Universities Of Medical Sciences In Iran Research Articles

The Attitude of Healthcare Providers and the General Population on the Concept of Do-Not-Resuscitate (DNR) Order in End-Stage Patients

Background: The do-not-resuscitate (DNR) order in end-stage patients constitutes a critical medical decision, directing healthcare providers to withhold cardiopulmonary resuscitation (CPR) in the event of cardiopulmonary arrest upon the patient's request. Objectives: This study aims to analyze the attitudes of healthcare providers and the general population toward the concept of DNR orders in end-stage patients. Methods: Conducted from September 2021 to May 2022, this cross-sectional study aimed to gauge the attitudes of healthcare providers and the general population toward DNR orders in end-stage patients using a questionnaire assessing attitudes toward DNR. The research population included healthcare providers—physicians and nurses—from healthcare centers affiliated with Iran University of Medical Sciences, selected through convenience sampling, and the general population comprising individuals frequenting parks near these healthcare centers within the relevant municipal districts. Results: Among the 164 participating healthcare providers, 139 (84.8%) were female. Participants' ages ranged from 21 to 57 years, with an average age of 36.78 ± 7.79 years. The study found that healthcare providers had a significantly higher average attitude score toward DNR (29.85 ± 9.46) compared to the general population (27.08 ± 9.78). Healthcare providers with adequate financial status exhibited a more positive attitude toward DNR in end-stage patients compared to those with excellent or poor economic status (P = 0.001). Additionally, the relative frequency of individuals experiencing a poor prognosis of disease was significantly lower among healthcare personnel than the general population (P = 0.018). Healthcare providers without family members or friends in their end-stage of life demonstrated a more favorable attitude toward DNR for these patients (P = 0.001). Conclusions: The study revealed that healthcare providers exhibited a significantly more positive attitude toward DNR compared to the general population. Furthermore, healthcare providers experienced a lower relative frequency of individuals facing a poor prognosis of disease compared to the general population. However, the relative frequency of experiencing family members or friends in the end stage did not significantly differ between healthcare providers and the general population. Healthcare providers with less than 2 years or more than 20 years of experience in the medical field demonstrated a more positive attitude toward DNR.

Knowledge, Attitude, and Practice (KAP) Status toward Clinical Reasoning and Evidence-Based Medicine among the Medical Interns and Gynecology Residents of Iran University of Medical Sciences.

Clinical reasoning and evidence-based medicine (EBM) are important concepts in modern medicine. We performed this study to investigate the knowledge, attitude, and practice (KAP) status toward clinical reasoning and EBM among the medical interns and gynecology resident physicians of Iran University of Medical Sciences and related factors. A cross-sectional study (Tehran, Iran, first half of 2022) was conducted based on two researcher-made questionnaires consisting of three components for each including clinical reasoning attitude (CR-A), clinical reasoning knowledge (CR-K), clinical reasoning practice (CR-P), EBM attitude (EBM-A), EBM knowledge (EBM-K), and EBM practice (EBM-P). The related factors were age, gender, educational level, score of general practice education, having research experience, and general practice experience. A total of 60 individuals participated. The mean score was good for CR-A, moderate for CR-K, moderate for CR-P, good for EBM-A, moderate for EBM-K, and moderate for EBM-P. The total score was moderate in both clinical reasoning and EBM. Among the related factors, CR-P was associated with higher educational levels and having experience in general practice (P < 0.05). Research experience was associated with better CR-K and all KAP components for EBM (P < 0.05). The total score and many of the KAP components had moderate status for clinical reasoning and EBM. Planning on the associated factors should be regarded in the future. Such questionnaires are suggested to be validated for use in quasi-experimental studies.

Microfluidic sperm sorting selects a subpopulation of high-quality sperm with a higher potential for fertilization.

Is a microfluidic sperm sorter (MSS) able to select higher quality sperm compared to conventional methods? The MSS selects sperm with improved parameters, lower DNA fragmentation, and higher fertilizing potential. To date, the few studies that have compared microfluidics sperm selection with conventional methods have used heterogeneous study population and have lacked molecular investigations. The efficiency of a newly designed MSS in isolating high-quality sperm was compared to the density-gradient centrifugation (DGC) and swim-up (SU) methods, using 100 semen samples in two groups, during 2023-2024. Semen specimens from 50 normozoospermic and 50 non-normozoospermic men were sorted using MSS, DGC, and SU methods to compare parameters related to the quality and fertilizing potential of sperm. The fertilizing potential of sperm was determined by measurement of phospholipase C zeta (PLCζ) and post-acrosomal sheath WW domain-binding protein (PAWP) expression using flow cytometry, and the chromatin dispersion test was used to assess sperm DNA damage. In both normozoospermic and non-normozoospermic groups, the MSS-selected sperm with the highest progressive motility, PLCζ positive expression and PLCζ and PAWP fluorescence intensity the lowest non-progressive motility, and minimal DNA fragmentation, compared to sperm selected by DGC and SU methods (P < 0.05). The major limitations of our study were the low yield of sperm in the MSS chips and intentional exclusion of severe male factor infertility to yield a sufficient sperm count for molecular experiments; thus testing with severe oligozoospermic semen and samples with low count and motility is still required. In addition, due to ethical considerations, at present, it was impossible to use the sperm achieved from MSS in the clinic to assess the fertilization rate and further outcomes. Our research presents new evidence that microfluidic sperm sorting may result in the selection of high-quality sperm from raw semen. This novel technology might be a key to improving clinical outcomes of assisted reproduction in infertile patients. The study is funded by the Iran University of Medical Sciences and no competing interest exists. N/A.

Performance Evaluation of Hospitals under Data Uncertainty: An Uncertain Common-Weights Data Envelopment Analysis.

In the context of healthcare systems, the performance evaluation of hospitals plays a crucial role in assessing the quality of healthcare systems and facilitating informed decision-making processes. However, the presence of data uncertainty poses significant challenges to accurate performance measurement. This paper presents a novel uncertain common-weights data envelopment analysis (UCWDEA) approach for evaluating the performance of hospitals under uncertain environments. The proposed UCWDEA approach addresses the limitations of traditional data envelopment analysis (DEA) models by incorporating the uncertainty theory (UT) to model the inherent uncertainty in input and output data. Also, by utilizing a common set of weights (CSW) technique, the UCWDEA method provides a more robust and reliable assessment of hospital performance. The main advantages of the proposed UCWDEA approach can be succinctly summarized as follows. Firstly, it allows for the comparison of all hospitals on a consistent basis to calculate a realistic efficiency score, rather than an overly optimistic efficiency score. Secondly, the uncertain common-weights DEA approach exhibits linearity, enhancing its applicability. Thirdly, it possesses the capability to extend its utility under various other prevalent uncertainty distributions. Moreover, it enhances the discriminatory power of results, facilitates the ranking of hospitals in the presence of data uncertainty, and aids in identifying the sensitivity and stability levels of hospitals towards data uncertainty. Notably, in order to showcase the pragmatic application and efficacy of the uncertain common-weights DEA model, a genuine dataset has been utilized to evaluate the efficiency of 20 public hospitals in Tehran, all of which are affiliated with the Iran University of Medical Sciences. The results of the experiment demonstrate the efficacy of the UCWDEA approach in assessing and ranking hospitals amidst uncertain conditions. In summary, the research outcomes can offer policymakers valuable insights regarding hospital performance amidst data uncertainty. Additionally, it can provide practical recommendations on optimizing resource allocation, benchmarking performance, and formulating effective policies to augment the overall efficiency and effectiveness of healthcare services.

Experiences of students on virtual education in Iranian medical science universities during the COVID-19 pandemic: A qualitative study.

Due to the changing environment and responding to the needs of the society, change in the traditional education system is inevitable. Also, the occurrence of events such as the COVID-19 pandemic showed that the existence of a virtual education system to prevent the cessation of education is the need of today's society. This study aimed to investigate the students' experiences of virtual education in Iranian universities of medical sciences during the COVID-19 pandemic. This qualitative study was conducted on 28 students studying in Iranian universities of medical sciences from October 2021 to January 2022 to investigate their experiences of virtual education during the COVID-19 pandemic. The participants were selected by purposive sampling. An interpretive phenomenological approach and semi-structured, face-to-face, in-depth interview were used to collect the data. The data were analyzed by Colizzi's seven-step method. Students' experiences of virtual education during the COVID-19 pandemic were categorized into three themes and seven sub-themes, including the strengths of virtual education (sub-themes: individual and educational dimensions), the weaknesses of virtual education (sub-themes: infrastructural, educational, tests and assignments fields), and suggestions to improve education virtual (sub-themes: infrastructural development and educational planning). According to the study results, the virtual education during the COVID-19 pandemic led to students staying away from the crowded centers. However, some weaknesses were also mentioned by the participants. Therefore, by anticipating requirements and needs, planning and policy making, and seriously reviewing human, financial, and support resources, virtual education can be developed and used as a supplement to face-to-face education in the future.

Implementation of thyroid eye disease registry in Iran: rationale and research protocol.

To describe the implementation of a registry system for patients with thyroid eye disease (TED) in Iran to obtain more information about its nature, prevalence, and annual incidence, as well as extend insight into the etiology, pathogenesis, and eventually make an accurate prognosis of different medical or surgical treatment methods. After receiving approval from the Disease Registry Committee of Iran University of Medical Sciences (IUMS) in 2019 and the Ministry of Health and Medical Education (MOHME) in 2020, the protocol was introduced in three consecutive phases at regional, provincial and national levels. The establishment of a registry committee in Rassoul Akram Hospital, one of the medical centers affiliated to IUMS, was the first step to organizing the registry project's main core. The steering committee included six subgroups of required subject fields. The members are experts in developing a guideline, providing a new dataset, drawing an outline for the next steps, and structuring user-friendly software through several panel discussion meetings. The data is collected from clinical and para-clinical/imaging findings, laboratory evaluations, and their selected treatment strategy, retrospectively and prospectively. The purpose is to broaden our knowledge about the profile of TED; accordingly, data related to patients' demographics, thyroid gland disease (status, duration, treatments, and function tests), general medical and ocular history, along with visual/ocular exams resulting TED status are collected and recorded in a 2- language software. The web-based software system is accessible at https://orc.iums.ac.ir . To maintain data security, prioritized user access was defined for different members. Furthermore, diverse methods, such as employing trained staff and utilizing software validation rules, were implemented to control data quality in every step of data collection, entry, and registration. Medical records of retrospective subjects were also evaluated and entered after accuracy verification. Iran's TED registry provides practitioners with comprehensive data on natural history and phenotype variations in clinical features and outcomes. It facilitates patient recruitment and, consequently, earlier diagnosis on a large scale which helps improve treatment and quality of life for patients.

A psychometric evaluation of inter-professional education competency tool in nursing and medicine students

IntroductionCollaboration between nurses and doctors is necessary for offering care to patients. Using team performance assessment tools and surveying them can be effective in promoting inter-professional collaboration, and the lack of a credible tool to assess inter-professional collaboration competency between the two groups is a major challenge in the healthcare sector. The present study aimed to translate and conduct a psychometric investigation on the inter-professional education collaboration (IPEC) tool for the students of medicine and nursing.MethodsThe present study was a cross-sectional one conducted as a psychometric investigation of the IPEC tool at the Iran University of Medical Sciences in 2022. The initial tool contained 42 items developed according to a 5-point Likert scale, which was translated into Persian with the consent of the original researcher. The validity index and the content validity ratio were investigated by a panel of 11 specialists in medical and clinical education, and its construct validity was evaluated using confirmatory factor analysis. Also, the second population of the study included medical and nursing students of Iran University of Medical Sciences and simple random sampling method. Moreover, the reliability of the instrument was investigated using internal consistency, Cronbach’s Alpha, and test–retest methods.ResultsBased on the indicators calculated to perform a psychometric investigation over the above tool, it had acceptable reliability and validity according to the specialists. The tool evaluates inter-professional collaboration competency between the students of medicine and nursing across four areas (values and ethics, roles and responsibilities, inter-professional communication, and team-based care and teamwork). Moreover, Cronbach’s Alpha coefficient for the tool was determined at 0.84.ConclusionThe results of the study showed that the above tool could evaluate inter-professional competency as a valid and reliable questionnaire, and its results could be utilized in planning and education.

Why do people get burned? Qualitative analysis of the causes of burns in a large survey of burn survivors

BackgroundUnderstanding the national epidemiology of burns is necessary for effective planning of prevention and treatment services. However, epidemiological studies of burns have often focused on short-term and retrospective investigations of a specific group of burned patients in Iran. Therefore, we conduct a comprehensive study from August 2016 to October 2017, in the Burn Research Center of Iran University of Medical Sciences on approximately 1700 hospitalized burn patients at Motahari Hospital to identify the underlying causes of burns. In this study, an open-ended question was asked about how the burn occurred in the patients. The current study was designed and conducted for the qualitatively analyzing of the responses to this question, using the content analysis method, in order to maximize its use in policymaking and prevention. MethodsContent analysis of written responses to open-ended questions was done as a part of a large questionnaire survey. This survey was conducted by face-to-face interview at a national referral center for burn injuries. ResultsAnswers from 1595 patients were coded and the underlying causes of injury were categorized into three themes and 43 subthemes. These underlying causes were lack of knowledge and awareness, inappropriate equipment, and inevitable accidents. The underlying cause of lack of knowledge and awareness had the highest proportion in causing burns in both men and women. The most common subthemes in descending order included lack of skills, dangerous actions, improper location of hot liquids, individual mistakes, and improper use of flammable materials. The top five subthemes with the highest average percentage of burn in patients in descending order were deficiency of residential equipment, self-immolation, accidents, inappropriate location of flammable materials, and unsafe kitchen appliances. ConclusionThe focus of prevention programs on educating and increasing awareness of individuals, preferably women, is suggested. Educational programs, tailored to occupational standards and workplace and household equipment, are recommended for men in work environments.

Comparing the Familiarity of the Basic and Clinical Faculty Members of Iran University of Medical Sciences with the Principles of Digital Professionalism.

Due to the changing conditions of education, research, and treatment in the world, especially the recent pandemic, and more use of virtual space, there is a need for evaluation of digital professionalism in faculty members as the most influential people who have a direct and deep impact on the next generation. In this analytical cross-sectional study that was conducted in 2023 on 149 faculty members of Iran University of Medical Sciences, they were invited to participate in the study through various methods (SMS, E-mail, and media messages). The link to the Persian standardized questionnaire was made available for participants. If a person received less than 70% of the score in each area, he/she would receive solutions to improve his/her situation in that area at the end of answering the questions. The self-administered questionnaire has 5 fields and 33 questions. Maximum scores were 10 points. Spearman and Pearson correlation coefficients and statistical tests consisting of chi-square, t-test, Mann-Whitney U, one-way ANOVA, and Kruskal-Wallis H were used in the analysis. The mean overall score of people in principles of digital professionalism was 0.8. Women and basic sciences faculties had a significantly better status than men and clinical faculties in the principles of digital professionalism as a whole (P = 0.001 and P = 0.049, respectively). The domain of "knowledge management and information literacy" had significantly lower scores in professors in comparison with other degree (instructors, assistant professors, and associate professors (P = 0.039). The mean score of the principles of digital professionalism is acceptable at 80%. Coherent, timely, and up-to-date training to ensure the effective, safe and appropriate use of digital technology, especially for men, professors and clinical faculty members who had a lower score than others, should be done.

The experiences of Persian medicine students of Iran University of Medical Sciences in ambulatory education: a qualitative study

The experiences of Persian medicine students of Iran University of Medical Sciences in ambulatory education: a qualitative study

The Group-based Compassion-focused Intervention on Academic Procrastination, Anxiety, and Quality of Life of University Students: A Controlled Trial With 3-month Follow-up

Objectives Procrastination is one of the critical issues for university students and is associated with various psychological problems. This study examined the effectiveness of group compassion-focused intervention on procrastination, anxiety, and quality of life of (QoL) university students. Methods This research is an experimental study of clinical trial type. The study participants were 40 students of Iran University of Medical Sciences selected by a convenience sampling method. After obtaining informed consent, they completed the demographic questionnaire; academic procrastination questionnaire; depression, anxiety, and stress scale-21 (DASS-21); and personal wellbeing index–adult (PWI-A), before, immediately after, and three months after the intervention. The experimental group received eight 120-minute sessions of group compassion-focused therapy once a week, while the control group received no intervention. The data were compared using GLM repeated measures analysis of variance (GLMRM). Results Regarding procrastination, there is no significant difference between the average preparation for assignments and the tendency to change people›s procrastination at different evaluation times. However, the interaction effect of time and group has a significance level smaller than 0.05, indicating a significant difference between the average preparation for the tasks of the experimental and control groups at different evaluation times (F=4.439, P=0.043). The effect size of 0.115 indicates a moderate effect. There is also a significant difference between the procrastination tendency of the experimental and control groups at different evaluation times (F=8.348, P=0.007). The effect size of 0.197 indicates a moderate effect. Also, there is a significant difference between the experimental and control groups› average anxiety (F=35.62, P=0.000) and quality of life (F=14.57, P=0.001) at different evaluation times. The size of the effect indicates its strength. Conclusion Group compassion-focused intervention can be used as an effective therapy in working with students. However, more studies are needed to examine and compare other variables with other evidence-based treatments.

Evaluating Primary Healthcare Quality from Migrants and Refugees' Viewpoint.

The likelihood of poor health outcomes for refugees is increased due to a variety of complicated causes. Lack of access to high-quality care during resettlement is frequently cited by migrants. Therefore, this study was carried out to assess the quality of primary care services from the perspective of refugees and migrants. This cross-sectional study was conducted in three health networks affiliated with Iran University of Medical Sciences in 2021. Data were collected by using a self-administrative questionnaire, the validity and reliability of which were checked and confirmed. The questionnaires were randomly completed by 280 migrants and refugees. Data were analyzed by using Kruskal-Wallis, Mann-Whitney U, Spearman correlation, exploratory factor analysis, and Cronbach's α with SPSS 22. According to the results, the overall service quality was 3.86 out of 5. The highest and lowest mean scores were related to efficiency (4.12 ±0.64) and tangibility (3.28 ±0.39). Furthermore, there was a significant relationship between the perception of service quality and gender, education, residence area, and the rate of center visits (P < 0.05). The quality of services was generally rated favorably by the refugees. Managers and decision-makers are recommended to allocate enough funds to equip and upgrade the amenities at health centers to increase the quality of services.

Designing an Evaluation Form for Professors in Iranian Universities of Medical Sciences in 2022

Designing an Evaluation Form for Professors in Iranian Universities of Medical Sciences in 2022

Molecular Investigation of Occult Hepatitis B Virus Infection Among Patients with Liver Cancers

Background: Hepatitis B virus (HBV) is still the leading cause of hepatocellular carcinoma (HCC). HBV could persist in the low replicate state that is defines as occult hepatitis B virus infection (OBI). Recently, OBI has been defined important in the development and/or exacerbation of HCC and other liver diseases. Objectives: This study tried to determine the frequency of OBI among liver tumor samples. Methods: This cross-sectional study was performed among patients with HCC and intrahepatic cholangiocarcinoma (iCCA) in hospitals affiliated with Iran University of Medical Sciences. Liver tumor samples (Fresh frozen and formalin fixed paraffin embedded) were processed for isolation of DNA and then subjected to molecular assays, including PCR examinations of HBV genes (S, X, and C), determination of viral loads, detection of HBV-cccDNA, phylogenetic analysis, and assessment of mutations in HBsAg and RT regions. Results: In total, there were 93 participants, including HCC (n = 60), iCCA (n = 33); among which, 15% were detected positive for OBI. The OBI among HCC and iCCA were 18.3% and 9.1%, respectively. The mean intrahepatic viral load was 1.3 × 105 ± 1.4 × 102 copies/µl, and 5 had detectable cccDNA. The OBI subjects belonged to the HBV genotype D and subgenotype D1. In the HBsAg protein, T45N (33.3%) and P105A (25%) were the most prevalent mutations. N53K (33.3%), Y54H (25%), L80I (33.3%), and A113G (25%) were missense mutations that were observed in the RT domain. Conclusions: HBV-DNA was detected among liver tumor samples with negative HBsAg status. The results of viral load and cccDNA tests are important in identification and prognosis of liver diseases. It’s needed more precise molecular and cohort studies to clarify the functions of OBI in liver diseases.

Estimating Out-of-Pocket Payments Among Iranian Women with Breast Cancer

Background: Breast cancer is the most common type of cancer among Iranian women with more than 10 000 cases per year. Objectives: This study aimed at determining out-of-pocket (OOP) payments among women with breast cancer at health care centers affiliated to Iran University of Medical Sciences. Methods: This descriptive cross-sectional and applied study was done among 336 women with breast cancer referring to hospitals affiliated to Iran University of Medical Sciences. The data on inpatient expenses were obtained from the cost bills and the outpatient was collected, using a researcher-made questionnaire. Finally, the data were analyzed, using SPSS V2 software. Results: The average monthly OOP payment for direct hospitalization costs in inpatient breast cancer patients was estimated 146 ± 47.98 dollars and the average OOP payment for direct costs of treatment in outpatients was 69 ± 102.99 dollars, and the average OOP payment for non-medical direct cost per month 34.88 ± 31.12 dollars. The results of this study showed the average OOP payment included drug costs with the rate of 37.99 ± 45.31 dollars imposed the highest medical direct costs. Among the non-medical direct costs of OOP payment for transportation, the average of 30.65 ± 103.23 dollars imposed the highest OOP payment on breast cancer patients. Conclusions: These findings show that individuals with breast cancer endure high OOP payments that could adversely affect their quality of life; hence, decision-makers should pay more attention to implementing proper policies.

Psychometric evaluation of Maastricht clinical teaching questionnaire based on the cognitive apprenticeship model.

The Maastricht Clinical Teaching Questionnaire is a valid and reliable instrument for measuring the quality of clinical teaching. This study was aimed at translation and psychometric evaluation of the Persian version of this questionnaire to evaluate clinical teaching based on the cognitive apprenticeship model. The translation of the questionnaire was performed according to Guillemins framework. Reliability was examined by calculating Cronbach's alpha coefficient. Confirmatory factor analysis was studied among 120 medical students. Content validity was assessed by calculating the content validity index and content validity ratio. Face validity was evaluated by conducting interviews with students using concurrent verbal probing and thinking aloud. Cronbach's alpha coefficient for the whole scale was 0.95. The content validity index was 0.92, and the content validity ratio was 0.82. Confirmatory factor analysis resulted in a seven-factor model and demonstrated an adequate fit with the data. The Persian version of the Maastricht Clinical Teaching Questionnaire with seven factors including modeling, coaching, scaffolding, articulation, reflection, exploration, and learning environment appears to be a valid and reliable instrument for the evaluation of clinical teaching in Iranian universities of medical sciences.

Significance of the Pretreatment Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Predicting the Response to Neoadjuvant Chemotherapy and Survival Rates in Extremity Osteosarcoma: A Multicentre Prospective Study

Objectives We aimed to assess the effects of pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios on the response to neoadjuvant chemotherapy and survival rates in patients with extremity osteosarcoma. Patients and methods Patients with high-grade osteosarcoma admitted to oncologic centers affiliated with Iran University of Medical Sciences, Tehran, Iran from 2015 to 2021 were evaluated retrospectively to assess the impact of complete blood count-related parameters on the pathologic response after neoadjuvant chemotherapy. Then, patients were followed up prospectively to evaluate the survival rates. All patients received at least three cycles of cisplatin/doxorubicin regimen, preoperatively. In this study, the cut-off values for high neutrophil-to-lymphocyte and high platelet-to-lymphocyte ratio were considered 3.28 and 128, respectively. Results One hundred eighty-six patients were enrolled. Patients with high neutrophil-to-lymphocyte ratio and high platelet-to-lymphocyte ratio had a significantly lower overall survival rates (20.7 [95% CI 18–23.5] month vs. 34.6 [95% CI 33.2–36], p = 0.003 and 21.9 [95% CI 20.2–23.6] month versus 35.3 [95% CI 33.9–36.7], p = 0.002; respectively). Moreover, disease-free survival of patients with high platelet-to-lymphocyte ratio was worse than patients with low platelet-to-lymphocyte ratio (20.4 [95% CI 18.4–22.4] month vs. 32.7 [95% CI 30.8–34.7], p = 0.02). Conclusion Our study showed that neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios at the baseline can predict the survival of patients with high-grade osteosarcoma.

Effect of ABO blood group on postoperative overall survival and recurrence-free survival rate in patients with hepatocellular carcinoma after hepatectomy: a multi-center retrospective cohort study

BackgroundHepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. The survival rate after hepatectomy as the first line of treatment for HCC depends on various factors. This study evaluated the association of the ABO blood group and Rh with overall survival (OS) and Recurrence-free survival (RFS) rate after hepatectomy.MethodsThis multicenter retrospective cohort study reviewed the medical files of 639 HCC patients who underwent hepatectomy from 2010 to 2022 in three medical centers affiliated with the Iran University of Medical Sciences. Patient data, including demographic, clinical, tumor characteristics, and post-surgery outcomes, were collected by referring to the patient’s medical profiles. The Cox proportional hazard investigated the relationship between ABO blood group type and OS and RFS rate after hepatectomy.ResultsThe five-year OS and RFS rates were 25.4% and 18.7%, respectively. The five-year OS (Lok rank:40.89, P:0.001) and RFS rate in patients with blood type A were significantly lower than in non-A patients. (Lok rank:10.8, P:0.001) The multivariate Cox analysis showed that blood type A, age < 45 years, tumor size > 5 cm, Poor tumor differentiation, presence of metastasis, The number of involved lymph nodes ≤ 2, and serum Alpha-Fetoprotein)AFP( level ≥ 400 were significantly related to the decreased survival rate of HCC patients after hepatectomy (P < 0.05) There was no significant association between Rh with OS and RFS (P > 0.05).ConclusionBlood group type A, compared to non-A, can be associated with decreased OS and RFS rates in patients with HCC after hepatectomy.

The Trends of Attitude Change and Interprofessional Collaboration Competencies among Medical and Nursing Students of Iran University of Medical Sciences.

Nurses' and physicians' collaboration is a precedent for patient care. This study examined attitude change and interprofessional collaboration competencies among medical and nursing students of Iran University of Medical Sciences. This study was quantitative cross-sectional. The study tools were two questionnaires, Attitudes Toward Interprofessional Education and IPEC Interprofessional Collaborative Competencies, which were completed by 211 medical and nursing students in online or in-person forms. The collected quantitative data were analyzed by SPSS 19 software. The results showed that nurses and physicians constituted 35.5% and 64.5% of the sample. The results of the independent T-test displayed no statistically significant difference in the mean age of both groups (P = 0.054). There was a statistically significant difference in the participants' attitudes toward interprofessional learning, and the medical group (46.68) obtained a higher mean score than the nurse group (34.92) (P = 0.001). The two groups with varying mean scores (179.34 for medical students and 131.72 for nursing students) were significantly different in their interpersonal collaboration competencies (P = 0.001). Considering Mauchly's test, there were statistically significant differences among medical students of varying academic years in their attitudes toward interprofessional education (P < 0.001). Nursing students were also different in their attitudes toward interprofessional education based on their academic years. The results of this study showed that the attitude of nursing students towards interprofessional education and interpersonal collaboration competencies should be increased in line with medical students in order to improve the quality of medical and health services.

Investigating the Effect of the 7S Technique on Performance Management and Productivity of Operating Room Staff: An Interventional Study

Background: One of the most important issues in a health care system is the performance management and productivity of employees. Sigma technique is a quality improvement method, which has proved effective in many organizations and has recently been used in the health care system, especially in the operating room. The aim of this study was to investigate the effect of the Seven Sigma technique (7S) on performance management and productivity of operating room staff in selected educational and medical centers of Iran University of Medical Sciences. Methods: In this interventional research, the study population consisted of 45 operating room staff including technicians, technologists, and surgeons. Before the intervention, a WhatsApp channel was created to gather group members. Then, over the course of three weeks, the principles of the Seven Sigma technique were gradually sent to the research population, and participants were asked to carefully review the materials. Every three days, after posting a question in the channel to ensure understanding of the previous topic, the next section was also posted in the channel. Then, after three weeks, a productivity questionnaire was sent to the research population, and using a researcher-made checklist, the performance of the employees was evaluated. Standard statistical methods were used to analyze the data in SPSS version 22.0. Results: From a total of 45 staff, 62% were women and 38% were men. The majority of subjects (36%) were between 24 and 28 years old. The majority of personnel (89%) had a university degree in operating room, and most of them (84%) had a bachelor’s degree. Most of the staff (91%) worked rotating shifts during the month. There was a significant difference between the pre-test and post-test mean scores of performance management (P&lt;0.001). There was also a significant difference between the pre-test and post-test mean scores of productivity (P&lt;0.001). Conclusion: The findings indicated the effectiveness of the 7S technique in performance management and productivity of the staff. Therefore, the relevant authorities are requested to increase performance management using the 7S technique to reduce defects and problems limiting the efficiency of personnel in the operating room. This method can also be practical and useful for other wards of hospitals.