuracy and possible effective factors were analyzed by χ2 or Fisher exact tests as well as the odds ratio (OR) and the 95 percent confidence interval for the OR. The results showed that using a tabular index for rechecking codes reduces errors (83 percent vs. 72 percent accuracy). Further, more thorough documentation by the clinician positively affected coding accuracy, though this relation was not significant. Readability of records decreased errors overall (p = .003), including major ones (p = .012). Moreover, records with no abbreviations had fewer major errors (p = .021). In conclusion, not using abbreviations, ensuring more readable documentation, and paying more attention to available information increased coding accuracy and the quality of procedure databases. PMID:19471647

Indirect costs of teaching in Canadian hospitals.

PubMed Central

MacKenzie, T A; Willan, A R; Cox, M A; Green, A

1991-01-01

We sought to determine whether there are indirect costs of teaching in Canadian hospitals. To examine cost differences between teaching and nonteaching hospitals we estimated two cost functions: cost per case and cost per patient-day (dependent variables). The independent variables were number of beds, occupancy rate, teaching ratio (number of residents and interns per 100 beds), province, urbanicity (the population density of the county in which the hospital was situated) and wage index. Within each hospital we categorized a random sample of patient discharges according to case mix and severity of illness using age and standard diagnosis and procedure codes. Teaching ratio and case severity were each highly correlated positively with the dependent variables. The other variables that led to higher costs in teaching hospitals were wage rates and number of beds. Our regression model could serve as the basis of a reimbursement system, adjusted for severity and teaching status, particularly in provinces moving toward introducing case-weighting mechanisms into their payment model. Even if teaching hospitals were paid more than nonteaching hospitals because of the difference in the severity of illness there should be an additional allowance to cover the indirect costs of teaching. PMID:1898870

Maternal request CS--role of hospital teaching status and for-profit ownership.

PubMed

Xirasagar, Sudha; Lin, Herng-Ching

2007-05-01

To examine whether hospitals' for-profit (FP) ownership and non-teaching status are associated with greater likelihood of maternal request cesarean (CS) relative to public and not-for-profit (NFP) and teaching status, respectively. Retrospective, cross-sectional, population-based study of Taiwan's National Health Insurance claims data, covering all 739,531 vaginal delivery-eligible singleton deliveries during 1997-2000, using multiple logistic regression analyses. Adjusted for maternal age and geographic location, FP district hospitals (almost all non-teaching), followed by ob/gyn clinics were significantly more likely to perform request CS (OR=3.5-2.3) than public and NFP teaching hospitals. Among non-teaching and teaching hospitals, FPs were more likely to perform request CS than public and NFP hospitals (OR=2.3 and 2.5, respectively). Our findings are consistent with greater propensity of physicians in FP institutions to accommodate patient requests involving revenue-maximizing procedures such as request CS. This effect is moderated by teaching hospitals' preference for complicated cases, consistent with their teaching mission and hi-tech infrastructure.

Mortality among high-risk patients with acute myocardial infarction admitted to U.S. teaching-intensive hospitals in July: a retrospective observational study.

PubMed

Jena, Anupam B; Sun, Eric C; Romley, John A

2013-12-24

Studies of whether inpatient mortality in US teaching hospitals rises in July as a result of organizational disruption and relative inexperience of new physicians (July effect) find small and mixed results, perhaps because study populations primarily include low-risk inpatients whose mortality outcomes are unlikely to exhibit a July effect. Using the US Nationwide Inpatient sample, we estimated difference-in-difference models of mortality, percutaneous coronary intervention rates, and bleeding complication rates, for high- and low-risk patients with acute myocardial infarction admitted to 98 teaching-intensive and 1353 non-teaching-intensive hospitals during May and July 2002 to 2008. Among patients in the top quartile of predicted acute myocardial infarction mortality (high risk), adjusted mortality was lower in May than July in teaching-intensive hospitals (18.8% in May, 22.7% in July, P<0.01), but similar in non-teaching-intensive hospitals (22.5% in May, 22.8% in July, P=0.70). Among patients in the lowest three quartiles of predicted acute myocardial infarction mortality (low risk), adjusted mortality was similar in May and July in both teaching-intensive hospitals (2.1% in May, 1.9% in July, P=0.45) and non-teaching-intensive hospitals (2.7% in May, 2.8% in July, P=0.21). Differences in percutaneous coronary intervention and bleeding complication rates could not explain the observed July mortality effect among high risk patients. High-risk acute myocardial infarction patients experience similar mortality in teaching- and non-teaching-intensive hospitals in July, but lower mortality in teaching-intensive hospitals in May. Low-risk patients experience no such July effect in teaching-intensive hospitals.

Mortality among High Risk Patients with Acute Myocardial Infarction Admitted to U.S. Teaching-Intensive Hospitals in July: A Retrospective Observational Study

PubMed Central

Jena, Anupam B.; Sun, Eric C.; Romley, John A.

2014-01-01

Background Studies of whether inpatient mortality in U.S. teaching hospitals rises in July as a result of organizational disruption and relative inexperience of new physicians (‘July effect’) find small and mixed results, perhaps because study populations primarily include low-risk inpatients whose mortality outcomes are unlikely to exhibit a July effect. Methods and Results Using the U.S. Nationwide Inpatient sample, we estimated difference-in-difference models of mortality, percutaneous coronary intervention (PCI) rates, and bleeding complication rates, for high and low risk patients with acute myocardial infarction (AMI) admitted to 98 teaching-intensive and 1353 non-teaching-intensive hospitals during May and July 2002 to 2008. Among patients in the top quartile of predicted AMI mortality (high risk), adjusted mortality was lower in May than July in teaching-intensive hospitals (18.8% in May, 22.7% in July, p<0.01), but similar in non-teaching-intensive hospitals (22.5% in May, 22.8% in July, p=0.70). Among patients in the lowest three quartiles of predicted AMI mortality (low risk), adjusted mortality was similar in May and July in both teaching-intensive hospitals (2.1% in May, 1.9% in July, p=0.45) and non-teaching-intensive hospitals (2.7% in May, 2.8% in July, p=0.21). Differences in PCI and bleeding complication rates could not explain the observed July mortality effect among high risk patients. Conclusions High risk AMI patients experience similar mortality in teaching- and non-teaching-intensive hospitals in July, but lower mortality in teaching-intensive hospitals in May. Low risk patients experience no such “July effect” in teaching-intensive hospitals. PMID:24152859

A Culture of Solidarity?

PubMed

Centellas, Kate

2015-01-01

In this article, based on interviews, ethnographic data, and documentary evidence, I examine the case of a Bolivian-Iranian hospital in the context of south-south scientific and economic collaboration. This hospital provides a lens through which we can understand the tensions between local and global processes. Medicine, in particular, has become a site where such alignments are made visible and tangible: the term 'biogeopolitics' helps to describe this process. I use the hospital as a way to illustrate what theory from the south might look like ethnographically, and conclude with a discussion of the contradictions and promises of theory from the south within south-south collaborations.

The incentive effects of the Medicare indirect medical education policy.

PubMed

Nicholson, S; Song, D

2001-11-01

Medicare provided teaching hospitals with US$ 5.9 billion in supplemental graduate medical education (GME) payments in 1998. These payments distort input and output prices and provide teaching hospitals with incentives to hire residents, close beds, and admit more Medicare patients. The structure of the GME payment policy creates substantial variation in input and output prices between teaching hospitals. We examine the extent to which hospitals responded to these financial incentives using a panel data set of 3,900 hospitals, including over 900 teaching hospitals. We find that teaching hospitals did hire residents and close beds in response to the Medicare policy, but did not increase Medicare admissions or alter their use of registered nurses (RNs).

Ethical challenges in the neonatal intensive care units: perceptions of physicians and nurses; an Iranian experience.

PubMed

Kadivar, Maliheh; Mosayebi, Ziba; Asghari, Fariba; Zarrini, Pari

2015-01-01

The challenging nature of neonatal medicine today is intensified by modern advances in intensive care and treatment of sicker neonates. These developments have caused numerous ethical issues and conflicts in ethical decision-making. The present study surveyed the challenges and dilemmas from the viewpoint of the neonatal intensive care personnel in the teaching hospitals of Tehran University of Medical Sciences (TUMS) in the capital of Iran. In this comparative cross-sectional study conducted between March 2013 and February 2014, the physicians' and nurses' perceptions of the ethical issues in neonatal intensive care units were compared. The physicians and nurses of the study hospitals were requested to complete a 36-item questionnaire after initial accommodations. The study samples consisted of 284 physicians (36%) and nurses (64%). Content validity and internal consistency calculations were used to examine the psychometric properties of the questionnaire. Data were analyzed by Pearson's correlation, t-test, ANOVA, and linear regression using SPSS v. 22. Respecting patients' rights and interactions with parents were perceived as the most challenging aspects of neonatal care. There were significant differences between sexes in the domains of the perceived challenges. According to the linear regression model, the perceived score would be reduced 0.33 per each year on the job. The results of our study showed that the most challenging issues were related to patients' rights, interactions with parents, communication and cooperation, and end of life considerations respectively. It can be concluded, therefore, that more attention should be paid to these issues in educational programs and ethics committees of hospitals.

Ethical challenges in the neonatal intensive care units: perceptions of physicians and nurses; an Iranian experience

PubMed Central

Kadivar, Maliheh; Mosayebi, Ziba; Asghari, Fariba; Zarrini, Pari

2015-01-01

The challenging nature of neonatal medicine today is intensified by modern advances in intensive care and treatment of sicker neonates. These developments have caused numerous ethical issues and conflicts in ethical decision-making. The present study surveyed the challenges and dilemmas from the viewpoint of the neonatal intensive care personnel in the teaching hospitals of Tehran University of Medical Sciences (TUMS) in the capital of Iran. In this comparative cross-sectional study conducted between March 2013 and February 2014, the physicians’ and nurses’ perceptions of the ethical issues in neonatal intensive care units were compared. The physicians and nurses of the study hospitals were requested to complete a 36-item questionnaire after initial accommodations. The study samples consisted of 284 physicians (36%) and nurses (64%). Content validity and internal consistency calculations were used to examine the psychometric properties of the questionnaire. Data were analyzed by Pearson's correlation, t-test, ANOVA, and linear regression using SPSS v. 22. Respecting patients’ rights and interactions with parents were perceived as the most challenging aspects of neonatal care. There were significant differences between sexes in the domains of the perceived challenges. According to the linear regression model, the perceived score would be reduced 0.33 per each year on the job. The results of our study showed that the most challenging issues were related to patients’ rights, interactions with parents, communication and cooperation, and end of life considerations respectively. It can be concluded, therefore, that more attention should be paid to these issues in educational programs and ethics committees of hospitals. PMID:26839675

Comparison of Surgical Outcomes Between Teaching and Nonteaching Hospitals in the Department of Veterans Affairs

PubMed Central

Khuri, Shukri F.; Najjar, Samer F.; Daley, Jennifer; Krasnicka, Barbara; Hossain, Monir; Henderson, William G.; Aust, J. Bradley; Bass, Barbara; Bishop, Michael J.; Demakis, John; DePalma, Ralph; Fabri, Peter J.; Fink, Aaron; Gibbs, James; Grover, Frederick; Hammermeister, Karl; McDonald, Gerald; Neumayer, Leigh; Roswell, Robert H.; Spencer, Jeannette; Turnage, Richard H.

2001-01-01

Objective To determine whether the investment in postgraduate education and training places patients at risk for worse outcomes and higher costs than if medical and surgical care was delivered in nonteaching settings. Summary Background Data The Veterans Health Administration (VA) plays a major role in the training of medical students, residents, and fellows. Methods The database of the VA National Surgical Quality Improvement Program was analyzed for all major noncardiac operations performed during fiscal years 1997, 1998, and 1999. Teaching status of a hospital was determined on the basis of a background and structure questionnaire that was independently verified by a research fellow. Stepwise logistic regression was used to construct separate models predictive of 30-day mortality and morbidity for each of seven surgical specialties and eight operations. Based on these models, a severity index for each patient was calculated. Hierarchical logistic regression models were then created to examine the relationship between teaching versus nonteaching hospitals and 30-day postoperative mortality and morbidity, after adjusting for patient severity. Results Teaching hospitals performed 81% of the total surgical workload and 90% of the major surgery workload. In most specialties in teaching hospitals, the residents were the primary surgeons in more than 90% of the operations. Compared with nonteaching hospitals, the patient populations in teaching hospitals had a higher prevalence of risk factors, underwent more complex operations, and had longer operation times. Risk-adjusted mortality rates were not different between the teaching and nonteaching hospitals in the specialties and operations studied. The unadjusted complication rate was higher in teaching hospitals in six of seven specialties and four of eight operations. Risk adjustment did not eliminate completely these differences, probably reflecting the relatively poor predictive validity of some of the risk adjustment models for morbidity. Length of stay after major operations was not consistently different between teaching and nonteaching hospitals. Conclusion Compared with nonteaching hospitals, teaching hospitals in the VA perform the majority of complex and high-risk major procedures, with comparable risk-adjusted 30-day mortality rates. Risk-adjusted 30-day morbidity rates in teaching hospitals are higher in some specialties and operations than in nonteaching hospitals. Although this may reflect the weak predictive validity of some of the risk adjustment models for morbidity, it may also represent suboptimal processes and structures of care that are unique to teaching hospitals. Despite good quality of care in teaching hospitals, as evidenced by the 30-day mortality data, efforts should be made to examine further the structures and processes of surgical care prevailing in these hospitals. PMID:11524590

Epidemiology and resource utilization in pediatric facial fractures.

PubMed

Soleimani, Tahereh; Greathouse, Shawn Travis; Sood, Rajiv; Tahiri, Youssef H; Tholpady, Sunil S

2016-02-01

Pediatric facial fractures, although uncommon, have a significant impact on public health and the US economy by the coexistence of other injuries and developmental deformities. Violence is one of the most frequent mechanisms leading to facial fracture. Teaching hospitals, while educating future medical professionals, have been linked to greater resource utilization in differing scenarios. This study was designed to compare the differences in patient characteristics and outcomes between teaching and non-teaching hospitals for violence-related pediatric facial fractures. Using the 2000-2009 Kids' Inpatient Database, 3881 patients younger than 18 years were identified with facial fracture and external cause of injury code for assault, fight, or abuse. Patients admitted at teaching hospitals were compared to those admitted at non-teaching hospitals in terms of demographics, injuries, and outcomes. Overall, 76.2% of patients had been treated at teaching hospitals. Compared to those treated at non-teaching hospitals, these patients were more likely to be younger, non-white, covered by Medicaid, from lower income zip codes, and have thoracic injuries; but mortality rate was not significantly different. After adjusting for potential confounders, teaching status of the hospital was not found as a predictor of either longer lengths of stay (LOS) or charges. There is an insignificant difference between LOS and charges at teaching and non-teaching hospitals after controlling for patient demographics. This suggests that the longer LOS observed at teaching hospitals is related to these institutions being more often involved in the care of underserved populations and patients with more severe injuries. Copyright © 2016 Elsevier Inc. All rights reserved.

Iranian EFL Teachers' Perception, Familiarity and Use of Web 2.0 Tools in TEFL

ERIC Educational Resources Information Center

Shahrokni, Seyed Abdollah; Sadeqjoola, Leila

2015-01-01

Following social-constructivist approaches in education, there has been a growing interest in employing Web 2.0 technologies in language classes. While the effectiveness of these digital teaching crafts has been corroborated in many studies (see Crook et al., 2008, for a survey), there is always doubt if they have reached a normalized state in L2…

Teachers' and Learners' Perceptions of Applying Translation as a Method, Strategy, or Technique in an Iranian EFL Setting

ERIC Educational Resources Information Center

Mollaei, Fatemeh; Taghinezhad, Ali; Sadighi, Firooz

2017-01-01

It has been found that translation is an efficient means to teach/learn grammar, syntax, and lexis of a foreign language. Meanwhile, translation is good for beginners who do not still enjoy the critical level of proficiency in their target language for expression. This study was conducted to examine the teachers' and learners' perceptions of…

The Effect of Explicit vs. Implicit Instruction on the Learnability of English Consonant Clusters by Iranian Learners of English

ERIC Educational Resources Information Center

Khanbeiki, Ruhollah; Abdolmanafi-Rokni, Seyed Jalal

2015-01-01

The present study was aimed at providing the English teachers across Iran with a good and fruitful method of teaching pronunciation. To this end, sixty female intermediate EFL learners were put in three different but equivalent groups of 20 based on the results of a pronunciation pre-test. One of the groups received explicit instruction including…

The Effects of Audio-Visual Recorded and Audio Recorded Listening Tasks on the Accuracy of Iranian EFL Learners' Oral Production

ERIC Educational Resources Information Center

Drood, Pooya; Asl, Hanieh Davatgari

2016-01-01

The ways in which task in classrooms has developed and proceeded have receive great attention in the field of language teaching and learning in the sense that they draw attention of learners to the competing features such as accuracy, fluency, and complexity. English audiovisual and audio recorded materials have been widely used by teachers and…

The Effect of Teaching Memory Strategies on Iranian EFL Learner's Vocabulary Retention in Terms of Learners' Multiple Intelligences

ERIC Educational Resources Information Center

Abbassi, Adele; Hassaskhah, Jaleh; Tahriri, Abdorreza

2018-01-01

This study targeted to explore the effect of memory strategy on EFL learners' vocabulary retention with a consideration of learners' multiple intelligences. In this study, the memory strategy consisted of three parts of grouping, acronym and images. The participants of this study were 80 male and female EFL learners of intermediate level who…

A Last Stronghold of Traditional Zoroastrianism. Teaching Aids for the Study of Inner Asia, No. 7.

ERIC Educational Resources Information Center

Boyce, Mary

Zoroastrianism, an ancient religion dating back to the Iranian Stone Age, is still practiced in areas of Iran and India. Following centuries of oppression under Muslim rule in Iran, the adherents are located today in remote areas and only recently have welcomed unbelievers into their fire temples to view the sacred fire (Atash Bahram) and the…

Variation in childbirth services in California: a cross-sectional survey of childbirth hospitals.

PubMed

Korst, Lisa M; Feldman, Daniele S; Bollman, D Lisa; Fridman, Moshe; El Haj Ibrahim, Samia; Fink, Arlene; Wyatt, Lacey; Gregory, Kimberly D

2015-10-01

The objective of the study was to describe the resources and activities associated with childbirth services. We adapted models for assessing the quality of healthcare to generate a conceptual framework hypothesizing that childbirth hospital resources and activities contributed to maternal and neonatal outcomes. We used this framework to guide development of a survey, which we administered by telephone to hospital labor and delivery nurse managers in California. We describe the findings by hospital type (ie, integrated delivery system [IDS], teaching, and other [community] hospitals). Of 248 nonmilitary childbirth hospitals in California, 239 (96%)responded; 187 community, 27 teaching, and 25 IDS hospitals reported. The context of services varied across hospital types, with community hospitals more likely to have for-profit ownership, be in a rural or isolated location, and have fewer annual deliveries per hospital. Results included the findings of the following: (1) 24 hour anesthesia availability in 50% of community vs 100% of IDS and teaching hospitals (P < .001); (2) 24 hour in-house labor and delivery physician coverage in 5% of community vs 100% of IDS and 48% of teaching hospitals (P < .001); (3) 24 hour blood bank availability in 88% of community vs 96% of IDS and 100% of teaching hospitals (P = .092); (4) adult subspecialty intensive care unit availability in 33% of community vs 36% of IDS and 82% of teaching hospitals (P < .001); (5) ability to perform emergency cesarean delivery in 30 minutes 100% of the time in 56% of community vs 100% of IDS and 85% of teaching hospitals (P < .001); (6) pediatric care available both day and night in 54% of community vs 63% of IDS vs 76% of teaching hospitals (P = .087); and (7) no neonatal intensive care unit in 44% of community vs 12% of IDS and 4% of teaching hospitals (P < .001). Childbirth services varied widely across California hospitals. Cognizance of this variation and linkage of these data to childbirth outcomes should assist in the identification of key resources and activities that optimize the hospital environment for pregnant women and set the groundwork for identifying criteria for the provision of maternal risk-appropriate care. Copyright © 2015 Elsevier Inc. All rights reserved.

Social Support Behaviors and Work Stressors among Nurses: A Comparative Study between Teaching and Non-Teaching Hospitals.

PubMed

Amarneh, Basil Hameed

2017-01-29

The concept of "work stressors" has been well studied. However, in the field of nursing, studies concerning social support behaviors are limited. The aim of this study was to compare nurse work stressors, social support behaviors, and predictors of these variables among nurses in Jordanian teaching and non-teaching hospitals. A convenience sampling technique and a comparative quantitative research design were used in the current study. Two hundred and ninety-one nurses were recruited from five teaching hospitals, and 172 were recruited from eight non-teaching hospitals in Jordan. The Nursing Stress Scale (NSS) and the Inventory of Social Supportive Behaviors (ISSB) were used to collect data. The studied variables differed across hospitals. In some subscales, as well as in some individual items of the scales, nurse work stressors and social support behaviors differed between teaching and non-teaching hospitals. In teaching hospitals, the work shift was the only predictor of nurses' work stressors, whereas the work shift and model of nursing care were predictors of social support behaviors. In non-teaching hospitals, the work shift, level of education, and model of nursing care were predictors of nurse work stressors. Predictors of social support behaviors were marital status, model of nursing, and organizational structure. Regardless of the type of hospital, nurse stressors should be assessed and, once identified, managed by providing various social support behaviors. By turning a work environment into a healthy workplace, researchers and nurse leaders believe that improvements can be realized in recruitment and patient safety and quality.

Social Support Behaviors and Work Stressors among Nurses: A Comparative Study between Teaching and Non-Teaching Hospitals

PubMed Central

Amarneh, Basil Hameed

2017-01-01

Purpose: The concept of “work stressors” has been well studied. However, in the field of nursing, studies concerning social support behaviors are limited. The aim of this study was to compare nurse work stressors, social support behaviors, and predictors of these variables among nurses in Jordanian teaching and non-teaching hospitals. Design: A convenience sampling technique and a comparative quantitative research design were used in the current study. Two hundred and ninety-one nurses were recruited from five teaching hospitals, and 172 were recruited from eight non-teaching hospitals in Jordan. Methods: The Nursing Stress Scale (NSS) and the Inventory of Social Supportive Behaviors (ISSB) were used to collect data. Results: The studied variables differed across hospitals. In some subscales, as well as in some individual items of the scales, nurse work stressors and social support behaviors differed between teaching and non-teaching hospitals. In teaching hospitals, the work shift was the only predictor of nurses’ work stressors, whereas the work shift and model of nursing care were predictors of social support behaviors. In non-teaching hospitals, the work shift, level of education, and model of nursing care were predictors of nurse work stressors. Predictors of social support behaviors were marital status, model of nursing, and organizational structure. Conclusions: Regardless of the type of hospital, nurse stressors should be assessed and, once identified, managed by providing various social support behaviors. Clinical relevance: By turning a work environment into a healthy workplace, researchers and nurse leaders believe that improvements can be realized in recruitment and patient safety and quality. PMID:28146045

Iranian entrepreneur nurses’ perceived barriers to entrepreneurship: A qualitative study

PubMed Central

Jahani, Simin; Abedi, Heidarali; Elahi, Nasrin; Fallahi-Khoshknab, Masoud

2016-01-01

Background: To respond efficiently to the increasing and new needs of people in health issues, it is necessary for nurses to develop their knowledge from hospital to society and to be equipped to play entrepreneur role in different levels of care. The present study was conducted to describe Iranian entrepreneur nurses’ perceived barriers to entrepreneurship, in order to identify the existing barriers. Materials and Methods: This is a qualitative study in which Graneheim and Lundman's content analysis method was employed. Thirteen entrepreneur nurses were chosen purposively, and data were gathered by unstructured interviews. Results: As a result of the data analysis, five major themes were extracted: Traditional nursing structure, legal limitations, traditional attitudes of governmental managers, unprofessional behaviors of colleagues, and immoral business. Conclusions: The findings of the present study show that Iranian nurses are confronted with various problems and barriers to enter entrepreneur nursing and keep going in this area. By focusing on such barriers and applying appropriate changes, policymakers and planners in health can facilitate nurses entering into this activity. PMID:26985222

Quality of work life: experiences of Iranian nurses.

PubMed

Vagharseyyedin, Seyyed Abolfazl; Vanaki, Zohreh; Mohammadi, Eesa

2011-03-01

The purpose of this qualitative study was to describe the experiences of Iranian nurses concerning their quality of work life. A purposive sample of nurses (n = 14) was recruited from two university hospitals. The data were collected through unstructured interviews and were analyzed by using qualitative content analysis. The results indicated that the participants discerned their quality of work life by assessing how favorable were their working conditions, the level of fulfilment of their personal needs, and the impact of their working conditions on their private life and their social life. Three main themes were identified: quality of work life, as experienced from a personal perspective; quality of work life, as experienced from a sociocultural perspective; and quality of work life, as experienced from an organizational-professional perspective. The results of the present study will help Iranian nurse administrators to adopt effective strategies in order to improve nurses' quality of work life. Future research can broaden the scope of the current results and offer a more comprehensive understanding of nurses' quality of work life. © 2011 Blackwell Publishing Asia Pty Ltd.

Changes in Teaching Hospitals' Community Benefit Spending After Implementation of the Affordable Care Act.

PubMed

Alberti, Philip M; Sutton, Karey M; Baker, Matthew

2018-05-22

U.S. teaching hospitals that qualify as 501(c)(3) organizations (a not-for-profit designation) are required to demonstrate community benefit annually. Increases in health insurance access driven by Affordable Care Act (ACA) implementation, along with new regulations, research opportunities, and educational expectations, may be changing hospitals' allocations of community benefit dollars. This study aimed to describe changes in teaching hospitals' community benefit spending between 2012 (pre-ACA implementation) and 2015 (post-ACA implementation), and to explore differences in spending changes between hospitals in Medicaid expansion and non-expansion states. In 2017, for each teaching hospital member of the Association of American Medical Colleges' (AAMC's) Council of Teaching Hospitals and Health Systems required to submit Form 990s to the Internal Revenue Service, the authors sought community benefit spending data for 2012 and 2015 as reported on Schedule H. The analysis included 169 pairs of Form 990s representing 184 AAMC member teaching hospitals (93% of 198 eligible hospitals). Compared with 2012, hospitals in 2015 spent $3.1 billion (20.14%) more on community benefit despite spending $804 million (16.17%) less on charity care. Hospitals in Medicaid expansion states increased spending on subsidized health services and Medicaid shortfalls at rates higher than hospitals in non-expansion states. The latter increased spending at higher rates on community health improvement and cash/in-kind contributions. After ACA implementation, teaching hospitals increased their overall community benefit spending while their charity care spending declined. Changes in community benefit spending differed according to states' Medicaid expansion status, demonstrating hospitals' responsiveness to state and local realities.

Compassion fatigue and burnout in Iranian nurses: The role of perceived social support.

PubMed

Ariapooran, Saeed

2014-05-01

Nurses are at risk for symptoms of compassion fatigue (CF) and burnout (BO). Social support plays an important role in predicting CF and BO. This study was performed to determine the prevalence of the symptoms of CF and BO and the role of perceived social support in predicting these symptoms in Iranian nurses. Using a correlational descriptive survey research design, we selected 173 participants among the nurses working in public hospitals of Malayer, Iran. Professional Quality of Life (CF and BO subscales) and Multidimensional Scale of Perceived Social Support (MSPSS) were used for collecting the data. The obtained results indicated that the prevalence of CF and BO symptoms was 45.3% and 15.03%, respectively, in Iranian nurses. Social support (significant other, family, and friends) was negatively correlated to BO (P < 0.01). Also, there was a negative correlation between social support from family and CF (P < 0.01). According to hierarchical multiple regressions, social support from family was the significant predictor to CF (P < 0.005) and BO (P < 0.001) in nurses. Based on the obtained results, some nurses (especially emergency nurses) are at risk for CF and BO and social support negatively correlated to CF and BO in Iranian nurses. It is necessary to develop support systems for nurses who are at risk for CF and BO.

Compassion fatigue and burnout in Iranian nurses: The role of perceived social support

PubMed Central

Ariapooran, Saeed

2014-01-01

Background: Nurses are at risk for symptoms of compassion fatigue (CF) and burnout (BO). Social support plays an important role in predicting CF and BO. This study was performed to determine the prevalence of the symptoms of CF and BO and the role of perceived social support in predicting these symptoms in Iranian nurses. Materials and Methods: Using a correlational descriptive survey research design, we selected 173 participants among the nurses working in public hospitals of Malayer, Iran. Professional Quality of Life (CF and BO subscales) and Multidimensional Scale of Perceived Social Support (MSPSS) were used for collecting the data. Results: The obtained results indicated that the prevalence of CF and BO symptoms was 45.3% and 15.03%, respectively, in Iranian nurses. Social support (significant other, family, and friends) was negatively correlated to BO (P < 0.01). Also, there was a negative correlation between social support from family and CF (P < 0.01). According to hierarchical multiple regressions, social support from family was the significant predictor to CF (P < 0.005) and BO (P < 0.001) in nurses. Conclusions: Based on the obtained results, some nurses (especially emergency nurses) are at risk for CF and BO and social support negatively correlated to CF and BO in Iranian nurses. It is necessary to develop support systems for nurses who are at risk for CF and BO. PMID:24949067

42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... services furnished in a teaching hospital. (g) Aggregate per diem methods of apportionment—(1) For the... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN...

42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

Code of Federal Regulations, 2014 CFR

2014-10-01

... services furnished in a teaching hospital. (g) Aggregate per diem methods of apportionment—(1) For the... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE...) SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS...

42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... services furnished in a teaching hospital. (g) Aggregate per diem methods of apportionment—(1) For the... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN...

42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

Code of Federal Regulations, 2012 CFR

2012-10-01

... services furnished in a teaching hospital. (g) Aggregate per diem methods of apportionment—(1) For the... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE...) SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS...

42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

Code of Federal Regulations, 2013 CFR

2013-10-01

... services furnished in a teaching hospital. (g) Aggregate per diem methods of apportionment—(1) For the... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE...) SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS...

Relationship between Gender and Vocabulary Teaching Methodology among Iranian EFL Children: A Comparison of TPR and Direct Method

ERIC Educational Resources Information Center

Naeini, Nazgol Nekoui; Shahrokhi, Mohsen

2016-01-01

The present study intended to examine the impact of methodology on EFL vocabulary learning of elementary school boys and girls. To achieve this end, 40 elementary female and male students aged 9-10 were selected from among 60 students studying at a language institute in Isfahan, Iran. The students were selected based on the results of an overall…

Period Prevalence and Reporting Rate of Needlestick Injuries to Nurses in Iran: A Systematic Review and Meta-Analysis.

PubMed

Rezaei, Satar; Hajizadeh, Mohammad; Zandian, Hamed; Fathi, Afshin; Nouri, Bijan

2017-08-01

The purpose of this systematic review and meta-analysis was to provide a precise estimate of the period prevalence of needlestick injuries (NSI) among nurses working in hospitals in Iran and the reporting rate of NSI to nurse managers. We searched both international (PubMed, Scopus and the Institute for Scientific Information) and Iranian (Scientific Information Database, Iranmedex and Magiran) scientific databases to find studies published from 2000 to 2016 of NSI among Iranian nurses. The following keywords in Persian and English were used: "needle-stick" or "needle stick" or "needlestick," with and without "injury" or "injuries," "prevalence" or "frequency," "nurses" or "nursing staff," and "Iran." In a sample of 21 articles with 6,480 participants, we estimated that the overall 1-year period prevalence of NSI was 44% (95% confidence interval [CI], 35-53%) among Iranian nurses. The overall 1-year period prevalence of reporting NSI to nurse managers was 42% (95% CI, 33-52%). In meta-regression analysis, sample size, mean age, years of experience, and gender ratio were not associated with prevalence of NSI or reporting rate. The year of data collection was positively associated with period prevalence of NSI (p < .05), but not with the period prevalence of reporting NSI to nurse managers. Results indicated a high NSI period prevalence and low NSI reporting rate among nurses in Iran. Thus, effective interventions are required in hospitals in Iran to reduce the prevalence and increase the reporting rate of NSI. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Finding Low-Cost Medical Care (For Teens)

MedlinePlus

... your insurance company before you go to one. Teaching Hospitals and Medical Centers Teaching hospitals and medical centers are the final step ... mentioned may offer specialist care at set times. Teaching hospitals and medical schools usually have clinics for ...

Sickness absenteeism rate in Iranian schools during the 2009 epidemic of type a influenza.

PubMed

Pourabbasi, Ata; Shirvani, Mahbubeh Ebrahimnegad; Khashayar, Patricia

2012-02-01

Influenza pandemic was a global event in 2009 and intraschool transmission was its main spread method. The present study was designed to evaluate the absenteeism rate during the type A influenza epidemic. Four hundred and eight students from both a guidance school and high school in the Iranian capital were recruited in this retrospective study. The number of days of absenteeism, since the beginning of the school year until the end of the epidemic was recorded. Two hundred and thirteen students missed school during the disease epidemic because of related causes. In other words, 581 person day absences were reported during this period. The influenza pandemic has led to an increase in the absenteeism rate and may negatively affect the academic performance of the students. Teaching precautionary measures is an effective tool in reducing the number of days of sickness.

Developing marketing strategies for university teaching hospitals.

PubMed

Fink, D J

1980-07-01

University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, a rising tide of consumerism, and in many cases a declining urban population base. These problems, which may threaten the teaching hospital's ability to continue tertiary care, teaching, and research functions, may be solved with the aid of new marketing strategies. In developing its marketing strategy, a hospital must assess its strengths and weaknesses, specify its goals in measurable terms, implement tactics to achieve these goals, and evaluate its marketing program. The strategies should be directed toward achieving better relationships with institutions, practitioners, and surrounding communities and increasing patient, visitor, and employee satisfaction. A wide variety of programs can be used to reach these goals and to help teaching hospitals meet the competitive challenges of this decade.

42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Conditions of payment: Assistants at surgery in... in Teaching Settings § 415.190 Conditions of payment: Assistants at surgery in teaching hospitals. (a... schedule basis for the services of an assistant at surgery in a teaching hospital. This section is based on...

42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Conditions of payment: Assistants at surgery in... in Teaching Settings § 415.190 Conditions of payment: Assistants at surgery in teaching hospitals. (a... schedule basis for the services of an assistant at surgery in a teaching hospital. This section is based on...

Financial, Resource Utilization and Mortality Impacts of Teaching Hospital Status on Pediatric Patients Admitted for Sepsis.

PubMed

Hsu, Benson S; Meyer, Benjamin D; Lakhani, Saquib A

2017-08-01

With the changing healthcare landscape in the United States, teaching hospitals face increasing pressure to provide medical education as well as cost-effective care. Our study investigated the financial, resource utilization and mortality impact of teaching hospital status on pediatric patients admitted with sepsis. We conducted a retrospective, weighted statistical analysis of hospitalized children with the diagnosis of sepsis. The Agency for Healthcare Research and Quality 2009 Kids' Inpatient Database provided the data for analysis. Diagnosis of sepsis and severity of illness levels were based on All Patient Refined Diagnosis-Related Groups of 720: Septicemia and Disseminated Infections. Teaching hospital status was based on presence of training programs. Statistical analysis was conducted using STATA 12.1 (Stata Corporation, College Station, TX). Weighted analysis revealed 17,461 patients with sepsis-9982 in teaching and 7479 in nonteaching hospitals. When comparing all patients, length of stay (8.2 vs. 4.8, P < 0.001), number of procedures received (2.03 vs. 0.87, P < 0.001), mortality (4.7% vs. 1.6%, P < 0.001), costs per day ($2326 vs. $1736, P < 0.001) and total costs ($20,428 vs. $7960, P < 0.001) were higher in teaching hospitals. Even when stratified by severity classes, length of stay, number of procedures received and total costs were higher in teaching hospitals with no difference in mortality. Our study suggested that teaching hospitals provide pediatric inpatient care for sepsis at greater costs and resource utilization without a clear improvement in overall mortality rates in comparison with nonteaching hospitals.

Trialling diagnosis-related groups classification in the Iranian health system: a case study examining the feasibility of introducing casemix.

PubMed

Ghaffari, S; Doran, C; Wilson, A; Aisbett, C

2010-05-01

This paper examines the quality of routinely collected information in an Iranian hospital in a trial of casemix classification. Australian Refined Diagnosis Related Groups (AR-DRG) were used to classify patient episodes. There were 327 DRGs identified, of which 20% had only 1 case. The grouper program identified invalid records for 4% of total separations. Approximately 4.5% of cases were classified into error DRGs and 3.4% were ungroupable. No complication and comorbidity effects were identified with 93% of total cases. R2 (variance in length of stay explained) was 44% for untrimmed cases, increasing to 63%, 57% and 58% after trimming by L3H3, IQR and 10th-95th percentile methods respectively.

Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments?

PubMed

Hajizadeh, Mohammad; Nghiem, Hong Son

2011-12-01

Since the beginning of 1980s, the Iranian health care system has undergone several reforms designed to increase accessibility of health services. Notwithstanding these reforms, out-of-pocket payments which create a barrier to access health services contribute almost half of total health are financing in Iran. This study aimed to provide a greater understanding about the inequality and determinants of the out-of-pocket expenditure (OOPE) and the related catastrophic expenditure (CE) for hospital services in Iran using a nationwide survey data, the 2003 Utilisation of Health Services Survey (UHSS). The concentration index and the Heckman selection model were used to assess inequality and factors associated with these expenditures. Inequality analysis suggests that the CE is concentrated among households in lower socioeconomic levels. The results of the Heckman selection model indicate that factors such as length of stay, admission to a hospital owned by private sector or Ministry of Health and Medical Education, and living in remote areas are positively associated with higher OOPE. Results of the ordered-probit selection model demonstrate that length of stay, lower household wealth index, and admission to a private hospital are major factors contributing to the increase in the probability of CE. Also, we find that households living in East Azarbaijan, Kordestan and Sistan and Balochestan face a higher level of CE. Based on our findings, the current employer-sponsored health insurance system does not offer equal protection against hospital expenditure in Iran. It seems that a single universal health insurance scheme that covers health services for all Iranian-regardless of their employment status-can better protect households from catastrophic health spending.

Iranian Effective Clinical Nurse Instructor evaluation tool: Development and psychometric testing

PubMed Central

Shahsavari, Hooman; Yekta, Zohreh Parsa; Zare, Zahra; Sigaroodi, Abdolhossain Emami

2014-01-01

Background: Clinical education is the heart of the nursing education program. Effective nursing clinical instructors are needed for graduating the future qualified nurses. There is a well-developed body of knowledge about the effectiveness of clinical teaching and the instructors. However, translating this knowledge into a context-based evaluation tool for measuring the effectiveness of Iranian clinical nursing instructors remains a deficiency. The purpose of this study is to describe the development and psychometric testing process of an instrument to evaluate the characteristics of Iranian effective clinical nurse instructor. Materials and Methods: Following a precise review of Iranian literatures and expert consultation, 83 statements about the characteristics that make clinical nurse instructors effective were extracted. In the next phase, the psychometric properties of the instrument were established by looking at the content validity, face validity, and internal consistency. Content validity of the instrument was assessed based on the comments of an expert panel including 10 nursing faculty members. During this phase, 30 items of the instrument were omitted or merged. Face validity of the instrument was assured based on the advices of 10 nursing students and 10 nursing faculty members. Finally, in the pilot test, the data of 168 filled questionnaires were gathered and analyzed by an exploratory factor analysis to reduce the items and identify the factor structure of the instrument. Results: Through subsequent analyses, of the 83 items, 31 items were merged or omitted. At last, 52 retained items were divided into four subscales including student-centric behaviors, clinical performances, planning ability, and personality traits. The Cronbach's alpha level of the inventory was 0.96, with the value for each domain ranging from 0.87 to 0.94. Conclusions: Iranian Effective Clinical Nurse Instructor evaluation tool has acceptable psychometric properties and can be used in evaluating the effectiveness of clinical nursing instructors. PMID:24834081

Case Mix Complexity Differences between Teaching and Nonteaching Hospitals.

ERIC Educational Resources Information Center

Ament, Richard P.; And Others

1981-01-01

The differences between teaching and nonteaching hospitals in complexity and variety of cases seen are described. The results show that teaching hospitals could be expected to cost somewhat more per patient even if case mix were the only factor. (Author/MLW)

Attitudes Toward Spirituality and Spiritual Care among Iranian Nurses and Nursing Students: A Cross-Sectional Study.

PubMed

Babamohamadi, Hassan; Ahmadpanah, Mahsa-Sadat; Ghorbani, Raheb

2017-08-22

Addressing spiritual needs is taken into account as an integral part of holistic health care and also an important component of nursing practice. The aim of present study is to evaluate attitudes toward spirituality and spiritual care among nurses and nursing students at Semnan University of Medical Sciences in Iran. In this cross-sectional study, all nurses (n = 180) working in the teaching hospitals affiliated to Semnan University of Medical Sciences as well as senior nursing students (n = 50) selected by the census method. Finally, 168 individuals meeting the inclusion criteria were evaluated as the study sample. The data collection instrument was the Spirituality and Spiritual Care Rating Scale. The mean and standard deviation scores of attitudes toward spirituality and spiritual care among nurses and nursing students were 59 ± 10.9, and the scores obtained by the majority of study population (64.3%) ranged between 32 and 62 which were at a moderate and relatively desirable level. Nurses and nursing students working in aforementioned hospitals reported positive attitudes to spirituality and spiritual care. Given the importance of spiritual care and also the moderate level of spirituality and spiritual care among nurses and nursing students in this study, institutionalization of the concept of spirituality, provision of an appropriate context to deliver such care, and also implementation of interventions in order to improve spiritual care along with other nursing skills were assumed of utmost importance.

Dietary Patterns and Risk of Gallbladder Disease: A Hospital-based Case-Control Study in Adult Women

PubMed Central

Jessri, Mahsa

2015-01-01

ABSTRACT Gallbladder disease is one of the most prevalent gastrointestinal disorders that may result from a complex interaction of genetic and environmental factors. This study examined the association of dietary patterns with gallstone disease among Iranian women. This case-control study was conducted in general teaching hospitals in Tehran, Iran. Participants were 101 female cases and 204 female controls aged 40-65 years who were admitted for problems other than GBD. Dietary patterns were identified using principal components analysis based on food frequency questionnaire. Compared to the control group, cases were less educated, less physically active, and consumed more total energy (p<0.02). Having ≥3 livebirths increased the risk of gallstone by more than 5 times, followed by having rapid weight loss, being single, having familial history of gallstone, and consuming high total energy. Two distinct dietary patterns were identified in women (healthy and unhealthy). After adjustment for several confounding variables, healthy dietary pattern was associated with a decreased risk of gallstone disease (OR=0.14, 95% CI 0.048-0.4) while unhealthy dietary pattern was associated with an increased risk (OR=3.77, 95% CI 1.52-9.36). These findings confirm that dietary pattern approach provides potentially useful and relevant information on the relationship between diet and disease. Identifying risk factors will provide an opportunity for prevention of gallbladder disease in developing countries facing an increased risk of obesity. PMID:25995720

Validation of the Ottawa Knee Rule in Iran: a prospective study.

PubMed

Jalili, Mohammad; Gharebaghi, Hadi

2010-11-01

This study was designed to determine the accuracy of the Ottawa Knee Rule (OKR) when applied to patients with acute knee injury in the Iranian population of the Imam Hospital Emergency Department (ED) at. This prospective cohort validation study included a convenience sample of all patients with a blunt knee injury sustained in the preceding 7 days presenting to the ED of a tertiary care teaching hospital during the study period. Patients were assessed for the five variables comprising the OKR, and a standardised data form was completed for each patient. Standard knee radiographs were ordered on all patients irrespective of the determination of the rule. The rules were interpreted by the primary investigator on the basis of the data sheet and the final orthopaedist radiograph reading. Outcome measures of this study were: sensitivity, specificity, positive predictive value and negative predictive value of the OKR. A total of 283 patients were enrolled in the study. 22 fractures (7.77%) were detected. The decision rule had a sensitivity of 0.95 (95% CI 0.77 to 0.99), and a specificity of 0.44 (95% CI 0.37 to 0.50). The potential reduction in use of radiography was estimated to be 41%. The OKR missed only one fracture. Prospective validation has shown that the OKR is a highly sensitive tool for detecting knee fractures and has the potential to reduce the number of radiographs in patients with acute knee injuries.

Competitive strategy in turbulent healthcare markets: an analysis of financially effective teaching hospitals.

PubMed

Langabeer, J

1998-01-01

As the healthcare marketplace, characterized by declining revenues and heavy price competition, continues to evolve toward managed care, teaching hospitals are being forced to act more like traditional industrial organizations. Profit-oriented behavior, including emphases on market strategies and competitive advantage, is now a necessity if these hospitals are going to survive the transition to managed care. To help teaching hospitals evaluate strategic options that maximize financial effectiveness, this study examined the financial and operating data for 100 major U.S. teaching hospitals to determine relationships among competitive strategy, market environment, and financial return on invested capital. Results should help major hospitals formulate more effective strategies to combat environmental turbulence.

Is there a relationship between high-quality performance in major teaching hospitals and residents' knowledge of quality and patient safety?

PubMed

Pingleton, Susan K; Horak, Bernard J; Davis, David A; Goldmann, Donald A; Keroack, Mark A; Dickler, Robert M

2009-11-01

The relationship of the quality of teaching hospitals' clinical performance to resident education in quality and patient safety is unclear. The authors studied residents' knowledge of these areas in major teaching hospitals with higher- and lower-quality performance rankings. They assessed the presence of formal and informal quality curricula to determine whether programmatic differences exist. The authors used qualitative research methodology with purposeful sampling. They gathered data from individual structured interviews with residents and key educational and quality leaders in six medical schools and teaching hospitals, which represented a range of quality performance rankings, geographic regions, and public or private status. No relationship emerged between a hospital's quality status, residents' curriculum, and the residents' understanding of quality. Residents' definitions of quality and safety and their knowledge of the practice-based learning and systems-based practice competencies were indistinguishable between hospitals. Residents in all programs had extensive patient safety knowledge acquired through an informal curriculum in the hospital setting. A formal curriculum existed in only two programs, both of them ambulatory settings. Residents' learning about quality and patient safety is extensive, largely through a positive informal curriculum in the teaching hospital and, less frequently, via a formal curriculum. No relationship was found between the quality performance of the teaching hospital and the residents' curriculum or understanding of quality or safety. Residents seem to learn through an informal curriculum provided by hospital initiatives and resources, and thus these data suggest the importance of major teaching hospitals in quality education.

Assessment and outcome of 496 penetrating gastrointestinal warfare injuries.

PubMed

Saghafinia, M; Nafissi, N; Motamedi, M R K; Motamedi, M H K; Hashemzade, M; Hayati, Z; Panahi, F

2010-03-01

The abdominal viscera are among the most vulnerable organs of the body to penetrating trauma. Proper management of such trauma in war victims at the first-line hospital where these victims are first seen is of paramount importance. We reviewed medical records of war victims suffering small bowel and colorectal injuries treated at first, second and third-line hospitals during the Iraq-Iran War (1980-88) to assess surgical outcomes. The medical records of 496 Iranian war victims suffering penetrating gastrointestinal (GI) injuries treated at first, second and third-line (tertiary) hospitals, a total of 19 centres, were reviewed. Laparotomy had been performed at the 1st line hospitals for all patients who had an acute abdomen, whose wounds violated the peritoneum or whose abdominal radiographs showed air or shrapnel in the abdominal cavity. Stable patients were transferred from first-line to second-line or from second line to tertiary hospitals postoperatively. The treatments, complications and patient outcomes were documented and analyzed. There were 496 patients; 145, 220 and 131 victims underwent laparotomy for GI injuries at first, second and third-line hospitals respectively. The small intestine and colon respectively were the most prevalent abdominal organs damaged. Those first treated for GI injuries at front-line hospitals (145 victims) had more serious conditions and could not be transferred prior to surgery and presented a higher prevalence of complications and mortality. Overall mortality from GI surgery was 3.6% (18 patients). Eleven patients (7.5%) whose first GI operation was performed at frontline hospitals and 7 patients (3.2%) who underwent their first surgical operation at second-line hospitals died. The most common reason for these deaths was complications relating to the gastrointestinal operation such as anastomotic leak. Six missed injuries were seen at the frontline and one at second line hospitals. There were no deaths at the 3rd line hospitals. Penetrating abdominal injuries were common in Iranian victims of war often causing multiple organ injuries. The colon and small intestine were the more commonly injured organs and carried the most postoperative complications. Mortality at 1st line hospitals was more than double that of 2nd line hospitals; the complication rate was also greater as was the number of missed injuries. Adherence to the standard surgical protocols, prompt evaluation, proper triage and management are factors which may lower patient morbidity and complications.

Developing 21st century accreditation standards for teaching hospitals: the Taiwan experience.

PubMed

Huang, Chung-I; Wung, Cathy; Yang, Che-Ming

2009-12-15

The purpose of this study is to establish teaching hospital accreditation standards anew with the hope that Taiwan's teaching hospitals can live up to the expectations of our society and ensure quality teaching. The development process lasted two years, 2005-2006, and was separated into three stages. The first stage centered on leadership meetings and consensus building, the second on drafting the new standards with expert focus groups, and the third on a pilot study and subsequent revision. Our new teaching hospital accreditation standards have six categories and 95 standards as follows: educational resources (20 items), teaching and training plans and outcomes (42 items), research and results (9 items), development of clinical faculty and continuing education (8 items), academic exchanges and community education (8 items), and administration (8 items). The new standards have proven feasible and posed reasonable challenges in the pilot study. We hope the new standards will strengthen teaching and research, and improve the quality of hospital services at the same time.

Family presence during resuscitation: A descriptive study with Iranian nurses and patients' family members.

PubMed

Zali, Mahnaz; Hassankhani, Hadi; Powers, Kelly A; Dadashzadeh, Abbas; Rajaei Ghafouri, Rouzbeh

2017-09-01

Family presence during resuscitation (FPDR) has advantages for the patients' family member to be present at the bedside. However, FPDR is not regularly practiced by nurses, especially in low to middle income countries. The purpose of this study was to determine Iranian nurses' and family members' attitudes towards FPDR. In a descriptive study, data was collected from the random sample of 178 nurses and 136 family members in four hospitals located in Iran. A 27-item questionnaire was used to collect data on attitudes towards FPDR, and descriptive and correlational analyses were conducted. Of family members, particularly the women, 57.2% (n=78) felt it is their right to experience FPDR and that it has many advantages for the family; including the ability to see that everything was done and worry less. However, 62.5% (n=111) of the nurses disagreed with an adult implementation of FPDR. Nurses perceived FPDR to have many disadvantages. Family members becoming distressed and interfering with the patient which may prolong the resuscitation effort. Nurses with prior education on FPDR were more willing to implement it. FPDR was desired by the majority of family members. To meet their needs, it is important to improve Iranian nurses' views about the advantages of the implementation of FPDR. Education on FPDR is recommended to improve Iranian nurses' views about the advantages of the implementation of FPDR. Copyright © 2017 Elsevier Ltd. All rights reserved.

A survey of staff attitudes to increasing medical undergraduate education in a district general hospital.

PubMed

Macdonald, John

2005-07-01

Medical student numbers in Britain are increasing rapidly, beyond the capacity of most teaching hospitals, with more clinical teaching taking place in district general hospitals (DGHs). Surveys show that students value the intensive clinical teaching, smaller student numbers and perceived greater friendliness in DGHs. This paper explores DGH staff attitudes to teaching--their level of initial enthusiasm, their attitudes to current teaching, its effect on the hospital and to the sustainability of DGH undergraduate teaching--as both student numbers and service workloads continue to rise. Semi-structured interviews with 6 key informants were used to generate themes for a 19-question pre-piloted anonymous postal questionnaire sent to all 68 staff involved in undergraduate medical teaching in Northampton General Hospital. The total response included 85% of consultants. Responses in the 3 staff groups were similar. Most respondents felt enthusiastic at the prospect of medical students, although they realised that this would be intellectually challenging and increase time pressures. These predictions were largely fulfilled. Respondents felt that in comparison to teaching hospitals the DGH teaching was more clinically based and consultant-led, with more approachable staff. Currently 41 respondents (82%) felt that they had inadequate teaching time. A majority felt that the arrival of students had improved patient care and that their department had benefited. Thirty-seven responders (74%) felt that the planned doubling of student numbers would impose an unsustainable departmental load, and would compromise teaching quality. The change felt most necessary to support additional teaching was increased clinical medical staff. Better co-ordination between the DGH and the medical school was also felt necessary. The most popular choice for the distribution of extra teaching finance was to the teacher's directorate, i.e. speciality [33 (66%)]. Forty-four (86%) felt that increased student numbers would have a significant impact on the character of the hospital. The 108 free-text comments (2.1 per respondent) centred on hospital character and the benefits of students. This study shows a considerable initial enthusiasm for teaching in DGH staff, which is persisting despite increasing student numbers. However, the current teaching load is seen to be substantial. Teaching more students is likely to produce major problems, based on lack of teaching time and increasingly heavy service commitments rather than lack of patients. This is likely to be a widespread problem for DGHs. Failure to ensure adequate teaching staff and facilities as well as co-ordination could threaten the sustainability of this potentially valuable teaching initiative.

Cervical Infection with Herpes simplex Virus, Chlamydia trachomatis, and Neisseria gonorrhoeae among Symptomatic Women, Dubai, UAE: A Molecular Approach

PubMed Central

Behzadi, Mohammad Amin; Azizi, Saeed; Payombarnia, Hamid; Vahdani, Ali; Namayandeh, Mandana; Ziyaeyan, Mazyar

2014-01-01

Tragically, genital tract infections are still a major public health problem in many regions. This study was undertaken to determine the prevalence of cervical infection with Herpes simplex virus (HSV), Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG) among married women referring to Iranian Hospital, Dubai, UAE. In a retrospective cross-sectional survey, 201 female patients aged 16–80 years who referred to the Obstetrics and Gynecology Department of Iranian Hospital, Dubai, UAE, in 2010 were enrolled. The patients were categorized into three age groups: 15–30 (group I), 31–40 (group II), and ≥41 years old (group III). A cervical swab sample was collected from each woman and the prevalence of cervical infection with HSV, CT, and NG was determined by PCR method. HSV, CT, and NG were detected in 6.5%, 10.4%, and 5.5% of swab samples, respectively. Regarding age, a significant difference was noticed for prevalence of NG and HSV between groups I and III. Because of public health importance of sexual transmitted diseases (STDs), their long-lasting impact on quality of life, and their economic burden, preventing measures and education of women seem necessary. PMID:24982675

Facilitators and Barriers to Implementing Clinical Governance: A Qualitative Study among Senior Managers in Iran.

PubMed

Ravaghi, Hamid; Rafiei, Sima; Heidarpour, Peigham; Mohseni, Maryam

2014-09-01

Health care systems should assign quality improvement as their main mission. Clinical governance (CG) is a key strategy to improve quality of health care services. The Iranian Ministry of Health and Medical Education (MOHME) has promoted CG as a framework for safeguarding quality and safety in all hospitals since 2009. The purpose of this study was to explore perceived facilitators and barriers to implementing CG by deputies for curative affairs of Iranian medical universities. A qualitative study was conducted using face to face interviews with a purposeful sample of 43 deputies for curative affairs of Iranian Medical Universities and documents review. Thematic analysis was used to analyze the data. Five themes were explored including: knowledge and attitude toward CG, culture, organizational factors, managerial factors and barriers. The main perceived facilitating factors were adequate knowledge and positive attitude toward CG, supporting culture, managers' commitment, effective communication and well designed incentives. Pe rceived barriers were the reverse of facilitators noted above in addition to insufficient resources, legal challenges, workload and parallel quality programs. Successful implementation of CG in Iran will require identifying barriers and challenges existing in the way of CG implementation and try to mitigate them by using appropriate facilitators.

One Strategy for Controlling Costs in University Teaching Hospitals

ERIC Educational Resources Information Center

Thompson, John D.; And Others

1978-01-01

A methodology is outlined that can be used by teaching hospitals in determining their costs of treating patients with a complex mix of diagnoses. It is not held that case mix alone explains all cost differences between teaching and nonteaching hospitals, but that factor must be isolated before examining other variables. (Author/LBH)

Wiring a medical school and teaching hospital for telemedicine.

PubMed

Hjelm, N M; Lee, J C K; Cheng, D; Chui, C

2002-06-01

The planning and installation of a telemedicine system for communication within a teaching hospital and its academic and hospital units with a capacity for accommodation of up to 400 video-stations is described. The system is intended for improving the communication between patients and health professionals, and between the health professionals themselves. It also provides the basis for improving pre-graduate teaching, especially problem-based learning, and all aspects of postgraduate teaching.

Wiring a medical school and teaching hospital for telemedicine.

PubMed

Hjelm, N M; Lee, J C; Cheng, D; Chui, C

2001-05-01

The planning and installation of a telemedicine system for communication within a teaching hospital and its academic and hospital units with a capacity for accommodation of up to 400 video-stations is described. The system is intended for improving the communication between patients and health professionals, and between the health professionals themselves. It also provides the basis for improving pre-graduate teaching, especially problem-based learning, and all aspects of postgraduate teaching.

Comparison of resource utilization and clinical outcomes between teaching and nonteaching medical services.

PubMed

Khaliq, Amir A; Huang, Chiung-Yu; Ganti, Apar Kishor; Invie, Kristie; Smego, Raymond A

2007-05-01

To compare the resource utilization and clinical outcomes of medical care delivered on general internal medicine inpatient services at teaching and nonteaching services at an academic hospital. From February to October 2002, 2189 patients admitted to a 450-bed university-affiliated community hospital were assigned either to a resident-staffed teaching service (n = 1637) or to a hospitalist- or clinic-based internist nonteaching service (n = 552). We compared total hospital costs per patient, length of hospital stay (LOS), hospital readmission within 30 days, in-hospital mortality, and costs for pharmacy, laboratory, radiology, and others between teaching and nonteaching services. Care on a teaching service was not associated with increased overall patient care costs ($5572 vs. $5576; P = .99), LOS (4.92 days vs. 5.10 days; P = .43), readmission rate (12.3% vs. 10.3%; P = .21), or in-hospital mortality (3.7% vs. 4.5%; P = .40). Mean laboratory and radiology costs were higher on the teaching service, but costs for the pharmacy and for speech therapy, occupational therapy, physical therapy, respiratory therapy, pulmonary function testing, and GI endoscopy procedures were not statistically different between the 2 services, and residents did not order more tests or procedures. Case mix and illness severity, as reflected by the distribution of the most frequent DRGs and mean number of secondary diagnoses per patient and DRG-specific LOS, were similar on the 2 services. At our academic hospital, admission to a general internal medicine teaching service resulted in patient care costs and clinical outcomes comparable to those admitted to a nonteaching service. (c) 2007 Society of Hospital Medicine.

Association of Resident Coverage with Cost, Length of Stay, and Profitability at a Community Hospital

PubMed Central

Shine, Daniel; Beg, Sumbul; Jaeger, Joseph; Pencak, Dorothy; Panush, Richard

2001-01-01

OBJECTIVE The effect of care by medical residents on hospital length of stay (LOS), indirect costs, and reimbursement was last examined across a range of illnesses in 1981; the issue has never been examined at a community hospital. We studied resource utilization and reimbursement at a community hospital in relation to the involvement of medical residents. DESIGN This nonrandomized observational study compared patients discharged from a general medicine teaching unit with those discharged from nonteaching general medical/surgical units. SETTING A 620-bed community teaching hospital with a general medicine teaching unit (resident care) and several general medicine nonteaching units (no resident care). PATIENTS All medical discharges between July 1998 and February 1999, excluding those from designated subspecialty and critical care units. MEASUREMENTS AND MAIN RESULTS Endpoints included mean LOS in excess of expected LOS, mean cost in excess of expected mean payments, and mean profitability (payments minus total costs). Observed values were obtained from the hospital's database and expected values from a proprietary risk–cost adjustment program. No significant difference in LOS between 917 teaching-unit patients and 697 nonteaching patients was demonstrated. Costs averaged $3,178 (95% confidencence interval (CI) ± $489) less than expected among teaching-unit patients and $4,153 (95% CI ± $422) less than expected among nonteaching-unit patients. Payments were significantly higher per patient on the teaching unit than on the nonteaching units, and as a result mean, profitability was higher: $848 (95% CI ± $307) per hospitalization for teaching-unit patients and $451 (95% CI ± $327) for patients on the nonteaching units. Teaching-unit patients of attendings who rarely admitted to the teaching unit (nonteaching attendings) generated an average profit of $1,299 (95% CI ± $613), while nonteaching patients of nonteaching attendings generated an average profit of $208 (95% CI ± $437). CONCLUSIONS Resident care at our community teaching hospital was associated with significantly higher costs but also with higher payments and greater profitability. PMID:11251744

General Practice Teaching--Within the Hospital

ERIC Educational Resources Information Center

Drury, M.

1976-01-01

A program of integrated teaching by consultants and general practitioners is described. The teaching took place in the hospitals used for the purpose by the Medical Faculty of the University of Birmingham. (Author)

[Scientific output of orthopaedic hospitals in the Netherlands: not all hospitals meet the requirements of the Dutch orthopaedic residency programme].

PubMed

Eshuis, Rienk; Verheyen, Cees C P M; de Gast, Arthur

2011-01-01

To evaluate the feasibility of the requirements for scientific participation in the Dutch orthopaedic residency programme by assessing the numbers of articles published by orthopaedic teaching hospitals. Descriptive. All 29 orthopaedic teaching hospitals in the Netherlands were asked to draw up a list of articles published from 2004 to 2009. The publications were subdivided into papers indexed in PubMed and papers published in the Nederlands Tijdschrift voor Orthopedie (NTvO, Netherlands Journal of Orthopaedics) and the Nederlands Tijdschrift voor Traumatologie (NTvT, Netherlands Journal of Traumatology). There was an overall response rate of 72% (21/29). For the 8 non-responders a search of PubMed and the NTvO-NTvT journal databases was used to compile a list of their publications. The university teaching hospitals (n = 8) published 1150 articles, 1118 of which were indexed in PubMed, 19 published in the NTvO and 13 in the NTvT. Peripheral teaching hospitals (n = 21) published 689 articles: 590 indexed in PubMed, 77 published in the NTvO and 22 in the NTvT. In the peripheral teaching hospitals there was a positive correlation between the number of orthopaedic surgeons and PhD students and the number of published articles. Of the 29 teaching hospitals, 9 (31%) did not meet the requirements for publication specified in the Dutch orthopaedic residency programme guidelines. The number of published articles is related to the numbers of orthopaedic surgeons and PhD students in peripheral teaching hospitals. The requirements for the minimum number of publications could therefore be revised to reflect the proportion of orthopaedic surgeons in each teaching hospital. The introduction of a weighting factor that accounts for the quality of the publications would also result in a more balanced assessment.

Hospital-level changes in adult ICU bed supply in the United States

PubMed Central

Wallace, David J.; Seymour, Christopher W.; Kahn, Jeremy M.

2017-01-01

Objective Although the number of intensive care beds in the United States is increasing, little is known about the hospitals responsible for this growth. We sought to better characterize national growth in intensive care beds by identifying hospital-level factors associated with increasing numbers of intensive care beds over time. Design We performed a repeated-measures time series analysis of hospital-level intensive care bed supply using data from Centers for Medicare and Medicaid Services. Setting All United States acute care hospitals with adult intensive care beds over the years 1996 to 2011. Measurements & Main Results We described the number of beds, teaching status, ownership, intensive care occupancy and urbanicity for each hospital in each year of the study. We then examined the relationship between increasing intensive care beds and these characteristics, controlling for other factors. The study included 4,457 hospitals and 55,865 hospital-years. Overall, the majority of intensive care bed growth occurred in teaching hospitals (net +13,471 beds, 72.1% of total growth), hospitals with 250 or more beds (net +18,327 beds, 91.8% of total growth) and hospitals in the highest quartile of occupancy (net +10,157 beds, 54.0% of total growth). In a longitudinal multivariable model, larger hospital size, teaching status, and high intensive care occupancy were associated with subsequent-year growth. Furthermore, the effects of hospital size and teaching status were modified by occupancy: the greatest odds of increasing intensive care unit beds were in hospitals with 500 or more beds in the highest quartile of occupancy (adjusted OR: 18.9; 95% CI: 14.0 – 25.5; p<0.01) and large teaching hospitals in the highest quartile of occupancy (adjusted OR: 7.3; 95% CI: 5.3 – 9.9; p<0.01). Conclusions Increasingly, intensive care bed expansion in the United States is occurring in larger hospitals and teaching centers, particularly following a year with high intensive care unit occupancy. PMID:27661861

"The Presence of the Past": A Historical Reading of Bizhan Najdi's "A Plant in Quarantine"

ERIC Educational Resources Information Center

Mehrvand, Ahad; Pourhassan, Amin

2016-01-01

Using flashbacks, Bizhan Najdi's "A Plant in Quarantine" tells the story of the central character called Taher, an Iranian boy, who has been quarantined in a hospital due to abnormal spread of skin rashes after a military service physician took off a lock from the back of his right shoulder. Immediately, Taher came down with a contagious…

The cost effectiveness of rotavirus vaccination in Iran.

PubMed

Mousavi Jarrahi, Yasaman; Zahraei, Seyed Mohsen; Sadigh, Nader; Esmaeelpoor Langeroudy, Keyhan; Khodadost, Mahmoud; Ranjbaran, Mehdi; Sanjari Moghaddam, Ali; Besharat, Mehdi; Mosavi Jarrahi, Alireza

2016-03-03

Rotavirus is the most common cause of severe diarrhea leading to hospitalization or disease-specific death among young children. Effective vaccines have recently been approved and successful vaccination program implemented. The aim of this study was to evaluate the cost effectiveness of mass rotavirus vaccination program in Iran. We developed a Markov model that reflects key features of rotavirus natural history. Parameters of the model were assessed by field study or developed through literature search and published data. We applied the model to the 2009 Iranian birth cohort and evaluated the cost-effectiveness of including the rotavirus vaccine (Rotarix®) into Iranian expanded immunization program (EPI). With an estimated hospitalization rate of 0.05 and outpatient rate of 0.23 cases per person-year, vaccinating cohort of 1231735 infants in Iran with 2 doses of (Rotarix®), would prevent 32092 hospitalizations, 158750 outpatient visits, and 1591 deaths during 5 y of follow-up. Under base-case assumption of $10 cost per course of vaccine, the vaccination would incur an extra cost of $1,019,192 from health care perspective and would avert 54680 DALYs. From societal perspective, there would be $15,192,568 saving for the society with the same averted DALYs. The incremental cost effectiveness ratio showed a cost of $19 US dollars per averted DALY from health care perspective and a saving of $278 US dollars for each averted DALY from societal perspective. Introducing rotavirus vaccine into EPI program would be highly cost-effective public health intervention in Iran.

Patients' perception of dignity in Iranian healthcare settings: a qualitative content analysis.

PubMed

Ebrahimi, Hossein; Torabizadeh, Camellia; Mohammadi, Eesa; Valizadeh, Sousan

2012-12-01

The importance of recognising patient dignity has been realised in recent years. Despite being a central phenomenon in medicine, dignity is a controversial concept, the definition of which in healthcare centres is influenced by a multitude of factors. The aim of this study was to explore the perspective of Iranian patients on respect for their dignity in healthcare centres. With the use of purposeful sampling, 20 patients were interviewed over an 11-month period in three educational hospitals affiliated with the government. They were questioned about experiences related to respect for their dignity during their hospital encounter. Data were processed by qualitative content analysis. Data analysis identified nine categories and four themes. Respondents expressed their expectations and attitudes about dignity by the following themes: seeking a haven; disrespecting privacy; communicating in a vacuum; and disregard for secondary caregivers. They described how respect for their privacy, effective communication, access to facilities, and a regard for the requirements of their companions made them feel that their dignity had been conserved. The findings indicate that almost no patient is satisfied with the quality of services with respect to maintenance of their dignity. Regardless of their hospital location and state of health, most participants had common complaints. These findings agree with the literature and confirm that grounds should be provided for conserving dignity in the healthcare system. To reach this goal, healthcare professionals should be aware of the factors that violate or preserve dignity from the patient's perspective.

[Clinical research outside of teaching hospitals: Current situation in north-eastern France].

PubMed

Goetz, C; Dupoux, A; Déloy, L; Hertz, C; Jeanmaire, T; Parneix, N

2015-04-01

Most clinical research in France takes place in teaching hospitals. There are, however, many advantages to developing it in other hospitals: access to innovative treatments, improvement in healthcare quality, attractiveness of hospitals, increased trial inclusion rates and reduced selection bias. The objectives of our study were to report on the current situation of clinical research outside teaching hospitals. A three-stage survey was conducted between January 2012 and May 2013 in non-teaching hospitals of north-eastern France. First, questionnaires were sent to administrative and medical boards of all hospitals with more than 100 beds, then to head doctors of every department in hospitals with more than 300 beds and finally meetings were organized with members of 20 selected hospitals. The administrative and medical boards of 85 hospitals participated in the first stage of the survey; half of these hospitals were engaged in clinical research activities and for 10 the internal structuring was cross-disciplinary. Answers from 178 departments were obtained during the second stage; 47% reported a clinical research activity. Meetings with research teams in 20 hospitals allowed us to identify difficulties concerning research funding, transversal organization and sponsoring. Clinical research existed in more than half of the respondent non-teaching hospitals. Obstacles to its development can be grouped in three categories: 1) internal structuring of clinical research, 2) access to information and knowledge of how clinical research functions and to interlocutors outside the hospital and 3) access to skills necessary to sponsor clinical research. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Council of Teaching Hospitals: Survey of Housestaff Stipends, Benefits and Funding, 1992.

ERIC Educational Resources Information Center

Evans, Alison

This report presents the results of an annual survey of housestaff stipends, benefits, and funding for physicians at teaching hospitals in 1992. The data, presented in 48 tables and 4 figures, are based on responses from 325 members of the Council of Teaching Hospitals (COTH), an 83 percent response rate to the survey. Chapter I contains stipend…

Evaluating ambulatory care training in Firoozgar hospital based on Iranian national standards of undergraduate medical education

PubMed Central

Sabzghabaei, Foroogh; Salajeghe, Mahla; Soltani Arabshahi, Seyed Kamran

2017-01-01

Background: In this study, ambulatory care training in Firoozgar hospital was evaluated based on Iranian national standards of undergraduate medical education related to ambulatory education using Baldrige Excellence Model. Moreover, some suggestions were offered to promote education quality in the current condition of ambulatory education in Firoozgar hospital and national standards using the gap analysis method. Methods: This descriptive analytic study was a kind of evaluation research performed using the standard check lists published by the office of undergraduate medical education council. Data were collected through surveying documents, interviewing, and observing the processes based on the Baldrige Excellence Model. After confirming the validity and reliability of the check lists, we evaluated the establishment level of the national standards of undergraduate medical education in the clinics of this hospital in the 4 following domains: educational program, evaluation, training and research resources, and faculty members. Data were analyzed according to the national standards of undergraduate medical education related to ambulatory education and the Baldrige table for scoring. Finally, the quality level of the current condition was determined as very appropriate, appropriate, medium, weak, and very weak. Results: In domains of educational program 62%, in evaluation 48%, in training and research resources 46%, in faculty members 68%, and in overall ratio, 56% of the standards were appropriate. Conclusion: The most successful domains were educational program and faculty members, but evaluation and training and research resources domains had a medium performance. Some domains and indicators were determined as weak and their quality needed to be improved, so it is suggested to provide the necessary facilities and improvements by attending to the quality level of the national standards of ambulatory education PMID:29951400

The psychometric properties of an Iranian translation of the Work Ability Index (WAI) questionnaire.

PubMed

Abdolalizadeh, M; Arastoo, A A; Ghsemzadeh, R; Montazeri, A; Ahmadi, K; Azizi, A

2012-09-01

This study was carried out to evaluate the psychometric properties of an Iranian translation of the Work Ability Index (WAI) questionnaire. In this methodological study, nurses and healthcare workers aged 40 years and older who worked in educational hospitals in Ahvaz (236 workers) in 2010, completed the questionnaire and 60 of the workers filled out the WAI questionnaire for the second time to ensure test-retest reliability. Forward-backward method was applied to translate the questionnaire from English into Persian. The psychometric properties of the Iranian translation of the WAI were assessed using the fallowing tests: Internal consistency (to test reliability), test-retest analysis, exploratory factor analysis (construct validity), discriminate validity by comparing the mean WAI score in two groups of the employees that had different levels of sick leave, criterion validity by determining the correlation between the Persian version of short form health survey (SF-36) and WAI score. Cronbach's alpha coefficient was estimated to be 0.79 and it was concluded that the internal consistency was high enough. The intraclass correlation coefficient was recognized to be 0.92. Factor analysis indicated three factors in the structure of the work ability including self-perceived work ability (24.5% of the variance), mental resources (22.23% of the variance), and presence of disease and health related limitation (18.55% of the variance). Statistical tests showed that this questionnaire was capable of discriminating two groups of employees who had different levels of sick leave. Criterion validity analysis showed that this instrument and all dimensions of the Iranian version of SF-36 were correlated significantly. Item correlation corrective for overlap showed the items tests had a good correlation except for one. The finding of the study showed that the Iranian version of the WAI is a reliable and valid measure of work ability and can be used both in research and practical activities.

Does outsourcing paramedical departments of teaching hospitals affect educational status of the students?

PubMed

Moslehi, Shandiz; Atefimanesh, Pezhman; Sarabi Asiabar, Ali; Ahmadzadeh, Nahal; Kafaeimehr, Mohamadhosein; Emamgholizadeh, Saeid

2016-01-01

There is an increasing trend of outsourcing public departments. Teaching hospitals also outsourced some of their departments to private sectors. The aim of this study was to investigate and compare the educational status of students in public and outsourced departments of teaching hospitals affiliated to Iran University of Medical Sciences. This study was conducted in six teaching hospitals of Iran University of Medical Sciences, which had public and outsourced teaching departments in 2015. One hundred fifty students from the departments of radiology, physiotherapy and laboratory participated in this study and their perceptions about their educational status were assessed. A valid and reliable questionnaire was used; participation in the study was voluntary. Descriptive statistics such as mean (SD), t-test and Kolmogorov-Smirnov were used. No difference was detected between the educational status of students in public and outsourced departments of radiology, physiotherapy and laboratory (p>0.05). Based on the students' perception, the private sectors could maintain the educational level of the teaching departments similar to the public departments. It is recommended to involve all the stakeholders such as hospital administrators, academic staff and students in the decision- making process when changes in teaching environments are being considered.

Lucinda Huffaker and the Hospitality of the Wabash Center

ERIC Educational Resources Information Center

Placher, William C.

2007-01-01

As associate director and then director of the Wabash Center for Teaching and Learning in Theology and Religion, Lucinda Huffaker has been a key factor in the Center's reputation for hospitality. The Center's work presupposes that reflection on teaching improves teaching and learning, and good reflection on one's teaching requires taking risks and…

The Hospitalist Huddle: a 1-year experience of teaching Hospital Medicine utilizing the concept of peer teaching in medical education.

PubMed

Elhassan, Mohammed

2017-01-01

The relatively new specialty of Hospital Medicine in the USA is one of the fastest growing fields in internal medicine. Academic hospitalists are largely involved in the medical education of postgraduate residents and medical students. Little is known about the effectiveness of peer-to-peer teaching in internal medicine residency training programs and how the medical residents perceive its educational value in learning Hospital Medicine. The Hospitalist Huddle is a weekly educational activity newly established by our Hospitalist Division to facilitate the concept of peer-to-peer teaching. It requires medical residents to teach and educate their peers about the clinical topics related to Hospital Medicine. Faculty hospitalists serve as facilitators during the teaching sessions. A survey disseminated at the end of the first year of its implementation examined the residents' perception of the educational value of this new teaching activity. Most residents reported that they see the Huddle as a useful educational forum which may improve their skills in teaching, create a better educational and learning environment during their inpatient rotation, and improve their understanding of Hospital Medicine. Most residents also prefer that their peers, rather than faculty hospitalists, run the activity and do the teaching. The survey results support the notion that teaching and learning with flat hierarchies can be an appealing educational method to medical residents to help them understand Hospital Medicine during their medical wards rotation. Some areas need to be improved and others need to be continued and emphasized in order to make this novel educational activity grow and flourish in terms of its educational value and residents' satisfaction.

Creative payment strategy helps ensure a future for teaching hospitals.

PubMed

Vancil, D R; Shroyer, A L

1998-11-01

The Colorado Medicaid Program in years past relied on disproportionate share hospital (DSH) payment programs to increase access to hospital care for Colorado citizens, ensure the future financial viability of key safety-net hospitals, and partially offset the state's cost of funding the Medicaid program. The options to finance Medicaid care using DSH payments, however, recently have been severely limited by legislative and regulatory changes. Between 1991 and 1997, a creative Medicaid refinancing strategy called the major teaching hospital (MTH) payment program enabled $131 million in net payments to be distributed to the two major teaching hospitals in Colorado to provide enhanced funding related to their teaching programs and to address the ever-expanding healthcare needs of their low-income patients. This new Medicaid payment mechanism brought the state $69.5 million in Federal funding that otherwise would not have been received.

Iranian staff nurses' views of their productivity and management factors improving and impeding it: a qualitative study.

PubMed

Dehghan Nayeri, Nahid; Nazari, Ali Akbar; Salsali, Mahvash; Ahmadi, Fazlollah; Adib Hajbaghery, Mohsen

2006-03-01

As the biggest proportion of hospital personnel, Iranian nurses have a major role in providing quality care to patients. Nursing managers and nurses no longer feel that nurses' work is valued and they are concerned about their productivity. Nurses' views about productivity and management factors affecting it have been identified as the most important aspects affecting productivity. Thus, this study assesses productivity from the nurse's view. A grounded theory approach was used for this research. Purposive sampling and semistructured interviews were used. The data were analyzed using constant comparative analysis. Most participants felt that the qualitative nature (effectiveness) of productivity is very important. Also, participants indicated that management is the most important factor that can promote or impede their productivity. They suggested that managers' performance and their skill level are the factors influencing productivity. Effective management can improve nurses' productivity and the quality of care that nurses provide.

Iranian Household Financial Protection against Catastrophic Health Care Expenditures

PubMed Central

Moghadam, M Nekoei; Banshi, M; Javar, M Akbari; Amiresmaili, M; Ganjavi, S

2012-01-01

Background: Protecting households against financial risks is one of objectives of any health system. In this regard, Iran’s fourth five year developmental plan act in its 90th article, articulated decreasing household’s exposure to catastrophic health expenditure to one percent. Hence, this study aimed to measure percentage of Iranian households exposed to catastrophic health expenditures and to explore its determinants. Methods: The present descriptive-analytical study was carried out retrospectively. Households whose financial contributions to the health system exceeded 40% of disposable income were considered as exposed to catastrophic healthcare expenditures. Influential factors on catastrophic healthcare expenditures were examined by logistic regression and chi-square test. Results: Of 39,088 households, 80 were excluded due to absence of food expenditures. 2.8% of households were exposed to catastrophic health expenditures. Influential factors on catastrophic healthcare were utilizing ambulatory, hospital, and drug addiction cessation services as well as consuming pharmaceuticals. Socioeconomics characteristics such as health insurance coverage, household size, and economic status were other determinants of exposure to catastrophic healthcare expenditures. Conclusion: Iranian health system has not achieved the objective of reducing catastrophic healthcare expenditure to one percent. Inefficient health insurance coverage, different fee schedules practiced by private and public providers, failure of referral system are considered as probable barriers toward decreasing households’ exposure to catastrophic healthcare expenditures. PMID:23193508

Urinary Iodine Concentrations in Cancer Patients

PubMed Central

Kargar, Saeed; Shiryazdi, Seyed Mostafa; Atashi, Seyed Reza; Neamatzadeh, Hossein; Kamali, Mahdieh

2017-01-01

Background: It has been suggested that incidence of some cancers, especially examples in the breast and stomach may be influenced by the iodine intake. However, only few studies are available at present. Therefore, we have conducted the present assessment of iodine status in Iranian patients diagnosed with a malignancy. Materials and Methods: This cross-sectional study was conducted in 85 patients diagnosed with different types of cancer at Shahid Sadoughi Hospital, Yazd, Iran. The method used was based on the Sandell–Kolthoff reaction. Results: The median urinary iodine concentration (UIC) was 17.4 μg/L, with ≤20 μg/L indicative of severe iodine deficiency. According to the WHO/IC C IDD/UNIC EF classification, 88.1%, 7.1% and 2.4% of patients had a UIC <20 (severe), 20–49 (mild), and 50–99 μg/L (moderate), respectively. There was no statistically significant differences in UIC between men and women. Conclusion: The UIC values indicate that Iranian cancer patients were seriously iodine deficient according to WHO/UNIC EF/IC C IDD, and that this is a suitable index to assess iodine status in Iranians. Daily consumption of salt fortified with iodine or other approaches to increase intake might be effective strategies for prevention or reduction of malignancies. PMID:28441792

Human dignity in religion-embedded cross-cultural nursing.

PubMed

Cheraghi, Mohammad A; Manookian, Arpi; Nasrabadi, Alireza N

2014-12-01

Although human dignity is an unconditional value of every human being, it can be shattered by extrinsic factors. It is necessary to discover the authentic meaning of patients' dignity preservation from different religious perspectives to provide professional cross-cultural care in a diverse setting. This article identifies common experiences of Iranian Muslim and Armenian Christian patients regarding dignified care at the bedside. This is a qualitative study of participants' experiences of dignified care elicited by individual in-depth semi-structured interviews. A purposeful sample of 10 participants (five Iranian Muslims and five Iranian Armenians) from various private and governmental hospital settings was chosen. This study was approved by the ethics committee of Tehran University of Medical Sciences. All the participants were provided with information about the purpose and the nature of the study, the voluntary condition of their participation in this study, and the anonymous reporting of recorded interviews. The common experiences of Christian and Muslim patients regarding dignity preservation emerged as "exigency of respecting human nobility" and "providing person-centered care." It is essential to recognize the humanness and individuality of each patient to preserve and promote human dignity in diverse cross-cultural settings. The findings support and expand current understanding about the objective and subjective nature of dignity preservation in cross-cultural nursing. © The Author(s) 2014.

Facilitators and Barriers to Implementing Clinical Governance: A Qualitative Study among Senior Managers in Iran

PubMed Central

RAVAGHI, Hamid; RAFIEI, Sima; HEIDARPOUR, Peigham; MOHSENI, Maryam

2014-01-01

Abstract Background Health care systems should assign quality improvement as their main mission. Clinical governance (CG) is a key strategy to improve quality of health care services. The Iranian Ministry of Health and Medical Education (MOHME) has promoted CG as a framework for safeguarding quality and safety in all hospitals since 2009. The purpose of this study was to explore perceived facilitators and barriers to implementing CG by deputies for curative affairs of Iranian medical universities. Methods A qualitative study was conducted using face to face interviews with a purposeful sample of 43 deputies for curative affairs of Iranian Medical Universities and documents review. Thematic analysis was used to analyze the data Results Five themes were explored including: knowledge and attitude toward CG, culture, organizational factors, managerial factors and barriers. The main perceived facilitating factors were adequate knowledge and positive attitude toward CG, supporting culture, managers’ commitment, effective communication and well designed incentives. Pe rceived barriers were the reverse of facilitators noted above in addition to insufficient resources, legal challenges, workload and parallel quality programs. Conclusions Successful implementation of CG in Iran will require identifying barriers and challenges existing in the way of CG implementation and try to mitigate them by using appropriate facilitators. PMID:26175981

42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Conditions of payment: Assistants at surgery in... Physician Services in Teaching Settings § 415.190 Conditions of payment: Assistants at surgery in teaching... a fee schedule basis for the services of an assistant at surgery in a teaching hospital. This...

42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Conditions of payment: Assistants at surgery in... Physician Services in Teaching Settings § 415.190 Conditions of payment: Assistants at surgery in teaching... a fee schedule basis for the services of an assistant at surgery in a teaching hospital. This...

42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Conditions of payment: Assistants at surgery in... Physician Services in Teaching Settings § 415.190 Conditions of payment: Assistants at surgery in teaching... a fee schedule basis for the services of an assistant at surgery in a teaching hospital. This...

76 FR 60452 - In the Matter of: Bahram Maghazehe, a.k.a. Benjamin Maghazehe, a.k.a. Ben Maghazehe, 154 Sequoia...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... Emirates to Iran of a Varian Ximatron oncology system, which was subject to the Regulations,\\3\\ and the...). Maghazehe had knowledge that a U.S. hospital was discarding the oncology system and that a company in Iran... the oncology system to the Iranian company, Maghazehe worked with a U.S. company to arrange for the de...

Potential pros and cons of external healthcare performance evaluation systems: real-life perspectives on Iranian hospital evaluation and accreditation program

PubMed Central

Jaafaripooyan, Ebrahim

2014-01-01

Background: Performance evaluation is essential to quality improvement in healthcare. The current study has identified the potential pros and cons of external healthcare evaluation programs, utilizing them subsequently to look into the merits of a similar case in a developing country. Methods: A mixed method study employing both qualitative and quantitative data collection and analysis techniques was adopted to achieve the study end. Subject Matter Experts (SMEs) and professionals were approached for two-stage process of data collection. Results: Potential advantages included greater attractiveness of high accreditation rank healthcare organizations to their customers/purchasers and boosted morale of their personnel. Downsides, as such, comprised the programs’ over-reliance on value judgment of surveyors, routinization and incurring undue cost on the organizations. In addition, the improved, standardized care processes as well as the judgmental nature of program survey were associated, as pros and cons, to the program investigated by the professionals. Conclusion: Besides rendering a tentative assessment of Iranian hospital evaluation program, the study provides those running external performance evaluations with a lens to scrutinize the virtues of their own evaluation systems through identifying the potential advantages and drawbacks of such programs. Moreover, the approach followed could be utilized for performance assessment of similar evaluation programs. PMID:25279381

Potential pros and cons of external healthcare performance evaluation systems: real-life perspectives on Iranian hospital evaluation and accreditation program.

PubMed

Jaafaripooyan, Ebrahim

2014-09-01

Performance evaluation is essential to quality improvement in healthcare. The current study has identified the potential pros and cons of external healthcare evaluation programs, utilizing them subsequently to look into the merits of a similar case in a developing country. A mixed method study employing both qualitative and quantitative data collection and analysis techniques was adopted to achieve the study end. Subject Matter Experts (SMEs) and professionals were approached for two-stage process of data collection. Potential advantages included greater attractiveness of high accreditation rank healthcare organizations to their customers/purchasers and boosted morale of their personnel. Downsides, as such, comprised the programs' over-reliance on value judgment of surveyors, routinization and incurring undue cost on the organizations. In addition, the improved, standardized care processes as well as the judgmental nature of program survey were associated, as pros and cons, to the program investigated by the professionals. Besides rendering a tentative assessment of Iranian hospital evaluation program, the study provides those running external performance evaluations with a lens to scrutinize the virtues of their own evaluation systems through identifying the potential advantages and drawbacks of such programs. Moreover, the approach followed could be utilized for performance assessment of similar evaluation programs.

Incidence of Nosocomial Infections in a Big University Affiliated Hospital in Shiraz, Iran: A Six-month Experience.

PubMed

Askarian, Mehrdad; Mahmoudi, Hilda; Assadian, Ojan

2013-03-01

Nosocomial infections (NIs) are one of the most important health issues, particularly in developing countries, because these infections cause high mortality and morbidity, and economic and human resource loss as a consequence. To date, most surveillance studies have been conducted in developed countries, and only a few have been performed in Iran. All of the few Iranian studies have been performed using paper-based collection forms, and none was conducted with the aid of an electronic patient data retrieving and collecting tool. The aim of this study is to determine the incidence of NIs in a big university hospital of Shiraz, with the help of specifically programmed surveillance software merging electronically the available patient data and the infection results input manually. The study was conducted prospectively through 6 months from 21(st) March up to 22(nd) September 2006, in a 374-bedded educational hospital. All patients admitted during this period were included in the study and examined everyday for detecting four types of NIs: surgical site infection (SSI), urinary tract infection (UTI), pneumonia (PNEU), and blood stream infection (BSI). Centres for Disease Control and Prevention National Nosocomial Infection Surveillance system criteria were applied. 4013 patients were admitted in the hospital. The overall infection rate was 4.14, and UTI, SSI, BSI, and PNEU rates were 1.82, 1.22, 0.5, and 0.5, respectively, per 1000 patient days of admission. The results of this study showed that the frequency of NI in the investigated hospital was not higher than in many other reported surveillance results from other countries. This, however, might be a bias as the administration of antibiotics was very high in this study and the quality of microbiological investigation might have influenced significantly, resulting in more false-negative results than expected. Overall, the use of the Iranian National Nosocomial Infection Surveillance System Software proved to be useful and allowed both rapid data collection and detailed data analysis.

Teaching surgery takes time: the impact of surgical education on time in the operating room

PubMed Central

Vinden, Christopher; Malthaner, Richard; McGee, Jacob; McClure, J. Andrew; Winick-Ng, Jennifer; Liu, Kuan; Nash, Danielle M.; Welk, Blayne; Dubois, Luc

2016-01-01

Background It is generally accepted that surgical training is associated with increased surgical duration. The purpose of this study was to determine the magnitude of this increase for common surgical procedures by comparing surgery duration in teaching and nonteaching hospitals. Methods This retrospective population-based cohort study included all adult residents of Ontario, Canada, who underwent 1 of 14 surgical procedures between 2002 and 2012. We used several linked administrative databases to identify the study cohort in addition to patient-, surgeon- and procedure-related variables. We determined surgery duration using anesthesiology billing records. Negative binomial regression was used to model the association between teaching versus nonteaching hospital status and surgery duration. Results Of the 713 573 surgical cases included in this study, 20.8% were performed in a teaching hospital. For each procedure, the mean surgery duration was significantly longer for teaching hospitals, with differences ranging from 5 to 62 minutes across individual procedures in unadjusted analyses (all p < 0.001). In regression analysis, procedures performed in teaching hospitals were associated with an overall 22% (95% confidence interval 20%–24%) increase in surgery duration, adjusting for patient-, surgeon- and procedure-related variables as well as the clustering of patients within surgeons and hospitals. Conclusion Our results show that a wide range of surgical procedures require significantly more time to perform in teaching than nonteaching hospitals. Given the magnitude of this difference, the impact of surgical training on health care costs and clinical outcomes should be a priority for future studies. PMID:27007088

Does outsourcing paramedical departments of teaching hospitals affect educational status of the students?

PubMed Central

Moslehi, Shandiz; Atefimanesh, Pezhman; Sarabi Asiabar, Ali; Ahmadzadeh, Nahal; Kafaeimehr, Mohamadhosein; Emamgholizadeh, Saeid

2016-01-01

Background: There is an increasing trend of outsourcing public departments. Teaching hospitals also outsourced some of their departments to private sectors. The aim of this study was to investigate and compare the educational status of students in public and outsourced departments of teaching hospitals affiliated to Iran University of Medical Sciences. Methods: This study was conducted in six teaching hospitals of Iran University of Medical Sciences, which had public and outsourced teaching departments in 2015. One hundred fifty students from the departments of radiology, physiotherapy and laboratory participated in this study and their perceptions about their educational status were assessed. A valid and reliable questionnaire was used; participation in the study was voluntary. Descriptive statistics such as mean (SD), t-test and Kolmogorov-Smirnov were used. Results: No difference was detected between the educational status of students in public and outsourced departments of radiology, physiotherapy and laboratory (p>0.05). Conclusion: Based on the students’ perception, the private sectors could maintain the educational level of the teaching departments similar to the public departments. It is recommended to involve all the stakeholders such as hospital administrators, academic staff and students in the decision- making process when changes in teaching environments are being considered. PMID:27683645

The Effect of Outpatient Visit Volume on Inpatient Teaching Services.

ERIC Educational Resources Information Center

Deyo, Richard A.

1984-01-01

Administrative changes causing a planned decrease in outpatient services offered at a teaching hospital resulted in adverse effects on teaching programs and hospital finances. These results emphasize the important of vertical integration of services to the survival of academic health centers. (Author/MSE)

A national analysis of the relationship between hospital factors and post-cardiac arrest mortality.

PubMed

Carr, Brendan G; Goyal, Munish; Band, Roger A; Gaieski, David F; Abella, Benjamin S; Merchant, Raina M; Branas, Charles C; Becker, Lance B; Neumar, Robert W

2009-03-01

We sought to generate national estimates for post-cardiac arrest mortality, to assess trends, and to identify hospital factors associated with survival. We used a national sample of US hospitals to identify patients resuscitated after cardiac arrest from 2000 to 2004 to describe the association between hospital factors (teaching status, location, size) and mortality, length of stay, and hospital charges. Analyses were performed using logistic regression. A total of 109,739 patients were identified. In-hospital mortality was 70.6%. A 2% decrease in unadjusted mortality from 71.6% in 2000 to 69.6% in 2004 (OR 0.96, P < 0.001) was observed. Mortality was lower at teaching hospitals (OR 0.58, P = 0.001), urban hospitals (OR 0.63, P = 0.004), and large hospitals (OR 0.55, P < 0.001). Mortality after in-hospital cardiac arrest decreased over 5 years. Mortality was lower at urban, teaching, and large hospitals. There are implications for dissemination of best practices or regionalization of post-cardiac arrest care.

Undergraduate radiology education in private and public teaching hospitals in Karachi, Pakistan: teaching duties, methodologies, and rewards

PubMed Central

Nadeem, Naila; Khawaja, Ranish Deedar Ali; Beg, Madiha; Naeem, Muhammad; Majid, Zain

2013-01-01

Background In an integrated method of education, medical students are introduced to radiology in their preclinical years. However, no study has been conducted in Pakistan to demonstrate an academic framework of medical radiology education at an undergraduate level. Therefore, we aimed to document and compare the current level of teaching duties, teaching methodologies, and teaching rewards among radiologists and residents in private and public teaching hospitals in Karachi, Pakistan. Methods A survey was conducted among 121 radiologists and residents in two private and two public teaching hospitals in Karachi, Pakistan. Radiologists who were nationally registered with the Pakistan Medical and Dental Council either part-time or full-time were included. Radiology residents and fellows who were nationally registered with the Pakistan Medical and Dental Council were also included. Self-administered questionnaires addressing teaching duties, methods, and rewards were collected from 95 participants. Results The overall response rate was 78.51% (95/121). All of the radiologists were involved in teaching residents and medical students, but only 36% reported formal training in teaching skills. Although most of the respondents (76%) agreed that medical students appeared enthusiastic about learning radiology, the time spent on teaching medical students was less than five hours per week annually (82%). Only 37% of the respondents preferred dedicated clerkships over distributed clerkships (41%). The most common preferred teaching methodology overall was one-on-one interaction. Tutorials, teaching rounds, and problem-based learning sessions were less favored by radiologists than by residents. Teaching via radiology films (86%) was the most frequent mode of instruction. Salary (59%) was the most commonly cited teaching reward. The majority of respondents (88%) were not satisfied with their current level of teaching rewards. Conclusion All radiologists and residents working in an academic radiology department are involved in teaching undergraduate students at multiple levels. The most valued teaching methodology involves use of images, with one-on-one interaction between the trainer and trainee. The monetary reward for teaching is inbuilt into the salary. The methodology adopted for teaching purposes was significantly different between respondents from private hospitals and those from public teaching hospitals. Because of low satisfaction among the respondents, efforts should be made to provide satisfying teaching rewards. PMID:23745098

Orthopaedic nurses' knowledge about pressure ulcers in Iran: a cross-sectional study.

PubMed

Iranmanesh, S; Tafti, A Abdoli; Rafiei, H; Dehghan, M; Razban, F

2013-03-01

To assess nurses' knowledge about pressure ulcers in an Iranian orthopaedic ward. A cross-sectional, self-report questionnaire study using Pieper's Pressure Ulcer Knowledge Test (PUKT). Orthopaedic nurses' knowledge about pressure ulcers was examined in two teaching hospitals in Iran. The questionnaire consisted of 41 true or false assertions, categorised according to pressure ulcer classification and onset, wound characteristics and preventive measure. Of 68 nurses, 57 participated in this study (response rate of 84%); of the respondents, 68%(n=39) were women and 32% (n= 18) were men. Mean age of participants was 30.2 ± 5.1 years and mean years of experience was 6.9 ± 4.6 years. The overall rate of correct responses by nurses was 70.1%.Nurses had the highest level of knowledge in the pressure ulcer prevention category and the lowest in the pressure ulcer categorisation and onset section. No relationship was found between level of knowledge and nurses' years of experience. Pressure ulcer prevention is one of the most important roles of nurses in an orthopaedic setting. The results of this study suggest that orthopaedic nurses in Iran were not sufficiently knowledgeable about pressure ulcers. Therefore, there is a need to improve their knowledge with some targeted, educational programmes.

Cost implications of ACGME's 2011 changes to resident duty hours and the training environment.

PubMed

Nuckols, Teryl K; Escarce, José J

2012-02-01

In July 2011, the Accreditation Council for Graduate Medical Education (ACGME) will implemented stricter duty-hour limits and related changes to the training environment. This may affect preventable adverse event (PAE) rates. To estimate direct costs under various implementation approaches, and examine net costs to teaching hospitals and cost-effectiveness to society across a range of hypothetical changes in PAEs. A decision-analytical model represented direct costs and PAE rates, mortality, and costs. Published literature and publicly available data. Patients admitted to hospitals with ACGME-accredited programs. One year. All teaching hospitals, major teaching hospitals, society. ACGME's 2011 Common Program Requirements. Direct annual costs (all accredited hospitals), net cost (major teaching hospitals), cost per death averted (society). RESULTS OF BASE-ANALYSIS: Nationwide, duty-hour changes would cost $177 million annually if interns maintain current productivity, vs. up to $982 million if they transfer work to a mixture of substitutes; training-environment changes will cost $204 million. If PAEs decline by 7.2-25.8%, net costs to major teaching hospitals will be zero. If PAEs fall by 3%, the cost to society per death averted would be -$523,000 (95%-confidence interval: -$1.82 million to $685,000) to $2.44 million ($271,000 to $6.91 million). If PAEs rise, the policy will be cost-increasing for teaching hospitals and society. The total direct annual cost nationwide would be up to $1.34 billion using nurse practitioners/physician assistants, $1.64 billion using attending physicians, $820 million hiring additional residents, vs. 1.42 billion using mixed substitutes. The effect on PAEs is unknown. Data were limited for some model parameters. Implementation decisions greatly affect the cost. Unless PAEs decline substantially, teaching hospitals will lose money. If PAEs decline modestly, the requirements might be cost-saving or cost-effective to society.

Where are lengths of stay longer and total charges higher for pediatric burn patients?

PubMed

Myers, John; Lehna, Carlee

2014-01-01

Treatment of pediatric burn patients is costly and may require long length of stay in the hospital (LOS). Establishing where these LOS and charges are highest is warranted. The current study investigated whether pediatric burn patients had higher total charges and longer LOS when seen at teaching hospitals, when compared with nonteaching hospitals. The study reviewed inpatient admissions for pediatric burn patients in 2003, 2006, and 2009 by using the Kids' Inpatient Database, which is part of the Healthcare Cost and Utilization Project. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 940-947 were used to define burn injury, LOS, total charges, and type of hospital. The authors tested for differences between the LOS and total charges between children seen at three types of hospitals (pediatric, nonpediatric/teaching, nonpediatric/nonteaching) while adjusting for traditional risk factors (eg age, total burn surface area) by using generalized linear mixed-effects modeling. A total of N=28,777 children had burn injuries (n=16,115, 56.0% seen at pediatric hospitals; n=9353, 32.5% seen at nonpediatric/teaching hospitals; and n=3309, 11.5% seen at nonpediatric/nonteaching hospitals). Pediatric burn patients seen at pediatric hospitals, unadjusted, have significantly longer LOS (5.54 days vs 4.25 days and 4.00 days, P<.001) and more total charges in 2009 dollars ($31,319 vs $24,413 and $21,499, P<.001). In addition, patients seen at pediatric hospitals had significantly more total burn surface area (P<.001), more comorbidities (P=.021), and were younger (P<.001). After adjusting for total burn surface area, number of comorbidities, and age, no differences existed between teaching and nonteaching hospitals for LOS (P=.481) or total charges (P=.758). Although pediatric burn patients may have increased LOS and total charges when seen at teaching hospitals, when taking an unadjusted perspective, this may be an artifact that teaching hospitals see pediatric burn patients who are younger, have more comorbidities, and have more total burn surface area. As such, after adjustment, type of hospital may have no influence on LOS and total charges.

Nurses' Perspectives on the Geriatric Nursing Practice Environment and the Quality of Older People's Care in Ontario Acute Care Hospitals.

PubMed

Fox, Mary T; Sidani, Souraya; Butler, Jeffrey I; Tregunno, Deborah

2017-06-01

Background Cultivating hospital environments that support older people's care is a national priority. Evidence on geriatric nursing practice environments, obtained from studies of registered nurses (RNs) in American teaching hospitals, may have limited applicability to Canada, where RNs and registered practical nurses (RPNs) care for older people in predominantly nonteaching hospitals. Purpose This study describes nurses' perceptions of the overall quality of care for older people and the geriatric nursing practice environment (geriatric resources, interprofessional collaboration, and organizational value of older people's care) and examines if these perceptions differ by professional designation and hospital teaching status. Methods A cross-sectional survey, using Dillman's tailored design, that included Geriatric Institutional Assessment Profile subscales, was completed by 2005 Ontario RNs and registered practical nurses to assess their perceptions of the quality of care and geriatric nursing practice environment. Results Scores on the Geriatric Institutional Assessment Profile subscales averaged slightly above the midpoint except for geriatric resources which was slightly below. Registered practical nurses rated the quality of care and geriatric nursing practice environment higher than RNs; no significant differences were found by hospital teaching status. Conclusions Nurses' perceptions of older people's care and the geriatric nursing practice environment differ by professional designation but not hospital teaching status. Teaching and nonteaching hospitals should both be targeted for geriatric nursing practice environment improvement initiatives.

Highlights of the COTH (Council of Teaching Hospitals) Survey of House Staff Policy, 1973

ERIC Educational Resources Information Center

Journal of Medical Education, 1973

1973-01-01

The Council of Teaching Hospitals (COTH) of the Association of American Medical Colleges has surveyed its member hospitals on the following subjects: trends in stipends, benefits, budget allocations, funding sources, extra-curricular employment, and night/weekend duty. (Author/PG)

Examining non-structural retrofitting status of teaching hospitals in Kerman against disasters.

PubMed

Moghadam, Mahmood Nekooi; Moradi, Seyed Mobin; Amiresmaili, Mohammadreza

2017-05-01

Continuous services provision of a hospital before and after a disaster is one of the most prominent issues that all people, especially the authorities must take into huge consideration. Concerning the experiences of previous earthquakes, the role and importance of nonstructural components becomes increasingly clear in the uninterrupted services of hospitals. In this study, non-structural retrofitting status of Kerman teaching hospitals was evaluated against natural disasters. This cross-sectional study was carried out in the second half of 2014 on the teaching hospitals in Kerman (Iran). The study population consisted of all Kerman teaching hospitals. The research instrument was World Health Organization/Pan American Health Organization (WHO/PAHO) standard checklist. Data analysis was carried out using descriptive statistics through SPSS 19. One hospital had a low retrofitting level, two hospitals had an average level and one had a high level. In the examined hospitals in this study, the medical gas section had the lowest preparedness against natural disasters, while the office, warehouse and furniture section had the highest resistance. Generally, the non-structural retrofitting status was 50% in one hospital and was between 65% and 85% in other hospitals. Generally, the retrofitting status of hospitals was not at the ideal condition, most hospitals were in average condition. Concerning the high risk of hospitals in disasters, it is necessary that senior executives and managers of Kerman Province and Kerman University of Medical Sciences take some measures to retrofit these buildings and to reduce the risk of vulnerability.

Some correlates of electronic health information management system success in nigerian teaching hospitals.

PubMed

Ojo, Adebowale I; Popoola, Sunday O

2015-01-01

Nowadays, an electronic health information management system (EHIMS) is crucial for patient care in hospitals. This paper explores the aspects and elements that contribute to the success of EHIMS in Nigerian teaching hospitals. The study adopted a survey research design. The population of study comprised 442 health information management personnel in five teaching hospitals that had implemented EHIMS in Nigeria. A self-developed questionnaire was used as an instrument for data collection. The findings revealed that there is a positive, close relationship between all the identified factors and EHIMS's success: technical factors (r = 0.564, P < 0.05); social factors (r = 0.616, P < 0.05); organizational factors (r = 0.621, P < 0.05); financial factors (r = 0.705, P < 0.05); and political factors (r = 0.589, P < 0.05). We conclude that consideration of all the identified factors was highly significant for the success of EHIMS in Nigerian teaching hospitals.

Relationship between Organizational Perceived Justice and Organizational Citizenship Behavior among an Iranian Hospital's Employees, 2013.

PubMed

Bahrami, Mohammad Amin; Montazeralfaraj, Razieh; Gazar, Saeed Hashemi; Tafti, Arefeh Dehghani

2014-01-01

Organizational citizenship behavior just referred to a set of discretionary workplace behaviors that exceed one's job requirements. The main objective of this study was to determine the relationship between organizational perceived justice and organizational citizenship behavior. This cross-sectional study was done in Shahid Sadoughi Hospital in Yazd, Iran in 2013. A total of 100 hospital employees contributed in the study. The required data was gathered using 2 valid questionnaires, including the Moorman & Niehoff organizational perceived justice questionnaire and the McKinsey organizational citizenship behavior questionnaire. Data were analyzed using SPSS version 16. Descriptive statistics, Chi square, and Pearson's correlation coefficient were used for data analysis. There was a significant positive relationship between organizational perceived justice and organizational citizenship behavior among the studied hospital's employees (P ≤ 0.05, R = 0.33). This study confirmed that any policy that leads to better organizational justice perception will contribute in better organizational citizenship behavior which will increase the hospital's productivity.

Implementing Medical Teaching Policy in University Hospitals

ERIC Educational Resources Information Center

Engbers, Rik; Fluit, Cornelia Cornelia R. M. G.; Bolhuis, Sanneke; de Visser, Marieke; Laan, Roland F. J. M.

2017-01-01

Within the unique and complex settings of university hospitals, it is difficult to implement policy initiatives aimed at developing careers in and improving the quality of academic medical teaching because of the competing domains of medical research and patient care. Factors that influence faculty in making use of teaching policy incentives have…

Ten thousand steps: a pedometer study of junior dentists in a major British teaching hospital and a district general hospital.

PubMed

Keat, R M; Thomas, M; McKechnie, A

2017-05-01

Sedentary behaviour is widely associated with deleterious health outcomes that in modern medicine have similar connotations to smoking tobacco and alcohol misuse. The integration of e-portfolio, e-logbook, British National Formulary (BNF) and encrypted emails has made smartphones a necessity for trainees. Smartphones also have the ability to record the amount of exercise taken, which allows activity at work to be monitored. The aim of this study to compare the activity of the same group of dental core trainees when they worked within a large multisite teaching hospital and a smaller district general hospital, to find out if supplementary activity was needed outside work. Data were collected from smartphones. To ensure continuity, data were collected only from those who had calibrated iPhones (n=10). At the teaching hospital six of the trainees walked over 10 000 steps a day while working (mean (SD) 10 004 (639)). At the district hospital none of the trainees walked 10 000 steps. The mean (SD) number of steps completed by all trainees was 6265 (119). Walking at work provides the full quota of recommended daily exercise most of the time for those working in the teaching hospital, but additional exercise is occasionally required. While working at the district hospital they walk less, meaning that they should try to increase their activity outside work. Trainees working in the teaching hospital walk significantly more steps than in the district hospital. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Changes in Latitudes, Changes in Attitudes: Narrating a Regime Change

DTIC Science & Technology

2015-03-01

Mossadeq’s alliance with the Tudeh party has led to the violation of the Iranian cultural norm of open hospitality toward foreigners.76 In addition to...6. AUTHOR( S ) Pattric R. Patterson and Matthew D. Ziobro 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION Naval...Postgraduate School REPORT NUMBER Monterey, CA 93943-5000 9. SPONSORING /MONITORING AGENCY NAME( S ) AND ADDRESS(ES) 10. SPONSORING/MONITORING N/A AGENCY

Experiences of clinical teaching for dental core trainees working in hospital.

PubMed

Mannion, C J; Brotherton, P

2014-07-11

There is recognition that the provision of excellence in education and training results in a skilled and competent workforce. However, the educational experiences of dental core trainees (DCT's) working in the hospital oral and maxillofacial surgery (OMFS) setting have not been previously investigated. In this paper, we examine DCT's learning experiences both 'formal' and 'non-formal' within the hospital setting of ward and clinic-based teaching. Are hospital dental core trainees receiving a meaningful educational experience? To conclude this paper, the authors recommend methods, based upon sound educational principles, to maximise the value of clinical sessions for teaching.

Patient education among nurses: bringing evidence into clinical applicability in Iran.

PubMed

Karimi Moonaghi, Hossein; Emami Zeydi, Amir; Mirhaghi, Amir

2016-04-01

The aim of this study was to present a comprehensive review of the literatures describing barriers and facilitators of patient education (PE) perceived by Iranian nurses in order to explain clinical applicability of patient education. Review of the literature was undertaken using the international databases including PubMed/Medline, Scopus, ScienceDirect, as well as Google Scholar. Also, Persian electronic databases such as Magiran, SID and IranMedex were searched. Electronic databases were searched up from conception to September 2014 using search terms: "patient education", " patients education", "patient teaching", "patient training", "nurse", " nurses", " nursing", " and "Iran". Only studies were included that were related to barriers and facilitators of PE among Iranian nurses. Twenty-seven studies were included. The main influential barriers were categorized into three major areas: 1) Nurse-related factors: nursing shortage 2) Administration-related factors: unsupportive organizational culture, and 3) Patient-related factors: low compliance. The most perceived facilitators were recognized as "increasing, selecting and training special nurses for providing PE" and "providing PE courses for nurses and appropriate facilities for PE". Iranian nurses encounter barriers in PE, and the most frequently encountered barriers were related to administration factors. These findings have implications for administrators and managers in health settings. In order to promote PE among nurses, administrators should create a supportive environment and use effective strategies to smooth the progress of PE by nurses in their practice in order to ensure optimal outcomes for patients.

Impact of a Resident-as-Teacher Workshop on Teaching Behavior of Interns and Learning Outcomes of Medical Students

PubMed Central

Hill, Andrew G.; Srinivasa, Sanket; Hawken, Susan J.; Barrow, Mark; Farrell, Susan E.; Hattie, John; Yu, Tzu-Chieh

2012-01-01

Background Residents and interns are recognized as important clinical teachers and mentors. Resident-as-teacher training programs are known to improve resident attitudes and perceptions toward teaching, as well as their theoretical knowledge, skills, and teaching behavior. The effect of resident-as-teacher programs on learning outcomes of medical students, however, remains unknown. An intervention cohort study was conducted to prospectively investigate the effects of a teacher-training workshop on teaching behavior of participating interns and on the clerkship learning outcomes of instructed fourth-year medical students. Methods The House Officer-as-Teacher Training Workshop was implemented in November 2009 over 1.5 days and attended by all 34 interns from one teaching hospital. Subsequently, between February and August 2010, 124 fourth-year medical students rated the observable teaching behavior of interns during 6-week general surgery clerkships at this intervention hospital as well as at 2 comparable hospitals serving as control sites. Ratings were collected using an anonymous 15-item Intern Clinical Teaching Effectiveness Instrument. Student achievement of clerkship learning outcomes during this period was evaluated using a validated and centralized objective structured clinical examination. Results Medical students completed 101 intern clinical teaching effectiveness instruments. Intern teaching behavior at the intervention hospital was found to be significantly more positive, compared with observed behavior at the control hospitals. Objective structured clinical examination results, however, did not demonstrate any significant intersite differences in student achievement of general surgery clerkship learning outcomes. Conclusions The House Officer-as-Teacher Training Workshop noticeably improved teaching behavior of surgical interns during general surgery clerkships. This improvement did not, however, translate into improved achievement of clerkship learning outcomes by medical students during the study period. PMID:23451304

Early Impact of the 2011 ACGME Duty Hour Regulations on Surgical Outcomes

PubMed Central

Scally, Christopher P.; Ryan, Andrew M.; Thumma, Jyothi R.; Gauger, Paul G.; Dimick, Justin B.

2015-01-01

Background In 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented additional restrictions on resident work hours. While the impact of these restrictions on the education of surgical trainees has been examined, the effect on patient safety remains poorly understood. Methods We used national Medicare Claims data for patients undergoing general (n = 1,223,815) and vascular (n = 475,262) surgery procedures in the 3 years preceding the duty hour changes (January, 2009 – June, 2011) and the 18 months following (July, 2011 - December, 2012). Hospitals were stratified into quintiles by teaching intensity using a resident to bed ratio. We utilized a difference-in-differences analytic technique, using non-teaching hospitals as a control group, to compare risk adjusted 30-day mortality, serious morbidity, readmission, and failure to rescue (FTR) rates before and after the duty hour changes. Results Following duty hour reform, no significant changes were seen in the measured outcomes when comparing teaching to non-teaching hospitals. Even when stratifying by teaching intensity there were no differences. For example, at the highest intensity teaching hospitals (resident/bed ratio ≥ .6), mortality rates before and after the duty hour changes were 4.2% and 4.0%, compared to 4.7% and 4.4% for non-teaching hospitals (RR .98, 95% CI .89-1.07). Similarly, serious complication (RR 1.02, 95% CI .98-1.06), FTR (RR .95, 95% CI .87-1.04), and readmission (OR 1.00, 95% CI .96-1.03) rates were unchanged. Conclusions In Medicare beneficiaries undergoing surgery at teaching hospitals, outcomes have not improved since the 2011 ACGME duty hour regulations. PMID:26054323

In-hospital mortality for children with hypoplastic left heart syndrome after stage I surgical palliation: teaching versus nonteaching hospitals.

PubMed

Berry, Jay G; Cowley, Collin G; Hoff, Charles J; Srivastava, Rajendu

2006-04-01

Teaching hospitals are perceived to provide a higher quality of care for the treatment of rare disease and complex patients. A substantial proportion of stage I palliation for hypoplastic left heart syndrome (HLHS) may be performed in nonteaching hospitals. This study compares the in-hospital mortality of stage I palliation between teaching and nonteaching hospitals. The authors conducted a retrospective cohort study using the Kids' Inpatient Database 1997 and 2000. Patients with HLHS undergoing stage I palliation were identified using International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic and procedural codes. Seven hundred fifty-four and 880 discharges of children with HLHS undergoing stage I palliation in 1997 and 2000, respectively, were identified. The in-hospital mortality for the study population was 28% in 1997 and 24% in 2000. Twenty percent of stage I palliation operations were performed in nonteaching hospitals in 1997. Two percent of operations were performed in nonteaching hospitals in 2000. In 1997 only, in-hospital mortality remained higher in nonteaching hospitals after controlling for stage I palliation hospital volume and condition-severity diagnoses. Low-volume hospitals performing stage I palliation were associated with increased in-hospital mortality in 1997 and 2000. Patients with HLHS undergoing stage I palliation in nonteaching hospitals experienced increased in-hospital mortality in 1997. A significant reduction in the number of stage I palliation procedures performed in nonteaching hospitals occurred between 1997 and 2000. This centralization of stage I palliation into teaching hospitals, along with advances in postoperative medical and surgical care for these children, was associated with a decrease in mortality. Patients in low-volume hospitals performing stage I palliation continued to experience increased mortality in 2000.

Prevention of self-immolation by community-based intervention.

PubMed

Ahmadi, Alireza; Ytterstad, Børge

2007-12-01

To describe the effectiveness of a community-based program targeting prevention of self-immolation. Suicide by burning is rare in developed countries (0.1-1.8% of all suicides), but more frequent in developing countries (up to 41% of all suicides). Self-immolation constitutes from 0.4% to 40% of admissions to burn centers worldwide. During 2001, an average of 11 Iranians committed suicide daily, 4 of these being self-immolations (36%). Self-immolation caused from 4% to 28% of all admissions to Iranian burn centers. Approximately 80% of hospitalized self-immolation patients die. All descriptive self-immolation studies in Iran emphasize the need for implementing prevention programs. Quasi-experimental. The Iranian cities Gilangharb (intervention) and Sarpolzahab (reference). The populations of these communities. Hospital data collection on self-immolation patients and suicide attempts (all mechanisms) was made from 21 March 1999 to 20 March 2003. The first 12 months of the study provided baseline data, while the last 3 years comprised of a community-based intervention, using a mix of passive and active interventions. Videos showing victim stories were an important component in the prevention program. The interventions were particularly aimed at young women and socio-economically deprived groups, these being shown to be at high risk in earlier studies. Compared to baseline, the mean self-immolation attempts rate decreased by 57% after the implementation of the intervention in Gilangharb (p=0.04, Yates corrected p=0.07). Correspondingly, the reference city rate decreased 27% (n.s.). Moreover, in Gilangharb a 19% decrease of suicide attempts (all mechanisms) was observed while the corresponding reference city rate increased by 24% (n.s.). While the suicide attempt rates were similar in the two populations during baseline, the mean rates observed during the intervention period differed significantly (p<0.0001). A community prevention program targeting self-immolation can be effective. Local data and the showing of videos depicting victim stories from self-immolation attempts provided a stimulus for community action.

The impact of hospital volume, residency, and fellowship training on perioperative outcomes after radical prostatectomy.

PubMed

Trinh, Quoc-Dien; Sun, Maxine; Kim, Simon P; Sammon, Jesse; Kowalczyk, Keith J; Friedman, Ariella A; Sukumar, Shyam; Ravi, Praful; Muhletaler, Fred; Agarwal, Piyush K; Shariat, Shahrokh F; Hu, Jim C; Menon, Mani; Karakiewicz, Pierre I

2014-01-01

Although high-volume hospitals have been associated with improved outcomes for radical prostatectomy (RP), the association of residency or fellowship teaching institutions or both and this volume-outcome relationship remains poorly described. We examine the effect of teaching status and hospital volume on perioperative RP outcomes. Within the Nationwide Inpatient Sample, we focused on RPs performed between 2003 and 2007. We tested the rates of prolonged length of stay beyond the median of 3 days, in-hospital mortality, and intraoperative and postoperative complications, stratified according to teaching status. Multivariable logistic regression analyses further adjusted for confounding factors. Overall, 47,100 eligible RPs were identified. Of these, 19,193 cases were performed at non-teaching institutions, 24,006 at residency teaching institutions, and 3,901 at fellowship teaching institutions. Relative to patients treated at non-teaching institutions, patients treated at fellowship teaching institutions were healthier and more likely to hold private insurance. In multivariable analyses, patients treated at residency (OR = 0.92, P = 0.015) and fellowship (OR = 0.82, P = 0.011) teaching institutions were less likely to experience a postoperative complication than patients treated at non-teaching institutions. Patients treated at residency (OR = 0.73, P<0.001) and fellowship (OR = 0.91, P = 0.045) teaching institutions were less likely to experience a prolonged length of stay. More favorable postoperative complication profile and shorter length of stay should be expected at residency and fellowship teaching institutions following RP. Moreover, postoperative complication rates were lower at fellowship teaching than at residency teaching institutions, despite adjustment for potential confounders. Copyright © 2014 Elsevier Inc. All rights reserved.

Severity of Illness and the Teaching Hospital.

ERIC Educational Resources Information Center

Berman, Richard A.; And Others

1986-01-01

The Medicare prospective payment system does not adequately account for severity of illness. Whether teaching hospitals treat a case mix of patients with more severe illness than do nonteaching hospitals was tested in a study using two severity measures, Horn's severity of illness index and Gonnnella's "disease staging." (Author/MLW)

Hospitals Productivity Measurement Using Data Envelopment Analysis Technique.

PubMed

Torabipour, Amin; Najarzadeh, Maryam; Arab, Mohammad; Farzianpour, Freshteh; Ghasemzadeh, Roya

2014-11-01

This study aimed to measure the hospital productivity using data envelopment analysis (DEA) technique and Malmquist indices. This is a cross sectional study in which the panel data were used in a 4 year period from 2007 to 2010. The research was implemented in 12 teaching and non-teaching hospitals of Ahvaz County. Data envelopment analysis technique and the Malmquist indices with an input-orientation approach, was used to analyze the data and estimation of productivity. Data were analyzed using the SPSS.18 and DEAP.2 software. Six hospitals (50%) had a value lower than 1, which represents an increase in total productivity and other hospitals were non-productive. the average of total productivity factor (TPF) was 1.024 for all hospitals, which represents a decrease in efficiency by 2.4% from 2007 to 2010. The average technical, technologic, scale and managerial efficiency change was 0.989, 1.008, 1.028, and 0.996 respectively. There was not a significant difference in mean productivity changes among teaching and non-teaching hospitals (P>0.05) (except in 2009 years). Productivity rate of hospitals had an increasing trend generally. However, the total average of productivity was decreased in hospitals. Besides, between the several components of total productivity, variation of technological efficiency had the highest impact on reduce of total average of productivity.

What do students actually do on an internal medicine clerkship? A log diary study.

PubMed

Murray, E; Alderman, P; Coppola, W; Grol, R; Bouhuijs, P; van der Vleuten, C

2001-12-01

There are limited data on the amount of time students spend on teaching and learning while on internal medicine clerkships, and existing data suggest a wide international variation. Community-based teaching of internal medicine is now widespread; but its strengths and weaknesses compared to traditional hospital based teaching are still unclear. To determine the proportion of time students spend on different activities on an internal medicine clerkship, and to determine whether this differs in general practice and in hospital. In addition we aimed to determine students' views on the educational value and enjoyment of various activities. Prospective completion of log diaries recording student activities. Each student was asked to complete the diary for two separate weeks of their internal medicine clerkship: one week of general practice-based teaching and one week of hospital-based teaching. The response rate was 68% (88/130). Students spent approximately 5.5 h per day on teaching and learning activities in both environments, with more time (50 min vs. 30 min, P = 0.007) on unsupervised interaction with patients in hospital than in general practice, and more time (53 min vs. 21 min, P < 0.001) undergoingassessment in general practice than in hospital. Standard deviations were wide, demonstrating the heterogeneous nature of the data. Students perceived supervised interaction with patients and teaching by doctors as the most educational activities in both environments, but found it even more educationally valuable and enjoyable in general practice than in hospital (mean score for educational value: 4.27 in general practice, 3.88 in hospital, P = 0.048; mean score for enjoyment 4.13 in general practice, 3.66 in hospital, P = 0.03). Students greatly value interactions with patients, perceiving these as both educational and enjoyable. Curriculum planners must continue to place patient-based learning at the centre of undergraduate medical education. The heterogeneity of the data suggests that individual students have very different experiences, despite apparently similar timetables.

The medical education funding gap. One hospital's perspective.

PubMed

Ling, Louis J; Meier, Gerhardt

2003-02-01

Graduate medical education (GME) is a complex and expensive enterprise in which costs are borne by the teaching institution. With teaching hospitals under increasing financial stress due to an expansion of managed care and shrinking governmental support of medical education, there is a growing gap between GME costs and funding. This article describes GME costs and revenues at Hennepin County Medical Center, a teaching hospital in Minneapolis, where in the calendar year 2000, GME costs exceeded GME funds by $21 million.

Factors associated with Salmonella shedding among equine colic patients at a veterinary teaching hospital.

PubMed

Kim, L M; Morley, P S; Traub-Dargatz, J L; Salman, M D; Gentry-Weeks, C

2001-03-01

To evaluate factors potentially associated with fecal Salmonella shedding among equine patients hospitalized for colic at a veterinary teaching hospital and to determine the effects of probiotic treatment on fecal Salmonella shedding and clinical signs. Longitudinal study and controlled trial. 246 equine colic patients. History and medical information were obtained from patient records. Fecal and environmental samples were submitted for aerobic bacterial culture for Salmonella enterica. Fifty-one patients were treated with a commercially available probiotic; 46 were treated with a placebo. Logistic regression was used to evaluate data. Salmonella organisms were detected in feces from 23 (9%) patients at least once during hospitalization. Patients were more likely to shed Salmonella organisms if diarrhea was evident < or = 6 hours after hospitalization and duration of hospitalization exceeded 8 days (odds ratio [OR], 20.3), laminitis developed during hospitalization (OR, 12.0), results of nasogastric intubation were abnormal (OR, 4.9), leukopenia was evident < or =6 hours after hospitalization (OR, 4.6), or travel time to the teaching hospital exceeded 1 hour (OR, 3.5). Horses treated with the probiotic did not differ from control horses in regard to likelihood of fecal Salmonella shedding (OR, 1.5) or prevalence of clinical signs. Results suggest that certain risk factors are associated with fecal shedding of S enterica among equine patients hospitalized at a veterinary teaching hospital because of colic and that pathogen monitoring in patients and the hospital environment and use of barrier nursing precautions for equine colic patients are beneficial.

The Balanced Budget Act of 1997 and the financial health of teaching hospitals.

PubMed

Phillips, Robert L; Fryer, George E; Chen, Frederick M; Morgan, Sarah E; Green, Larry A; Valente, Ernest; Miyoshi, Thomas J

2004-01-01

We wanted to evaluate the most recent, complete data related to the specific effects of the Balanced Budget Act of 1997 relative to the overall financial health of teaching hospitals. We also define cost report variables and calculations necessary for continued impact monitoring. We undertook a descriptive analysis of hospital cost report variables for 1996, 1998, and 1999, using simple calculations of total, Medicare, prospective payment system, graduate medical education (GME), and bad debt margins, as well as the proportion with negative total operating margins. Nearly 35% of teaching hospitals had negative operating margins in 1999. Teaching hospital total margins fell by nearly 50% between 1996 and 1999, while Medicare margins remained relatively stable. GME margins have fallen by nearly 24%, however, even as reported education costs have risen by nearly 12%. Medicare + Choice GME payments were less than 10% of those projected. Teaching hospitals realized deep cuts in profitability between 1996 and 1999; however, these cuts were not entirely attributable to the Balanced Budget Act of 1997. Medicare payments remain an important financial cushion for teaching hospitals, more than one third of which operated in the red. The role of Medicare in supporting GME has been substantially reduced and needs special attention in the overall debate. Medicare + Choice support of the medical education enterprise is 90% less than baseline projections and should be thoroughly investigated. The Medicare Payment Advisory Commission, which has a critical role in evaluating the effects of Medicare policy changes, should be more transparent in its methods.

Large Variability in the Diversity of Physiologically Complex Surgical Procedures Exists Nationwide Among All Hospitals Including Among Large Teaching Hospitals.

PubMed

Dexter, Franklin; Epstein, Richard H; Thenuwara, Kokila; Lubarsky, David A

2017-11-22

Multiple previous studies have shown that having a large diversity of procedures has a substantial impact on quality management of hospital surgical suites. At hospitals with substantial diversity, unless sophisticated statistical methods suitable for rare events are used, anesthesiologists working in surgical suites will have inaccurate predictions of surgical blood usage, case durations, cost accounting and price transparency, times remaining in late running cases, and use of intraoperative equipment. What is unknown is whether large diversity is a feature of only a few very unique set of hospitals nationwide (eg, the largest hospitals in each state or province). The 2013 United States Nationwide Readmissions Database was used to study heterogeneity among 1981 hospitals in their diversities of physiologically complex surgical procedures (ie, the procedure codes). The diversity of surgical procedures performed at each hospital was quantified using a summary measure, the number of different physiologically complex surgical procedures commonly performed at the hospital (ie, 1/Herfindahl). A total of 53.9% of all hospitals commonly performed <10 physiologically complex procedures (lower 99% confidence limit [CL], 51.3%). A total of 14.2% (lower 99% CL, 12.4%) of hospitals had >3-fold larger diversity (ie, >30 commonly performed physiologically complex procedures). Larger hospitals had greater diversity than the small- and medium-sized hospitals (P < .0001). Teaching hospitals had greater diversity than did the rural and urban nonteaching hospitals (P < .0001). A total of 80.0% of the 170 large teaching hospitals commonly performed >30 procedures (lower 99% CL, 71.9% of hospitals). However, there was considerable variability among the large teaching hospitals in their diversity (interquartile range of the numbers of commonly performed physiologically complex procedures = 19.3; lower 99% CL, 12.8 procedures). The diversity of procedures represents a substantive differentiator among hospitals. Thus, the usefulness of statistical methods for operating room management should be expected to be heterogeneous among hospitals. Our results also show that "large teaching hospital" alone is an insufficient description for accurate prediction of the extent to which a hospital sustains the operational and financial consequences of performing a wide diversity of surgical procedures. Future research can evaluate the extent to which hospitals with very large diversity are indispensable in their catchment area.

Association of the 2011 ACGME resident duty hour reforms with mortality and readmissions among hospitalized Medicare patients.

PubMed

Patel, Mitesh S; Volpp, Kevin G; Small, Dylan S; Hill, Alexander S; Even-Shoshan, Orit; Rosenbaum, Lisa; Ross, Richard N; Bellini, Lisa; Zhu, Jingsan; Silber, Jeffrey H

2014-12-10

Patient outcomes associated with the 2011 Accreditation Council for Graduate Medical Education (ACGME) duty hour reforms have not been evaluated at a national level. To evaluate the association of the 2011 ACGME duty hour reforms with mortality and readmissions. Observational study of Medicare patient admissions (6,384,273 admissions from 2,790,356 patients) to short-term, acute care, nonfederal hospitals (n = 3104) with principal medical diagnoses of acute myocardial infarction, stroke, gastrointestinal bleeding, or congestive heart failure or a Diagnosis Related Group classification of general, orthopedic, or vascular surgery. Of the hospitals, 96 (3.1%) were very major teaching, 138 (4.4%) major teaching, 442 (14.2%) minor teaching, 443 (14.3%) very minor teaching, and 1985 (64.0%) nonteaching. Resident-to-bed ratio as a continuous measure of hospital teaching intensity. Change in 30-day all-location mortality and 30-day all-cause readmission, comparing patients in more intensive relative to less intensive teaching hospitals before (July 1, 2009-June 30, 2011) and after (July 1, 2011-June 30, 2012) duty hour reforms, adjusting for patient comorbidities, time trends, and hospital site. In the 2 years before duty hour reforms, there were 4,325,854 admissions with 288,422 deaths and 602,380 readmissions. In the first year after the reforms, accounting for teaching hospital intensity, there were 2,058,419 admissions with 133,547 deaths and 272,938 readmissions. There were no significant postreform differences in mortality accounting for teaching hospital intensity for combined medical conditions (odds ratio [OR], 1.00; 95% CI, 0.96-1.03), combined surgical categories (OR, 0.99; 95% CI, 0.94-1.04), or any of the individual medical conditions or surgical categories. There were no significant postreform differences in readmissions for combined medical conditions (OR, 1.00; 95% CI, 0.97-1.02) or combined surgical categories (OR, 1.00; 95% CI, 0.98-1.03). For the medical condition of stroke, there were higher odds of readmissions in the postreform period (OR, 1.06; 95% CI, 1.001-1.13). However, this finding was not supported by sensitivity analyses and there were no significant postreform differences for readmissions for any other individual medical condition or surgical category. Among Medicare beneficiaries, there were no significant differences in the change in 30-day mortality rates or 30-day all-cause readmission rates for those hospitalized in more intensive relative to less intensive teaching hospitals in the year after implementation of the 2011 ACGME duty hour reforms compared with those hospitalized in the 2 years before implementation.

Association of the 2011 ACGME Resident Duty Hour Reforms With Mortality and Readmissions Among Hospitalized Medicare Patients

PubMed Central

Patel, Mitesh S.; Volpp, Kevin G.; Small, Dylan S.; Hill, Alexander S.; Even-Shoshan, Orit; Rosenbaum, Lisa; Ross, Richard N.; Bellini, Lisa; Zhu, Jingsan; Silber, Jeffrey H.

2017-01-01

IMPORTANCE Patient outcomes associated with the 2011 Accreditation Council for Graduate Medical Education (ACGME) duty hour reforms have not been evaluated at a national level. OBJECTIVE To evaluate the association of the 2011 ACGME duty hour reforms with mortality and readmissions. DESIGN, SETTING, AND PARTICIPANTS Observational study of Medicare patient admissions (6 384 273 admissions from 2 790 356 patients) to short-term, acute care, nonfederal hospitals (n = 3104) with principal medical diagnoses of acute myocardial infarction, stroke, gastrointestinal bleeding, or congestive heart failure or a Diagnosis Related Group classification of general, orthopedic, or vascular surgery. Of the hospitals, 96 (3.1%) were very major teaching, 138 (4.4%) major teaching, 442 (14.2%) minor teaching, 443 (14.3%) very minor teaching, and 1985 (64.0%) nonteaching. EXPOSURE Resident-to-bed ratio as a continuous measure of hospital teaching intensity. MAIN OUTCOMES AND MEASURES Change in 30-day all-location mortality and 30-day all-cause readmission, comparing patients in more intensive relative to less intensive teaching hospitals before (July 1, 2009–June 30, 2011) and after (July 1, 2011–June 30, 2012) duty hour reforms, adjusting for patient comorbidities, time trends, and hospital site. RESULTS In the 2 years before duty hour reforms, there were 4 325 854 admissions with 288 422 deaths and 602 380 readmissions. In the first year after the reforms, accounting for teaching hospital intensity, there were 2 058 419 admissions with 133 547 deaths and 272 938 readmissions. There were no significant postreform differences in mortality accounting for teaching hospital intensity for combined medical conditions (odds ratio [OR], 1.00; 95% CI, 0.96–1.03), combined surgical categories (OR, 0.99; 95% CI, 0.94–1.04), or any of the individual medical conditions or surgical categories. There were no significant postreform differences in readmissions for combined medical conditions (OR, 1.00; 95% CI, 0.97–1.02) or combined surgical categories (OR, 1.00; 95% CI, 0.98–1.03). For the medical condition of stroke, there were higher odds of readmissions in the postreform period (OR, 1.06; 95% CI, 1.001–1.13). However, this finding was not supported by sensitivity analyses and there were no significant postreform differences for readmissions for any other individual medical condition or surgical category. CONCLUSIONS AND RELEVANCE Among Medicare beneficiaries, there were no significant differences in the change in 30-day mortality rates or 30-day all-cause readmission rates for those hospitalized in more intensive relative to less intensive teaching hospitals in the year after implementation of the 2011 ACGME duty hour reforms compared with those hospitalized in the 2 years before implementation. PMID:25490327

Examining non-structural retrofitting status of teaching hospitals in Kerman against disasters

PubMed Central

Moghadam, Mahmood Nekooi; Moradi, Seyed Mobin; Amiresmaili, Mohammadreza

2017-01-01

Background and objective Continuous services provision of a hospital before and after a disaster is one of the most prominent issues that all people, especially the authorities must take into huge consideration. Concerning the experiences of previous earthquakes, the role and importance of nonstructural components becomes increasingly clear in the uninterrupted services of hospitals. In this study, non-structural retrofitting status of Kerman teaching hospitals was evaluated against natural disasters. Methods This cross-sectional study was carried out in the second half of 2014 on the teaching hospitals in Kerman (Iran). The study population consisted of all Kerman teaching hospitals. The research instrument was World Health Organization/Pan American Health Organization (WHO/PAHO) standard checklist. Data analysis was carried out using descriptive statistics through SPSS 19. Results One hospital had a low retrofitting level, two hospitals had an average level and one had a high level. In the examined hospitals in this study, the medical gas section had the lowest preparedness against natural disasters, while the office, warehouse and furniture section had the highest resistance. Generally, the non-structural retrofitting status was 50% in one hospital and was between 65% and 85% in other hospitals. Conclusions Generally, the retrofitting status of hospitals was not at the ideal condition, most hospitals were in average condition. Concerning the high risk of hospitals in disasters, it is necessary that senior executives and managers of Kerman Province and Kerman University of Medical Sciences take some measures to retrofit these buildings and to reduce the risk of vulnerability. PMID:28713518

Self-efficacy and postpartum depression teaching behaviors of hospital-based perinatal nurses.

PubMed

Logsdon, M Cynthia; Foltz, Melissa Pinto; Scheetz, James; Myers, John A

2010-01-01

Based upon the Self-Efficacy Theory, this study examined the relationship between self-efficacy, self-efficacy-related variables, and postpartum depression teaching behaviors of hospital-based perinatal nurses. Findings revealed that teaching new mothers about postpartum depression is related to a perinatal nurse's self-efficacy in postpartum-depression teaching, self-esteem, and the following self-efficacy-related variables: social persuasion (supervisor's expectations for teaching); mastery (postpartum depression continuing education and teaching experience); and vicarious experience (observing other nurses teach new mothers about postpartum depression). Teaching new mothers about postpartum depression can assist mothers in overcoming barriers to depression treatment. Nurse educators and managers play an important role in encouraging postpartum depression education for perinatal nurses.

What Really Motivates Iranian Nurses to Be Creative in Clinical Settings?: A Qualitative Study

PubMed Central

Isfahani, Sara Shahsavari; Hosseini, Mohammad Ali; Khoshknab, Masoud Fallahi; Peyrovi, Hamid; Khanke, Hamid Reza

2015-01-01

Background: Creativity and innovation are key elements for organization improvement, particularly in nursing, and for finding alternatives for solving nurses’ occupational problems. Nurses’ creativity is affected by motivation. Although, there are many possible sources of motivation, the Iranian nurses’ creativity is seldom clarified, and the most important factors motivating nurses to be creative in clinical settings has rarely been addressed. Objectives: The aim of this study was to explore Iranian nurses’ experiences regarding the most important factors that motivate their creativity in clinical settings. Methods: This qualitative study was conducted using conventional content analysis approach. A purposive sample of sixteen nurses was recruited from two educational hospitals affiliated to Tehran and Jahrom Universities of Medical Sciences in Iran. Data were gathered through conducting face-to-face semi-structured interviews and were analyzed by qualitative content analysis approach. Findings: Five main themes emerged from the data analysis, including: (a) Intrinsic motivators, (b) Extrinsic motivators, (c) Achievement motivators, (d) Relational or altruistic motivators, and (e) Spiritual motivators. Conclusions: Study findings indicated that nurses are creative and innovative individuals. So nurse managers and health policy makers should consider creativity as an integral part of all health and clinical strategies and policies. They should support creative and innovative efforts of nurses and provide a climate in which nurses engage in more creative and productive behaviors. PMID:26156918

Ambulatory surgery and anaesthesia in HUKM, a teaching hospital in Malaysia: the first two years experience.

PubMed

Norsidah, A M; Yahya, N; Adeeb, N; Lim, A L

2001-03-01

Ambulatory or day care surgery is still in its infancy in this part of the world. Our newly built university affiliated hospital started its Day Surgery Centre in February 1998. It is the first multidisciplinary ambulatory surgery centre in a teaching hospital in the country. It caters for Orthopaedic surgery, Urology, Plastic surgery, Otorhinolaryngology, General surgery, Paediatric surgery and Ophthalmology. We have done 2,604 cases and our unanticipated admission rate is less than 2%. There has been no major morbidity or mortality. The problems of setting up a multidisciplinary ambulatory centre in a teaching hospital are discussed.

Hospitable Kinship in Theological Education: Cross-Cultural Perspectives on Teaching and Learning as Gift Exchange

ERIC Educational Resources Information Center

Wimberly, Anne E. Streaty

2004-01-01

Using an autobiographical approach for pedagogical reflection, the author raises questions about how to include "hospitable kinship" and "gift exchange" in teaching and learning. Her experience with a Zimbabwean community circle of hospitable kinship has prompted her to consider how this method of community formation might be…

78 FR 32663 - Medicare Program; Notification of Closure of Teaching Hospitals and Opportunity To Apply for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-31

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1459-N... Slots AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice. SUMMARY: This notice announces the closure of two teaching hospitals and the initiation of an application process where hospitals...

Bridging the Gap: A Framework and Strategies for Integrating the Quality and Safety Mission of Teaching Hospitals and Graduate Medical Education.

PubMed

Tess, Anjala; Vidyarthi, Arpana; Yang, Julius; Myers, Jennifer S

2015-09-01

Integrating the quality and safety mission of teaching hospitals and graduate medical education (GME) is a necessary step to provide the next generation of physicians with the knowledge, skills, and attitudes they need to participate in health system improvement. Although many teaching hospital and health system leaders have made substantial efforts to improve the quality of patient care, few have fully included residents and fellows, who deliver a large portion of that care, in their efforts. Despite expectations related to the engagement of these trainees in health care quality improvement and patient safety outlined by the Accreditation Council for Graduate Medical Education in the Clinical Learning Environment Review program, a structure for approaching this integration has not been described.In this article, the authors present a framework that they hope will assist teaching hospitals in integrating residents and fellows into their quality and safety efforts and in fostering a positive clinical learning environment for education and patient care. The authors define the six essential elements of this framework-organizational culture, teaching hospital-GME alignment, infrastructure, curricular resources, faculty development, and interprofessional collaboration. They then describe the organizational characteristics required for each element and offer concrete strategies to achieve integration. This framework is meant to be a starting point for the development of robust national models of infrastructure, alignment, and collaboration between GME and health care quality and safety leaders at teaching hospitals.

A successful experience of the Iranian blood transfusion organization in improving accessibility and affordability of plasma derived medicine.

PubMed

Chegini, Azita; Torab, Seyed Ardeshir; Pourfatollah, Ali Akbar

2017-02-01

Plasma is the liquid part of blood. It is estimated 21.6 million liters of plasma collect from Whole blood annually. From these plasma, 4.2 million liters transfuse, 8.1 million liters fractionate, 9.3 million liters waste. Nowadays, blood products and PDM (plasma derived medicine) consider as essential medicine in modern health care and transfusion medicine. Iranian blood transfusion organization as a non-profit organization was established in 1974 in order to centralize all blood transfusion activities from donor recruitment to distribution of blood components to hospitals. Iran is the only country in EMR region with the rate of 20-29.9 blood donations per 1000 population and reached 100% voluntary non-remunerated blood donation in 2007. RBCs and platelets demand are much more than FFPs so the IBTO was faced the surplus plasma that could cause surplus plasma wastage. Simultaneously, hospitals need more plasma derived medicine especially albumin, IVIG, factor VIII, factor IX. IBTO was faced the challenges such as Fractionators selection, Plasma volume shipment, Contract duration, Product profile, Multiple External audits, Cold chain maintenance, Transporting plasma across international borders, NAT test. To overcome plasma wastage and storage of PDM. IBTO involved toll manufacturing in 2005 and not only prevents plasma wastage but also save MOH (ministry of health) budget. Copyright © 2016. Published by Elsevier Ltd.

Socioeconomic inequality of unintended pregnancy in the Iranian population: a decomposition approach.

PubMed

Omani-Samani, Reza; Amini Rarani, Mostafa; Sepidarkish, Mahdi; Khedmati Morasae, Esmaeil; Maroufizadeh, Saman; Almasi-Hashiani, Amir

2018-05-09

There are several studies regarding the predictors or risk factors of unintended pregnancy, but only a small number of studies have been carried out concerning the socio-economic factors influencing the unintended pregnancy rate. This study aimed to determine the socioeconomic inequality of unintended pregnancy in Tehran, Iran, as a developing country. In this hospital based cross-sectional study, 5152 deliveries from 103 hospitals in Tehran (the capital of Iran) were included in the analysis in July 2015. Socioeconomic status (SES) was measured through an asset-based method and principal component analysis was carried out to calculate the household SES. The concentration index and curve was used to measure SES inequality in unintended pregnancy, and then decomposed into its determinants. The data was analyzed by statistical Stata software. The Wagstaff normalized concentration index of unintended pregnancy (- 0.108 (95% Confidence Interval (CI) = - 0.119 ~ - 0.054)) endorses that unintended pregnancy is more concentrated among poorer mothers. The results showed that SES accounted for 27% of unintended pregnancy inequality, followed by the mother's nationality (19%), father's age (16%), mother's age (10%), father's education level (7%) and Body Mass Index (BMI) groups (5%). Unintended pregnancy is unequally distributed among Iranian women and is more concentrated among poor women. Economic status had the most positive contribution, explaining 27% of inequality in unintended pregnancy.

A grounded theory of humanistic nursing in acute care work environments.

PubMed

Khademi, Mojgan; Mohammadi, Eesa; Vanaki, Zohreh

2017-12-01

Humanistic nursing practice which is dominated by technological advancement, outcome measurement, reduced resources, and staff shortages is challenging in the present work environment. To examine the main concern in humanistic nursing area and how the way it is solved and resolved by Iranian nurses in acute care setting. Data were collected from interviews and observations in 2009-2011 and analyzed using classic grounded theory. Memos were written during the analysis, and they were sorted once theoretical saturation occurred. Participants and research context: In total, 22 nurses, 18 patients, and 12 families from two teaching hospitals in Tehran were selected by purposeful and theoretical sampling. Ethical considerations: The research was approved by the Ethics Committee of the university and hospitals. The main concern for the nurses is the violation of their rights. They overcome this concern when there is a synergy of situation-education/learning, that is, a positive interaction between education and learning of values and sensitivity of the situation or existence of care promotion elements. They turn to professional values and seeking and meeting others' needs, resulting in "success and accomplishment" of nurse/nursing manager and patient/family. This theory shows that professional values, elements of care promotion, and sensitivity of the situation have a key role in activation of humanistic approach in nursing. Violation of the nurses' professional rights often leads to a decrease in care, but these factors make the nurses practice in an unsparing response approach. It is necessary to focus on development of professional values and provide essential elements of care promotion as changeable factors for realization of humanistic nursing although there is a context in which the nurses' rights are violated.

[Impact of the funding reform of teaching hospitals in Brazil].

PubMed

Lobo, M S C; Silva, A C M; Lins, M P E; Fiszman, R

2009-06-01

To assess the impact of funding reform on the productivity of teaching hospitals. Based on the Information System of Federal University Hospitals of Brazil, 2003 and 2006 efficiency and productivity were measured using frontier methods with a linear programming technique, data envelopment analysis, and input-oriented variable returns to scale model. The Malmquist index was calculated to detect changes during the study period: 'technical efficiency change,' or the relative variation of the efficiency of each unit; and 'technological change' after frontier shift. There was 51% mean budget increase and improvement of technical efficiency of teaching hospitals (previously 11, 17 hospitals reached the empirical efficiency frontier) but the same was not seen for the technology frontier. Data envelopment analysis set benchmark scores for each inefficient unit (before and after reform) and there was a positive correlation between technical efficiency and teaching intensity and dedication. The reform promoted management improvements but there is a need of further follow-up to assess the effectiveness of funding changes.

Some Correlates of Electronic Health Information Management System Success in Nigerian Teaching Hospitals

PubMed Central

Ojo, Adebowale I; Popoola, Sunday O

2015-01-01

Nowadays, an electronic health information management system (EHIMS) is crucial for patient care in hospitals. This paper explores the aspects and elements that contribute to the success of EHIMS in Nigerian teaching hospitals. The study adopted a survey research design. The population of study comprised 442 health information management personnel in five teaching hospitals that had implemented EHIMS in Nigeria. A self-developed questionnaire was used as an instrument for data collection. The findings revealed that there is a positive, close relationship between all the identified factors and EHIMS’s success: technical factors (r = 0.564, P < 0.05); social factors (r = 0.616, P < 0.05); organizational factors (r = 0.621, P < 0.05); financial factors (r = 0.705, P < 0.05); and political factors (r = 0.589, P < 0.05). We conclude that consideration of all the identified factors was highly significant for the success of EHIMS in Nigerian teaching hospitals. PMID:25983557

National Incidence of Medication Error in Surgical Patients Before and After Accreditation Council for Graduate Medical Education Duty-Hour Reform.

PubMed

Vadera, Sumeet; Griffith, Sandra D; Rosenbaum, Benjamin P; Chan, Alvin Y; Thompson, Nicolas R; Kshettry, Varun R; Kelly, Michael L; Weil, Robert J; Bingaman, William; Jehi, Lara

2015-01-01

The Accreditation Council for Graduate Medical Education (ACGME) established duty-hour regulations for accredited residency programs on July 1, 2003. It is unclear what changes occurred in the national incidence of medication errors in surgical patients before and after ACGME regulations. Patient and hospital characteristics for pre- and post-duty-hour reform were evaluated, comparing teaching and nonteaching hospitals. A difference-in-differences study design was used to assess the association between duty-hour reform and medication errors in teaching hospitals. We used the Nationwide Inpatient Sample database, which consists of approximately annual 20% stratified sample of all the United States nonfederal hospital inpatient admissions. A query of the database, including 4 years before (2000-2003) and 8 years after (2003-2011) the ACGME duty-hour reform of July 2003, was performed to extract surgical inpatient hospitalizations (N = 13,933,326). The years 2003 and 2004 were discarded in the analysis to allow for a wash-out period during duty-hour reform (though we still provide medication error rates). The Nationwide Inpatient Sample estimated the total national surgical inpatients (N = 135,092,013) in nonfederal hospitals during these time periods with 68,736,863 patients in teaching hospitals and 66,355,150 in nonteaching hospitals. Shortly after duty-hour reform (2004 and 2006), teaching hospitals had a statistically significant increase in rate of medication error (p = 0.019 and 0.006, respectively) when compared with nonteaching hospitals even after accounting for trends across all hospitals during this period. After 2007, no further statistically significant difference was noted. After ACGME duty-hour reform, medication error rates increased in teaching hospitals, which diminished over time. This decrease in errors may be related to changes in training program structure to accommodate duty-hour reform. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Some Problems of American Students in Mastering Persian Phonology.

NASA Astrophysics Data System (ADS)

Ghadessy, Esmael

1988-12-01

An adult learning to speak a foreign language normally retains an "accent" which may affect the intelligibility of certain sounds, but more often simply conveys the fact that the speaker is a non-native speaker. Various scholars have experimented and discussed the elements involved in a foreign accent. However, in Iran very few researchers have attempted to verify scientifically what are the phonetic and phonological aspects of an "accent." This author tried to determine whether or not a selected group of words, emphasizing stop voicing, produced by native speakers of Persian had significant phonetic and phonemic differences from those achieved by the American students. Subjects for the experiments were three groups of students, one Iranian, two American. A contrastive analysis of the Persian and the English stop consonants was made. An identical measurement test for all three groups was administered. Utilized was a Kay Sona-graph for acoustic analysis, and all spoken data from the Iranian group were compared with those of the American groups. An examination of acoustic correlates of Tehran stops produced by American students shows that the phonetically different but similar feature of /voice/ found in Tehran, Persian and English stops is intuitive to the Americans, and that the language learner cannot readily disassociate a phonological feature from habits of articulation. The results of this research support using the phonetic method for adult learners who want to improve their pronunciation ability. Further research and experimentation is necessary on the effect of the suprasegmental elements on a foreign accent and the most effective teaching materials and methods and to explore other possible techniques in the teaching process.

Mortality and treatment patterns among patients hospitalized with acute cardiovascular conditions during dates of national cardiology meetings.

PubMed

Jena, Anupam B; Prasad, Vinay; Goldman, Dana P; Romley, John

2015-02-01

Thousands of physicians attend scientific meetings annually. Although hospital physician staffing and composition may be affected by meetings, patient outcomes and treatment patterns during meeting dates are unknown. To analyze mortality and treatment differences among patients admitted with acute cardiovascular conditions during dates of national cardiology meetings compared with nonmeeting dates. Retrospective analysis of 30-day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure, or cardiac arrest from 2002 through 2011 during dates of 2 national cardiology meetings compared with identical nonmeeting days in the 3 weeks before and after conferences (AMI, 8570 hospitalizations during 82 meeting days and 57,471 during 492 nonmeeting days; heart failure, 19,282 during meeting days and 11,4591 during nonmeeting days; cardiac arrest, 1564 during meeting days and 9580 during nonmeeting days). Multivariable analyses were conducted separately for major teaching hospitals and nonteaching hospitals and for low- and high-risk patients. Differences in treatment utilization were assessed. Hospitalization during cardiology meeting dates. Thirty-day mortality, procedure rates, charges, length of stay. Patient characteristics were similar between meeting and nonmeeting dates. In teaching hospitals, adjusted 30-day mortality was lower among high-risk patients with heart failure or cardiac arrest admitted during meeting vs nonmeeting dates (heart failure, 17.5% [95% CI, 13.7%-21.2%] vs 24.8% [95% CI, 22.9%-26.6%]; P < .001; cardiac arrest, 59.1% [95% CI, 51.4%-66.8%] vs 69.4% [95% CI, 66.2%-72.6%]; P = .01). Adjusted mortality for high-risk AMI in teaching hospitals was similar between meeting and nonmeeting dates (39.2% [95% CI, 31.8%-46.6%] vs 38.5% [95% CI, 35.0%-42.0%]; P = .86), although adjusted percutaneous coronary intervention (PCI) rates were lower during meetings (20.8% vs 28.2%; P = .02). No mortality or utilization differences existed for low-risk patients in teaching hospitals or high- or low-risk patients in nonteaching hospitals. In sensitivity analyses, cardiac mortality was not affected by hospitalization during oncology, gastroenterology, and orthopedics meetings, nor was gastrointestinal hemorrhage or hip fracture mortality affected by hospitalization during cardiology meetings. High-risk patients with heart failure and cardiac arrest hospitalized in teaching hospitals had lower 30-day mortality when admitted during dates of national cardiology meetings. High-risk patients with AMI admitted to teaching hospitals during meetings were less likely to receive PCI, without any mortality effect.

Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department

PubMed Central

Haghighinejad, Hourvash Akbari; Kharazmi, Erfan; Hatam, Nahid; Yousefi, Sedigheh; Hesami, Seyed Ali; Danaei, Mina; Askarian, Mehrdad

2016-01-01

Background: Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED) is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emergency department services in an Iranian hospital ED and to propose scenarios to reduce its queue and waiting time. Methods: This is a cross-sectional study in which simulation software (Arena, version 14) was used. The input information was extracted from the hospital database as well as through sampling. The objective was to evaluate the response variables of waiting time, number waiting and utilization of each server and test the three scenarios to improve them. Results: Running the models for 30 days revealed that a total of 4088 patients left the ED after being served and 1238 patients waited in the queue for admission in the ED bed area at end of the run (actually these patients received services out of their defined capacity). The first scenario result in the number of beds had to be increased from 81 to179 in order that the number waiting of the “bed area” server become almost zero. The second scenario which attempted to limit hospitalization time in the ED bed area to the third quartile of the serving time distribution could decrease the number waiting to 586 patients. Conclusion: Doubling the bed capacity in the emergency department and consequently other resources and capacity appropriately can solve the problem. This includes bed capacity requirement for both critically ill and less critically ill patients. Classification of ED internal sections based on severity of illness instead of medical specialty is another solution. PMID:26793727

31 CFR 560.518 - Transactions in Iranian-origin and Iranian government property.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Transactions in Iranian-origin and Iranian government property. 560.518 Section 560.518 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRANIAN...

31 CFR 560.518 - Transactions in Iranian-origin and Iranian government property.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Transactions in Iranian-origin and Iranian government property. 560.518 Section 560.518 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY IRANIAN...

Teaching Quality, Learning Satisfaction, and Academic Performance among Hospitality Students in Taiwan

ERIC Educational Resources Information Center

Ko, Wen-Hwa; Chung, Feng-Ming

2014-01-01

The purpose of this study is to examine the effect of the teaching quality of culinary arts teachers and student learning satisfaction on the academic performance of hospitality students. This study surveys the students in hospitality departments at universities in Taiwan. A total of 406 (81.2%) valid questionnaires were received. Research results…

A Multidisciplinary Work-Related Low Back Pain Predictor Questionnaire: Psychometric Evaluation of Iranian Patient-Care Workers.

PubMed

Sarallah, Shojaei; Sadat, Tavafian Sedigheh; Jamshidi, Ahmad Reza; Joan, Wagner

2016-06-01

Psychometric evaluation design. Psychometric evaluation of a multidisciplinary work-related low back pain predictor questionnaire (MWRLBPPQ) of Iranians patient-care workers based on the social cognitive theory. Healthcare is one of the professions in which work-related musculoskeletal disorders are prevalent. The chronic low back pain experienced by patient caregivers can negatively impact their professional performance, and patient handling in a hospital is the main cause of low back pain in this population. This was a cross-sectional study carried out in Qom, Iran from July 2014 to November 2014. A MWRLBPPQ based on nine concepts of the social cognitive theory and existing literature regarding chronic low back pain was developed. Ten patient-care workers first completed the questionnaire as a pilot test, allowing the ambiguities of the instrument to be resolved. Exploratory factor analysis was used to confirm construct validity. This questionnaire was distributed among 452 patient-care workers in hospitals located in different geographically areas in Qom, Iran. Cronbach's Alpha was calculated to assess reliability. In all, 452 caregivers of patients with mean age of 37.71 (standard deviation=8.3) years participated in the study. An exploratory factor analysis loaded seven concepts of self-efficacy, knowledge, outcome perception, self-control, emotional coping, and self-efficacy in overcoming impediments and challenges in the environment. All concepts were jointly accounted for 50.08% of variance of behavior change. The Cronbach's alpha coefficient showed favorable internal consistency (alpha=0.83), and test-retest of the scale with 2-week intervals indicated an appropriate stability for the MWRLBPPQ. The MWRLBPPQ is a reliable and valid theory-based instrument that can be used to predict factors influencing work-related low back pain among workers who lift and transfer patients in hospitals.

Emergency Response of Iranian Hospitals Against Disasters: A Practical Framework for Improvement.

PubMed

Janati, Ali; Sadeghi-Bazargani, Homayoun; Hasanpoor, Edris; Sokhanvar, Mobin; HaghGoshyie, Elaheh; Salehi, Abdollah

2018-04-01

Hospital emergency management is a continuous process that requires monolithic integration of planning and response attempts with local and national schemes. The aim of the current study is to evaluate emergency response by hospitals against potential disasters in Tabriz, north-west Iran. A cross-sectional study was conducted in the city of Tabriz, in Iran, in 2016. The study population included all hospitals in Tabriz. A total of 18 hospitals were assessed. The hospital emergency response checklist was used to collect data. Tool components included command and control, communication, safety and security, triage, surge capacity, continuity of essential services, human resources, logistics and supply management, and post-disaster recovery. Data entry and analysis were carried out using SPSS software (version 20). The results showed that the emergency response rate of hospitals was 54.26% in Tabriz. The lowest response rates were for Shafaa hospital (18.89%) and the highest response rates were for Razi Hospital (91.67%). The components of hospital emergency response were assessed to be between 48.07% (surge capacity) and 58.95% (communication). On the basis of the World Health Organization checklist, the emergency response rate for hospitals in Tabriz was only 54.26%. Therefore, hospital emergency responses against disasters have to be improved and must be made to reach 100%. It is essential to design a comprehensive framework for hospital emergency response. (Disaster Med Public Health Preparedness. 2018;12:166-171).

Cultural Intelligence and Social Adaptability: A Comparison between Iranian and Non-Iranian Dormitory Students of Isfahan University of Medical Sciences

PubMed Central

Soltani, Batoul; Keyvanara, Mahmoud

2013-01-01

Introduction: At the modern age, to acquire knowledge and experience, the individuals with their own specific culture have to enter contexts with cultural diversity, adapt to different cultures and have social interactions to be able to have effective inter-cultural relationships.To have such intercultural associations and satisfy individual needs in the society, cultural intelligence and social adaptability are deemed as inevitable requirements, in particular for those who enter a quite different culture. Hence, the present study tries to compare the cultural intelligence and its aspects and social adaptability in Iranian and non-Iranian dormitory students of Isfahan University of Medical Sciences in 2012. Methodology: The study was of descriptiveanalytical nature. The research population consisted of Iranian and non-Iranian students resided in the dormitories of Isfahan University of Medical Sciences which are 2500, totally. For Iranian students, two-stage sampling method was adopted. At the first stage, classified sampling and at the second stage, systematic random sampling was conducted. In this way, 441 students were selected. To form non-Iranian students’ sample, consensus sampling method was applied and a sample of 37 students were obtained. The research data was collected by using Earley & Ang’s Cultural Intelligence Questionnaire with the Cronbach’s coefficient α of 76% and California Social Adaptability Standard Questionnaire with the Cronbach’s coefficient α of over 70%. Then, the data were put into SPSS software to be analyzed. Finally, the results were presented by descriptive and inferential statistics methods. Results: The study findings revealed that there was no statistically significant difference between cultural intelligence and cognitive aspect of cultural intelligence in Iranian and non-Iranian students (P≥0/05). However, Iranian and non-Iranian students statistically differed in terms of the following aspects of cultural intelligence: meta-cognitive aspect (61.8% for Iranian students vs. 47.6% for non-Iranians), motivational aspect (59.0% vs. 42.6%), behavioral aspect (31.8% vs. 41.2%) as well as social adaptability as the other variable in question ( 68.9% vs. 56.2%) (p<0.001). Conclusion: The comparison of the mean scores gained for meta-cognitive and motivational aspects of cultural intelligence as well as social adaptability in Iranian and non-Iranian students resided in the dormitories of Isfahan University of Medical Sciences revealed that the Iranian students had the higher rank. On the other hand, the mean score acquired for the behavioral aspect in Iranian and non-Iranian students were comparable, with non-Iranian students having the higher mean scores. Therefore, it can be said that the meta-cognitive and motivational aspects of cultural intelligence and social adaptability of non-Iranian students and the behavioral aspect of Iranian students’ cultural intelligence may be promoted by educational planning, thereby, taking effective steps towards their achievement in contexts with inter-cultural interaction . In this way, their mental health will be enhanced, as well. PMID:23678339

Cultural Intelligence and Social Adaptability: A Comparison between Iranian and Non-Iranian Dormitory Students of Isfahan University of Medical Sciences.

PubMed

Soltani, Batoul; Keyvanara, Mahmoud

2013-01-01

At the modern age, to acquire knowledge and experience, the individuals with their own specific culture have to enter contexts with cultural diversity, adapt to different cultures and have social interactions to be able to have effective inter-cultural relationships.To have such intercultural associations and satisfy individual needs in the society, cultural intelligence and social adaptability are deemed as inevitable requirements, in particular for those who enter a quite different culture. Hence, the present study tries to compare the cultural intelligence and its aspects and social adaptability in Iranian and non-Iranian dormitory students of Isfahan University of Medical Sciences in 2012. The study was of descriptiveanalytical nature. The research population consisted of Iranian and non-Iranian students resided in the dormitories of Isfahan University of Medical Sciences which are 2500, totally. For Iranian students, two-stage sampling method was adopted. At the first stage, classified sampling and at the second stage, systematic random sampling was conducted. In this way, 441 students were selected. To form non-Iranian students' sample, consensus sampling method was applied and a sample of 37 students were obtained. The research data was collected by using Earley & Ang's Cultural Intelligence Questionnaire with the Cronbach's coefficient α of 76% and California Social Adaptability Standard Questionnaire with the Cronbach's coefficient α of over 70%. Then, the data were put into SPSS software to be analyzed. Finally, the results were presented by descriptive and inferential statistics methods. The study findings revealed that there was no statistically significant difference between cultural intelligence and cognitive aspect of cultural intelligence in Iranian and non-Iranian students (P≥0/05). However, Iranian and non-Iranian students statistically differed in terms of the following aspects of cultural intelligence: meta-cognitive aspect (61.8% for Iranian students vs. 47.6% for non-Iranians), motivational aspect (59.0% vs. 42.6%), behavioral aspect (31.8% vs. 41.2%) as well as social adaptability as the other variable in question ( 68.9% vs. 56.2%) (p<0.001). The comparison of the mean scores gained for meta-cognitive and motivational aspects of cultural intelligence as well as social adaptability in Iranian and non-Iranian students resided in the dormitories of Isfahan University of Medical Sciences revealed that the Iranian students had the higher rank. On the other hand, the mean score acquired for the behavioral aspect in Iranian and non-Iranian students were comparable, with non-Iranian students having the higher mean scores. Therefore, it can be said that the meta-cognitive and motivational aspects of cultural intelligence and social adaptability of non-Iranian students and the behavioral aspect of Iranian students' cultural intelligence may be promoted by educational planning, thereby, taking effective steps towards their achievement in contexts with inter-cultural interaction . In this way, their mental health will be enhanced, as well.

The costs of acute readmissions to a different hospital - Does the effect vary across provider types?

PubMed

Møller Dahl, Christian; Planck Kongstad, Line

2017-06-01

Treatment costs are found to vary substantially and systematically within DRGs. Several factors have been shown to contribute to the variation in costs within DRGs. We argue that readmissions might also explain part of the observed variation in costs. A substantial number of all readmissions occur to a different hospital. The change in hospital indicates that a progression of the illness has occurred since the initial hospitalisation. As a result, different-hospital readmissions might be more costly compared to same-hospital admissions. The aim of this paper is twofold. Firstly, to analyse differences in costs between different-hospital readmissions and same-hospital readmissions within the same DRG. Secondly, to investigate whether the effect of different-hospital readmission on costs vary depending of provider type (general versus teaching hospital). We use a rich Danish patient-level administrative data set covering inpatient stays in the period 2008-2010. We exploit the fact that some patients are readmitted within the same DRG and that some of these readmissions occur at different hospitals in a propensity score difference-in-difference design. The estimates are based on a restricted sample of n = 328 patients. Our results show that the costs of different-hospital readmissions are significantly higher relative to the costs of same-hospital readmission (approx. €777). Furthermore, the cost difference is found to be almost twice the size for patients readmitted to a teaching hospital (approx. €1016) (P < 0.10) compared to patients readmitted to a different general hospital (approx. €511) (P < 0.10). The results suggest that hospitals in general face a potential risk by treating different-hospital readmissions, and that the financial consequences are highest among teaching hospitals. If teaching hospitals are not compensated for the additional costs of treating different-hospital readmission patients, they might be unfairly funded under a DRG-based payment scheme. Copyright © 2017 Elsevier Ltd. All rights reserved.

Hospital diversification strategy.

PubMed

Eastaugh, Steven R

2014-01-01

To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger.

How do Supervising Clinicians of a University Hospital and Associated Teaching Hospitals Rate the Relevance of the Key Competencies within the CanMEDS Roles Framework in Respect to Teaching in Clinical Clerkships?

PubMed

Jilg, Stefanie; Möltner, Andreas; Berberat, Pascal; Fischer, Martin R; Breckwoldt, Jan

2015-01-01

In German-speaking countries, the physicians' roles framework of the "Canadian Medical Education Directives for Specialists" (CanMEDS) is increasingly used to conceptualize postgraduate medical education. It is however unclear, whether it may also be applied to the final year of undergraduate education within clinical clerkships, called "Practical Year" (PY). Therefore, the aim of this study was to explore how clinically active physicians at a university hospital and at associated teaching hospitals judge the relevance of the seven CanMEDS roles (and their (role-defining) key competencies) in respect to their clinical work and as learning content for PY training. Furthermore, these physicians were asked whether the key competencies were actually taught during PY training. 124 physicians from internal medicine and surgery rated the relevance of the 28 key competencies of the CanMEDS framework using a questionnaire. For each competency, following three aspects were rated: "relevance for your personal daily work", "importance for teaching during PY", and "implementation into actual PY teaching". In respect to the main study objective, all questionnaires could be included into analysis. All seven CanMEDS roles were rated as relevant for personal daily work, and also as important for teaching during PY. Furthermore, all roles were stated to be taught during actual PY training. The roles "Communicator", "Medical Expert", and "Collaborator" were rated as significantly more important than the other roles, for all three sub-questions. No differences were found between the two disciplines internal medicine and surgery, nor between the university hospital and associated teaching hospitals. Participating physicians rated all key competencies of the CanMEDS model to be relevant for their personal daily work, and for teaching during PY. These findings support the suitability of the CanMEDS framework as a conceptual element of PY training.

Teaching efficacy of nurses in clinical practice education: A cross-sectional study.

PubMed

Kim, Eun-Kyeung; Shin, Sujin

2017-07-01

Clinical nurses play a vital role in clinical practice education; thus, it is necessary to help clinical nurses have teaching efficacy through the development and application of systematic education programs. To identify nurses' teaching efficacy for clinical education and analyze the influencing factors of teaching efficacy. The study used a cross-sectional design. We used a convenience sample of 263 nurses from two hospitals. Teaching efficacy, general characteristics, and perception of clinical practice education were collected via self-reported questionnaires. Teaching efficacy was measured using Hwang's (2006) questionnaire, while perception of clinical practice education was measured using the Clinical Nurse Teacher Survey developed by Nishioka et al. (2014). Participants completed the questionnaire directly. The collected data were then analyzed using descriptive statistics, t-tests, ANOVAs, and multiple regression analysis with PASW Statistics 18.0. The mean total score of teaching efficacy was 72.5 (range 21-105). The leadership for students subscale had the highest score (3.56±0.59). The factors influencing teaching efficacy were length of clinical career (β=0.26, p<0.001) and perceptions of work satisfaction (β=0.20, p=.005), clinical supervisory relationship (β=0.18, p=.010), and nursing at the hospital ward (β=0.13, p=.029). Altogether, these variables explained 28% of the variance in teaching efficacy in nurses. Based on these results, nursing educators might need to develop greater confidence in their knowledge and enhance control of their teaching strategies. Nursing schools and hospitals might need to provide greater support and educational opportunities to nurse clinical practice instructors. Furthermore, constructing a system of cooperation between these colleges and educational hospitals, developing programs to enhance teaching efficacy, and identifying the clinical instructor's role are all necessary to promote clinical practice education. Copyright © 2017. Published by Elsevier Ltd.

A comparison of congestive heart failure readmissions among teaching and nonteaching hospital services.

PubMed

Palacio, Carlos; House, Jeffrey; Ibrahim, Saif; Touchan, Jean N; Mooradian, Ariana

2014-08-01

Heart failure (HF) is a leading cause of hospitalization in the United States. With the population trend shifting to a higher volume of elderly adults, the efficient management of HF will become increasingly essential. The development and implementation of The Patient Protection and Affordable Care Act and subsequent changes in reimbursement practices have made 30-day readmission rates a topic of much interest and relevance. The aim of the study was to compare rates of readmission among teaching and nonteaching hospitals. The authors gathered retrospective data on HF quality measures and readmission rates between August 2011 and July 2012, extracted from the institution's managerial accounting database. These data were compared among teaching and nonteaching hospitals. Patient demographics, readmission rates, readmission diagnoses, severity of illness, patient disposition, medications prescribed, cost of services, and mortality were reviewed. Analysis of variance was used for continuous variables; χ(2) analysis was used for evaluating categorical variables. A higher proportion of patients on the cardiology teaching service were men than on either the medicine teaching service or the medicine nonteaching service. Length of stay, case costs, and care costs were lowest for the cardiology teaching service; however, patient illness severity was lower on this service than on the other two services. Overall, readmissions and mortality were similar among all groups, but readmission for the same diagnosis was more likely on the cardiology service than on the medicine teaching and nonteaching services. Studies comparing teaching and nonteaching providers for an HF diagnosis are needed. Hospital readmission and mortality rates were similar across services and compared favorably with national data. Opportunities that target cost reduction and length of stay may be leveraged.

Income Analysis of University-Owned Teaching Hospitals.

ERIC Educational Resources Information Center

Isaacs, Joseph C.

1979-01-01

The annual survey, undertaken by the Association of American Medical Colleges, of income, expense and general operating information for university-owned teaching hospitals is discussed. Focus is on sources of income, including state funds, Medicare, and insurance companies. (JMD)

[Costs of serious adverse events in a community teaching hospital, in Mexico].

PubMed

Gutiérrez-Mendoza, Luis Meave; Torres-Montes, Abraham; Soria-Orozco, Manuel; Padrón-Salas, Aldanely; Ramírez-Hernández, María Elizabeth

2015-01-01

Serious adverse events during hospital care are a worldwide reality and threaten the safety of the hospitalised patient. To identify serious adverse events related to healthcare and direct hospital costs in a Teaching Hospital in México. A study was conducted in a 250-bed Teaching Hospital in San Luis Potosi, Mexico. Data were obtained from the Quality and Patient Safety Department based on 2012 incidents report. Every event was reviewed and analysed by an expert team using the "fish bone" tool. The costs were calculated since the event took place until discharge or death of the patient. A total of 34 serious adverse events were identified. The average cost was $117,440.89 Mexican pesos (approx. €7,000). The great majority (82.35%) were largely preventable and related to the process of care. Undergraduate medical staff were involved in 58.82%, and 14.7% of patients had suffered adverse events in other hospitals. Serious adverse events in a Teaching Hospital setting need to be analysed to learn and deploy interventions to prevent and improve patient safety. The direct costs of these events are similar to those reported in developed countries. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Educating Children in the Midst of Health Crises: A Phenomenological Study of Teachers in Children's Hospital Schools

ERIC Educational Resources Information Center

Burns, Johnna N.

2013-01-01

Purpose, Scope, and Method of Study: Hospital school teachers are a unique population of educators highly qualified and experienced in teaching students who are facing health crises. The purpose of this phenomenological study was to describe the lived experience of teaching seriously ill students in the hospital school setting. The study was…

Films reject analysis for conventional radiography in Iranian main hospitals.

PubMed

Roohi Shalemaei, R

2011-09-01

The purpose of this study was to evaluate image quality, to determine the reject film rate in conventional radiology procedures and to determine the causes of defects on the films. Rejected films were collected in four main hospitals in Iran and five routine examinations were considered. The rejected films were analysed and assigned to five different categories. There was a significant reduction in the overall film reject rate for all examinations investigated from 17.6 to 11.4 % when a quality assurance (QA) programme was implemented. The major reasons for rejection of films were over- or under-exposure and processing problems. The study showed the importance of a QA programme in order to deliver high-quality health service to patients.

Maternity and parental leave policies at COTH hospitals: an update. Council of Teaching Hospitals.

PubMed

Philibert, I; Bickel, J

1995-11-01

Because residents' demands for parental leave are increasing, updated information about maternity and paternity leave policies was solicited from hospitals that are members of the Council of Teaching Hospitals (COTH) of the AAMC. A 20-item questionnaire, combining forced-choice categories and open-ended questions, was faxed to 405 COTH hospitals in October 1994; 45% responded. A total of 77% of the respondents reported having written policies for maternity and/or parental leave; in 1989, only 52% of COTH hospitals had reported having such policies. Forty-one percent of the 1994 responding hospitals offered dedicated paid maternity leave, with a mean of 42 days allowed. Twenty-five percent of the respondents offered paternity leave, and 15% offered adoption leave. It is encouraging that the majority of the teaching hospitals that responded to the survey had adopted written policies, but the 23% without written policies remain a source of concern. Well-defined policies for maternity, paternity, and adoption leave can reduce stress and foster equity both for trainees requiring leave and for their colleagues.

Current national incidence, trends, and health care resource utilization of cleft lip-cleft palate.

PubMed

Basseri, Benjamin; Kianmahd, Benjamin D; Roostaeian, Jason; Kohan, Emil; Wasson, Kristy L; Basseri, Robert J; Bradley, James P

2011-03-01

Available reports on the epidemiology of cleft lip, cleft palate, and cleft lip-cleft palate have been numerous yet inconsistent, and have originated only from institutional or regional studies. The need for current national data and the recognition of recent trends exists. The authors examined the Kids' Inpatient Database to obtain national information on pediatric orofacial cleft discharges from 1997 to 2007. The authors examined patient and hospital characteristics to discern differences in use of care, hospital charges, type of hospital, untoward events, and other variables among various groups. A detailed investigation searching for significant trends during the 6-year study period was also conducted. Trends appreciated from 1997 to 2007 included (1) an increase in cleft operations performed at teaching hospitals compared with nonteaching hospitals (teaching increased 13.4 percent and nonteaching decreased 15.8 percent); (2) an increase in the mean overall charges (74.5 percent increase; p < 0.001) and a rate of rise higher than that of aggregate charges (60 percent; p < 0.001); and (3) a lower rate of perioperative complications in teaching hospitals from 2000 to 2007, ranging from 14 to 27 percent less than in nonteaching hospitals. The authors' data show that there is a current trend of cleft patients receiving treatment at teaching hospitals, with higher costs and decreasing complications. An understanding of such trends and disparities in resource use among various patient, hospital, and geographic settings is important for physicians and policy makers.

THE EFFECT OF OUTPATIENT SERVICE QUALITY ON PATIENT SATISFACTION IN TEACHING HOSPITALS IN IRAN

PubMed Central

Pouragha, Behrouz; Zarei, Ehsan

2016-01-01

Aim: The quality of services plays a primary role in achieving patient satisfaction. The main purpose of this study was to explore the effect of outpatient service quality on patient satisfaction in teaching hospitals in Iran. Methods: this cross-sectional study was conducted in 2014. The study sample included 500 patients were selected with systematic random method from the outpatient departments (clinics) of four teaching hospitals in Tehran. The survey instrument was a questionnaire consisted of 44 items, which were confirmed its reliability and validity. The data were analyzed by using descriptive statistics, Pearson’s correlation, and multivariate regression methods with the SPSS.18 software. Results: According to the findings of this study, the majority of patients had a positive experience in the outpatient departments of the teaching hospitals and thus evaluated the services as good. Perceived service costs, physician consultation, physical environment, and information to patient were found to be the most important determinants of outpatient satisfaction. Conclusion: The results suggest that improving the quality of consultation, providing information to the patients during examination and consultation, creating value for patients by reducing costs or improving service quality, and enhancing the physical environment quality of the clinic can be regarded as effective strategies for the management of teaching hospitals toward increasing outpatient satisfaction. PMID:27047262

Resident versus no resident: a single institutional study on operative complications, mortality, and cost.

PubMed

Hwang, Christine S; Pagano, Christina R; Wichterman, Keith A; Dunnington, Gary L; Alfrey, Edward J

2008-08-01

Previous studies have demonstrated an increase in surgical morbidity, mortality, duration of stay, and costs in teaching hospitals. These studies are confounded by many variables. Controlling for these variables, we studied the effect of surgical residents on these outcomes during rotations with non-academic-based teaching faculty at a teaching hospital. Patients received care at a single teaching hospital from a group of 8 surgeons. Four surgeons did not have resident coverage (group 1) and the other 4 had coverage (group 2). Continuous severity adjusted complications, mortality, length of stay, cost, and hospital margin data were collected and compared. Five common procedures were examined: bowel resection, laparoscopic cholecystectomy, hernia, mastectomy, and appendectomy. Comparing all procedures together, there were no differences in complications between the groups, although there was greater mortality, a greater duration of stay, and higher costs in group 2. When comparing the 5 most common procedures individually, there was no difference in complications or mortality, although a greater length of stay and higher costs in group 2. Comparing the most common procedures performed individually, patients cared for by surgeons with surgical residents at a teaching hospital have an increase in duration of stay and cost, although no difference in complications or mortality compared to surgeons without residents.

THE EFFECT OF OUTPATIENT SERVICE QUALITY ON PATIENT SATISFACTION IN TEACHING HOSPITALS IN IRAN.

PubMed

Pouragha, Behrouz; Zarei, Ehsan

2016-02-01

The quality of services plays a primary role in achieving patient satisfaction. The main purpose of this study was to explore the effect of outpatient service quality on patient satisfaction in teaching hospitals in Iran. this cross-sectional study was conducted in 2014. The study sample included 500 patients were selected with systematic random method from the outpatient departments (clinics) of four teaching hospitals in Tehran. The survey instrument was a questionnaire consisted of 44 items, which were confirmed its reliability and validity. The data were analyzed by using descriptive statistics, Pearson's correlation, and multivariate regression methods with the SPSS.18 software. According to the findings of this study, the majority of patients had a positive experience in the outpatient departments of the teaching hospitals and thus evaluated the services as good. Perceived service costs, physician consultation, physical environment, and information to patient were found to be the most important determinants of outpatient satisfaction. The results suggest that improving the quality of consultation, providing information to the patients during examination and consultation, creating value for patients by reducing costs or improving service quality, and enhancing the physical environment quality of the clinic can be regarded as effective strategies for the management of teaching hospitals toward increasing outpatient satisfaction.

Gender differences in depression scores of Iranian and german medical students.

PubMed

Ahmadi, Jamshid; Ahmadi, Nahid; Soltani, Fereshteh; Bayat, Fatemeh

2014-01-01

The aim was to evaluate gender differences in depression scores of Iranian and German medical students. Two hundred Iranian medical students (100 men and 100 women) and 200 German medical students (100 men and 100 women) were selected randomly and completed the English form of the self-rating Beck Depression Inventory (BDI). Analysis gave a mean rating of 10.7 ± 6.6 for Iranian men and 10.9 ± 7.81 for Iranian women (NS). Also, 5 ± 4.9 for German men and 5.6 ± 5.0 for German women (NS). On Item 2, which asked whether the person was pessimistic 33% of Iranian men and 30% of Iranian women indicated that they were pessimistic (NS). Also, 21% of German men and 20% of German women indicated that they were pessimistic (NS). On Item 9, which asked about suicidal tendencies, 9% of Iranian men and 13% of Iranian women reported as having suicidal tendencies (NS). Also, 13% of German men and 21% of German women reported as having self-harming thoughts (NS). The present study showed no gender differences in Iranian and German medical students' scores on the BDI.

Incidence and risk factors of workplace violence against nurses in a Chinese top-level teaching hospital: A cross-sectional study.

PubMed

Chen, Xiaoming; Lv, Ming; Wang, Min; Wang, Xiufeng; Liu, Junyan; Zheng, Nan; Liu, Chunlan

2018-04-01

To investigate the incidence of workplace violence involving nurses and to identify related risk factors in a high-quality Chinese teaching hospital. A cross-sectional study design was used. The final sample comprised responses from 1831 registered nurses collected with a whole-hospital survey from June 1 to June 15, 2016. The demographic characteristics of the nurses who had experienced any form of violence were collected, and logistic regression analysis was applied to evaluate the risk factors for nurses related to workplace violence. Out of the total number of nurses surveyed, 904 (49.4%) nurses reported having experienced any type of violence in the past year. The frequencies of exposure to physical and non-physical violence were 6.3% (116) and 49.0% (897), respectively. All the incidence rates of violence were lower than those of other studies based on regional hospitals in China and were at the same level found in developed countries and districts. Binary logistic regression analysis revealed that nurses at levels 2 to 4 and female nurses in clinical departments were the most vulnerable to non-physical violence. For physical violence, the two independent risk factors were working in an emergency department and having 6-10 years of work experience. Workplace violence directly threatens nurses from high-quality Chinese teaching hospitals. However, the incidence of WPV against nurses in this teaching hospital was better than that in regional hospitals. This study also provides reference material to identify areas where nurses encounter relatively high levels of workplace violence in high-quality Chinese teaching hospitals. Copyright © 2018 Elsevier Inc. All rights reserved.

Opening the Black Box: The Experiences and Lessons From the Public Hospitals Autonomy Policy in Iran.

PubMed

Doshmangir, Leila; Rashidian, Arash; Jafari, Mehdi; Takian, Amirhossein; Ravaghi, Hamid

2015-07-01

Policy formulation and adoption often happen in a black box. Implementation challenges affect and modify the nature of a policy. We analyzed hospitals' autonomy policy in Iran that was intended to reduce hospitals' financial burden on government and improve their efficiency. We followed a retrospective case-study methodology, involving inductive and deductive analyses of parliamentary proceedings, policy documents, gray literature, published papers and interview transcripts. We analyzed data to develop a policy map that included important dates and events leading to the policy process milestones. We identified four time-periods with distinctive features: 'moving toward the policy' (1989 - 1994), disorganized implementation' (1995 - 1997), 'continuing challenges and indecisiveness in hospitals financing' (1998 - 2003), and 'other structural and financial policies in public hospitals' (2004 to date). We found that stakeholders required different and conflicting objectives, which certainly resulted in an unsatisfactory implementation process. The policy led to long-lasting and often negative changes in the hospital sector and the entire Iranian health system. Hospital autonomy appeared to be an ill-advised policy to remedy the inefficiency problems in low socioeconomic areas of the country. The assumption that hospital autonomy reforms would necessarily result in a better health system, may be a false assumption as their success relies on many contextual, structural and policy implementation factors.

Pabon Lasso and Data Envelopment Analysis: A Complementary Approach to Hospital Performance Measurement

PubMed Central

Mehrtak, Mohammad; Yusefzadeh, Hasan; Jaafaripooyan, Ebrahim

2014-01-01

Background: Performance measurement is essential to the management of health care organizations to which efficiency is per se a vital indicator. Present study accordingly aims to measure the efficiency of hospitals employing two distinct methods. Methods: Data Envelopment Analysis and Pabon Lasso Model were jointly applied to calculate the efficiency of all general hospitals located in Iranian Eastern Azerbijan Province. Data was collected using hospitals’ monthly performance forms and analyzed and displayed by MS Visio and DEAP software. Results: In accord with Pabon Lasso model, 44.5% of the hospitals were entirely efficient, whilst DEA revealed 61% to be efficient. As such, 39% of the hospitals, by the Pabon Lasso, were wholly inefficient; based on DEA though; the relevant figure was only 22.2%. Finally, 16.5% of hospitals as calculated by Pabon Lasso and 16.7% by DEA were relatively efficient. DEA appeared to show more hospitals as efficient as opposed to the Pabon Lasso model. Conclusion: Simultaneous use of two models rendered complementary and corroborative results as both evidently reveal efficient hospitals. However, their results should be compared with prudence. Whilst the Pabon Lasso inefficient zone is fully clear, DEA does not provide such a crystal clear limit for inefficiency. PMID:24999147

Iranian nursing staff's self-reported general and mental health related to working conditions and family situation.

PubMed

Arsalani, N; Fallahi-Khoshknab, M; Josephson, M; Lagerstrom, M

2012-09-01

There is increasing global evidence that today's work environment results in higher risk of adverse health among nursing staff than among other professions. To investigate self-reported general and mental health among Iranian nursing staff, and associations with organizational, physical and psychosocial working conditions and family situation. 520 nursing personnel from 10 university hospitals in Tehran participated in this cross-sectional study. Data were collected using a validated questionnaire in the Persian language, containing the Copenhagen Psychosocial Questionnaire, physical items from the Nurse Early eXit Study and two scales relating to general health and mental health from the Short Form-36. The Chi-square test with P<0.05 and logistic regression were used to analyse data. Three out of four nursing staff reported overtime work. The self-reported general and mental health rates of participants were poor/fair (38%, 41%), good (44%, 39%) and very good/excellent (18%, 20%), respectively. Family demands were associated with general health but were not associated with mental health. Adverse physical and psychosocial work conditions gave an elevated odds ratio for poor health. Poor general and mental health was associated with adverse working conditions and family demands. Physical and psychosocial working conditions of nursing personnel should be improved. Social facilities such as daycare for children and care for the elderly should be available during work shifts to help Iranian nurses play their family roles. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

Seroepidemiology of Varicella and value of self-reported history of Varicella infection in Iranian medical students.

PubMed

Allami, Abbas; Mohammadi, Navid; Najar, Azade

2014-04-01

We conducted this study to assess the seroprevalence of Varicella zoster virus (VZV) antibodies in a group of Iranian medical sciences students that were at risk of Varicella and the value of self-reported history as a predictor of immunity. 255 medical, nursing and obstetrics students who had not entered as a student or worked in a hospital from 3 different schools were enrolled in the study in 2012 (Qazvin province, Iran). Demographics and other information as well as the history of Varicella were obtained through a self-administered questionnaire. Blood samples were collected to determine the Varicella IgG levels via an enzyme-linked immunosorbent assay. A statistical analysis was performed by calculating prevalences and their 95% confidence intervals. Sensitivity, specificity, positive and negative predictive values, Cohen's kappa and positive and negative likelihood ratios of recalled history were determined. p < 0.05 was considered statistically significant. The mean age of participants was 21.3 ± 4.3 years. Seropositivity rate was 74.5%. The relationships between marital status, number of family members, and acquired VZV history with immunity against the virus were statistically significant. The overall rate of reported history was 57%. The positive and negative predictive values of self-reported history of Varicella were 91% and 47.3%, respectively. Immunization of students of Iranian medical sciences seems logical in the near future. Also, they should be tested for Varicella immunity regardless of the history of previous infection.

Iranian Clinical Nurses’ Activities for Self-Directed Learning: A Qualitative Study

PubMed Central

Ghiyasvandian, Shahrzad; Malekian, Morteza; Cheraghi, Mohammad Ali

2016-01-01

Background: Clinical nurses need lifelong learning skills for responding to the rapid changes of clinical settings. One of the best strategies for lifelong learning is self-directed learning. The aim of this study was to explore Iranian clinical nurses’ activities for self-directed learning. Methods: In this qualitative study, 23 semi-structured personal interviews were conducted with nineteen clinical nurses working in all four hospitals affiliated to Isfahan Social Security Organization, Isfahan, Iran. Study data were analyzed by using the content analysis approach. The study was conducted from June 2013 to October 2014. Findings: Study participants’ activities for self-directed learning fell into two main categories of striving for knowledge acquisition and striving for skill development. The main theme of the study was ‘Revising personal performance based on intellectual-experiential activities’. Conclusions: Study findings suggest that Iranian clinical nurses continually revise their personal performance by performing self-directed intellectual and experiential activities to acquire expertise. The process of acquiring expertise is a linear process which includes two key steps of knowledge acquisition and knowledge development. In order to acquire and advance their knowledge, nurses perform mental learning activities such as sensory perception, self-evaluation, and suspended judgment step-by-step. Moreover, they develop their skills through doing activities like apprenticeship, masterly performance, and self-regulation. The absolute prerequisite to expertise acquisition is that a nurse needs to follow these two steps in a sequential manner. PMID:26652072

Disclosure of Cancer Information in Iran: a Perspective of Patients, Family Members, and Health Professionals.

PubMed

Beyraghi, N; Mottaghipour, Y; Mehraban, A; Eslamian, E; Esfahani, F

2011-01-01

In the last decades cancer has become one of the important causes of death in Iran .This study examined perspective of a group of Iranian health professionals, patients and patients' family members regarding their view on disclosure of cancer information at a university hospital in Tehran, Iran. The method of study was qualitative semi-structured focused group content analysis. Two group leaders (psychologist and psychiatrist) run the focus groups. Oncologists, nurses, patients and family members participated in separate focus groups. Five group sessions were held to sum up the participants views in four major topics related to disclosure of cancer information to patients and families. Most of physicians and nurses believed that disclosure of cancer diagnosis is a mistake. Family members think that it should be delivered gradually during stages of therapy based on patient's psychological state, but most of the patients consider truth telling as a patient right. All physicians, most of nurses and all the patients see the physician as a person responsible to break the diagnostic disclosure. All patients wanted the physicians to take the total control of decision-making process for their treatment. Iranian physicians and nurses hesitate to disclose cancer diagnosis compared to patients, who want to know the truth. Patients, nurses and physicians consider the physician to be the person responsible for delivering the information of cancer diagnosis .Development and implementation of a protocol based on Iranian culture is a necessity.

The real world of blood glucose point-of-care testing (POCT) system running in China teaching hospital.

PubMed

Li, Feng-Fei; Xie, Yun; Shi, Bing-Yin; Niu, Min; Guo, Hui; Cao, Yan; Liu, Bing-Li; Yan, Reng-Na; Su, Xiao-Fei; Wu, Jin-Dan; Zhang, Dan-Feng; Chen, Li-Ming; Ma, Jian-Hua

2018-06-01

 The blood glucose point-of-care testing (POCT) system is important in the decision-making process involving patients suspected of having hypoglycemia. To investigate the real world of the POCT system being used in teaching hospitals in China. The survey was conducted by Hisend Research Group from May 2015 to July 2015 in four teaching hospitals in China. The survey questions were referred to the ISO 15197:2013 standard requirements for the use of the POCT system in a hospital setting. A total of 170 subjects were included from 4 hospitals, which included nursing staff, nurse unit managers, employees from the department of medical instruments, and staff members employed by the clinical laboratories in the Tianjin Metabolism Hospital, Nanjing First Hospital, First Affiliated Hospital of Dalian Medical University, and the First hospital affiliated with the Xi'an Transportation University. The average score for the four hospitals surveyed in this study was 66.6, which varied from 46.1 to 79.7. The main factors influencing the scores were the multiple choices of blood-glucose meters, and the quality control assessment. Our data indicates that the real world use of the POCT system in hospital settings in China needs more closer adherence to a quality management framework.

The internal organization of hospitals: a descriptive study.

PubMed Central

Sloan, F A

1980-01-01

This study presents descriptive information on several dimensions of the internal organization of hospitals, with particular emphasis on medical staff, using data from two unique national surveys. Three alternative theories of hospital behavior by economists are described and evaluated with these data. The study also shows how standard bed size, teaching, and ownership categories relate to important features of hospital organization. In this way, understanding of these standard "control" variables is enhanced. For example, systematic organizational differences between proprietary and other hospitals are reported, holding bed size and teaching status constant. No single theory of hospital behavior emerges as dominant. The tables demonstrate the diversity of hospitals and the likelihood that no single model can adequately describe the behavior of all hospitals. PMID:7204062

The clinicopathologic association of c-MET overexpression in Iranian gastric carcinomas; an immunohistochemical study of tissue microarrays

PubMed Central

2012-01-01

Background c-MET is an oncogene protein that plays important role in gastric carcinogenesis and has been introduced as a prognostic marker and potential therapeutic target. The aim of this study was to evaluate the frequency of c-MET overexpression and its relationship with clinicopathological variables in gastric cancer of Iranian population using tissue microarray. Methods In a cross sectional study, representative paraffin blocks of 130 patients with gastric carcinoma treated by curative gastrectomy during a 2 years period of 2008–2009 in two university hospitals in Tehran-Iran were collected in tissue microarray and c-MET expression was studied by immunohistochemical staining. Results Finally 124 cases were evaluated, constituted of 99 male and 25 female with the average age of 61.5 years. In 71% (88/124) of tumors, c-MET high expression was found. c-MET high expression was more associated with intestinal than diffuse tumor type (P = 0.04), deeper tumor invasion, pT3 and pT4 versus pT1 and pT2 (P = 0.014), neural invasion (P = 0.002) and advanced TNM staging, stage 3 and 4 versus stage 1 and2 (P = 0.044). The c-MET high expression was not associated with age, sex, tumor location, differentiation grade and distant metastasis, but relative associations with lymph node metastasis (P = 0.065) and vascular invasion (P = 0.078) were observed. Conclusions c-MET oncogene protein was frequently overexpressed in Iranian gastric carcinomas and it was related to clinicopathological characteristics such as tumor type, depth of invasion, neural invasion and TNM staging. It can also support the idea that c-MET is a potential marker for target therapy in Iranian gastric cancer. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9744598757151429 PMID:22640970

Adherence to Alternative Healthy Eating Index in relation to depression and anxiety in Iranian adults.

PubMed

Saneei, Parvane; Hajishafiee, Maryam; Keshteli, Ammar Hassanzadeh; Afshar, Hamid; Esmaillzadeh, Ahmad; Adibi, Peyman

2016-07-01

Earlier studies have shown a protective association between adherence to healthy eating guidelines and mental disorders in Western nations; however, data in this regard are limited from the understudied region of Middle East. We examined the association between adherence to healthy eating guidelines, as measured by Alternative Healthy Eating Index (AHEI)-2010, and prevalence of anxiety and depression in a large sample of Iranian adults. In this cross-sectional study, data on dietary intakes of 3363 adult participants were collected using a validated dish-based 106-item semi-quantitative FFQ. Adherence to healthy eating was quantified using AHEI-2010, as suggested by earlier publications. The Iranian validated version of Hospital Anxiety and Depression Scale was used to assess anxiety and depression in study participants. Data on other covariates were gathered using a pre-tested questionnaire. Overall, the prevalence of anxiety and depression was 15·2 % (males 10·8 % and females 18·3 %) and 30·0 % (males 22·9 % and females 35·1 %), respectively. After controlling for potential confounders, those in the top quartile of AHEI-2010 had a 49 % lower chance of anxiety (OR 0·51; 95 % CI 0·35, 0·72) and a 45 % lower odds of depression (OR 0·55; 95 % CI 0·42, 0·72), compared with those in the bottom quartile. Stratified analysis by sex revealed that women in the highest categories of AHEI-2010 had a 49 % lower odds of having anxiety and depression, after adjustment for confounders, but no significant association was found in men. In addition, among individuals who were 40 years old or younger, those with high adherence to AHEI-2010 were 58 and 51 % less likely to have anxiety and depression, compared with those with less adherence. Adherence to healthy eating was inversely associated with a lower chance of anxiety and depression in Iranian adults. Prospective studies are required to confirm these associations in Middle-Eastern populations.

The clinicopathologic association of c-MET overexpression in Iranian gastric carcinomas; an immunohistochemical study of tissue microarrays.

PubMed

Sotoudeh, Kambiz; Hashemi, Forough; Madjd, Zahra; Sadeghipour, Alireza; Molanaei, Saadat; Kalantary, Elham

2012-05-28

c-MET is an oncogene protein that plays important role in gastric carcinogenesis and has been introduced as a prognostic marker and potential therapeutic target. The aim of this study was to evaluate the frequency of c-MET overexpression and its relationship with clinicopathological variables in gastric cancer of Iranian population using tissue microarray. In a cross sectional study, representative paraffin blocks of 130 patients with gastric carcinoma treated by curative gastrectomy during a 2 years period of 2008-2009 in two university hospitals in Tehran-Iran were collected in tissue microarray and c-MET expression was studied by immunohistochemical staining. Finally 124 cases were evaluated, constituted of 99 male and 25 female with the average age of 61.5 years. In 71% (88/124) of tumors, c-MET high expression was found. c-MET high expression was more associated with intestinal than diffuse tumor type (P = 0.04), deeper tumor invasion, pT3 and pT4 versus pT1 and pT2 (P = 0.014), neural invasion (P = 0.002) and advanced TNM staging, stage 3 and 4 versus stage 1 and2 (P = 0.044). The c-MET high expression was not associated with age, sex, tumor location, differentiation grade and distant metastasis, but relative associations with lymph node metastasis (P = 0.065) and vascular invasion (P = 0.078) were observed. c-MET oncogene protein was frequently overexpressed in Iranian gastric carcinomas and it was related to clinicopathological characteristics such as tumor type, depth of invasion, neural invasion and TNM staging. It can also support the idea that c-MET is a potential marker for target therapy in Iranian gastric cancer. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9744598757151429.

High rate of burnout among anaesthesiologists in Belgrade teaching hospitals: Results of a cross-sectional survey.

PubMed

Milenović, Miodrag; Matejić, Bojana; Vasić, Vladimir; Frost, Elizabeth; Petrović, Nataša; Simić, Dušica

2016-03-01

Decisions by anaesthesiologists directly impact the treatment, safety, recovery and quality of life of patients. Physical or mental collapse due to overwork or stress (burnout) in anaesthesiologists may, therefore, be expected to negatively affect patients, departments, healthcare facilities and families. To evaluate the prevalence of burnout among anaesthesiologists in Belgrade public teaching hospitals. A cross-sectional survey. Anaesthesiologists in 10 Belgrade teaching hospitals. Burnout was assessed using Maslach Burnout Inventory-Human Services Survey. The response rate was 76.2% (205/272) with the majority of respondents women (70.7%). The prevalence of total burnout among anaesthesiologists in Belgrade teaching hospitals was 6.34%. Measured level of burnout as assessed by high emotional exhaustion, high depersonalisation and low personal accomplishment was 52.7, 12.2 and 28.8%, respectively. More than a quarter of the studied population responded in each category with symptoms of moderate burnout. We detected that sex, additional academic education, marital status and working conditions were risk factors for emotional exhaustion and depersonalisation. Ageing increased the likelihood of burnout by 21.3% with each additional year. Shorter professional experience and increased educational accomplishment increased the risk of total burnout by 272%. Burnout rates in Belgrade teaching hospitals among anaesthesiologists are higher than in foreign hospitals. Emotional and/or physical breakdowns can have serious effects when these individuals care for patients in extremely stressed situations that may occur perioperatively. Causes for burnout should be examined more closely and means implemented to reverse this process.

Evaluation of the medical records system in an upcoming teaching hospital-a project for improvisation.

PubMed

Kumar, B Deepak; Kumari, C M Vinaya; Sharada, M S; Mangala, M S

2012-08-01

The medical records system of an upcoming teaching hospital in a developing nation was evaluated for its accessibility, completeness, physician satisfaction, presence of any lacunae, suggestion of necessary steps for improvisation and to emphasize the importance of Medical records system in education and research work. The salient aspects of the medical records department were evaluated based on a questionnaire which was evaluated by a team of 40 participants-30 doctors, 5 personnel from Medical Records Department and 5 from staff of Hospital administration. Most of the physicians (65%) were partly satisfied with the existing medical record system. 92.5% were of the opinion that upgradation of the present system is necessary. The need of the hour in the present teaching hospital is the implementation of a hospital-wide patient registration and medical records re-engineering process in the form of electronic medical records system and regular review by the audit commission.

Risk adjustment policy options for casemix funding: international lessons in financing reform.

PubMed

Antioch, Kathryn M; Ellis, Randall P; Gillett, Steve; Borovnicar, Daniel; Marshall, Ric P

2007-09-01

This paper explores modified hospital casemix payment formulae that would refine the diagnosis-related group (DRG) system in Victoria, Australia, which already makes adjustments for teaching, severity and demographics. We estimate alternative casemix funding methods using multiple regressions for individual hospital episodes from 2001 to 2003 on 70 high-deficit DRGs, focussing on teaching hospitals where the largest deficits have occurred. Our casemix variables are diagnosis- and procedure-based severity markers, counts of diagnoses and procedures, disease types, complexity, day outliers, emergency admission and "transfers in." The results are presented for four policy options that vary according to whether all of the dollars or only some are reallocated, whether all or some hospitals are used and whether the alternatives augment or replace existing payments. While our approach identifies variables that help explain patient cost variations, hospital-level simulations suggest that the approaches explored would only reduce teaching hospital underpayment by about 10%. The implications of various policy options are discussed.

Investigating Knowledge and Attitude of Nursing Students Towards Iranian Traditional Medicine

PubMed Central

Khorasgani, Sahar Rabani; Moghtadaie, Leila

2014-01-01

The present study aimed at Investigating the knowledge and attitude of Nursing Students towards Iranian Traditional Medicine in universities of Tehran in 2012-2013. 300 students of nursing studying at different universities in Tehran participated in this descriptive, cross-sectional study. The data was collected through a standard questionnaire with an acceptable validity and reliability. The questionnaire was made of five sections including demographic, general knowledge of the Iranian traditional medicine, general attitude towards it, resources of the Iranian traditional medicine and the barriers to it. The results revealed that general knowledge of the students about Iranian traditional medicine and complementary medicine is low. The attitude of the students towards including Iranian traditional medicine and complementary medicine in their curriculum is positive. General attitude of students towards Iranian traditional medicine is positive too. The majority of the participants had not passed any course on Iranian traditional medicine. There was no relationship between participants’ attitude towards Iranian traditional medicine and the number of semesters they had passed. Considering the participants’ positive attitude and their low level of knowledge, it seems necessary for the university policy makers to provide nursing students with different training courses on Iranian traditional medicine and complementary medicine in order to increase their knowledge. PMID:25363119

Pharmaceuticals in Australia: priorities in a teaching hospital.

PubMed

Kearney, B J

1993-01-01

In spite of rigorous government programs for control of the pricing and dissemination of pharmaceutical products in Australia, the list of new drugs continues to grow and prices to increase. To regain control over drug usage at Royal Adelaide Hospital, the Hospital Drug Committee developed a rating method that judged drugs on the basis of their cost-benefit to patients. The ratio of a total quality score to a total cost score becomes the determinant of additions to the hospital formulary. The background for the Australian approach to pharmaceuticals and the new evaluation technique at the teaching hospital are described in this report.

How do Supervising Clinicians of a University Hospital and Associated Teaching Hospitals Rate the Relevance of the Key Competencies within the CanMEDS Roles Framework in Respect to Teaching in Clinical Clerkships?

PubMed Central

Jilg, Stefanie; Möltner, Andreas; Berberat, Pascal; Fischer, Martin R.; Breckwoldt, Jan

2015-01-01

Background and aim: In German-speaking countries, the physicians’ roles framework of the “Canadian Medical Education Directives for Specialists” (CanMEDS) is increasingly used to conceptualize postgraduate medical education. It is however unclear, whether it may also be applied to the final year of undergraduate education within clinical clerkships, called “Practical Year” (PY). Therefore, the aim of this study was to explore how clinically active physicians at a university hospital and at associated teaching hospitals judge the relevance of the seven CanMEDS roles (and their (role-defining) key competencies) in respect to their clinical work and as learning content for PY training. Furthermore, these physicians were asked whether the key competencies were actually taught during PY training. Methods: 124 physicians from internal medicine and surgery rated the relevance of the 28 key competencies of the CanMEDS framework using a questionnaire. For each competency, following three aspects were rated: “relevance for your personal daily work”, “importance for teaching during PY”, and “implementation into actual PY teaching”. Results: In respect to the main study objective, all questionnaires could be included into analysis. All seven CanMEDS roles were rated as relevant for personal daily work, and also as important for teaching during PY. Furthermore, all roles were stated to be taught during actual PY training. The roles “Communicator”, “Medical Expert”, and “Collaborator” were rated as significantly more important than the other roles, for all three sub-questions. No differences were found between the two disciplines internal medicine and surgery, nor between the university hospital and associated teaching hospitals. Conclusion: Participating physicians rated all key competencies of the CanMEDS model to be relevant for their personal daily work, and for teaching during PY. These findings support the suitability of the CanMEDS framework as a conceptual element of PY training. PMID:26413171

Comparison of current practices of cardiopulmonary perfusion technology in Iran with American Society of Extracorporeal Technology's standards.

PubMed

Faravan, Amir; Mohammadi, Nooredin; Alizadeh Ghavidel, Alireza; Toutounchi, Mohammad Zia; Ghanbari, Ameneh; Mazloomi, Mehran

2016-01-01

Standards have a significant role in showing the minimum level of optimal optimum and the expected performance. Since the perfusion technology staffs play an the leading role in providing the quality services to the patients undergoing open heart surgery with cardiopulmonary bypass machine, this study aimed to assess the standards on how Iranian perfusion technology staffs evaluate and manage the patients during the cardiopulmonary bypass process and compare their practice with the recommended standards by American Society of Extracorporeal Technology. In this descriptive study, data was collected from 48 Iranian public hospitals and educational health centers through a researcher-created questionnaire. The data collection questionnaire assessed the standards which are recommended by American Society of Extracorporeal Technology. Findings showed that appropriate measurements were carried out by the perfusion technology staffs to prevent the hemodilution and avoid the blood transfusion and unnecessary blood products, determine the initial dose of heparin based on one of the proposed methods, monitor the anticoagulants based on ACT measurement, and determine the additional doses of heparin during the cardiopulmonary bypass based on ACT or protamine titration. It was done only in 4.2% of hospitals and health centers. Current practices of cardiopulmonary perfusion technology in Iran are inappropriate based on the standards of American Society of Cardiovascular Perfusion. This represents the necessity of authorities' attention to the validation programs and development of the caring standards on one hand and continuous assessment of using these standards on the other hand.

Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study.

PubMed

Lee, Kun Yun; Wan Ahmad, Wan Azman; Low, Ee Vien; Liau, Siow Yen; Anchah, Lawrence; Hamzah, Syuhada; Liew, Houng-Bang; Mohd Ali, Rosli B; Ismail, Omar; Ong, Tiong Kiam; Said, Mas Ayu; Dahlui, Maznah

2017-01-01

The increasing disease burden of coronary artery disease (CAD) calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI), a common treatment for CAD. Few studies have analyzed the contemporary data on local cardiac facilities. Service expansion and budget allocation require cost evidence from various providers. We aim to compare the patient characteristics, procedural outcomes, and cost profile between a teaching hospital (TH) and a general hospital (GH). This cross-sectional study was conducted from the healthcare providers' perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test. The mean hospitalization cost was RM 12,117 (USD 3,366) at GH and RM 16,289 (USD 4,525) at TH. The higher cost at TH can be attributed to worse patients' comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost. The high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure sustainable and equitable cardiac service in Malaysia.

[Anesthesia practice in Catalan hospitals and other health care facilities].

PubMed

Villalonga, Antonio; Sabaté, Sergi; Campos, Juan Manuel; Fornaguera, Joan; Hernández, Carmen; Sistac, José María

2006-05-24

The aim of this arm of the ANESCAT study was to characterize anesthesia practice in the various types of health care facilities of Catalonia, Spain, in 2003. We analyzed data from the survey according to a) source of a facility's funding: public hospitals financed by the Catalan Public Health Authority (ICS), the network of subsidized hospitals for public use (XHUP), or private hospitals; b) size: facilities without hospital beds, hospitals with fewer than 250 beds, those with 251 to 500, and those with over 500; and c) training accreditation status: whether or not a facility gave medical resident training. A total of 131 facilities participated (11 under the ICS, 47 from the XHUP, and 73 private hospitals). Twenty-six clinics had no hospital beds, 78 facilities had fewer than 250, 21 had 251 to 500, and 6 had more than 500. Seventeen hospitals trained medical residents. XHUP hospitals performed 44.3% of all anesthetic procedures, private hospitals 36.7%, and ICS facilities 18.5%. Five percent of procedures were performed in clinics without beds, 42.9% in facilities with fewer than 250 beds, 35% in hospitals with 251 to 500, and 17.1% in hospitals with over 500. Anesthetists in teaching hospitals performed 35.5% of all procedures. The mean age of patients was lower in private hospitals, facilities with fewer than 250 beds, and hospitals that did not train medical residents. The physical status of patients was worse in ICS hospitals, in facilities with over 500 beds, and in teaching hospitals. It was noteworthy that 25% of anesthetic procedures were performed on an emergency basis in XHUP and ICS hospitals, in facilities with more than 250 beds, and in teaching hospitals. Anesthesia for outpatient procedures accounted for 40% of the total in private hospitals and 31% of the practice in ICS and XHUP hospitals. The duration of anesthesia and postanesthetic recovery was longer in ICS hospitals, in facilities with over 500 beds, and in those with medical resident training programs. The numbers of postoperative admissions to critical care units and of specialized analgesic techniques performed were higher in ICS hospitals, in facilities with over 500 beds, and in teaching hospitals. The complexity of both anesthesia and surgical practice and the severity of patient condition increased with hospital size and public funding status.

Integrating the hospital library with patient care, teaching and research: model and Web 2.0 tools to create a social and collaborative community of clinical research in a hospital setting.

PubMed

Montano, Blanca San José; Garcia Carretero, Rafael; Varela Entrecanales, Manuel; Pozuelo, Paz Martin

2010-09-01

Research in hospital settings faces several difficulties. Information technologies and certain Web 2.0 tools may provide new models to tackle these problems, allowing for a collaborative approach and bridging the gap between clinical practice, teaching and research. We aim to gather a community of researchers involved in the development of a network of learning and investigation resources in a hospital setting. A multi-disciplinary work group analysed the needs of the research community. We studied the opportunities provided by Web 2.0 tools and finally we defined the spaces that would be developed, describing their elements, members and different access levels. WIKINVESTIGACION is a collaborative web space with the aim of integrating the management of all the hospital's teaching and research resources. It is composed of five spaces, with different access privileges. The spaces are: Research Group Space 'wiki for each individual research group', Learning Resources Centre devoted to the Library, News Space, Forum and Repositories. The Internet, and most notably the Web 2.0 movement, is introducing some overwhelming changes in our society. Research and teaching in the hospital setting will join this current and take advantage of these tools to socialise and improve knowledge management.

The Nomogram of Penile Length and Circumference in Iranian Term and Preterm Neonates.

PubMed

Soheilipour, Fahimeh; Rohani, Farzaneh; Dehkordi, Elham Hashemi; Isa Tafreshi, Roya; Mohagheghi, Parisa; Zaheriani, Seyed-Mohammadsalar; Jesmi, Fatemeh; Salehiniya, Hamid

2018-01-01

The normal length of penis in preterm and term neonates is different among different nations, and is affected by various factors. The present study aimed to determine stretched penile length (SPL) values and cutoff level of micropenis in term and preterm Iranian neonates, for the first time. All male neonates born in two general hospitals of Tehran (Akbarabadi, and Rasoul hospitals), center of Iran, with gestational age of 28-42 weeks were included and their SPL and penile circumference (PC) were examined on the first 3 days after birth by the same physician. Birth weight (BW), and height, gestational age, type of delivery, mother's age, twin/multiple pregnancy, drug, and medical history of mother during pregnancy were recorded and cutoff levels of two variables were calculated based on the collected variables for different gestational ages. Among a total of 587 neonates, 203 neonates were born term and 384 preterm. Mean ± SD of neonates' BW were 2,682.51 ± 739.30 (850-4800) gr. Mean ± SD of their SPL was 22.48 ± 3.34 mm; 25.92 ± 1.54 mm in term and 20.66 ± 2.50 mm in preterm infants ( P  = 0.001). Mean ± SD of PC was 6.71 ± 1.31 mm; 8.14 ± 0.48 in term and 5.96 ± 0.92 in preterm infants ( P  = 0.001). SPL and PC were significantly correlated with type of delivery, number of parity, gestational age, BW, and crown-heel length, head circumference ( P  < 0.001). This study suggested that SPL in male neonates was 22.48 mm and PC was 6.71 mm, both correlated with gestational age and BW. Due to the ethnical variety of this cutoff points and lack of an appropriate study in Iran, these cutoff points can be used by all physicians as a reference for Iranian newborns (term and preterm), in order to prevent misdiagnosis of micropenis and genital disorders.

Applying the Balanced Scorecard approach in teaching hospitals: a literature review and conceptual framework.

PubMed

Trotta, Annarita; Cardamone, Emma; Cavallaro, Giusy; Mauro, Marianna

2013-01-01

Teaching hospitals (THs) simultaneously serve three different roles: offering medical treatment, teaching future doctors and promoting research. The international literature recognises such organisations as 'peaks of excellence' and highlights their economic function in the health system. In addition, the literature describes the urgent need to manage the complex dynamics and inefficiency issues that threaten the survival of teaching hospitals worldwide. In this context, traditional performance measurement systems that focus only on accounting and financial measures appear to be inadequate. Given that THs are highly specific and complex, a multidimensional system of performance measurement, such as the Balanced Scorecard (BSC), may be more appropriate because of the multitude of stakeholders, each of whom seek a specific type of accountability. The aim of the paper was twofold: (i) to review the literature on the BSC and its applications in teaching hospitals and (ii) to propose a scorecard framework that is suitable for assessing the performance of THs and serving as a guide for scholars and practitioners. In addition, this research will contribute to the ongoing debate on performance evaluation systems by suggesting a revised BSC framework and proposing specific performance indicators for THs. Copyright © 2012 John Wiley & Sons, Ltd.

77 FR 11723 - Iranian Financial Sanctions Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-27

... Assets Control 31 CFR Part 561 Iranian Financial Sanctions Regulations; Final Rule #0;#0;Federal Register... OF THE TREASURY Office of Foreign Assets Control 31 CFR Part 561 Iranian Financial Sanctions... the Treasury's Office of Foreign Assets Control (``OFAC'') is amending the Iranian Financial Sanctions...

Evidence for a link between mortality in acute COPD and hospital type and resources.

PubMed

Roberts, C M; Barnes, S; Lowe, D; Pearson, M G

2003-11-01

The 1997 BTS/RCP national audit of acute care of chronic obstructive pulmonary disease (COPD) found wide variations in mortality between hospitals which were only partially explained by known audit indicators of outcome. It was hypothesised that some of the unexplained variation may result from differences in hospital type, organisation and resources. This pilot study examined the hypothesis as a factor to be included in a future national audit programme. Thirty hospitals in England and Wales were randomly selected by geographical region and hospital type (teaching, large district general hospital (DGH), small DGH). Data on process and outcome of care (death and length of stay) were collected retrospectively at 90 days on all prospectively identified COPD admissions over an 8 week period. Each centre completed a questionnaire relating to organisation and resources available for the care of COPD patients. Eleven teaching hospitals, nine large DGHs, and 10 small DGHs provided data on 1274 cases. Mortality was high (14%) with wide variation between centres (IQR 9-19%). Small DGHs had a higher mortality (17.5%) than teaching hospitals (11.9%) and large DGHs (11.2%). When corrected for confounding factors, an excess of deaths in small DGHs was still observed (OR 1.56 (CI 1.04 to 2.35)) v teaching hospitals. Analysis of resource and organisational factors suggested higher mortality was associated with fewer doctors (OR 1.5) and with fewer patients being under the care of a specialist physician (OR 1.8). Small DGHs had fewest resources. Significant differences in mortality may exist between hospital types. The findings justify further study in a proposed national audit.

Evidence for a link between mortality in acute COPD and hospital type and resources

PubMed Central

Roberts, C; Barnes, S; Lowe, D; Pearson, M

2003-01-01

Background: The 1997 BTS/RCP national audit of acute care of chronic obstructive pulmonary disease (COPD) found wide variations in mortality between hospitals which were only partially explained by known audit indicators of outcome. It was hypothesised that some of the unexplained variation may result from differences in hospital type, organisation and resources. This pilot study examined the hypothesis as a factor to be included in a future national audit programme. Methods: Thirty hospitals in England and Wales were randomly selected by geographical region and hospital type (teaching, large district general hospital (DGH), small DGH). Data on process and outcome of care (death and length of stay) were collected retrospectively at 90 days on all prospectively identified COPD admissions over an 8 week period. Each centre completed a questionnaire relating to organisation and resources available for the care of COPD patients. Results: Eleven teaching hospitals, nine large DGHs, and 10 small DGHs provided data on 1274 cases. Mortality was high (14%) with wide variation between centres (IQR 9–19%). Small DGHs had a higher mortality (17.5%) than teaching hospitals (11.9%) and large DGHs (11.2%). When corrected for confounding factors, an excess of deaths in small DGHs was still observed (OR 1.56 (CI 1.04 to 2.35)) v teaching hospitals. Analysis of resource and organisational factors suggested higher mortality was associated with fewer doctors (OR 1.5) and with fewer patients being under the care of a specialist physician (OR 1.8). Small DGHs had fewest resources. Conclusion: Significant differences in mortality may exist between hospital types. The findings justify further study in a proposed national audit. PMID:14586045

Factors affecting length of stay in teaching hospitals of a middle-income country

PubMed Central

Khosravizadeh, Omid; Vatankhah, Soudabeh; Bastani, Peivand; Kalhor, Rohollah; Alirezaei, Samira; Doosty, Farzane

2016-01-01

Introduction The length of stay (LOS) in hospitals is a widely used and important criteria for evaluating hospital performance. The aim of this study was to determine factors affecting LOS in teaching hospitals of Qazvin Providence. Methods In this cross-sectional study, patients’ health records were randomly selected from archives in teaching hospitals of Qazvin in 2013. Data were collected through a data entry form and were analyzed using Kolmogorov–Smirnov, Kruskal–Wallis, and Mann–Whitney U tests at the significant level of 0.05. Results The mean of hospital LOS was 5.45 ± 6.14 days. Age, employment, marital status, history of previous admission, patient condition at discharge, method of payment, and type of treatment had an impact on LOS (p<0.05). Other factors, including gender, place of residence, and type of admission, did not affect LOS. Conclusion Because hospitals consume a perceptible part of resources in a health system, controlled and optimized use of its resources help to save a lot. Therefore, this study showed many clinical and nonclinical factors affect LOS in evaluating these factors, which may reduce inappropriate hospital stays and decrease costs. PMID:27957301

Hospitals' readiness for clinical governance implementation in educational hospitals of yazd, iran.

PubMed

Bahrami, Mohammad Amin; Sabahi, Ali Akbar; Montazeralfaraj, Razieh; Shamsi, Farimah; Ardekani, Samaneh Entezarian

2014-01-01

Clinical governance is a systematic approach to maintaining and improving the quality of patient care. This study aimed to assess some Iranian educational hospitals' readiness for clinical governance implementation through the organizational climate. It was a cross-sectional study that used the Clinical Governance Climate Questionnaire (CGCQ) in three educational hospitals in Yazd, a city in central Iran, in 2012. A total of 186 personnel contributed to the study. Data were analyzed using SPSS version 16. Descriptive statistics and the Kruskal-Wallis test were used for data analyses. The mean scores of the clinical governance climate in Shahid Sadoughi, Shahid Rahnemoon and Afshar hospitals were 2.63±0.29, 2.58±0.32, and 2.68±0.29. The mean scores of quality improvement planning and change, quality improvement integration and motivation, clinical risk management and climate of blame and punishment, organizational learning, and training and development (T&D) opportunities for learning in the studied hospitals were 2.21±0.49, 2.80±0.40, 2.76±0.40, 2.91±0.54 and 3.06±0.72, respectively. The results of this study showed that the educational hospitals' climate should be more supportive for successful implementation of clinical governance.

Pre-hospital burn mission as a unique experience: a qualitative study.

PubMed

Froutan, Razieh; Khankeh, Hamid Reza; Fallahi, Masoud; Ahmadi, Fazlollah; Norouzi, Kian

2014-12-01

A thorough understanding of experiences related to pre-hospital emergency care of burns is a prerequisite of skill promotion for medical personnel. The aim of the present study was to evaluate the experiences of pre-hospital emergency personnel during burn accidents. The present qualitative study was performed using a content analysis method. In total, 18 Iranian emergency care personnel participated in the study. A purposeful sampling method was applied until reaching data saturation. Data were collected using semi-structured interviews and field observations. Afterwards, the gathered data were analyzed through face content analysis. By analyzing 498 primary codes, four main categories; the nature of burn care, tension at the accident scene, gradual job 'burnout', and insufficient information, were extracted from the experiences of pre-hospital emergency personnel during burn care. These categories each included several sub-categories, which were classified according to their significant characteristics. This study showed that different factors affect the quality of pre-hospital clinical services for burns. Authorities and health system administrators should consider the physical and psychological health of their staff, and assign policies to improve the quality of pre-hospital medical care. According to the present results, it is recommended that the process of pre-hospital emergency care for burns be investigated further. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Pediatric facial fractures: current national incidence, distribution, and health care resource use.

PubMed

Vyas, Raj M; Dickinson, Brian P; Wasson, Kristy L; Roostaeian, Jason; Bradley, James P

2008-03-01

To date, reports on the incidence and distribution of pediatric facial fractures have been inconsistent and have originated only from institutional studies. The need for current national data exists. We examined the Kids' Inpatient Database and the Nationwide Inpatient Sample to obtain national information on facial fracture discharges from 1997 to 2003. Data showed that pediatric patients (age, 0-17 years) make up 14.7% of all facial fractures, with children aged 1 to 4 years comprising only 5.6% of the total and children 15 to 17 years old making up more than half the group. The male-to-female ratio was 2.5. Significantly lengthier hospitalizations were observed with female patients, Medicaid insurance, teaching hospitals, government hospitals, and metropolitan hospitals. Significantly higher charges were associated with patients aged 1 to 4 years, Medicaid insurance, Western US geography, teaching hospitals, metropolitan hospitals, and children's hospitals. During the 6-year period of this study, there was a trend toward (1) increased hospital charges (with stable costs), (2) more patients treated at teaching hospitals, and (3) a convergence in length of stay between hospitals with differing ownerships (with government hospitals having progressively shorter hospitalizations, whereas private for-profit hospitals have progressively lengthier hospitalizations). The incidence of facial fractures in children is small yet significant and has remained stable during the past few decades. Certain patient populations are prone to facial fractures, and various patient and hospital factors are associated with lengthier and more expensive hospitalizations. An understanding of disparities in resource use among various patient, hospital, and geographic settings is critical for physicians and policy makers.

High frequency of methicillin-resistant Staphylococcus aureus (MRSA) with SCCmec type III and spa type t030 in Karaj's teaching hospitals, Iran.

PubMed

Bayat, Bahareh; Zade, Masoumeh Hallaj; Mansouri, Samaneh; Kalantar, Enayat; Kabir, Kourosh; Zahmatkesh, Ehsan; Sepehr, Mohammad Noori; Naseri, Mohammmad Hassan; Darban-Sarokhalil, Davood

2017-09-01

Methicillin-resistant Staphylococcus aureus (MRSA) has been one of the most important antibiotic-resistant pathogen in many parts of the world over the past decades. This cross-sectional study was conducted to investigate MRSA isolated between July 2013 and July 2014 in Karaj, Iran. All tested isolates were collected in teaching hospitals from personnel, patients, and surfaces and each MRSA was analyzed by SCCmec and spa typing. Antibiotic susceptibility testing was accomplished by disk diffusion method. Out of 49 MRSA isolates from the Karaj's teaching hospitals, 82%, 10%, and 6% of the isolates were SCCmec types III, II, and I, respectively. The main spa type in this study was spa t030 with frequency as high as 75.5% from intensive care unit (ICU) of the hospitals and high rate of resistance to rifampicin (53%) was found in MRSA isolates. In conclusion, high frequency of spa t030 with SCCmec type III and MRSA phenotype illustrated circulating of one of the antibiotic-resistant strains in ICU of Karaj's teaching hospitals and emphasizes the need for ongoing molecular surveillance, antibiotic susceptibility monitoring, and infection control.

The hospital incident command system: modified model for hospitals in iran.

PubMed

Djalali, Ahmadreza; Hosseinijenab, Vahid; Peyravi, Mahmoudreza; Nekoei-Moghadam, Mahmood; Hosseini, Bashir; Schoenthal, Lisa; Koenig, Kristi L

2015-03-27

Effectiveness of hospital management of disasters requires a well-defined and rehearsed system. The Hospital Incident Command System (HICS), as a standardized method for command and control, was established in Iranian hospitals, but it has performed fairly during disaster exercises. This paper describes the process for, and modifications to HICS undertaken to optimize disaster management in hospitals in Iran. In 2013, a group of 11 subject matter experts participated in an expert consensus modified Delphi to develop modifications to the 2006 version of HICS. The following changes were recommended by the expert panel and subsequently implemented: 1) A Quality Control Officer was added to the Command group; 2) Security was defined as a new section; 3) Infrastructure and Business Continuity Branches were moved from the Operations Section to the Logistics and the Administration Sections, respectively; and 4) the Planning Section was merged within the Finance/Administration Section. An expert consensus group developed a modified HICS that is more feasible to implement given the managerial organization of hospitals in Iran. This new model may enhance hospital performance in managing disasters. Additional studies are needed to test the feasibility and efficacy of the modified HICS in Iran, both during simulations and actual disasters. This process may be a useful model for other countries desiring to improve disaster incident management systems for their hospitals.

Prevalence of oral lichen planus in Iranian children and adolescents: a 12-year retrospective study.

PubMed

Bakhtiari, S; Taheri, J B; Toossi, P; Azimi, S; Kawosi Nezhad, Sh

2017-12-01

To investigate the prevalence of oral lichen planus in patients younger than 18 years, referred to a dermatology centre in Iran during 2002-2014. Lichen planus is a chronic inflammatory, immune-mediated disease that could affect the oral mucosa and is a pre-cancerous condition. The disease usually develops in middle age with female predominance and is rare in children. In this retrospective study, cases with definitive histopathologic diagnosis of lichen planus, over a 12-year period from 2002 to 2014 from a dermatologic hospital archive were evaluated. The prevalence of both cutaneous and oral lichen planus, the male:female ratio and site of involvement were calculated using SPSS version 21. Thirty-six of 564 patients younger than 18 years old diagnosed with lichen planus. Two females (0.4%) had oral lichen planus. One patient had erosive, and one had bullous, oral lichen planus. Oral lichen planus had a very low frequency in Iranian population younger than 18 years old, identifying these patients is recommended for long-term follow-up.

A "Prepaid Package" for Obstetrics: Effect on Teaching and Patient Care in a University Hospital

ERIC Educational Resources Information Center

Young, Philip E.

1976-01-01

The changing social milieu has removed the charity patient but not the need for a teaching population. The University Hospital's program is described, in which patients prepaid a fixed, single fee for all obstetrics-related care through the third post partum day. (LBH)

A Teaching Hospital Medical Clinic: Secondary Rather than Primary Care.

ERIC Educational Resources Information Center

Fletcher, Suzanne; And Others

1979-01-01

A review of 287 patient visits to a teaching hospital polyclinic shows that most patients had multiple problems that required the help of subspecialists. However, the patients' needs for accessibility, comprehensiveness, coordination, and continuity are as great as those of patients receiving primary care. Implications for academic internal…

Innovative Model for Information Assurance Curriculum: A Teaching Hospital

ERIC Educational Resources Information Center

Goel, Sanjay; Pon, Damira; Bloniarz, Peter; Bangert-Drowns, Robert; Berg, George; Delio, Vince; Iwan, Laura; Hurbanek, Thomas; Schuman, Sandoor P.; Gangolly, Jagdish; Baykal, Adnan; Hobbs, Jon

2006-01-01

A novel idea for information security education created by the New York State Center for Information Forensics and Assurance (CIFA) is presented. This new approach incorporates a teaching hospital model originally developed for medical training. In this model, information security problems from industry and government are solved and abstracted…

Hospitality and Embodied Encounters in Educational Spaces

ERIC Educational Resources Information Center

Ruitenberg, Claudia W.

2018-01-01

This short paper responds to the essays by Shilpi Sinha, Shaireen Rasheed, and Lyudmila Bryzzheva. It considers how racial inequality between teachers and students affects the possibilities of educational hospitality, both in cases of white teachers teaching racialized students and in cases of racialized teachers teaching white students. The…

Assessing Governance Alternatives for University-Owned Public Teaching Hospitals.

ERIC Educational Resources Information Center

Whitley, Evangeline L.

The governance options matrix is provided to offer a way for state and university policymakers to examine the functioning environments of specific university-owned public teaching hospitals. With it, they can consider the benefits and problems involved with different options for governance. The issues related to the environmental factors affecting…

Worse outcomes for patients undergoing brain tumor and cerebrovascular procedures following the ACGME resident duty-hour restrictions

PubMed Central

Babu, Ranjith; Thomas, Steven; Hazzard, Matthew A.; Friedman, Allan H.; Sampson, John H.; Adamson, Cory; Zomorodi, Ali R.; Haglund, Michael M.; Patil, Chirag G.; Boakye, Maxwell; Lad, Shivanand P.

2015-01-01

Object On July 1, 2003, the Accreditation Council for Graduate Medical Education (ACGME) implemented duty-hour restrictions for resident physicians due to concerns for patient and resident safety. Though duty-hour restrictions have increased resident quality of life, studies have shown mixed results with respect to patient outcomes. In this study, the authors have evaluated the effect of duty-hour restrictions on morbidity, mortality, length of stay, and charges in patients who underwent brain tumor and cerebrovascular procedures. Methods The Nationwide Inpatient Sample was used to evaluate the effect of duty-hour restrictions on complications, mortality, length of stay, and charges by comparing the pre-reform (2000–2002) and post-reform (2005–2008) periods. Outcomes were compared between nonteaching and teaching hospitals using a difference-in-differences (DID) method. Results A total of 90,648 patients were included in the analysis. The overall complication rate was 11.7%, with the rates not significantly differing between the pre –and post–duty hour eras (p = 0.26). Examination of hospital teaching status revealed that complication rates decreased in nonteaching hospitals (12.1% vs 10.4%, p = 0.0004) and remained stable in teaching institutions (11.8% vs 11.9%, p = 0.73) in the post-reform era. Multivariate analysis demonstrated a significantly higher complication risk in teaching institutions (OR 1.33 [95% CI 1.11–1.59], p = 0.0022), with no significant change in nonteaching hospitals (OR 1.11 [95% CI 0.91–1.37], p = 0.31). A DID analysis to compare the magnitude in change between teaching and nonteaching institutions revealed that teaching hospitals had a significantly greater increase in complications during the post-reform era than nonteaching hospitals (p = 0.040). The overall mortality rate was 3.0%, with a significant decrease occurring in the post-reform era in both nonteaching (5.0% vs 3.2%, p < 0.0001) and teaching (3.2% vs 2.3%, p < 0.0001) hospitals. DID analysis to compare the changes in mortality between groups did not reveal a significant difference (p = 0.40). The mean length of stay for all patients was 8.7 days, with hospital stay decreasing from 9.2 days to 8.3 days in the post-reform era (p < 0.0001). The DID analysis revealed a greater length of stay decrease in nonteaching hospitals than teaching institutions, which approached significance (p = 0.055). Patient charges significantly increased in the post-reform era for all patients, increasing from $70,900 to $96,100 (p < 0.0001). The DID analysis did not reveal a significant difference between the changes in charges between teaching and nonteaching hospitals (p = 0.17). Conclusions The implementation of duty-hour restrictions correlated with an increased risk of postoperative complications for patients undergoing brain tumor and cerebrovascular neurosurgical procedures. Duty-hour reform may therefore be associated with worse patient outcomes, contrary to its intended purpose. Due to the critical condition of many neurosurgical patients, this patient population is most sensitive and likely to be negatively affected by proposed future increased restrictions. PMID:24926647

Worse outcomes for patients undergoing brain tumor and cerebrovascular procedures following the ACGME resident duty-hour restrictions.

PubMed

Babu, Ranjith; Thomas, Steven; Hazzard, Matthew A; Friedman, Allan H; Sampson, John H; Adamson, Cory; Zomorodi, Ali R; Haglund, Michael M; Patil, Chirag G; Boakye, Maxwell; Lad, Shivanand P

2014-08-01

On July 1, 2003, the Accreditation Council for Graduate Medical Education (ACGME) implemented duty-hour restrictions for resident physicians due to concerns for patient and resident safety. Though duty-hour restrictions have increased resident quality of life, studies have shown mixed results with respect to patient outcomes. In this study, the authors have evaluated the effect of duty-hour restrictions on morbidity, mortality, length of stay, and charges in patients who underwent brain tumor and cerebrovascular procedures. The Nationwide Inpatient Sample was used to evaluate the effect of duty-hour restrictions on complications, mortality, length of stay, and charges by comparing the pre-reform (2000-2002) and post-reform (2005-2008) periods. Outcomes were compared between nonteaching and teaching hospitals using a difference-in-differences (DID) method. A total of 90,648 patients were included in the analysis. The overall complication rate was 11.7%, with the rates not significantly differing between the pre- and post-duty hour eras (p = 0.26). Examination of hospital teaching status revealed that complication rates decreased in nonteaching hospitals (12.1% vs 10.4%, p = 0.0004) and remained stable in teaching institutions (11.8% vs 11.9%, p = 0.73) in the post-reform era. Multivariate analysis demonstrated a significantly higher complication risk in teaching institutions (OR 1.33 [95% CI 1.11-1.59], p = 0.0022), with no significant change in nonteaching hospitals (OR 1.11 [95% CI 0.91-1.37], p = 0.31). A DID analysis to compare the magnitude in change between teaching and nonteaching institutions revealed that teaching hospitals had a significantly greater increase in complications during the post-reform era than nonteaching hospitals (p = 0.040). The overall mortality rate was 3.0%, with a significant decrease occurring in the post-reform era in both nonteaching (5.0% vs 3.2%, p < 0.0001) and teaching (3.2% vs 2.3%, p < 0.0001) hospitals. DID analysis to compare the changes in mortality between groups did not reveal a significant difference (p = 0.40). The mean length of stay for all patients was 8.7 days, with hospital stay decreasing from 9.2 days to 8.3 days in the post-reform era (p < 0.0001). The DID analysis revealed a greater length of stay decrease in nonteaching hospitals than teaching institutions, which approached significance (p = 0.055). Patient charges significantly increased in the post-reform era for all patients, increasing from $70,900 to $96,100 (p < 0.0001). The DID analysis did not reveal a significant difference between the changes in charges between teaching and nonteaching hospitals (p = 0.17). The implementation of duty-hour restrictions correlated with an increased risk of postoperative complications for patients undergoing brain tumor and cerebrovascular neurosurgical procedures. Duty-hour reform may therefore be associated with worse patient outcomes, contrary to its intended purpose. Due to the critical condition of many neurosurgical patients, this patient population is most sensitive and likely to be negatively affected by proposed future increased restrictions.

The intricate relationship between a medical school and a teaching hospital: A case study in Uganda.

PubMed

Mubuuke, Aloysius Gonzaga; Businge, Francis; Mukule, Emmanuel

2014-01-01

The relationship between medical schools and teaching hospitals is full of opportunities but also challenges even though they have complementary goals that could enhance each other. Although medical schools and teaching hospitals may face some similar challenges around the world, there could be context-specific observations that differ in resource-rich versus resource-limited settings. The purpose of this study was to investigate factors that are perceived to have influenced the relationship between a medical school and a teaching hospital in Uganda, a resource-limited setting. This was a cross-sectional, descriptive study in which key informant individual interviews were conducted with senior administrators and senior staff members of the Mulago Hospital and Makerere University Medical School. The interviews explored factors perceived to have favoured the working relationship between the two institutions, challenges faced and likely future opportunities. Both quantitative and qualitative data were generated. Thematic analysis was used with the qualitative data. Respondents reported a strained relationship between the two institutions, with unfavourable factors far outweighing the favourable factors influencing the relationship. Key negative reported factors included having different administrative set-ups, limited opportunities to share funds and to forge research collaborations, unexploited potential of sharing human resources to address staff shortages, as well as a lack of a memorandum of understanding between the two institutions. This study identifies barriers in the existing relationship between a teaching hospital and medical college in a resource-poor country. It proposes a collaborative model, rather than competitive model, for the two institutions that may work in both resource-limited and resource-rich settings.

Militarization of Energy Security: Turkey as a Case Study

DTIC Science & Technology

2010-06-01

diplomats 22 Sep 1987 U.S. ship attacks and captures Iranian mine-laying vessel with mines on board 8–22 Oct 1987 U.S. sinks three Iranian patrol...U.S. blows up two Iranian oilrigs, destroys an Iranian frigate and immobilizes another. American warships sink six Iranian vessels 3 Jul 1988 USS...Libya, Romania, and Maldives ) and none of them attempted to participate in the war. The incentive for third parties to enter the war was not strong

Construction of the radiation oncology teaching files system for charged particle radiotherapy.

PubMed

Masami, Mukai; Yutaka, Ando; Yasuo, Okuda; Naoto, Takahashi; Yoshihisa, Yoda; Hiroshi, Tsuji; Tadashi, Kamada

2013-01-01

Our hospital started the charged particle therapy since 1996. New institutions for charged particle therapy are planned in the world. Our hospital are accepting many visitors from those newly planned medical institutions and having many opportunities to provide with the training to them. Based upon our experiences, we have developed the radiation oncology teaching files system for charged particle therapy. We adopted the PowerPoint of Microsoft as a basic framework of our teaching files system. By using our export function of the viewer any physician can create teaching files easily and effectively. Now our teaching file system has 33 cases for clinical and physics contents. We expect that we can improve the safety and accuracy of charged particle therapy by using our teaching files system substantially.

Physician's acquittal of responsibility in Iranian statutes

PubMed Central

Abbasi, Mahmoud; Pirouz, Amir Samavati

2011-01-01

The physician's acquittal has obsessed Iranian legislator's mind to a large extent. This is exclusively observed in Iranian statuses and specifically in Shi’ite school of though. Muslim jurists’ opinions play a very important role in enacting legal articles related to it. After reviewing the literature, the authors tried to pick and collect common features of physician's responsibilities and duties to introduce Iranian Acts with respect to the subject. Also, Iranian Acts are analyzed and the challenging medical topics such as emergency situations and infectious diseases are discussed. Iranian legislator didn’t specify a kind of physician's acquittal which received from the patient knowingly and is based on his/her free will. There are also some medical and legal gaps. Patients are not often informed of all exact and scientific information and results of their treatments. Furthermore, the forms prepared to receive the patient's consent do not provide what Iranian legislator meant. PMID:22091234

31 CFR 535.301 - Iran; Iranian Entity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Iran; Iranian Entity. 535.301 Section... § 535.301 Iran; Iranian Entity. (a) The term Iran and Iranian Entity includes: (1) The state and the Government of Iran as well as any political subdivision, agency, or instrumentality thereof or any territory...

31 CFR 560.518 - Transactions in Iranian-origin and Iranian Government property.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Iran, all domestic transactions with respect to Iranian-origin goods located in the United States are... services of Iranian origin or owned or controlled by the Government of Iran that are located or to be... owned or controlled by the Government of Iran, except that the following transactions are authorized: (1...

31 CFR 535.301 - Iran; Iranian Entity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Iran; Iranian Entity. 535.301 Section... § 535.301 Iran; Iranian Entity. (a) The term Iran and Iranian Entity includes: (1) The state and the Government of Iran as well as any political subdivision, agency, or instrumentality thereof or any territory...

31 CFR 535.301 - Iran; Iranian Entity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Iran; Iranian Entity. 535.301 Section... § 535.301 Iran; Iranian Entity. (a) The term Iran and Iranian Entity includes: (1) The state and the Government of Iran as well as any political subdivision, agency, or instrumentality thereof or any territory...

31 CFR 535.301 - Iran; Iranian Entity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Iran; Iranian Entity. 535.301 Section 535.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 535.301 Iran; Iranian Entity. (a) The term Iran and Iranian Entity includes: (1) The state and the...

31 CFR 535.301 - Iran; Iranian Entity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Iran; Iranian Entity. 535.301 Section 535.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 535.301 Iran; Iranian Entity. (a) The term Iran and Iranian Entity includes: (1) The state and the...

31 CFR 560.518 - Transactions in Iranian-origin and Iranian Government property.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Iran, all domestic transactions with respect to Iranian-origin goods located in the United States are... services of Iranian origin or owned or controlled by the Government of Iran that are located or to be... owned or controlled by the Government of Iran, except that the following transactions are authorized: (1...

31 CFR 560.518 - Transactions in Iranian-origin and Iranian Government property.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Iran, all domestic transactions with respect to Iranian-origin goods located in the United States are... services of Iranian origin or owned or controlled by the Government of Iran that are located or to be... owned or controlled by the Government of Iran, except that the following transactions are authorized: (1...

77 FR 6657 - Blocking Property of the Government of Iran and Iranian Financial Institutions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-08

... Property of the Government of Iran and Iranian Financial Institutions #0; #0; #0; Presidential Documents #0... Blocking Property of the Government of Iran and Iranian Financial Institutions By the authority vested in... the Central Bank of Iran and other Iranian banks to conceal transactions of sanctioned parties, the...

31 CFR 560.549 - Policy governing Iranian news organizations' offices in the United States.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Policy governing Iranian news... Policy § 560.549 Policy governing Iranian news organizations' offices in the United States. Specific... operation of news bureaus in the United States by Iranian organizations whose primary purpose is the...

31 CFR 560.549 - Policy governing Iranian news organizations' offices in the United States.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Policy governing Iranian news... Policy § 560.549 Policy governing Iranian news organizations' offices in the United States. Specific... operation of news bureaus in the United States by Iranian organizations whose primary purpose is the...

Transnational Learning: The Integration of Jugyou Kenkyuu into Iranian Teacher Training

ERIC Educational Resources Information Center

Arani, Mohammad Reza Sarkar

2006-01-01

I clarify in this chapter what Iran can learn from Japan's experience of jugyou kenkyuu(lesson study) model, and what we can apply to the Iranian educational context. The chapter also discusses the process, progress and challenges of incorporating jugyou kenkyuu into Iranian teacher training. I examine how Iranian teachers and school…

Assessing and Managing Caregiver Stress: Development of a Teaching Tool for Medical Residents

ERIC Educational Resources Information Center

Famakinwa, Abisola; Fabiny, Anne

2008-01-01

Forty medical residents from major teaching hospitals in Boston, Massachusetts, participated in small group teaching sessions about caregiver stress. A teaching tool was developed that included a teaching handout, interactive cases, standard instruments for assessing caregiver stress, peer-reviewed articles about caregiving, and a list of…

Indexing of Iranian Publications in Well-known Endodontic Textbooks: A Scientometric Analysis.

PubMed

Kakooei, Sina; Mostafavi, Mahshid; Parirokh, Masoud; Asgary, Saeed

2016-01-01

Quoting an article in well-known textbooks is held as a credit for that paper. The numbers of Iranian publications mentioned in endodontic textbooks have increased during recent years. The aim of this investigation was to evaluate the number of Iranian articles quoted in eminent endodontic textbooks. Three known textbooks (Ingle's Endodontics, Seltzer and Bender's Dental Pulp and Cohen's Pathways of the Pulp) were chosen and all the editions of the textbooks since 2000 were investigated for quoted Iranian publications. Only Iranian authors with affiliations from a domestic university were chosen. All references at the end of each chapter were read by hand searching, and results were noted. The trend and percentage of Iranian publications in different editions of the textbooks were also calculated. The number of citations of these publications in Google Scholar and Scopus databases were also obtained. The number of Iranian publications in all well-known textbooks have notably increased since 2000. The number and percentage of Iranian publications in the latest edition of Cohen's Pathways of the Pulp was higher compared to other textbooks as well as the previous edition of the same text. Number and percentage of Iranian publications in the field of endodontics in all three textbooks have remarkably increased since 2000.

Inequity in Timeliness of MMR Vaccination in Children Living in the Suburbs of Iranian Cities

PubMed Central

Jadidi, Rahmatollah; Mohammadbeigi, Abolfazl; Mohammadsalehi, Narges; Ansari, Hossein; Ghaderi, Ebrahim

2015-01-01

Introduction: High coverage of immunization is one of the indicators of good performance of health system but timely vaccination is another indicator which is associated with protective effect of vaccines. The present study aimed at evaluating the inequity in timely vaccination with a focus on inequities in timeliness by gender, birth order, parents’ education and place of residence (rural or urban). Methods: A historical cohort study was conducted on children of 24-47 months of age who were living in the suburbs of big cities in Iran and were selected through stratified proportional sampling method. Only children who had vaccine cards -i.e. 3610 children -were included in data analysis. The primary outcome was age-appropriate vaccination of MMR1. Inequity was measured by Concentration Index (C) and Relative Index of Inequity (RII). Inequity indexes were calculated according to the mother and father’s education, child birth order, child’s sex and the family’s place of residence at the time of vaccination. Results: The overall on-time MMR1 vaccination was 70% and 54.4% for Iranians and Non-Iranians, respectively. The C index of mother and father’s education for timely MMR vaccination was 0.023 and was 0.029 in Iranian children as well as 0.044 and 0.019 for non-Iranians, respectively. The C index according to child order in Iranians and Non-Iranians was 0.025 and C=0.078. With regard to children who lived in cities, the on-time vaccination was 0.36% and 0.29% higher than that in rural areas . In male children it was 0.12% and 0.14% higher than that in female children for Iranians and Non-Iranians, respectively. Conclusion: Timeliness MMR vaccination in Iranian children is higher than that in non-Iranian children. Regarding the existence of differences in timely vaccination rate in all Iranian and Non-Iranian children, no evidence was observed for inequity by focusing on parents’ education, birth order, gender or place of residence. So, increasing timeliness of vaccination for enhancing the protective effect of vaccines can be considered a health-related goal in Iran after receiving high immunization coverage. PMID:26199583

Inequity in Timeliness of MMR Vaccination in Children Living in the Suburbs of Iranian Cities.

PubMed

Jadidi, Rahmatollah; Mohammadbeigi, Abolfazl; Mohammadsalehi, Narges; Ansari, Hossein; Ghaderi, Ebrahim

2015-06-01

High coverage of immunization is one of the indicators of good performance of health system but timely vaccination is another indicator which is associated with protective effect of vaccines. The present study aimed at evaluating the inequity in timely vaccination with a focus on inequities in timeliness by gender, birth order, parents' education and place of residence (rural or urban). A historical cohort study was conducted on children of 24-47 months of age who were living in the suburbs of big cities in Iran and were selected through stratified proportional sampling method. Only children who had vaccine cards -i.e. 3610 children -were included in data analysis. The primary outcome was age-appropriate vaccination of MMR1. Inequity was measured by Concentration Index (C) and Relative Index of Inequity (RII). Inequity indexes were calculated according to the mother and father's education, child birth order, child's sex and the family's place of residence at the time of vaccination. The overall on-time MMR1 vaccination was 70% and 54.4% for Iranians and Non-Iranians, respectively. The C index of mother and father's education for timely MMR vaccination was 0.023 and was 0.029 in Iranian children as well as 0.044 and 0.019 for non-Iranians, respectively. The C index according to child order in Iranians and Non-Iranians was 0.025 and C=0.078. With regard to children who lived in cities, the on-time vaccination was 0.36% and 0.29% higher than that in rural areas . In male children it was 0.12% and 0.14% higher than that in female children for Iranians and Non-Iranians, respectively. Timeliness MMR vaccination in Iranian children is higher than that in non-Iranian children. Regarding the existence of differences in timely vaccination rate in all Iranian and Non-Iranian children, no evidence was observed for inequity by focusing on parents' education, birth order, gender or place of residence. So, increasing timeliness of vaccination for enhancing the protective effect of vaccines can be considered a health-related goal in Iran after receiving high immunization coverage.

Hand Hygiene Adherence Among Health Care Workers at Japanese Hospitals: A Multicenter Observational Study in Japan.

PubMed

Sakihama, Tomoko; Honda, Hitoshi; Saint, Sanjay; Fowler, Karen E; Shimizu, Taro; Kamiya, Toru; Sato, Yumiko; Arakawa, Soichi; Lee, Jong Ja; Iwata, Kentaro; Mihashi, Mutsuko; Tokuda, Yasuharu

2016-03-01

Although proper hand hygiene among health care workers is an important component of efforts to prevent health care-associated infection, there are few data available on adherence to hand hygiene practices in Japan. The aim of this study was to examine hand hygiene adherence at teaching hospitals in Japan. An observational study was conducted from July to November 2011 in 4 units (internal medicine, surgery, intensive care, and/or emergency department) in 4 geographically diverse hospitals (1 university hospital and 3 community teaching hospitals) in Japan. Hand hygiene practice before patient contact was assessed by an external observer. In a total of 3545 health care worker-patient observations, appropriate hand hygiene practice was performed in 677 (overall adherence, 19%; 95% confidence interval, 18%-20%). Subgroup rates of hand hygiene adherence were 15% among physicians and 23% among nurses. The ranges of adherence were 11% to 25% between hospitals and 11% to 31% between units. Adherence of the nurses and the physicians to hand hygiene was correlated within each hospital. There was a trend toward higher hand hygiene adherence in hospitals with infection control nurses, compared with hospitals without them (29% versus 16%). The hand hygiene adherence in Japanese teaching hospitals in our sample was low, even lower than reported mean values from other international studies. Greater adherence to hand hygiene should be encouraged in Japan.

Healthcare's crown jewels. A looming 15% reduction in Medicare payments could tarnish the financial viability of teaching hospitals, studies say. Others, however, say they'll keep shining despite the scheduled cuts.

PubMed

Lovern, Ed

2002-05-27

Though saddled with higher costs than other hospitals, teaching hospitals reap plump margins on Medicare. But that could change this fall. A volley of studies say a looming 15% cut in indirect medical education payments and disproportionate-share payments could threaten the financial viability of healthcare's crown jewels unless Congress reverses current law.

[Academician Li Lianda talking about doctors doing scientific research].

PubMed

He, Ping; Li, Yi-kui

2015-09-01

At present, Chinese medical field faces with an important problem of how to correctly handle the relationship between medical and scientific research. Academician Li Lianda advocates doctors doing scientific research under the premise of putting the medical work first. He points out that there are many problems in the process of doctors doing scientific research at present such as paying more attention to scientific research than medical care, excessively promoting building scientific research hospital, only paying attention to training scientific talents, research direction be flashy without substance, the medical evaluation system should be improved and so on. Medical, scientific research and teaching are inseparable because improving medical standards depends on scientific research and personnel training. But not all doctors need to take into account of medical treatment, scientific research and teaching in the same degree while not all hospitals need to turn into three-in-one hospital, scientific research hospital or teaching hospital. It must be treated differently according to the actual situation.

77 FR 39700 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-05

..., and teaching hospitals and non-profit research institutes that are either owned by or formally... to determine the most appropriate and effective method of compliance with these requirements by... teaching hospital that is not owned by a college or university must keep a copy of its formal written...

Comfort as a basic need in hospitalized patients in Iran: a hermeneutic phenomenology study.

PubMed

Yousefi, Hojatollah; Abedi, Heidar Ali; Yarmohammadian, Mohammad Hossein; Elliott, Doug

2009-09-01

This paper is a report of a study conducted to explore the comfort experiences of hospitalized patients during their admission to medical-surgical wards in an Iranian hospital. Comfort has various definitions, ranging from a basic human need, to a process, function or an outcome of nursing. As comfort is a substantive need throughout life in health and illness, providing comfort is a major function and challenge for holistic nursing care. This hermeneutic phenomenological study was conducted between July 2006 and April 2007 in six medical-surgical wards of one of a university hospital in Iran. Data were generated with 22 participants (16 hospitalized patients and six nurses), using in-depth interviews to capture their detailed experiences of comfort. Analysis based on the framework of Diekelmann enabled data interpretation and elaboration of shared themes. One constitutive pattern, 'Comfort: a need of hospitalized patients' and four related themes - A friend in hospital, Relief of suffering within a calm environment, Seeking God, and Presence among family - were identified in the data. These findings offer unique insight for planning and implementing appropriate clinical practices in Iran, especially in caring for Muslim patients. Two major implications are to: (1) consider comfort criteria during nursing assessment and planning of care during a patient's hospitalization and (2) note that Shiite people in particular are more comfortable and feel better when they are able to follow their religious principles.

The Investigation of Construct Validity of Diagnostic and Statistical Manual of Mental Disorder-5 Personality Traits on Iranian sample with Antisocial and Borderline Personality Disorders.

PubMed

Amini, Mehdi; Pourshahbaz, Abbas; Mohammadkhani, Parvaneh; Ardakani, Mohammad-Reza Khodaie; Lotfi, Mozhgan

2014-12-01

The goal of this study was to examine the construct validity of the diagnostic and statistical manual of mental disorder-5 (DSM-5) conceptual model of antisocial and borderline personality disorders (PDs). More specifically, the aim was to determine whether the DSM-5 five-factor structure of pathological personality trait domains replicated in an independently collected sample that differs culturally from the derivation sample. This study was on a sample of 346 individuals with antisocial (n = 122) and borderline PD (n = 130), and nonclinical subjects (n = 94). Participants randomly selected from prisoners, out-patient, and in-patient clients. Participants were recruited from Tehran prisoners, and clinical psychology and psychiatry clinics of Razi and Taleghani Hospital, Tehran, Iran. The SCID-II-PQ, SCID-II, DSM-5 Personality Trait Rating Form (Clinician's PTRF) were used to diagnosis of PD and to assessment of pathological traits. The data were analyzed by exploratory factor analysis. Factor analysis revealed a 5-factor solution for DSM-5 personality traits. Results showed that DSM-5 has adequate construct validity in Iranian sample with antisocial and borderline PDs. Factors similar in number with the other studies, but different in the content. Exploratory factor analysis revealed five homogeneous components of antisocial and borderline PDs. That may represent personality, behavioral, and affective features central to the disorder. Furthermore, the present study helps understand the adequacy of DSM-5 dimensional approach to evaluation of personality pathology, specifically on Iranian sample.

Development of Mother’s Lifestyle Scale during Pregnancy with an Approach to Social Determinants of Health

PubMed Central

Mahmoodi, Zohreh; Karimlou, Masoud; Sajjadi, Homeira; Dejman, Masoumeh; Vameghi, Meroe

2013-01-01

Background and Objective: The present study was conducted to design and measure psychometrics of mothers’ lifestyle scale during pregnancy with regards to Iranians’ cultural norms and an approach to social determinants. Method: this study, started by reviewing previous studies and exploring similar questionnaires that examine different domains of lifestyle (nutrition, exercising, self-care, smoking, using alcohol and illegal drugs, social relations, and stress control), then besides translating questions of the questionnaires, content of some questions was modified and proper statements with regards to social determinant of health and Iranian cultural, was used. Secondly, the validity of the designed instruments was determined using face, content, criterion, and construct validity. Thirdly, the reliability of the measurement instruments was examined using Cronbach’s alpha. Participants were Healthy Iranian pregnant women (37-42 week) who refer to selected hospital for delivery. Results: In the first step of the study, of the 222 questions obtained from a review of the related instruments, certain questions were omitted due to their irrelevance to social determinants of health and finally 160 questions were selected in 10 sections. After determining the face and content validity qualitatively and quantitatively and exploratory factor analysis, the number of questionnaire items was reduced to 132. Calculation of Cronbach’s alpha confirmed the high internal consistency (0.76) of the questionnaire. Conclusion: This measurement instrument was designed in the context of the Iranian culture and sounded suitable for studying the pregnant women’s lifestyle due to its appropriate validity and reliability, simplicity, and functionality in different situations. PMID:23618491

Attitudes toward English & English Learning at an Iranian Military University: A Preliminary Survey

ERIC Educational Resources Information Center

Mahdavi Zafarghandi, Amir; Jodai, Hojat

2012-01-01

This study intends to represent attitudes toward English and English learning at an Iranian military university. Iranian military staff is required to study English in a social environment where there is little immediate need or opportunity to use the language for real communicative purposes.The subjects included 34 Iranian military personnel who…

31 CFR 535.403 - Termination and acquisition of an interest of Iran or an Iranian entity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... interest of Iran or an Iranian entity. 535.403 Section 535.403 Money and Finance: Treasury Regulations... Iran or an Iranian entity. (a) Whenever a transaction licensed or authorized by or pursuant to this part results in the transfer of property (including any property interest) away from Iran or an Iranian...

31 CFR 535.403 - Termination and acquisition of an interest of Iran or an Iranian entity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... interest of Iran or an Iranian entity. 535.403 Section 535.403 Money and Finance: Treasury Regulations... Iran or an Iranian entity. (a) Whenever a transaction licensed or authorized by or pursuant to this part results in the transfer of property (including any property interest) away from Iran or an Iranian...

31 CFR 535.579 - Authorization of new transactions concerning certain Iranian property.

Code of Federal Regulations, 2014 CFR

2014-07-01

... which Iran or an Iranian entity has an interest are authorized where: (1) The property comes within the... of the United States after January 19, 1981, or (2) The interest in the property of Iran or an Iranian entity (e.g. exports consigned to Iran or an Iranian entity) arises after January 19, 1981. (b...

31 CFR 535.579 - Authorization of new transactions concerning certain Iranian property.

Code of Federal Regulations, 2013 CFR

2013-07-01

... which Iran or an Iranian entity has an interest are authorized where: (1) The property comes within the... of the United States after January 19, 1981, or (2) The interest in the property of Iran or an Iranian entity (e.g. exports consigned to Iran or an Iranian entity) arises after January 19, 1981. (b...

31 CFR 535.579 - Authorization of new transactions concerning certain Iranian property.

Code of Federal Regulations, 2012 CFR

2012-07-01

... which Iran or an Iranian entity has an interest are authorized where: (1) The property comes within the... of the United States after January 19, 1981, or (2) The interest in the property of Iran or an Iranian entity (e.g. exports consigned to Iran or an Iranian entity) arises after January 19, 1981. (b...

31 CFR 535.403 - Termination and acquisition of an interest of Iran or an Iranian entity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... interest of Iran or an Iranian entity. 535.403 Section 535.403 Money and Finance: Treasury Regulations... Iran or an Iranian entity. (a) Whenever a transaction licensed or authorized by or pursuant to this part results in the transfer of property (including any property interest) away from Iran or an Iranian...

31 CFR 535.579 - Authorization of new transactions concerning certain Iranian property.

Code of Federal Regulations, 2010 CFR

2010-07-01

... which Iran or an Iranian entity has an interest are authorized where: (1) The property comes within the... of the United States after January 19, 1981, or (2) The interest in the property of Iran or an Iranian entity (e.g. exports consigned to Iran or an Iranian entity) arises after January 19, 1981. (b...

31 CFR 535.403 - Termination and acquisition of an interest of Iran or an Iranian entity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... interest of Iran or an Iranian entity. 535.403 Section 535.403 Money and Finance: Treasury Regulations... Iran or an Iranian entity. (a) Whenever a transaction licensed or authorized by or pursuant to this part results in the transfer of property (including any property interest) away from Iran or an Iranian...

31 CFR 535.579 - Authorization of new transactions concerning certain Iranian property.

Code of Federal Regulations, 2011 CFR

2011-07-01

... which Iran or an Iranian entity has an interest are authorized where: (1) The property comes within the... of the United States after January 19, 1981, or (2) The interest in the property of Iran or an Iranian entity (e.g. exports consigned to Iran or an Iranian entity) arises after January 19, 1981. (b...

31 CFR 535.403 - Termination and acquisition of an interest of Iran or an Iranian entity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... interest of Iran or an Iranian entity. 535.403 Section 535.403 Money and Finance: Treasury Regulations... Iran or an Iranian entity. (a) Whenever a transaction licensed or authorized by or pursuant to this part results in the transfer of property (including any property interest) away from Iran or an Iranian...

A Culturally-Adaptive Iranian Version of the Questionnaire on Teacher Interaction to Investigate English Teachers' Interpersonal Behaviour

ERIC Educational Resources Information Center

Ahmadi Safa, Mohammad; Doosti, Mehdi

2017-01-01

We investigated Iranian secondary-school English teachers' interpersonal behaviour with a validated culturally-adaptive Iranian version of the Questionnaire on Teacher Interaction. Data were collected from 971 Iranian secondary-school students (398 students participated in the pilot study and 573 students in the main study) and 55 Iranian…

Chemical Society Reinstates Iranian Chemists; Iranian-American Scholar Arrested

ERIC Educational Resources Information Center

Bollag, Burton

2007-01-01

The frosty relationship between the United States and Iran has created a chill in many areas of scholarly endeavor. One resulting battle, over whether Iranian scholars can belong to the American Chemical Society, has been largely resolved. But a new imbroglio looms with the arrest of a prominent U.S.-Iranian scholar who was visiting Tehran. The…

Parental responses to involvement in rounds on a pediatric inpatient unit at a teaching hospital: a qualitative study.

PubMed

Latta, Linda C; Dick, Ronald; Parry, Carol; Tamura, Glen S

2008-03-01

In pediatric teaching hospitals, medical decisions are traditionally made by the attending and resident physicians during rounds that do not include parents. This structure limits the ability of the medical team to provide "family-centered care" and the attending physician to model communication skills. The authors thus set out to identify how parents responded to participation in interdisciplinary teaching rounds conducted in a large tertiary care children's teaching hospital. A qualitative descriptive study was conducted using data from semistructured interviews of parents who had participated in rounds on the inpatient medical unit of a large academic children's hospital. From December 2004 to April 2005, 18 parents were interviewed after their participation in rounds. Questions assessed their experiences, expectations, preferred communication styles, and suggestions for improvement. Transcripts of the interviews were analyzed using qualitative content analysis. Being able to communicate, understand the plan, and participate with the team in decision making about their child's care were the most frequently cited outcomes of importance to parents. All 18 participants described the overall experience as positive, and 17 of 18 described themselves as "comfortable" with inclusion in rounds. Use of lay terminology and inclusion of nurses in rounds were preferred. Including parents on ward rounds at a teaching hospital was viewed positively by parents. Specific themes of particular importance to parents were identified. Further study is needed to assess the impact of inclusion of parents on rounds on patient outcomes and the resident experience.

Use of ventricular assist devices in children across the United States: analysis of 7.5 million pediatric hospitalizations.

PubMed

Morales, David L S; Zafar, Farhan; Rossano, Joseph W; Salazar, Jorge D; Jefferies, John L; Graves, Daniel E; Heinle, Jeffrey S; Fraser, Charles D

2010-10-01

Recently, there has been a surge of interest by clinicians, industry, and the government in the development and use of ventricular assist devices (VAD) in children. Despite this rapidly expanding interest, the incidence of VAD use in children across the United States is unknown. The Healthcare Cost and Utilization Project (H-CUP) Kids' Inpatients Database (KID) was analyzed to characterize the current utilization of VADs in children nationwide. The most recent HCUP-KID (2006) was analyzed (n = 7.5 million). This database is a nationwide sampling of hospital discharges of patients less than 20 years old weighted to provide national estimates. In 2006, 187 children had a VAD implanted in the United States. Mean age was 13 ± 7 years. Forty patients (21%) were bridged to VAD by extracorporeal membrane oxygenation. Forty-nine patients (26%) were bridged to heart transplant. Fifty-six patients (30%) died in hospital. Eighty-six patients (46%) were discharged or transferred. Length of stay was 29 days (range, 0 to 285). Total cost was $174,743 (range, $4,230 to $1,911,588). Sixty-seven hospitals placed VADs; 66% of VADs (124) were implanted at large teaching hospitals (more than 500 beds), and 46% (85) were at high-volume hospitals (more than 5 VADs per year). High-volume, large teaching hospitals (10) had better survival (89% versus 61%; p < 0.001) and lower hospital cost ($236,000 ± $184,000 versus $300,000 ± $355,000; p = 0.002) compared with all other hospitals. On multivariate analysis, acute renal failure and extracorporeal membrane oxygenation were risk factors for mortality, whereas transplant and being at a high-volume large teaching hospital were protective factors from death. Preliminary data suggest that the growing use of VADs in children may be better served in regard to resource utilization and outcomes if centralized to high-volume large teaching hospitals. Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Assessing hand hygiene resources and practices at a large african teaching hospital.

PubMed

Owusu-Ofori, Alex; Jennings, Rebecca; Burgess, Jennifer; Prasad, Priya A; Acheampong, Faustina; Coffin, Susan E

2010-08-01

To gather baseline data on hand hygiene (HH) practices in an African hospital with a newly established infection prevention and control team. Cross-sectional, observational study. Setting. Komfo Anokye Teaching Hospital, a large teaching hospital in Ghana with approximately 1,000 beds. All hospital staff with patient contact were eligible for assessment of HH practices. HH observations were conducted using a standardized data collection tool and method based on the World Health Organization's "5 Moments of Hand Hygiene." Small-group interviews were conducted to gather additional information on perceptions of HH and barriers to its use. HH resource needs were also assessed using a standardized tool. HH was attempted in 12% of the opportunities and was performed appropriately in 4% of the opportunities. Most main wards (89%) had at least 1 functional HH station. The most commonly identified barriers to HH were limited resources and lack of knowledge on appropriate times to perform HH. We developed and applied tools to evaluate HH resources and practices in a large African hospital. These assessments were undertaken to guide future efforts to improve HH at this hospital but can also serve as a model of the way to perform a systematic assessment at acute care hospitals in developing countries.

Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study

PubMed Central

Wan Ahmad, Wan Azman; Low, Ee Vien; Liau, Siow Yen; Anchah, Lawrence; Hamzah, Syuhada; Liew, Houng-Bang; Mohd Ali, Rosli B.; Ismail, Omar; Ong, Tiong Kiam; Said, Mas Ayu; Dahlui, Maznah

2017-01-01

Introduction The increasing disease burden of coronary artery disease (CAD) calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI), a common treatment for CAD. Few studies have analyzed the contemporary data on local cardiac facilities. Service expansion and budget allocation require cost evidence from various providers. We aim to compare the patient characteristics, procedural outcomes, and cost profile between a teaching hospital (TH) and a general hospital (GH). Methods This cross-sectional study was conducted from the healthcare providers’ perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test. Results The mean hospitalization cost was RM 12,117 (USD 3,366) at GH and RM 16,289 (USD 4,525) at TH. The higher cost at TH can be attributed to worse patients’ comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost. Conclusions The high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure sustainable and equitable cardiac service in Malaysia. PMID:28873473

Relationship Between Job Characteristics and Organizational Commitment: A Descriptive Analytical Study.

PubMed

Faraji, Obeidollah; Ramazani, Abbas Ali; Hedaiati, Pouria; Aliabadi, Ali; Elhamirad, Samira; Valiee, Sina

2015-11-01

Many factors influence the organizational commitment of employees. One of these factors is job designing since it affects the attitude, beliefs, and feelings of the organization employees. We aimed to determine the relationship between job characteristics and organizational commitment among the employees of hospitals. In this descriptive and correlational study, 152 Iranian employees of the hospitals (physicians, nurses, and administrative staff) were selected through stratified random sampling. Data gathered using 3-part questionnaire of "demographic information", "job characteristics model," and "organizational commitment," in 2011. Study data were analyzed using SPSS v. 16. There was significant statistical correlation between organizational commitment and variables of educational level (P = 0.001) and job category (P = 0.001). Also, a direct and significant correlation existed between motivating potential score and job feedback on one hand and organizational commitment on the other hand (P = 0.014). According to the results, managers of the hospitals should increase staff's commitment through paying attention to proper job designing.

Feasibility of introducing rejection criteria for stool cultures in a teaching hospital in Portugal.

PubMed

Hänscheid, T; Cristino, J M; Salgado, M J

2002-02-01

The possible introduction of rejection criteria for stool cultures (

Drug-food interaction counseling programs in teaching hospitals.

PubMed

Wix, A R; Doering, P L; Hatton, R C

1992-04-01

The results of a survey to characterize drug-food interaction counseling programs in teaching hospitals and solicit opinions on these programs from pharmacists and dietitians are reported. A questionnaire was mailed to the pharmacy director and the director of dietary services at teaching hospitals nationwide. The questionnaire contained 33 questions relating to hospital characteristics, drug-food interaction counseling programs, and the standard calling for such programs issued by the Joint Commission on Accreditation of Healthcare Organizations. Of 792 questionnaires mailed, 425 were returned (response rate, 53.7). A majority of the pharmacists and dietitians (51.2%) did not consider their drug-food interaction counseling program to be formal; some had no program. The pharmacy department was involved more in program development than in the daily operation of such programs. The most frequent methods of identifying patients for counseling were using lists of patients' drugs and using physicians' orders. A mean of only five drugs were targeted per program. Slightly over half the respondents rated the Joint Commission standard less effective than other standards in its ability to improve patient care. A majority of teaching hospitals did not have formal drug-food interaction counseling programs. Pharmacists and dietitians did not view these programs as greatly beneficial and did not believe that the Joint Commission has clearly delineated the requirements for meeting its standard.

Performance of US teaching hospitals: a panel analysis of cost inefficiency.

PubMed

Rosko, Michael D

2004-02-01

This research summarizes an analysis of the impact of environment pressures on hospital inefficiency during the period 1990-1999. The panel design included 616 hospitals. Of these, 211 were academic medical centers and 415 were hospitals with smaller teaching programs. The primary sources of data were the American Hospital Association's Annual Survey of Hospitals and Medicare Cost Reports. Hospital inefficiency was estimated by a regression technique called stochastic frontier analysis. This technique estimates a "best practice cost frontier" for each hospital that is based on the hospital's outputs and input prices. The cost efficiency of each hospital was defined as the ratio of the stochastic frontier total costs to observed total costs. Average inefficiency declined from 14.35% in 1990 to 11.42% in 1998. It increased to 11.78% in 1999. Decreases in inefficiency were associated with the HMO penetration rate and time. Increases in inefficiency were associated with for-profit ownership status and Medicare share of admissions. The implementation of the provisions of the Balanced Budget Act of 1997 was followed by a small decrease in average hospital inefficiency. Analysis found that the SFA results were moderately sensitive to the specification of the teaching output variable. Thus, although the SFA technique can be useful for detecting differences in inefficiency between groups of hospitals (i.e., those with high versus those with low Medicare shares or for-profit versus not-for-profit hospitals), its relatively low precision indicates it should not be used for exact estimates of the magnitude of differences associated with inefficiency-effects variables.

Teaching the teacher program to assist nurse managers to educate nursing staff in Ecuadorian hospitals.

PubMed

Palmer, Sheri P; Heaston, Sondra

2009-03-01

Continuing education for hospital staff nurses is a concern worldwide. Current research shows that continuing education among nurses can positively affect patient outcomes (O'Brien, T., Freemantle, N., Oxman, A, et al., 2002. Interactive continuing education workshops or conferences can improve professional practice and patient outcomes. Journal of Evidence Based Nursing. 26 (5)). Seeing a need for improved patient outcomes among hospitals in Ecuador, we conducted a teaching the teacher program to assist nurse managers to carry-out continuing education in their hospital system. This teaching the teacher program was established through the collaboration between one College of Nursing in Utah, USA and a large healthcare system in Guayaquil, Ecuador. The collaboration has been ongoing for five years, 2003 to present. Initial projects included classes for the nursing staff including technical skills, life-saving techniques, and nursing process and assessment. Collaborators from the US and Ecuador believed that in order to maximize the improvement of nursing care in the hospital system it was necessary to turn attention on the nurse managers and not just the staff nurses. This would allow for meaningful ongoing learning beyond the one-time classroom setting. Continuing education is not common in Ecuadorian hospitals as it is in the United States. The purpose of this paper is to describe the project and provide initial evaluative data on the response to the curriculum; including evidence of managers using the teaching principles they were taught. The underlying aim of the project was to achieve a sustainable impact by teaching the leaders of each unit how to be more effective teachers. In May 2007, a two-day "teaching the teacher" workshop was developed with the needs of the managers in mind. The participants in the course included the chief nursing officer and leaders of various units of the hospital. In May 2008 a follow-up class was taught, along with an evaluation by a verbal and written survey with open ended questions and an observation of an actual class being taught by the participants.

Performance of Clinical Nurse Educators in Teaching Pharmacology and Medication Management: Nursing Students’ Perceptions

PubMed Central

Ghamari Zare, Zohre; Adib-Hajbaghery, Mohsen

2016-01-01

Background Pharmacological knowledge and medication management skills of student nurses greatly depend on the clinical nurse educators’ performance in this critical issue. However, the Iranian nurse educators’ performance in teaching pharmacology and medication management are not adequately studied. Objectives The current study aimed to investigate the nursing students’ perceptions on the status of clinical pharmaceutical and medication management education. Materials and Methods A cross-sectional study was conducted on all 152 nursing students registered in the seventh and eighth semesters at the Qom and Naragh branches of Islamic Azad University, and Kashan University of Medical Sciences in 2013 - 2014 academic year. The students’ perceptions on the performance of clinical nurse educators in teaching pharmacology and medication management were assessed using a researcher made questionnaire. The questionnaire consisted of 31 items regarding clinical educators’ performance in teaching pharmacology and medication management and two questions about students’ satisfaction with their level of knowledge and skills in pharmacology and medication management. Descriptive statistics was employed and analysis of variance was performed to compare the mean of scores of teaching pharmacology and medication management in the three universities. Results Among a total of 152 subjects, 82.9% were female and their mean age was 22.57 ± 1.55 years. According to the students, instructors had the weakest performance in the three items of teaching pharmacology and medication management based on the students’ learning needs, teaching medication management through a patient-centered method and teaching pharmacology and medication management based on the course plan. The students’ satisfaction regarding their own knowledge and skill of pharmacology and medication management was at medium level. Conclusions Nursing students gave a relatively low score in several aspects of their instructors’ performance regarding teaching pharmacology and medication management. It seems that many clinical nurse educators in the studied settings were incompetent especially in teaching pharmacology and medication management, while these are critical areas and need special attention. PMID:27331055

Performance of Clinical Nurse Educators in Teaching Pharmacology and Medication Management: Nursing Students' Perceptions.

PubMed

Ghamari Zare, Zohre; Adib-Hajbaghery, Mohsen

2016-03-01

Pharmacological knowledge and medication management skills of student nurses greatly depend on the clinical nurse educators' performance in this critical issue. However, the Iranian nurse educators' performance in teaching pharmacology and medication management are not adequately studied. The current study aimed to investigate the nursing students' perceptions on the status of clinical pharmaceutical and medication management education. A cross-sectional study was conducted on all 152 nursing students registered in the seventh and eighth semesters at the Qom and Naragh branches of Islamic Azad University, and Kashan University of Medical Sciences in 2013 - 2014 academic year. The students' perceptions on the performance of clinical nurse educators in teaching pharmacology and medication management were assessed using a researcher made questionnaire. The questionnaire consisted of 31 items regarding clinical educators' performance in teaching pharmacology and medication management and two questions about students' satisfaction with their level of knowledge and skills in pharmacology and medication management. Descriptive statistics was employed and analysis of variance was performed to compare the mean of scores of teaching pharmacology and medication management in the three universities. Among a total of 152 subjects, 82.9% were female and their mean age was 22.57 ± 1.55 years. According to the students, instructors had the weakest performance in the three items of teaching pharmacology and medication management based on the students' learning needs, teaching medication management through a patient-centered method and teaching pharmacology and medication management based on the course plan. The students' satisfaction regarding their own knowledge and skill of pharmacology and medication management was at medium level. Nursing students gave a relatively low score in several aspects of their instructors' performance regarding teaching pharmacology and medication management. It seems that many clinical nurse educators in the studied settings were incompetent especially in teaching pharmacology and medication management, while these are critical areas and need special attention.

Construct Validity and Reliability of the Tolerance Scale among Iranian College Students

ERIC Educational Resources Information Center

Ersanli, Ercümend; Mameghani, Shiva Saeighi

2016-01-01

In the present study, the Tolerance Scale developed by Ersanli (2014) was adapted to the Iranian culture, and its validity and reliability were investigated in the case of Iranian college students. The participants consisted of 552 Iranian college students (62% male, M = 20.84, S.D.: 1.53) selected using the convenience sampling method. The sample…

31 CFR 535.504 - Certain judicial proceedings with respect to property of Iran or Iranian entities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... respect to property of Iran or Iranian entities. 535.504 Section 535.504 Money and Finance: Treasury... § 535.504 Certain judicial proceedings with respect to property of Iran or Iranian entities. (a) Subject... existed an interest of Iran or an Iranian entity. (b) This section does not authorize: (1) Any pre...

31 CFR 535.504 - Certain judicial proceedings with respect to property of Iran or Iranian entities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... respect to property of Iran or Iranian entities. 535.504 Section 535.504 Money and Finance: Treasury... § 535.504 Certain judicial proceedings with respect to property of Iran or Iranian entities. (a) Subject... existed an interest of Iran or an Iranian entity. (b) This section does not authorize: (1) Any pre...

31 CFR 535.504 - Certain judicial proceedings with respect to property of Iran or Iranian entities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... respect to property of Iran or Iranian entities. 535.504 Section 535.504 Money and Finance: Treasury... § 535.504 Certain judicial proceedings with respect to property of Iran or Iranian entities. (a) Subject... existed an interest of Iran or an Iranian entity. (b) This section does not authorize: (1) Any pre...

31 CFR 535.504 - Certain judicial proceedings with respect to property of Iran or Iranian entities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... respect to property of Iran or Iranian entities. 535.504 Section 535.504 Money and Finance: Treasury... § 535.504 Certain judicial proceedings with respect to property of Iran or Iranian entities. (a) Subject... existed an interest of Iran or an Iranian entity. (b) This section does not authorize: (1) Any pre...

31 CFR 535.504 - Certain judicial proceedings with respect to property of Iran or Iranian entities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... respect to property of Iran or Iranian entities. 535.504 Section 535.504 Money and Finance: Treasury... § 535.504 Certain judicial proceedings with respect to property of Iran or Iranian entities. (a) Subject... existed an interest of Iran or an Iranian entity. (b) This section does not authorize: (1) Any pre...

A model of determining a fair market value for teaching residents: who profits?

PubMed

Cullen, Edward J; Lawless, Stephen T; Hertzog, James H; Penfil, Scott; Bradford, Kathleen K; Nadkarni, Vinay M; Corddry, David H; Costarino, Andrew T

2003-07-01

Centers for Medicare & Medicaid Services (CMS) Health Resources and Services Administration Children's Hospitals Graduate Medical Education (GME) Payment Program now supports freestanding children's teaching hospitals. To analyze the fair market value impact of GME payment on resident teaching efforts in our pediatric intensive care unit (PICU). Cost-accounting model, developed from a 1-year retrospective, descriptive, single-institution, longitudinal study, applied to physician teachers, residents, and CMS. Sixteen-bed PICU in a freestanding, university-affiliated children's teaching hospital. Pediatric critical care physicians, second-year residents. Cost of physician opportunity time; CMS investment return; the teaching physicians' investment return; residents' investment return; service balance between CMS and teaching service investment margins; economic balance points; fair market value. GME payments to our hospital increased 4.8-fold from 577 886 dollars to 2 772 606 dollars during a 1-year period. Critical care physicians' teaching opportunity cost rose from 250 097 dollars to 262 215 dollars to provide 1523 educational hours (6853 relative value units). Residents' net financial value for service provided to the PICU rose from 245 964 dollars to 317 299 dollars. There is an uneven return on investment in resident education for CMS, critical care physicians, and residents. Economic balance points are achievable for the present educational efforts of the CMS, critical care physicians, and residents if the present direct medical education payment increases from 29.38% to 36%. The current CMS Health Resources and Services Administration Children's Hospitals GME Payment Program produces uneven investment returns for CMS, critical care physicians, and residents. We propose a cost-accounting model, based on perceived production capability measured in relative value units and available GME funds, that would allow a clinical service to balance and obtain a fair market value for the resident education efforts of CMS, physician teachers, and residents.

Are medical students accepted by patients in teaching hospitals?

PubMed Central

Marwan, Yousef; Al-Saddique, Muhammad; Hassan, Adnan; Karim, Jumanah; Al-Saleh, Mervat

2012-01-01

Background Worldwide, patients are the cornerstone of bedside teaching of medical students. In this study, the authors aimed to assess patients’ acceptability toward medical students in teaching hospitals of the Faculty of Medicine of Kuwait University. Methods Ninehundred and ninety five patients were approached in 14 teaching hospitals; 932 patients agreed to participate (refusal rate is 6.3%). A self-administered questionnaire was used to collect data. Results In general, higher acceptance of students by patients was found when there is no direct contact between the patient and the student (e.g., reading patients’ files, presenting in outpatient clinic, observing doctors performing examination or procedures) compared to other situations (e.g., performing physical examination or procedures). Pediatrics patients showed higher acceptance of students compared to patients in other specialties, while Obstetrics/Gynecology patients showed the highest refusal of students. Gender of patients (especially females) and students appeared to affect the degree of acceptance of medical students by patients. Majority of the patients (436; 46.8%) believed that the presence of medical students in hospitals improves the quality of health care. Conclusion Patients are an important factor of bedside teaching. Clinical tutors must take advantage of patients who accept medical students. Clinical tutors and medical students should master essential communication skills to convince patients in accepting students, thus improving bedside teaching. Also, using simulation and standardization should be considered to address scenarios that most patients are unwilling to allow students to participate. PMID:22509091

A Multidisciplinary Work-Related Low Back Pain Predictor Questionnaire: Psychometric Evaluation of Iranian Patient-Care Workers

PubMed Central

Sarallah, Shojaei; Jamshidi, Ahmad Reza; Joan, Wagner

2016-01-01

Study Design Psychometric evaluation design. Purpose Psychometric evaluation of a multidisciplinary work-related low back pain predictor questionnaire (MWRLBPPQ) of Iranians patient-care workers based on the social cognitive theory. Overview of Literature Healthcare is one of the professions in which work-related musculoskeletal disorders are prevalent. The chronic low back pain experienced by patient caregivers can negatively impact their professional performance, and patient handling in a hospital is the main cause of low back pain in this population. Methods This was a cross-sectional study carried out in Qom, Iran from July 2014 to November 2014. A MWRLBPPQ based on nine concepts of the social cognitive theory and existing literature regarding chronic low back pain was developed. Ten patient-care workers first completed the questionnaire as a pilot test, allowing the ambiguities of the instrument to be resolved. Exploratory factor analysis was used to confirm construct validity. This questionnaire was distributed among 452 patient-care workers in hospitals located in different geographically areas in Qom, Iran. Cronbach's Alpha was calculated to assess reliability. Results In all, 452 caregivers of patients with mean age of 37.71 (standard deviation=8.3) years participated in the study. An exploratory factor analysis loaded seven concepts of self-efficacy, knowledge, outcome perception, self-control, emotional coping, and self-efficacy in overcoming impediments and challenges in the environment. All concepts were jointly accounted for 50.08% of variance of behavior change. The Cronbach's alpha coefficient showed favorable internal consistency (alpha=0.83), and test-retest of the scale with 2-week intervals indicated an appropriate stability for the MWRLBPPQ. Conclusions The MWRLBPPQ is a reliable and valid theory-based instrument that can be used to predict factors influencing work-related low back pain among workers who lift and transfer patients in hospitals. PMID:27340530

Barriers to education in cardiac rehabilitation within an Iranian society: a qualitative descriptive study.

PubMed

Alavi, Mousa; Irajpour, Alireza; Giles, Tracey; Rabiei, Katayoun; Sarrafzadegan, Nizal

2013-06-01

Cardiac rehabilitation programmes that include patient education aim to maximise physical, psychological and social functioning, and enable people with acute coronary syndrome to lead fulfilling and productive lives. Despite strong evidence for the benefits of patient education, various barriers exist that need to be addressed to ensure the effective delivery of care. This study explores patients/family members and health professionals' perceptions and experiences of the barriers to cardiac rehabilitation education in an Iranian context. A thematic analysis of in-depth interviews was undertaken using a constant comparative approach. Participants (10 health professionals, 15 patients/family members) were recruited from educational-medical centers and hospitals in Iran. Credibility and trustworthiness were grounded on four aspects: factual value, applicability, consistency and neutrality. Five major barriers to cardiac rehabilitation were identified relating to human resources, service provision, available educational services, unfavourable attitudes and collaboration gaps. Two main challenges exist to the provision of effective patient education; inadequate human resources in the hospital wards, specifically in terms of trained health care professionals and service users specific health related views and behaviours. Barriers to comprehensive patient education and cardiac rehabilitation in Iran must be addressed and urgent consideration should be given to the introduction and evaluation of education programmes to prepare health/support system professionals as well as service users, and cardiac rehabilitation services that employ a collaborative and individualised approach. This in turn may reduce the burden of CVD and improve the overall health and quality of life for people in Isfahan Iran.

Respiratory Complications in Iranian Hospitalized Patients with HIV/AIDS.

PubMed

Alinaghi, Seyed Ahmad Seyed; Vaghari, Bahram; Roham, Maryam; Badie, Banafsheh Moradmand; Jam, Sara; Foroughi, Maryam; Djavid, Gholamreza Esmaeeli; Hajiabdolbaghi, Mahboubeh; Hosseini, Mostafa; Mohraz, Minoo; McFarland, Willi

2011-01-01

The respiratory tract has been the most commonly affected site of illness in HIV-infected patients. The current study was done to identify the frequency of respiratory complications in a consecutive case series of HIV-positive patients in Iran. This study was a retrospective analysis at the national academic reference medical center of Imam-Khomeini Hospital, in Tehran, Iran. The study included 199 new admissions for 177 HIV-infected patients between 2000 and 2005. Demographic characteristics, risk factors for HIV infection, respiratory complications, and CD4+ lymphocyte counts were evaluated in these patients. All patients were males. The mean age was 35 years (age range: 15 to 63 years). Among 34 cases with available CD4+ lymphocyte count results, 70.6% had results <200 cells/mm(3). Nearly half the patients (47.7%) had respiratory symptoms. The most common pulmonary complications were cough (86.3%), sputum (71.6%), dyspnea (54.7%), and hemoptysis (10.5%). The most common diagnosis was pulmonary tuberculosis (27.1%), followed by other bacterial pneumonias (16.6%) and pneumocystis carinii pneumonia (4.5%). Intravenous drug users who had history of incarceration had the highest risk factors for Mycobacterium tuberculosis infection (59%), and other bacterial pneumonias (52%). Our study demonstrates that respiratory complications are highly frequent in HIV patients in Iran and that pulmonary tuberculosis is still a common complication in HIV infected patients, despite the availability of effective treatment. Results suggest the need for more effective preventive and prophylactic measures, wider use of antiretroviral treatment and effective chemotherapy for Iranian patients with HIV/AIDS.

Virulence Factors of Staphylococcus aureus Isolates in an Iranian Referral Children's Hospital.

PubMed

Sabouni, Farah; Mahmoudi, Shima; Bahador, Abbas; Pourakbari, Babak; Sadeghi, Reihaneh Hosseinpour; Ashtiani, Mohammad Taghi Haghi; Nikmanesh, Bahram; Mamishi, Setareh

2014-04-01

The clinical importance of Staphylococcus aureus (S. aureus) is attributed to notable virulence factors, surface proteins, toxins, and enzymes as well as the rapid development of drug resistance. The aim of this study was to compare the occurrence of virulence factors produced by S. aureus strains isolated from children in an Iranian referral children's hospital. The presence of genes encoding for the enterotoxins A (sea), B (seb), C (sec), D (sed), TSST-1 (tsst), exfoliative toxin A (eta), and exfoliative toxin B (etb) were detected by Multiplex polymerase chain reaction (PCR) using specific primers. In addition, the standardized Kirby-Bauer disc-diffusion method was performed on Mueller-Hinton agar. In total, 133 S. aureus isolates were obtained from different patients. Of these S. aureus isolates, 64 (48%) were methicillin-resistant S. aureus (MRSA), and all of these tested positive for the mecA gene. Regarding the classical enterotoxin genes, sea gene (40.6%) was the most prevalent followed by seb (19.6%), tsst (12.8%), eta (11.3%), etb (9%), sed (4.5%), and sec (3%). Among methicillin-susceptible S. aureus (MSSA) isolates, seb and tsst were the more prevalent toxins in comparison with MRSA isolates (p < 0.05), while the frequency of sea, sed, eta, and etb genes were higher among MRSA isolates (p > 0.05). In our study enterotoxin A was produced by 40.6% of the isolates (48% from MRSA and 33% from MSSA isolates) which was higher than in previous reports. According to our results, strict hygiene and preventative measures during food processing are highly recommended.

Comparison of current practices of cardiopulmonary perfusion technology in Iran with American Society of Extracorporeal Technology’s standards

PubMed Central

Faravan, Amir; Mohammadi, Nooredin; Alizadeh Ghavidel, Alireza; Toutounchi, Mohammad Zia; Ghanbari, Ameneh; Mazloomi, Mehran

2016-01-01

Introduction: Standards have a significant role in showing the minimum level of optimal optimum and the expected performance. Since the perfusion technology staffs play an the leading role in providing the quality services to the patients undergoing open heart surgery with cardiopulmonary bypass machine, this study aimed to assess the standards on how Iranian perfusion technology staffs evaluate and manage the patients during the cardiopulmonary bypass process and compare their practice with the recommended standards by American Society of Extracorporeal Technology. Methods: In this descriptive study, data was collected from 48 Iranian public hospitals and educational health centers through a researcher-created questionnaire. The data collection questionnaire assessed the standards which are recommended by American Society of Extracorporeal Technology. Results: Findings showed that appropriate measurements were carried out by the perfusion technology staffs to prevent the hemodilution and avoid the blood transfusion and unnecessary blood products, determine the initial dose of heparin based on one of the proposed methods, monitor the anticoagulants based on ACT measurement, and determine the additional doses of heparin during the cardiopulmonary bypass based on ACT or protamine titration. It was done only in 4.2% of hospitals and health centers. Conclusion: Current practices of cardiopulmonary perfusion technology in Iran are inappropriate based on the standards of American Society of Cardiovascular Perfusion. This represents the necessity of authorities’ attention to the validation programs and development of the caring standards on one hand and continuous assessment of using these standards on the other hand. PMID:27489600

A Census of Residents in Canadian Hospitals Approved for Training by the Royal College of Physicians and Surgeons of Canada, April 1965

PubMed Central

Clarke, G. Grant; Fish, D. G.; Giles, T. J.

1966-01-01

A census taken in April 1965 revealed that there were 3162 residents training in Canadian hospitals approved by the Royal College of Physicians and Surgeons of Canada. Thirty-one of the 151 approved hospitals had no residents in training, and another 43 hospitals each having 20 or more residents accounted for 85% of all residents training in Canada. Fifty-seven per cent of the residents in Canada were Canadian citizens, 19% were landed immigrants, and 24% were foreign trainees. Major teaching hospitals contained 65% of all residents; 70% of Canadian graduates and 60% of non-Canadian graduates were training in major teaching hospitals. Hospitals approved for full training in the specialty of the trainee contained 57% of all residents; 64% of Canadian graduates and 48% of foreign graduates were in such hospitals. PMID:5908720

Learning as Leaving Home: Fear, Empathy, and Hospitality in the Theology and Religion Classroom

ERIC Educational Resources Information Center

Fleming, Daniel; Lovat, Terence

2015-01-01

The article is a response to this journal's call for papers on metaphors for teaching, and also draws from a previous publication in which Kent Eilers developed a methodology for teaching global theologies. In this methodology, the ultimate goal was the development of "hermeneutical dispositions of empathy, hospitality, and receptivity toward…

Approaching Hospital-Bound/Home-Bound Special Education as an Opportunity for Innovation in Teaching

ERIC Educational Resources Information Center

Trentin, Guglielmo

2014-01-01

Paradoxically some "extreme" didactic needs, such as those of students who are unable to attend normal education regularly (e.g., hospitalized and/or homebound students), have shown themselves to be ideal for the development of a teaching style aimed at stimulating the active role of the student, at fostering a learning process based…

Quality Communication in Hospitality: Language Skills or Culture Transfer?

ERIC Educational Resources Information Center

Leung, Peggy; Lo, Terence

This paper focuses on English language teaching for the hospitality industry in Hong Kong, presenting a brief statement on the concept of transfer and its relevance to teaching English as a Foreign Language (EFL) for the world of work. The observable changes in the nature of language in the world of work in a service-oriented economy are…

An Exploratory Study of the Language-Learning Style Preferences of Iranian EFL High School Students

ERIC Educational Resources Information Center

Ramezani, Afsaneh Effatdokht; Dehgahi, Meysam; Hashemi, Hanie

2015-01-01

This study explored the learning style preferences of 40 Iranian students at Marefat Iranian high school in Kuala Lumpur of which, 20 are females and 20 are males. To this end, this study used structured interview to elicit in-depth information from the students. The results of the study showed that learning style preferences of Iranian students…

The Effect of High Dose Folic Acid throughout Pregnancy on Homocysteine (Hcy) Concentration and Pre-Eclampsia: A Randomized Clinical Trial

PubMed Central

Sayyah-Melli, Manizheh; Ghorbanihaghjo, Amir; Alizadeh, Mahasti; Kazemi-Shishvan, Maryamalsadat; Ghojazadeh, Morteza; Bidadi, Sanam

2016-01-01

Pre-eclampsia is a pregnancy-related multi-systemic hypertensive disorder and affects at least 5% of pregnancies. This randomized clinical trial aimed at assessing the effect of low doses and high doses of folic acid on homocysteine (Hcy) levels, blood pressure, urea, creatinine and neonatal outcome. A randomized clinical trial was done at Alzahra Teaching Hospital, Tabriz University of Medical Sciences from April 2008 to March 2013. Four-hundred and sixty nulliparous pregnant women were randomly assigned into two groups. Group 1 (n = 230) received 0.5 mg of folic acid and group 2 (n = 230) received 5 mg of folic acid per daily. They were followed until delivery. Blood pressure and laboratory changes, including plasma Hcy levels, were measured and compared between the groups. Homocysteine concentrations were significantly higher at the time of delivery in group 1 (13.17±3.89 μmol/l) than in group 2 (10.31±3.54, μmol/l) (p<0.001). No statistically significant differences were observed in systolic and diastolic blood pressure (p = 0.84 and 0.15, respectively). Birth weight was significantly higher in group 2 (p = 0.031) and early abortion was significantly higher in group 1 than group 2 (p = 0.001). This study has provided evidence that a high dosage of folic acid supplements throughout pregnancy reduces Hcy concentrations at the time of delivery. Trial Registration: Iranian Registry of Clinical Trials IRCT201402175283N9 PMID:27166794

Electronic fetal monitoring: a Canadian survey.

PubMed Central

Davies, B L; Niday, P A; Nimrod, C A; Drake, E R; Sprague, A E; Trépanier, M J

1993-01-01

OBJECTIVES: To determine the current status of electronic fetal monitoring (EFM) in Canadian teaching and nonteaching hospitals, to review the medical and nursing standards of practice for EFM and to determine the availability of EFM educational programs. DESIGN: National survey in 1989. PARTICIPANTS: The directors of nursing at the 737 hospitals providing obstetric care were sent a questionnaire and asked to have it completed by the most appropriate staff member. The response rate was 80.5% (593/737); 44 hospitals did not have deliveries in 1988 and were excluded. The remaining hospitals varied in size from 8 to 1800 (mean 162.1) beds and had 1 to 7500 (mean 617.1) births in 1988; 18.8% were teaching hospitals. RESULTS: Of the 549 hospitals 419 (76.3%) reported having at least 1 monitor (range 1 to 30; mean 2.6); the mean number of monitors per hospital was higher in the teaching hospitals than in the nonteaching hospitals (6.2 v. 1.7). Manitoba had the lowest mean number of monitors per hospital (1.1) and Ontario the highest (3.7). In 71.8% of the hospitals with monitors almost all of the obstetric patients were monitored at some point during labour. However, 21.6% of the hospitals with monitors had no policy on EFM practice. The availability of EFM educational programs for physicians and nurses varied according to hospital size, type and region. CONCLUSIONS: Most Canadian hospitals providing obstetric services have electronic fetal monitors and use them frequently. Although substantial research has questioned the benefits of EFM, further definitive research is required. In the meantime, a national committee should be established to develop multidisciplinary guidelines for intrapartum fetal assessment. PMID:8485677

Culture care of Iranian immigrants in New South Wales, Australia: sharing transcultural nursing knowledge.

PubMed

Omeri, A

1997-01-01

Discovery and analysis of care meanings, expressions, and practices of Iranian Immigrants in New South Wales, Australia was the focus of this ethnonursing qualitative research. The purpose of the study was to systematically discover, describe and analyse the values, beliefs, and practices of Iranian immigrants in New South Wales, Australia. The aim of the investigation was to discover transcultural nursing knowledge to guide nurses and health professionals to provide culturally congruent nursing and health care to Iranians. Leininger's theory of Culture Care Diversity and Universality (Leininger, 1991) was used as the conceptual framework for the study. It was predicted that care meanings and expressions of Iranian immigrants would be influenced by their worldview, social structure features, language, and cultural values rooted in their long ethnohistorical past and reflected in their lifeways in Australia. Using the ethnonursing qualitative research method, key and general informants were purposefully selected among Iranian immigrants residing in New South Wales. Three care themes supported by a number of universal and some diverse patterns were identified for Iranian immigrants. The three themes were: (1) Care meant family and kinship ties (hambastegie) as expressed in daily lifeways and interactions with family, friends, and community; (2) Care as expressed in carrying out traditional urban gender roles (role-zan-o-mard) (Azadie zan) as well as in fulfilling emerging new role responsibilities related to equality for female Iranian immigrants; and (3) Care as preservation of Iranian identity (inhamoni, hamonandi) as expressed in traditional cultural events and health care practices. Leininger's (1991) three modes of actions and decisions were used to develop appropriate and culturally meaningful nursing care actions and decisions which were in harmony with the cultural beliefs of Iranian immigrants.

Iranian Expert Opinion about Necessary Criteria for Hospitals Management Performance Assessments

PubMed Central

Dadgar, Elham; Janati, Ali; Tabrizi, Jafar Sadegh; Asghari-Jafarabadi, Mohammad; Barati, Omid

2012-01-01

Background: Managers in the hospital should have enough managerial skill to be coordinated with the complex environment. Defining a competency framework assessment for hospital man-agement will help to establish core competencies for hospital managers. The aim of this study was to develop concrete and suitable performance assessment criteria using expert's view. Methods: In this qualitative study in total, 20 professionals participated in the interview and Fo¬cus Group Discussions (FGD). Two of informants were interviewed and 18 professionals par¬ticipants in three focus group discussions. Discussions and interviews were well planned, the FGD environments were suitable and after interviews completion the notes were checked with participant for completeness. Thematic analysis method was used for the analysis of qualitative data. Results: Findings from 3 FGDs and 2 semi structured interviews done with 20 professionals were categorized accordance to themes. The findings were classified in 7 major and 41 sub themes. The major themes include competency related to planning, organization and staff per-formance management, leadership, information management, and clinical governance and per-formance indicators. Conclusion: All participants had hospital administration experience; so their explanation impor¬tant in identifying the criteria and developing hospital managers’ performance assessment tool. In addition to professional perspectives and studies done in other countries, in order to design this kind of tools, it is necessary to adopt the obtained findings to the local hospital conditions. PMID:24688938

Pharmacy Information Systems in Teaching Hospitals: A Multi-dimensional Evaluation Study.

PubMed

Kazemi, Alireza; Rabiei, Reza; Moghaddasi, Hamid; Deimazar, Ghasem

2016-07-01

In hospitals, the pharmacy information system (PIS) is usually a sub-system of the hospital information system (HIS). The PIS supports the distribution and management of drugs, shows drug and medical device inventory, and facilitates preparing needed reports. In this study, pharmacy information systems implemented in general teaching hospitals affiliated to medical universities in Tehran (Iran) were evaluated using a multi-dimensional tool. This was an evaluation study conducted in 2015. To collect data, a checklist was developed by reviewing the relevant literature; this checklist included both general and specific criteria to evaluate pharmacy information systems. The checklist was then validated by medical informatics experts and pharmacists. The sample of the study included five PIS in general-teaching hospitals affiliated to three medical universities in Tehran (Iran). Data were collected using the checklist and through observing the systems. The findings were presented as tables. Five PIS were evaluated in the five general-teaching hospitals that had the highest bed numbers. The findings showed that the evaluated pharmacy information systems lacked some important general and specific criteria. Among the general evaluation criteria, it was found that only two of the PIS studied were capable of restricting repeated attempts made for unauthorized access to the systems. With respect to the specific evaluation criteria, no attention was paid to the patient safety aspect. The PIS studied were mainly designed to support financial tasks; little attention was paid to clinical and patient safety features.

Iranian Nursing Students' Experiences of Case-Based Learning: A Qualitative Study.

PubMed

Gholami, Mohammad; Saki, Mandana; Toulabi, Tahereh; Kordestani Moghadam, Parastou; Hossein Pour, Amir Hossein; Dostizadeh, Reza

The purpose of this study was to explore the experiences of undergraduate nursing students of the implementation of case-based learning in an emergency nursing course. The present qualitative study was conducted using the qualitative content analysis method. Participants consisted of 18 third year undergraduate nursing students selected through purposive sampling, which continued until the saturation of the data. Data were collected using semistructured interviews and were analyzed concurrently with their collection through the constant comparison method. The process of data analysis led to the emergence of 4 main themes, including "the continuum of knowledge from production to transfer competence," "a positive atmosphere of interaction," "the process of stress relieving," "the sense of role-playing in professional life," and the emergence of 12 subthemes signifying participants' experiences and perceptions with regard to the implementation of case-based learning (CBL) in teaching the emergency nursing course. The results of the present study showed that CBL is a stressful but pleasant and empowering experience for Iranian nursing students that develops critical thinking and stress management skills, reinforces peers' potentials, improves diagnostic abilities, and helps acquire professional competencies for use in future practices through the creation of a positive environment. Copyright © 2016 Elsevier Inc. All rights reserved.

Can teaching hospitals use serial formative OSCEs to improve student performance?

PubMed

Lien, Heng-Hui; Hsu, Sang-Feng; Chen, Shu-Chen; Yeh, Jiann-Horng

2016-10-14

We report on interns' clinical competence and experiences of an objective structured clinical examination (OSCE) training program over 3 years. We aimed to determine whether repeated formative OSCEs allow teaching hospitals to improve the effectiveness of clinical training and help interns to achieve high scores in the national summative OSCE. This study included 207 participants, among whom 82 were interns who had completed four mock OSCEs and a national OSCE at the clinical center of Cathay General Hospital (CGH). The other 125 participants were final-year medical students from Fu-Jen University who had completed the national OSCE between 2013 and 2015 at one of four teaching hospitals (including CGH). CGH interns were categorized into three groups according to the medical school attended and Fu-Jen University students were grouped according to their training hospitals. CGH held four mock OSCEs (30 stations), whereas each of the four training hospitals for Fu-Jen students each held one or two OSCEs (6-12 stations) annually. Differences in the mean OSCE scores among groups were analyzed. The medical school attended, pre-internship OSCE experience and the frequency of mock OSCEs held by training hospitals were independent factors in this study. The cumulative mean scores for five OSCEs among three groups of students trained at CGH tended to increase from the first OSCE (OSCE1) to the fifth (OSCE5). The mean score of the students who attended Fu-Jen Medical School was higher than that of students who graduated from foreign medical schools in all five OSCEs; however, the differences were significant only for OSCE2 (P = 0.022) and OSCE3 (P = 0.027). The mean national OSCE scores of FJU students showed no statistically significant differences among the four training hospitals for 2013; however, students training at CGH had significantly higher mean scores in the 2014 (P = 0.001) and 2015 (P = 0.005) OSCEs compared with students training at the other three hospitals. Serial administration of formative OSCEs by teaching hospitals enhances the performance of students on the sequential summative OSCE. Such programs provide multiple opportunities for students to practice their clinical skills, and for faculty to develop their teaching, assessment and consensus building skills.

[Investigation and analysis of status in simulation education of anesthesiology of China].

PubMed

Wang, Tian-long; Xue, Ji-xiu; Xiao, Wei; Wu, Xin-min

2010-03-09

To investigate the status of simulation education of anesthesiology in China. Five hundreds questionnaires were mailed to chairmen of department of anesthesiology in teaching hospitals in 29 provinces and autonomous regions in China. The retrieved questionnaires and data were processed and analyzed with statistics. Sixty one questionnaires were retrieved, and retrieved rate is 12.2%. The result indicated that the theory and knowledge of anesthesiology was adopted for the training of medical students and residents in 2% teaching hospitals, theory and knowledge of anesthesiology combined with problem-based learning discussion in 52% teaching hospitals, theory and knowledge of anesthesiology combined with problem-based learning discussion and simulation training in 46% teaching hospitals. The order of simulation devices possessed was as follows: Basic Life Support (BLS) (79.6%), training model for clinical anesthesia techniques (53.1%) and Advances Life Support (ALS) (51.0%). There were only six teaching hospitals utilized Human Patient Simulator for anesthesia training. The result of evaluation of simulation education showed that 91.2% anesthesiologists recognized it as applicable, 90.1% anesthesiologists recognized it as medical ethic requirement and 86.0% anesthesiologists recognized it as partly close to clinical situation. The degree of cognition of anesthesiologists to simulation education was ordered as follows: manipulation correcting ability (92.6%), procedure controllability (87.0%), training adjustability (76.0%) and patients safety (68.5%). The simulation education of anesthesiology in China is still in the preliminary period. The executive departments of education should enhance supports to the simulation education in both hard ware and in soft ware.

Facial Anthropometric Norms of the Young Iranian Population.

PubMed

Bayat, Mohammad; Shariati, Mahsa; Rajaeirad, Fatemeh; Yekaninejad, Mir Saeed; Momen-Heravi, Fatemeh; Davoudmanesh, Zeinab

2018-06-01

Facial anthropometric measurement is considered an essential concern of surgeons, orthodontists, artists and forensic scientists. The aim of this study is to investigate facial anthropometric norms of the young Iranian population. The study participants consisted of 200 healthy Iranian students (100 males, 100 females) aged 18-25 years old. Twenty-three liner and four angular measurements were investigated twice by a dentist. Independent-samples t test was used to compare indices between males and females and also between countries. A p value less than 0.05 was considered statistically significant. It was found that the mean measurements of c'-sn' of both sides, nasolabial angle, trichion-gnathion, tragion-tragion and gnathion-gnathion were statistically greater in Iranian males than in females ( p  < 0.05). Comparing Iranian anthropometric norms with North American Whites, Malays, Turkish and African American women demonstrated that there were statistically significant differences in most anthropometric measurements between Iranians and other populations ( p  < 0.05). In Iranians, mean measurements of c'-sn' of the right and left sides, nasolabial angle, trichion-gnathion, tragion-tragion and gnathion-gnathion were greater in men than in women. Comparing Iranian males and females with different ethnicities indicated several interracial differences, which should be taken into consideration when dealing with patients or also practitioners originated in this region.

CHILDREN HOSPITALIZED WITH LOWER EXTREMITY FRACTURES IN THE UNITED STATES IN 2006: A POPULATION-BASED APPROACH

PubMed Central

Gao, Yubo

2011-01-01

OBJECTIVE The purpose of this study was to examine the demographic and hospitalization characteristics of children hospitalized with lower extremity fractures in the United States in 2006. METHODS Children aged 0 to 20 years with a diagnosis of lower extremity fracture in the 2006 Healthcare Cost and Utilization Project Kids’ Inpatient Database (KID) were included. Lower extremity fractures were defined by International Classification of Diseases, 9th Revision, Clinical Modification codes 820-829 under “Injury and Poisoning (800-999).” Patient demographic and hospitalization-related data were analyzed by chi-square testing and unbalanced analysis of variance. RESULTS There were more boys than girls with lower extremity fractures and 53% had private insurance as their primary payer. About one half of the children were between the ages of 13 and 20 years, but all ages were represented from age 0 to 20. White children accounted for 56%. Urban hospitalizations accounted for 93% of cases and 66 percent of admissions were to teaching hospitals. All patients had an average length of stay (LOS) 4.04 days, and infant patients had the longest average LOS of 5.46 days. The average number of diagnoses per patient was 3.07, and the average number of procedures per patient was 2.21. The average charge per discharge was $35,236, and the oldest patients had the largest average charge of $41,907. The average number of comorbidities increased with increasing patient age. There was a 55.6% greater mortality risk in non-teaching hospitals than in teaching hospitals and there was at least ten times the mortality risk in rural hospitals than in urban hospitals. CONCLUSIONS This study provides an understanding of the demographic and hospitalization characteristics of children with lower extremity fractures in the United States in 2006. This information may be useful in implementing measures to help prevent similar injuries in the future. Further research is required to determine causality of the associations found including increased mortality risk for this population at rural and non-teaching hospitals. PMID:22096438

Children hospitalized with lower extremity fractures in the United States in 2006: a population-based approach.

PubMed

Gao, Yubo

2011-01-01

The purpose of this study was to examine the demographic and hospitalization characteristics of children hospitalized with lower extremity fractures in the United States in 2006. Children aged 0 to 20 years with a diagnosis of lower extremity fracture in the 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) were included. Lower extremity fractures were defined by International Classification of Diseases, 9th Revision, Clinical Modification codes 820-829 under "Injury and Poisoning (800-999)." Patient demographic and hospitalization-related data were analyzed by chi-square testing and unbalanced analysis of variance. There were more boys than girls with lower extremity fractures and 53% had private insurance as their primary payer. About one half of the children were between the ages of 13 and 20 years, but all ages were represented from age 0 to 20. White children accounted for 56%. Urban hospitalizations accounted for 93% of cases and 66 percent of admissions were to teaching hospitals. All patients had an average length of stay (LOS) 4.04 days, and infant patients had the longest average LOS of 5.46 days. The average number of diagnoses per patient was 3.07, and the average number of procedures per patient was 2.21. The average charge per discharge was $35,236, and the oldest patients had the largest average charge of $41,907. The average number of comorbidities increased with increasing patient age. There was a 55.6% greater mortality risk in non-teaching hospitals than in teaching hospitals and there was at least ten times the mortality risk in rural hospitals than in urban hospitals. This study provides an understanding of the demographic and hospitalization characteristics of children with lower extremity fractures in the United States in 2006. This information may be useful in implementing measures to help prevent similar injuries in the future. Further research is required to determine causality of the associations found including increased mortality risk for this population at rural and non-teaching hospitals.

A randomized controlled trial of vitamin D supplementation on perinatal depression: in Iranian pregnant mothers.

PubMed

Vaziri, Farideh; Nasiri, Samira; Tavana, Zohreh; Dabbaghmanesh, Mohammad Hossein; Sharif, Farkhondeh; Jafari, Peyman

2016-08-20

Mood disorders in pregnancy and post-partum period are common and considered as a public health issue. Researchers have studied the relationship between low serum vitamin D concentration and perinatal depression, although no clinical trial has been conducted on vitamin D's effects on depression related to childbirth. This study evaluated the effect of vitamin D3 supplementation on perinatal depression scores. This randomized clinical trial was done in pregnant women who were under prenatal care in a teaching hospital in Shiraz, Iran. The inclusion criteria were: being 18 years or older, no history of mental illness and internal diseases, a singleton live fetus, without any pregnancy complications, gestational age of 26-28 weeks upon enrollment, and depression score of 0 to 13. The Edinburgh Postnatal Depression scale was used to evaluate depression scores. A total of 169 participants were assigned to the two groups of placebo and vitamin D through block randomization design. Vitamin D group received 2000 IU vitamin D3 daily from 26 to 28 weeks of gestation until childbirth. Maternal serum 25-hydroxyvitamin D concentrations were measured at baseline and childbirth. Besides, depression scores were evaluated four times: at 26-28 and 38-40 weeks of gestation, and finally at 4 and 8 weeks after birth. The two groups were similar in relation to baseline 25-hydroxyvitamin D concentrations. However, at childbirth, the vitamin D group had significantly higher 25-hydroxyvitamin D concentration in comparison to the control group (p < 0.001). At baseline, no correlation was observed between 25-hydroxyvitamin D concentration and depression score (r = 0.13, p = 0.09). There was no significant difference between the two study groups in relation to the baseline depression score. While, the vitamin D group had greater reduction in depression scores than the control group at 38-40 weeks of gestation (p = 0.01) also, at 4 and 8 weeks after birth (p < 0.001). The present trial showed that consuming 2000 IU vitamin D3 daily during late pregnancy was effective in decreasing perinatal depression levels. We suggest further clinical trial in pregnant mothers who are at risk for postnatal depression. Iranian Registry of Clinical Trials  IRCT2015020310327N11 . Date of registration: March 9th 2015.

Impact of psychological problems in chemical warfare survivors with severe ophthalmologic complication, a cross sectional study.

PubMed

Ghaedi, Gholamhosein; Ghasemi, Hassan; Mousavi, Batool; Soroush, Mohammad Reza; Rahnama, Parvin; Jafari, Farhad; Afshin-Majd, Siamak; Sadeghi Naeeni, Maryam; Naghizadeh, Mohammad Mehdi

2012-04-12

Sulfur mustard (SM) has been used as a chemical warfare agent since the early twentieth century. Despite the large number of studies that have investigated SM induced ocular injuries, few of those studies have also focused on the psychological health status of victims. This study has evaluated the most prominent influences on the psychological health status of patients with severe SM induced ocular injuries. This descriptive study was conducted on 149 Iranian war veterans with severe SM induced eye injuries. The psychological health status of all patients was assessed using the Iranian standardized Symptom Check List 90-Revised (SCL90-R) questionnaire. The results of patients' Global Severity Index (GSI) were compared with the optimal cut-off point of 0.4 that has previously been calculated for GSI in Iranian community. The Mann-Whitney U test, T tests and effect sizes (using Cohen's d) were employed as statistical methods. Data were analyzed using SPSS software. The mean age of patients was 44.86 (SD=8.7) and mean duration of disease was 21.58 (SD=1.20) years. Rate of exposure was once in 99 (66.4%) cases. The mean GSI (1.46) of the study group was higher compared to standardized cut off point (0.4) of the Iranian community. The results of this study showed that the mean of total GSI score was higher in participants with lower educational levels (effect size=0.507), unemployment (effect size=0.464) and having more than 3 children (effect size=0.62). Among the participants, 87 (58.4%) cases had a positive psychological history for hospitalization or receiving outpatient cares previously and 62 (41.6%) cases had a negative psychological history. In addition, the mean of GSI in participants with negative psychological history was lower than those with positive psychological history (Mean Change Difference=-0.621 with SD=0.120). There was a significant difference between positive and negative psychological history with respect to GSI (P<0.001). The study showed that severe ophthalmologic complications in chemical survivors are accompanied with destructive effects on psychological health status. Appropriate management may improve psychological health status in these patients.

Welcoming and Restoring, Dwelling and Sending: Creating a Space for Hospitality in Faculty Development

ERIC Educational Resources Information Center

Larson, Marion H.

2009-01-01

Parker Palmer's (1983) often-quoted definition of teaching--"To teach is to create a space in which obedience to truth is practiced"--can be applied productively to work in faculty development. Exploring this notion is enhanced by the theological literature in hospitality, which can be viewed through Amy Oden's (2001) discussion of four movements…

Knowledge Practice and Outcome of Quality Nursing Care among Nurses in University of Calabar Teaching Hospital (UCTH)

ERIC Educational Resources Information Center

Oyira, Emilia James; Ella, R. E.; Chukwudi, Usochukwu Easter; Paulina, Akpan Idiok

2016-01-01

Objectives: The main purpose of this study was to determine knowledge practice and outcome of quality nursing care among nurses in University of Calabar Teaching Hospital (UCTH). Three research questions and one hypothesis were formulated to guide this study. Literature related to the variables under study was reviewed according to the research…

Factors Associated with Waiting Time for Breast Cancer Treatment in a Teaching Hospital in Ghana

ERIC Educational Resources Information Center

Dedey, Florence; Wu, Lily; Ayettey, Hannah; Sanuade, Olutobi A.; Akingbola, Titilola S.; Hewlett, Sandra A.; Tayo, Bamidele O.; Cole, Helen V.; de-Graft Aikins, Ama; Ogedegbe, Gbenga; Adanu, Richard

2016-01-01

Background: Breast cancer is the leading cause of cancer-related mortality among women in Ghana. Data are limited on the predictors of poor outcomes in breast cancer patients in low-income countries; however, prolonged waiting time has been implicated. Among breast cancer patients who received treatment at Korle Bu Teaching Hospital, this study…

Investigating the prevention of hospital-acquired infection through standardized teaching ward rounds in clinical nursing.

PubMed

Zhang, R

2015-04-22

This study aimed to explore the effect of standardized teaching ward rounds in clinical nursing on preventing hospital-acquired infection. The experimental group comprised 120 nursing students from our hospital selected between June 2010 and June 2012. The control group consisted of 120 nursing students selected from May 2008 to May 2010. Traditional teaching ward rounds for nursing education were carried out with the control group, while a standardized teaching ward round was carried out with the experimental group. The comprehensive application of nursing abilities and skills, the mastering of situational infection knowledge, and patient satisfaction were compared between the two groups. The applied knowledge of nursing procedures and the pass rate on comprehensive skill tests were significantly higher in the experimental group than in the control group (P < 0.05). The rate of mastery of sterilization and hygiene procedures was also higher in the experimental group than in the control group (P < 0.05). The patient satisfaction rate with infection control procedures in the experimental group time period was 98.09%, which was significantly higher than patient satisfaction in the control group time period (93.05%, P < 0.05). Standardized teaching ward rounds for nursing education expanded the knowledge of the nursing staff in controlling hospital-acquired infection and enhanced the ability of comprehensive application and awareness of infection control procedures.

Electronic implementation of national nursing standards--NANDA, NOC and NIC as an effective teaching tool.

PubMed

Allred, Sharon K; Smith, Kevin F; Flowers, Laura

2004-01-01

With the increased interest in evidence-based medicine, Internet access and the growing emphasis on national standards, there is an increased challenge for teaching institutions and nursing services to teach and implement standards. At the same time, electronic clinical documentation tools have started to become a common format for recording nursing notes. The major aim of this paper is to ascertain and assess the availability of clinical nursing tools based on the NANDA, NOC and NIC standards. Faculty at 20 large nursing schools and directors of nursing at 20 hospitals were interviewed regarding the use of nursing standards in clinical documentation packages, not only for teaching purposes but also for use in hospital-based systems to ensure patient safety. A survey tool was utilized that covered questions regarding what nursing standards are being taught in the nursing schools, what standards are encouraged by the hospitals, and teaching initiatives that include clinical documentation tools. Information was collected on how utilizing these standards in a clinical or hospital setting can improve the overall quality of care. Analysis included univariate and bivariate analysis. The consensus between both groups was that the NANDA, NOC and NIC national standards are the most widely taught and utilized. In addition, a training initiative was identified within a large university where a clinical documentation system based on these standards was developed utilizing handheld devices.

Current practice of preoperative fasting: a nationwide survey in Japanese anesthesia-teaching hospitals.

PubMed

Shime, Nobuaki; Ono, Akira; Chihara, Eiichi; Tanaka, Yoshifumi

2005-01-01

We conducted a nationwide survey to investigate the current practice of the preoperative fasting period in Japanese anesthesia-teaching hospitals. Acceptance of the clinical practice guideline published by the American Society of Anesthesiologists (ASA) was also surveyed. A written type of questionnaire was mailed to 795 teaching hospitals. The response rate of the questionnaires was 57%. Most (>90%) of the respondents had been applying a longer fasting period than the ASA-recommended minimum period specifically in adults; the median duration of fasting was 12-13 h for solids and 6-9 h for liquids. Children or infants were allowed a more liberalized fasting period, frequently being permitted an oral intake of clear fluids up to 3 h before anesthesia. The incidence of pulmonary aspiration was 1/12,500 general anesthesia cases, and application of the ASA guideline appeared not to affect the incidence. Japanese anesthesiologists were still reluctant to depart from their traditional long fasting periods, as most of them could find little benefit in reducing the fasting periods. The long preoperative fasting period is still common practice in Japanese anesthesia-teaching hospitals. A national guideline for a preoperative fasting policy is worth exploring to change the current practice.

Eliminating Residents Increases the Cost of Care.

PubMed

DeMarco, Deborah M; Forster, Richard; Gakis, Thomas; Finberg, Robert W

2017-08-01

Academic health centers are facing a potential reduction in Medicare financing for graduate medical education (GME). Both the Medicare Payment Advisory Commission and the National Commission on Fiscal Responsibility and Reform (Deficit Commission) have suggested cutting approximately half the funding that teaching hospitals receive for indirect medical education. Because of the effort that goes into teaching trainees, who are only transient employees, hospital executives often see teaching programs as a drain on resources. In light of the possibility of a Medicare cut to GME programs, we undertook an analysis to assess the financial risk of training programs to our institution and the possibility of saving money by reducing resident positions. The chief administrative officer, in collaboration with the hospital chief financial officer, performed a financial analysis to examine the possibility of decreasing costs by reducing residency programs at the University of Massachusetts Memorial Medical Center. Despite the real costs of our training programs, the analysis demonstrated that GME programs have a positive impact on hospital finances. Reducing or eliminating GME programs would have a negative impact on our hospital's bottom line.

The effect of transfers between health care facilities on costs and length of stay for pediatric burn patients.

PubMed

Myers, John; Smith, Michael; Woods, Charles; Espinosa, Claudia; Lehna, Carlee

2015-01-01

Hospitals vary widely in the services they offer to care for pediatric burn patients. When a hospital does not have the ability or capacity to handle a pediatric burn, the decision often is made to transfer the patient to another short-term hospital. Transfers may be based on available specialty coverage for children; which adult and non-teaching hospitals may not have available. The effect these transfers have on costs and length of stay (LOS) has on pediatric burn patients is not well established and is warranted given the prominent view that pediatric hospitals are inefficient or more costly. The authors examined inpatient admissions for pediatric burn patients in 2003, 2006, and 2009 using the Kids' Inpatient Database, which is part of the Healthcare Cost and Utilization Project. ICD-9-CM codes 940 to 947 were used to define burn injury. The authors tested if transfer status was associated with LOS and total charges for pediatric burn patients, while adjusting for traditional risk factors (eg, age, TBSA, insurance status, type of hospital [pediatric vs adult; teaching vs nonteaching]) by using generalized linear mixed-effects modeling. A total of n = 28,777 children had a burn injury. Transfer status (P < .001) and TBSA (P < .001) was independently associated with LOS, while age, insurance status, and type of hospital were not associated with LOS. Similarly, transfer status (P < .001) and TBSA (P < .001) was independently associated with total charges, while age, insurance status, and type of hospital were not associated with total charges. In addition, the data suggest that the more severe pediatric burn patients are being transferred from adult and non-teaching hospitals to pediatric and teaching hospitals, which may explain the increased costs and LOS seen at pediatric hospitals. Larger more severe burns are being transferred to pediatric hospitals with the ability or capacity to handle these conditions in the pediatric population, which has a dramatic impact on costs and LOS. As a result, unadjusted, pediatric hospitals are seen as being inefficient in treating pediatric burns. However, since pediatric hospitals see more severe cases, after adjustment, type of hospital did not influence costs and LOS. TBSA and transfer status were the predictors studied that independently affect costs and LOS.

A comparative study of the costliness of Manitoba hospitals.

PubMed

Shanahan, M; Loyd, M; Roos, N P; Brownell, M

1999-06-01

In light of ongoing discussions about health care policy, this study offered a method of calculating costs at Manitoba hospitals that compared relative costliness of inpatient care provided in each hospital. This methodology also allowed comparisons across types of hospitals-teaching, community, major rural, intermediate and small rural, as well as northern isolated facilities. Data used in this project include basic hospital information, both financial and statistical, for each of the Manitoba hospitals, hospital charge information by case from the State of Maryland, and hospital discharge abstract information for Manitoba. The data from Maryland were used to create relative cost weights (RCWs) for refined diagnostic related groups (RDRGs) and were subsequently adjusted for Manitoba length of stay. These case weights were then applied to cases in Manitoba hospitals, and several other adjustments were made for nontypical cases. This case mix system allows cost comparisons across hospitals. In general, hospital case mix costing demonstrated variability in hospital costliness, not only across types of hospitals but also within hospitals of the same type and size. Costs at the teaching hospitals were found to be considerably higher than the average, even after accounting for acuity and case mix.

31 CFR 560.512 - Iranian Government missions in the United States.

Code of Federal Regulations, 2010 CFR

2010-07-01

... to, the Iranian Interests Section of the Embassy of Pakistan (or any successor protecting power) in... United States, and to employees of the Iranian Interests Section of the Embassy of Pakistan (or any...

Perceived cultural attitudes toward homosexuality and their effects on Iranian and American sexual minorities.

PubMed

Mireshghi, Sholeh I; Matsumoto, David

2008-10-01

This study examined the relationship between three mental health constructs and perceived cultural attitudes toward homosexuality among lesbian, gay, and bisexual individuals. Specifically, differences in perceived cultural attitudes and depression, self-esteem, and perceived stress between 49 Iranians and 47 Americans were compared. It was hypothesized that (a) perceived cultural attitudes toward homosexuality would be more negative among Iranians than Americans; (b) perceived cultural attitudes would be related to depression, self-esteem, and perceived stress; and (c) that Iranian participants' scores on the depression, self-esteem, and perceived stress measures would reflect poorer mental health than that of their American counterparts. Results indicated more negative perceptions of cultural attitudes toward homosexuality among Iranians. Contrary to prediction, however, no difference was found in levels of depression, self-esteem, and perceived stress among American and Iranian participants. Findings are discussed in terms of cultural and familial differences with regard to sexual orientation disclosure.

Menorrhagia Management in Iranian Traditional Medicine.

PubMed

Tansaz, Mojgan; Memarzadehzavareh, Hajar; Qaraaty, Marzieh; Eftekhar, Tahereh; Tabarrai, Malihe; Kamalinejad, Mohammad

2016-01-01

Menorrhagia is a common problem. Medical management for menorrhagia includes hormonal and nonhormonal treatments. These treatments have different side effects, which reduce quality of life. Complementary and traditional medicines have been used to handle menorrhagia for centuries in many cultures. There is a lot of information and data in Iranian traditional documents or books about medicinal herbs that are used by Iranian traditional medicine scientists for the treatment of menorrhagia. The aim of this study was to review the approaches to menorrhagia in Iranian traditional medicine texts. In this study, some main Iranian traditional medicine manuscripts including Canon of Medicine and Al-Havi of Rhazes were studied to extract important information about menorrhagia management. Iranian traditional medicine physicians have relied on an organized system of etiological theories and treatments for menorrhagia. Their methods for menorrhagia management may be able to convince the desire of many women to preserve their uterus and avoid hormonal therapy. © The Author(s) 2015.

Defining teaching hospitals' GME strategy in response to new financial and market challenges.

PubMed

Wray, J L; Sadowski, S M

1998-04-01

The authors present an overview of current graduate medical education (GME) issues, particularly the financial challenges to teaching hospitals resulting from the Balanced Budget and Tax Payer Relief Acts of 1997 and other recent market-driven factors. They describe in detail the nature of Medicare GME payments before and after the 1997 legislation, with specific examples, and explain the negative financial impact of the legislation and aspects of the legislation that are designed to alleviate that impact. Other factors influencing GME program size and composition are also discussed, including oversupplies or shortages of physicians, the concern that teaching hospitals are using public funds to train international medical graduates, changing training requirements, etc. The authors also describe a recent consulting assignment during which they assisted a major teaching hospital to develop a GME strategy that was responsive to the organization's mission and patients and that took into account future GME financing challenges. Detailed explanations are given of how the consultants analyzed the hospital's GME programs and finances, developed and ranked key institution-specific program criteria (strategic, organizational and operational, and financial), and, in consultation with all key stakeholders, formulated a GME strategy specific to the institution's needs. The authors conclude by cautioning that each institution's GME strategy will be different, but that it is important for institutions to develop such strategies to better face future challenges.

Predictors of job satisfaction among academics at an Iranian university.

PubMed

Zarafshani, Kiumars; Alibaygi, Amir Hossein

2009-04-01

The overall job satisfaction of 128 faculty of Razi University in Iran was investigated using a modified version of the Minnesota Satisfaction Questionnaire to elicit information in this stratified random sample. Faculty members were most satisfied with intrinsic aspects of the work such as "social service," "activity," and "ability utilization" and less satisfied with extrinsic aspects of work such as "security," "university policies," and "compensation." Publication counts and years of teaching experience contributed significantly to the prediction of overall job satisfaction among these faculty members. Intervention efforts must involve socializing faculty in the early stages of their careers, encouraging them to engage in research activities and write for reputable journals, while providing compensation and job security.

The experience of Iranian entrepreneurial nurses on the identification of entrepreneurial opportunities: A qualitative study

PubMed Central

Jahani, Simin; Abedi, Heidarali; Khoshknab, Masoud Fallahi; Elahi, Nasrin

2018-01-01

Background: To respond to the growing and emerging needs of the people in the health sector, the nurses need to develop their working domain from the hospitals to the community and be prepared to provide entrepreneurial roles at different care levels. Thus, to discover how to identify entrepreneurial opportunities in the field of nursing entrepreneurship, a study was conducted with the aim of describing the experiences of Iranian entrepreneurs on the identification of proper opportunities in entrepreneurship. Materials and Methods: This study was a qualitative research in which the Graneheim and Lundman's content analysis was used to collect and analyze the data. Thirteen entrepreneurial nurses were purposefully selected, and the data were collected by unstructured interviews. Results: As a result of data analysis, three main themes were obtained including the resources for opportunity identification and opportunity assessment and identification of proper opportunities. Conclusion: The findings indicate how to identify entrepreneurial opportunities in the field of health by entrepreneurial nurses which is the first step in the entrepreneurial process. Therefore, the findings of this study can be used to educate nurses who are interested in entering the field of nursing entrepreneurship.

Occupational risk of bladder cancer among Iranian male workers

PubMed Central

Aminian, Omid; Saburi, Amin; Mohseni, Hossein; Akbari, Hamed; Chavoshi, Farzaneh; Akbari, Hesam

2014-01-01

Background: Approximately 5-10% of human cancers are thought to be caused by occupational exposure to carcinogens. Compare to other cancers, bladder cancer is most strongly linked to occupational exposure to chemical toxins. This study has been performed to understand which occupations and exposures are related to bladder cancer in Iran. Materials and Methods: This study is a case-control study which is conducted on cases with bladder cancer (160 cases) diagnosed in Baharlou hospital in 2007-2009. One hundred sixty cases without any occupational exposure were considered as controls matched for demographic characteristics. Demographic data and characteristics of occupation were compared. Results: Mean age of cases and controls were 63.7 and 64 years, respectively (P = 0.841). History of urinary tract stone had significantly difference in two groups (P = 0.039). Occupations such as bus and truck driving, road and asphalt making, mechanics, working in refinery and Petrochemical, plastic, metal manufactory, welding, and pipeline founded a higher risk for bladder cancer rather than controls. Conclusion: Our findings on Iranian workers are concurrent and compatible with findings of previous reports about occupational and environmental risk factors of bladder cancer. Although our study population was PMID:24833825

Association of nutritional status with quality of life in breast cancer survivors.

PubMed

Mohammadi, Shooka; Sulaiman, Suhaina; Koon, Poh Bee; Amani, Reza; Hosseini, Seyed Mohammad

2013-01-01

Nutritional status and dietary intake play a significant role in the prognosis of breast cancer and may modify the progression of disease. The aim of this study was to determine the influence of nutritional status on the quality of life of Iranian breast cancer survivors. Cross-sectional data were collected for 100 Iranian breast cancer survivors, aged 32 to 61 years, attending the oncology outpatient clinic at Golestan Hospital, Ahvaz, Iran. Nutritional status of subjects was assessed by anthropometric measurements, Patient-Generated Subjective Global Assessment (PG-SGA) and three non-consecutive 24-hour diet recalls. The European Organization of Research and Treatment of Cancer Quality of Life form (EORTC QLQ-C30) was used to assess quality of life. Ninety-four percent of the survivors were well-nourished, 6% were moderately malnourished or suspected of being malnourished while none were severely malnourished. Prevalence of overweight and obesity was 86%. Overall, participants had an inadequate intake of vitamin D, E, iron and magnesium according to dietary reference intake (DRI) recommendations. Survivors with better nutritional status had better functioning scales and experienced fewer clinical symptoms. It appears important to provide educational and nutritional screening programs to improve cancer survivor quality of life.

Job stress dimensions and their relationship to musculoskeletal disorders in Iranian nurses.

PubMed

Barzideh, M; Choobineh, A R; Tabatabaee, H R

2014-01-01

There is little data available on job stress dimensions and their relationship to musculoskeletal disorders (MSDs) among Iranian nurses. The objectives of this study were to investigate job stress dimensions and examine their relationship to MSDs among nurses of Shiraz University of Medical Sciences (SUMS) hospitals. In this cross-sectional study, 385~randomly selected nurses of SUMS participated. The Persian version of Job Content Questionnaire (P-JCQ) and Nordic MSDs questionnaire were used for data collection. Descriptive statistics and Mann-Whitney U test were applied for data analysis. Decision latitude and social support dimensions had low levels, but psychological and physical job demands as well as job insecurity dimensions had high levels among the nurses. 89.9% of the subjects experienced some form of MSDs during the last 12 months. Lower back symptoms were the most prevalent problem reported (61.8%). Physical isometric loads was the only sub-scale that had significant relationship with MSDs. In the majority of cases, subjects were exposed to high levels of job stress. MSDs prevalence was high. Based on the results, any interventional program for MSDs prevention should focus on reducing physical and psychological job demands as well as increasing decision latitudes.

Clinical teaching and learning within a preceptorship model in an acute care hospital in Ireland; a qualitative study.

PubMed

McSharry, Edel; Lathlean, Judith

2017-04-01

A preceptorship model of clinical teaching was introduced to support the new all-graduate nurse education programme in Ireland in 2002. Little is known about how this model impacts upon the pedagogical practices of the preceptor or student learning in clinical practice leading to question what constitutes effective teaching and learning in clinical practice at undergraduate level. This study aimed to explore the clinical teaching and learning within a preceptorship model in an acute care hospital in Ireland and identify when best practice, based on current theoretical professional and educational principles occurred. A qualitative research study of a purposively selected sample of 13 students and 13 preceptors, working together in four clinical areas in one hospital in Ireland. Methods were semi-structured interviews, analysed thematically, complemented by documentary analysis relating to the teaching and assessment of the students. Ethical approval was gained from the hospital's Ethics Committee. Preceptor-student contact time within an empowering student-preceptor learning relationship was the foundation of effective teaching and learning and assessment. Dialoguing and talking through practice enhanced the students' knowledge and understanding, while the ability of the preceptor to ask higher order questions promoted the students' clinical reasoning and problem solving skills. Insufficient time to teach, and an over reliance on students' ability to participate in and contribute to practice with minimal guidance were found to negatively impact students' learning. Concepts such as cognitive apprenticeship, scaffolding and learning in communities of practice can be helpful in understanding the processes entailed in preceptorship. Preceptors need extensive educational preparation and support to ensure they have the pedagogical competencies necessary to provide the cognitive teaching techniques that foster professional performance and clinical reasoning. National competency based standards for preceptor preparation should be developed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Decentralization and hospital pharmacy services: the case of Iranian university affilliated hospitals.

PubMed

Ashna Delkhosh, Reza; Ardama, Ali; Salamzadeh, Jamshid

2013-01-01

The aim of this study was to evaluate the satisfaction rate of hospital managerial/clinical teams (HMCTs) including principles (chief executives), managers, supervisor pharmacists and head nurses from services presented by private sectors directing 10 pharmacy departments in hospitals affiliated to Shahid Beheshti University of Medical Sciences. This study is an observational and descriptive study in which a questionnaire containing 16 questions evaluating the satisfaction of the HMCTs from private sectors, and questions about demography of the responders was used for data collection. Collected data was applied to assign a satisfaction score (maximum 64) for each respondent. SPSS 17.0 and Microsoft Office Excel 2007 were used for statistical description and analysis of these information (where applicable). Overall, 97 people in charge of the hospitals (HMCTs) entered the study. The average satisfaction score was 26.38 ± 6.81 with the lowest satisfaction rate observed in Mofid children specialty hospital (19.5%) and the highest rate obtained for Imam Hussein (p.b.u.h) general hospital (65.3%). Generally, 59% of the HMCTs believed that the function of the private sector in the pharmacy of hospitals is satisfactory. Assuming that the satisfaction scores under 75% of the total obtainable score (i.e. 48 out of 64) could not be considered as an indicator of desired pharmacy services, our results revealed that the status of the services offered by private sectors are far behind the desired satisfactory level.

Effects of resident duty hour reform on surgical and procedural patient safety indicators among hospitalized Veterans Health Administration and Medicare patients.

PubMed

Rosen, Amy K; Loveland, Susan A; Romano, Patrick S; Itani, Kamal M F; Silber, Jeffrey H; Even-Shoshan, Orit O; Halenar, Michael J; Teng, Yun; Zhu, Jingsan; Volpp, Kevin G

2009-07-01

Improving patient safety was a strong motivation behind duty hour regulations implemented by Accreditation Council for Graduate Medical Education on July 1, 2003. We investigated whether rates of patient safety indicators (PSIs) changed after these reforms. Observational study of patients admitted to Veterans Health Administration (VA) (N = 826,047) and Medicare (N = 13,367,273) acute-care hospitals from July 1, 2000 to June 30, 2005. We examined changes in patient safety events in more versus less teaching-intensive hospitals before (2000-2003) and after (2003-2005) duty hour reform, using conditional logistic regression, adjusting for patient age, gender, comorbidities, secular trends, baseline severity, and hospital site. Ten PSIs were aggregated into 3 composite measures based on factor analyses: "Continuity of Care," "Technical Care," and "Other" composites. Continuity of Care composite rates showed no significant changes postreform in hospitals of different teaching intensity in either VA or Medicare. In the VA, there were no significant changes postreform for the technical care composite. In Medicare, the odds of a Technical Care PSI event in more versus less teaching-intensive hospitals in postreform year 1 were 1.12 (95% CI; 1.01-1.25); there were no significant relative changes in postreform year 2. Other composite rates increased in VA in postreform year 2 in more versus less teaching-intensive hospitals (odds ratio, 1.63; 95% CI; 1.10-2.41), but not in Medicare in either postreform year. Duty hour reform had no systematic impact on PSI rates. In the few cases where there were statistically significant increases in the relative odds of developing a PSI, the magnitude of the absolute increases were too small to be clinically meaningful.

The Teaching Nursing Home: Past Accomplishments and Future Directions.

ERIC Educational Resources Information Center

Lipsitz, Lewis A.

1996-01-01

Discusses the past, present, and future of the use of nursing homes as teaching sites. Suggests that teaching nursing homes must provide state-of-the-art care while avoiding the pitfalls that threaten academic hospitals; balance must be maintained between the benefits of teaching and the burdens placed on patients and staff. (JOW)

42 CFR 412.624 - Methodology for calculating the Federal prospective payment rates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... defined in § 412.602. (4) Adjustments for teaching hospitals. For discharges on or after October 1, 2005... facilities that are teaching institutions or units of teaching institutions. This adjustment is made on a... location, and for teaching programs) as specified by CMS. The additional payment equals 80 percent of the...

42 CFR 415.206 - Services of residents in nonprovider settings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Services of Residents § 415.206 Services... equivalency residents in the calculation of a teaching hospital's resident count. The teaching physician rules on carrier payments in §§ 415.170 through 415.184 apply in these teaching settings. (b) Physician fee...

42 CFR 415.160 - Election of reasonable cost payment for direct medical and surgical services of physicians in...

Code of Federal Regulations, 2010 CFR

2010-10-01

... medical and surgical services of physicians in teaching hospitals: General provisions. 415.160 Section 415... TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.160 Election of reasonable cost payment for direct medical and surgical services of physicians in teaching...

Population-based incidence and cost of non-fatal injuries in Iran: a consistent under-recognized public health concern.

PubMed

Hafezi-Nejad, Nima; Rahimi-Movaghar, Afarin; Motevalian, Abbas; Amin-Esmaeili, Masoumeh; Sharifi, Vandad; Hajebi, Ahmad; Radgoodarzi, Reza; Hefazi, Mitra; Eslami, Vahid; Karimi, Hasti; Saadat, Soheil; Mohammad, Kazem; Rahimi-Movaghar, Vafa

2015-05-01

To investigate the incidence and determinants of non-fatal injuries, and the cost imposed on victims in an Iranian population aged 15-64 years. Cross-sectional household survey. Three-stage probability sampling was conducted for selection of a representative sample of Iranians. Data on the demographics, history and cost of injury were obtained from face-to-face interviews and telephone calls. In total, 7886 subjects were included in this study. The annual incidence rate of all injuries was 905 (95% confidence interval 853-957) per 1000 population (approximately nine injuries per ten Iranians). The mean (±standard error) incidence rates of first aid injuries (FAIs; medical care not required) and medical-attended injuries (MAIs; medical treatment sought) were 737 ± 24 and 168 ± 12 per 1000 population, respectively. Young, urban females were at highest risk for FAIs, and single males were at highest risk for MAIs. The most common injury description was as follows: non-paid work (activity), home (place), inanimate mechanical force (mechanism), upper limb (site of injury) and open wound (type of injury). For MAIs, the most common place of treatment was hospital. Traffic-related injuries had the highest total cost and the lowest out-of-pocket cost. Total and out-of-pocket costs of non-fatal injuries in Iran in 2011 have been estimated to be US$6,111,138,000 and US$1,480,411,000, respectively. Non-fatal injuries are an under-recognized public health problem. Cost-control policies are essential to reduce the out-of-pocket cost of injuries. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Prevalence and Prognosis of Cerebrovascular Accidents and its Subtypes Among Patients with Systemic Lupus Erythematosus in Isfahan, Iran: A Hospital Clinic-based Study.

PubMed

Saadatnia, Mohammad; Sayed-Bonakdar, Zahra; Mohammad-Sharifi, Ghasem; Sarrami, Amir Hossein

2014-01-01

The aim of the present study was to determine the prevalence and prognosis of cerebrovascular accident (CVA) and its subtypes among Iranian patients with systemic lupus erythematosus (SLE). In a cross-sectional study, medical records of 575 SLE patients were reviewed. The patients developing CVA in their course of disease were extracted. In these patients, data about demographic features, lupus anti bodies, duration of the disease until CVA, CVA manifestation(s) and follow-up duration were gathered. In the next step, patients with any kinds of CVA were summoned to Neurology clinic to identify the grade of disability in each patient with CVA. We identified 38 patients with CVA of which 6 (15.8%) were men and 32 (84.2%) were women. The most common subtype of CVA was small vessels thrombosis (21.05%) among the study patients and hemi paresis was the most prevalent initial presentation (39.47%). In 11 (28.9%) patients, SLE was initiated with CVA and in 3 (7.9%) patients CVA had happened in the 1(st) year of SLE. Anti-phospholipid antibodies (APLA) were positive in 29 (76.3%) patients. Mean modified Rankin Scale in patient with positive and negative serology for APLA was 0.93 ± 1.11 and 0.22 ± 0.66 respectively (P = 0.006). Our study shows that 6.6% of Iranian SLE patients have CVA during their course of the disease. Small vessels thrombosis is the most common CVA subtype and hemi paresis is the most prevalent initial presentation. Moreover, we showed that the prognosis of CVA in Iranian SLE patients is not unfavorable.