mohammad reza maleki

The transition of hospitals from non-teaching to teaching institutions has been increasing in recent years. This study aimed to investigate the key processes involved in this transition.

This research was conducted using a mixed-methods qualitative approach. The first step involveddocument analysis, the multiple voting technique, and scenario and process development. The second step employed a comparative qualitative study using data extraction tables.

In the first step, 195 processes were identified, and after prioritization, 19 were selected. Then, 67 documents were reviewed to categorize the content related to each type of hospital. Workstations and flowcharts were compared, leading to the identification and mapping of seven new processes introduced by the addition of the teaching mission, as well as the strengthening of 12 existing processes. The changes include the involvement of new personnel in activities, an increase in the number of process steps and processes, and a greater number of individuals responsible for executing these steps. Also, the complexity of teaching processes increases due to clinical training, requiring the simultaneous presence of students and medical staff.

Considering the involvement of new personnel and the changes in the number and variety of responsible individuals, special attention should be given to employee resistance, potential conflicts, and both individual and group communication. The doubling and prolonging of processes require careful consideration of hospital performance, patient satisfaction, and the clinical training of future healthcare professionals. The simultaneous presence of students and medical staff highlights the need for increased supervision and attention to patient safety and quality. Two key processes from the total reviewed processes are related to patient acceptance and assignment, making it crucial to focus on these as the first point of contact and key communication channels for providing services and preventing quality and performance gaps, based on the findings of this study.

The present study aimed to determine and compare the weight gain patterns of Iranian and Afghan pregnant women and investigate their relationship with neonatal anthropometric features.

In this descriptive-analytical study, the health profiles of randomly selected Iranian and Afghan pregnant women referred to health centers in Semnan city, Iran, were reviewed. Data were collected following the guidelines recommended by the Institute of Medicine (IOM). Neonatal anthropometric measures were evaluated based on the reference values issued by the Iranian Ministry of Health (MOH). A statistical significance level of P < 0.05 was considered.

The average age of Afghan mothers was 27.36 ± 5.46 years, while that of Iranian mothers was 29.13 ± 5.44 years. The average weight gain during pregnancy was slightly lower in Afghan mothers (OR = -0.88, 95% CI: 0.82 - 0.94). Although the average weight gain in both groups and the percentiles of neonatal anthropometric measures were within permissible limits, a regression model indicated that weight gain during pregnancy significantly affected neonatal birth weight only in Iranian mothers (β = -0.313, P ≤ 0.001). Logistic regression analysis revealed no significant difference in the impact of maternal weight gain on neonatal anthropometric measures between the Iranian and Afghan mothers.

The findings of this study suggest that nationality (i.e., Iranian or Afghan) does not influence maternal weight gain or neonatal anthropometric measures. The establishment of guest houses and training programs, such as Behbakhsh initiatives for Afghan women, appears to have been effective in ensuring equitable access to health services for Afghan immigrants.

Jaundice is a common condition in newborns caused by bilirubin accumulation, which can lead to severe complications, including brain damage. This study aimed to identify risk factors for severe jaundice requiring blood transfusion, as such procedures carry potential risks.

Data were reviewed for 3,266 infants admitted for jaundice at Quds Hospital in Qazvin from 2017 to 2022, of whom 49 required blood transfusions. Information was collected from medical records and maternal questionnaires.

Among the 49 infants, 66% were male, 36% were preterm, and 49% were firstborn. The most common maternal blood type was O+ (20 cases), while A+ was the most frequent blood type among infants (21 cases). Notably, 71.4% of cases involved blood type incompatibility between the infant and mother. Delivery methods included 32 vaginal births and 17 cesarean sections. G6PD deficiency was present in 18% of the infants, and 78% of parents had no familial relationship.

ABO incompatibility was the primary cause of blood transfusion (19.94%), followed by Rh incompatibility (6.1%) and G6PD deficiency (5%). These findings highlight the importance of identifying and managing risk factors for severe jaundice to minimize the need for blood transfusion and its associated risks.

It has always been argued that countries should not be inactive about the quality of health services. Therefore, a clear policy needs to be created regarding how quality of health services should be. The present scoping review was aimed to identify and map the available evidence regarding the National Quality Policy and Strategy (NQPS) of the health services in health systems of developing countries, graphically and tabularly. We followed the published methodological guidance of the Joanna Briggs Institute reviews. Also, we employed a narrative thematic synthesis integrated with the systematic analysis using the World Health Organization’s approach of NQPS, and the multiple‑streams framework of Kingdon. We included 33 records that met the inclusion criteria; these records were published between 2010 and 2019. Meanwhile, government documents were the most frequent records (61%). Zimbabwe, Indonesia, and Sudan were the most frequent locations (each one 8%). The Ministry of Health was in charge of the ultimate responsibility for developing the NQPS in all identified countries. Besides, 82% of the countries were in the development phase of NQPS formulation, and convergence of three streams was observed in Indonesia, Sudan, and Tanzania. It seems that the African countries were informed about their quality issues, and the need for having NQPS have been more popular with them. We recommend that future research focuses on examining NQPS in terms of prioritizing in the agenda‑setting phase of the policy‑making cycle, and also, document analysis of all identified NQPS based on the core eight interdependent elements related to the NQPS approach.

Context: Our world is characterized by a dynamic landscape of variations, complexities, uncertainties, and ambiguities (VUCA). These elements manifest in various domains, including politics, economics, communication, information, science, and research, all of which significantly impact our lives. It is crucial for policymakers and managers to adopt a forward-thinking approach to comprehend these VUCA elements and their implications for the future. The future will undoubtedly differ from the present and the past. However, humans possess an inherent desire to understand and anticipate the future, particularly in the face of uncertainty. Therefore, exploring and understanding the future is not just a curiosity, but a necessity. Futures Studies can serve as a valuable tool in this context, enabling us to efficiently leverage opportunities and resources to navigate the chaotic environment. Review studies play a pivotal role in this process by reviewing existing work and synthesizing knowledge in a specific field. This study aims to collate findings related to the key concepts of Futures Research, thereby contributing to our collective understanding and preparation for the future.

The present study investigated how a general hospital is restructured in Iran when transforming from a non-teaching into a teaching hospital.

This applied study was conducted based on a mixed-method design from 2020 to 2021 using a systematic search and review, document analysis, comparative and cross-sectional design, multiple voting technique, and qualitative phenomenological method.

The conceptual framework of the components of a hospital as a system includes inputs (governance and policy-making, goals and mission, clinical and support departments, physical space, clients, and human resources), processes (internal and external relations, key processes, type and level of services, and teaching mission systematization), and outputs (performance evaluation, internal and external customer satisfaction, human capital empowerment, organizational behavior, income-cost management, cost-effectiveness and efficiency, service quality, and legal and social responsibility).

The findings from the present study depicted how the components of teaching and non-teaching hospitals are restructured when changing their functions. Restructuring an established organization, such as a hospital, is very challenging and requires multiple changes. This study had some implications including highlighting the need to formulate protocols for restructuring non-teaching hospitals into teaching hospitals or constructing new teaching hospitals, classifying teaching hospitals and clarifying their differences, focusing on the teaching mission in hospitals, and reviewing and updating the integration of medical education in providing health services.

Sigmund Freud speaks of repressive civilization in opposition to Marxists' optimism in building a governance system with the least amount of pain and suffering. Freud examines this repression in the two fields of genesis and genesis type. In the individual field and by analyzing the triple mental apparatus, he mentions the substitution of the principle of reality instead of the principle of pleasure and postponement in instincts. In the field of genesis, with the rebellion of the children against the first father and his murder, a feeling of guilt is created and the moral seed of suppressing instincts sprouts. In this article, with a descriptive-analytical method, we will examine Freud's claim that "civilization is based on the repression of instincts" from the perspective of Shahid Motahari and we will show that in the eyes of the master of Shahid, not only nature-based civilization will not bring repression, but Human society, history and culture are moving towards a single civilization because the category of nature is deposited in the human nature and essence of all human beings, and humans and, accordingly, societies, cultures and civilizations, are moving towards that. They will be in motion, which human nature tends to, as a result, the repressive phenomenon is not inherent to civilization or culture, but rather a temporary thing arising from the role and place of instinct in civilization, as well as the element of "external necessity".

Measuring the seed and fertilizer mass flow rate in drill delivery tubes is an essential tool for real-time monitoring of the application rates. In the present study, a non-contact capacitance measuring system was implemented to monitor the granular discharge rate in seed and fertilizer applicators. The set-up consisted of a fluted-roller feeding mechanism and the capacitance measuring system incorporated in the discharge tube. The set-up was mounted on a custom-built vibratory stand to simulate the field condition during the measurement. Then, triple super phosphate, wheat, and alfalfa granular discharge rates were measured over 30 s intervals in both static and dynamic conditions from 3.42±1.22 to 19.3±0.95 g/s in 5 rates, from 2.55±0.23 to 19.02±0.86 g/s in 8 rates, and from 0.42±0.02 to 1.6±0.08 g/s in 7 rates, respectively. The results revealed that the mass flow was effectively correlated with sensor signals for all examined materials. However, the capacitance sensor failed to measure the sudden change in mass flow rate synchronously with the digital scale. This phenomenon was predictable because it is attributed to the feature of a digital balance, which is always accompanied by an initial lag. Also, the results revealed that the vibrating stand had no effect on the sensor accuracy.

The social security is one of achievements of development and business activists bear an important part of burden of economic development. Hence, in long term both sectors (the social security and business activists)would encounter some problems. This issue necessitates the interaction between them. The purpose of this study is to recognize challenges of the interaction relying on entrepreneurs’ viewpoints. Experts in social security field and business activists were interviewed. The qualitative data were analyzed. The findings show that the main challenges for interacting with the social security organization are as follows: weakness of processes related to incorporation of a company, problems related to present list of insurance, lack of unity in procedure and transparency in calculating insurance premiums for contractual agreements, weakness of processes and structures related to insurance inspection, lack of enough attention to branches and votes by boards, reconsideration of votes by Administrative Court of Justice, weakness of administrative, financial, and legal structures and process of account settling. Therefore, it has been tried to consider both exogenous and endogenous factors in solutions.

The article’s aim is to analyze the interaction of internal and external factors of sustainable development in the free zones of Iran. In other words, identifying the most important internal factors affecting the improvement of external factors and vice versa is considered. For this purpose, the relationships between internal and external factors of sustainable development in the free zones of Iran are analyzed through the analysis of the correlation structure between them. For the success of organizations in a dynamic and changing environment, managers must strive to improve processes and sustainability. Also, in the process of sustainable development, the impact of internal and external factors of sustainability should be examined and analyzed. Based on the importance of free zones in the country's economy, the issue of sustainable development of these zones needs to be considered from different angles and using scientific methods. Given that the multiple relationships between internal and external factors and the direct relationship between internal and external factors, the sustainable development of free zones has not been done with each other, and closing this gap is a necessity. Because, external factors of sustainable development are not within the authority of free zones and depend on organizations, companies and communities. Neglecting the impact of these factors on domestic factors can lead to more costs in achieving sustainable development of free zones. For this purpose, in this study, the relationships between internal and external factors are examined and analyzed to finally achieve sustainable development of free zones based on accurate information and analysis of various aspects to achieve the best achievement at the lowest cost in sustainable development of these zones.

The main method is the canonical correlation analysis method. Using questionnaires containing questions related to internal and external indicators, which are prepared in the form of a five-point Likert option, experts answer it in an online survey. The collected data from internal and external factor questionnaires are analyzed using SPSS 24 software. Then, canonical correlation analysis is performed to study the correlation between internal and external factors of sustainable development of free zones. This canonical correlation is made for the study between two data sets that include seven internal factors in the first set and four external factors in the second set. The statistical population of this study consists of specialists and professors of Payame Noor University and 184 randomly selected statistical sample participated.

After performing the canonical correlation analysis method, the findings related to the correlation between canonical variables, the proportion of variance of internal and external factors explained by the first and second set canonical variables, canonical factor loads, and canonical cross-factor loads were obtained. The results, based on the Fisher test show that the correlation of three pairs of canonical variables among the four possible pairs is confirmed at the significance level of 0.05. The correlation of the first canonical pair is equal to 0.994 with a specific value of 9.039. Also, the correlations of the second and the third canonical pair are equal to 0.705 and 0.659, respectively, with special values of 0.989 and 0.767. The calculated values show that 90, 49.7 and 43.4% of the variance in the canonical variables related to external (internal) factors are explained by the canonical variables related to internal (external) factors, respectively. The set of canonical variables related to internal factors represents 65.9% of the sample dispersion of the sample of internal factors, while the three identified canonical variables related to external factors cover 93% of the sample dispersion of the sample of external factors. Also, the proportion of variance of the canonical variables of the first group to the total dispersion of the four external factors was equal to 46.3%, while 69.3% of the variance of the seven internal factors is explained by the canonical measures of the second set.

The results show that the proportion of variance in the set of internal factors that is explained by the canonical variables of the first set is less than the proportion of variance identified in the set of external factors that is explained by the canonical variables of the second set. Also, the proportion of variance of the four external factors explained by the canonical variables of the first set is less than the proportion of variance of the seven internal factors covered by the canonical variables of the second set. Based on the calculated factor load values, it was shown that the canonical variables of the first set generally have significant factor loads with all internal factors, including 1) welfare and services, 2) support and regulation, 3) pollution control, 4) protection and prevention 5) Productivity, 6) green operation and 7) infrastructure and facilities. Similarly, it was observed that the values of the factor load of the second set, canonical variables on all four external factors, including 1) culture building, 2) environmental measures, 3) knowledge and communication, and 4) local community support are significant. In this context, the internal factors of "welfare and services" and the external factors of "culturalization" have the most factor factors with the canonical variables of the first and second categories, respectively. The calculated values for cross-factor loads showed that changes in the four internal factors "welfare and services", "support and regulation", "green operation" and "infrastructure and facilities" will have the greatest effect on canonical variables derived from external factors. In addition, cross-factor loads are significant for all external factors other than "knowledge and communication", the largest of which is related to the "culture-building" factor. In general conclusion, it can be said that internal and external factors of sustainable development of free zones significantly affect each other.

Every year, a significant part of fruit and vegetable products is lost due to the country's inappropriate transportation systems and storage facilities. The waste of strawberry and apple products in Iran is estimated at 40% and 31%, respectively; which can be considered as a source of biomass in bioenergy production. Despite the good biogas production potential, fruit waste requires pretreatment due to lignocellulosic matter to reduce biological decomposition time. This research investigated the effect of mechanical, chemical and thermal pretreatments on the degradability of fruit waste and the amount of biogas production from its co-digestion with cow manure. Mechanical pretreatment was by crushing apple and strawberry waste into pieces of 5, 10 and 15 mm, chemical pretreatment was by placing fruit waste in sodium hydroxide solution (NaOH) at concentrations of 6, 8 and 10% for 3 hours and heat treatment was done by putting waste together with distilled water inside the microwave at 800 watts for 10, 20 and 30 minutes. The pretreated wastes were co-digested with cow manure and were fed into the batch digesters under anaerobic digestion conditions for 25 days. The results showed that the pretreatments of crushing, sodium hydroxide and the microwave increased biogas production compared to the control by 5%, 50.9% and 27.3%, respectively. Chemical pretreatment can be suggested as a preferred method of pretreatment of the identified wastes.

Ascites is a prominent example of the pathophysiological interaction between the heart and lungs in broilers. Previous experiments have shown that the amount of apoptosis increases in heart failure and pulmonary hypertension. In the current study, the effect of vitamin C on apoptosis was investigated by measuring the expression of the CASP3 gene in the heart and lungs of chickens with ascites. For this purpose, 90 one-day-old meat-type chickens were divided into three groups (sham (basal diet), control (basal diet +1.5 mg/kg of triiodothyronine (T3)), and treatment group (basal diet + 1.5 mg/kg of T3 + 1200 ppm of vitamin C)) and bred for 49 days. On the 21st and 49th days after rearing, 15 chickens from each group were selected randomly, and the right ventricle/ total ventricle weight ratio (RV/TV), as well as the expression level of CASP3 genes in the lung and right ventricle of all groups were measured and compared. The amount of mRNA related to CASP3 gene at the age of 21 and 49 days demonstrated a meaningful decrease in the treatment group compared to the control group (P<0.05). This significant difference indicates the reduction of apoptosis in the group treated with vitamin C. Also, RV/TV as an index of the induction of this syndrome improved in the treatment group at the age of 21 and 49 days (P<0.05). Finally, according to the current study's findings, vitamin C has ameliorating effects in treating ascites in meat-type chickens.

Students can play an effective role in protecting the environment by changing environment-related beliefs and strengthening responsibility and self-efficacy. The use of behavior change models is a reasonable approach to identifying psychological factors effective on pro-environmental behavior (and is an undeniable necessity before designing cognitive-behavioral interventions. The current study aimed to determine the variables affecting pro-environmental behaviors in elementary school students in Qazvin City using the theory of planned behavior (TPB).

Using a multi-stage sampling method, 184 fifth- and sixth-grade students of public elementary schools participated in a cross-sectional study in 2022-2023. The data collection tool was a self-report questionnaire including demographic information, a knowledge scale, and a 20-item questionnaire to assess pro-environmental behaviors and TPB-related subscales. The data were analyzed using LISREL 8.80 software and statistical tests, such as the Chi-square test, independent T-test, one-way ANOVA, Pearson correlation, and path analysis at a significant level of less than 0.05.

The status of some behaviors, such as warning about environmental issues, controlling the ambient temperature, using public transportation, and the pattern of watching TV programs were inappropriate. The strongest correlation coefficient was reported between knowledge and attitude (r=0.675, P<0.05) and the weakest between subjective norms and behavior (r=0.235, P<0.01). Moreover, perceived behavioral control (β=0.49, P<0.05) and attitude (β=0.31, P<0.05) formed the most important constructs affecting intention, and 66.7% and 28.5% of the variance of pro-environmental intentions and behaviors was explained by TPB, respectively.

The TPB is considered a suitable and logical theoretical framework for understanding and evaluating psychological variables effective on pro-environmental behavior in students. It is recommended to focus on attitude and perceived behavioral control in designing educational interventions to encourage pro-environmental behaviors.

The rapidly changing world, necessitates new demands which forces the governments to change the game in terms of policies to support entrepreneurs to fasten the development of new technologies in response to the needs. The success rates of the policies are monitored and reported by GEM. Iran’s entrepreneurship development indicators have a downward trend in recent years. This study is conducted to analyze the content of Iran's entrepreneurship development policies to uncover the weaknesses for policymaker.

Quantitative and qualitative content analysis of Iran’s entrepreneurship development policies (2016) is the focus of our criticism; using the basic theory of the global alphabet model of entrepreneurship as our target. The data is analyzed by Max QDA 2020 software.

The regulatory policies in Iran's entrepreneurship development document are not consistent with the global alphabet model of entrepreneurship quantitatively and qualitatively. The most attention has been paid to behavior instead of perception and attitude and no policy has been formulated in the field of entrepreneurial intention, innovation for production of goods and qualified services.

There is an asymmetry in dealing with entrepreneurial ecosystem which is probably one of the most important causes of our failure and breakdown.

Context:

 Growing needs mandates economic growth. Entrepreneurship policies play a significant role in achieving productive employment and sustainable development for the health and wealth of society. Aims: This study is conducted to find the accordance of this document with the basic theory of the global alphabet model of entrepreneurship on the one hand and a comparison to the real entrepreneurial and economic achievements as social determinants of health (SDOH) on the other hand.

Methods and Material: 

This research is a quantitative and qualitative content analysis of entrepreneurship documents in the health sector of Iran, using the basic theory of the global alphabet model as our target. We reviewed the Work Bank and Global Entrepreneurship Monitor (GEM) reports as world indicators to compare whether our entrepreneurship policies have been successful.

Statistical Analysis: 

MAXQDA is a software program designed for computer-assisted qualitative and mixed methods data, text and multimedia analysis in academic, scientific, and business institutions.

Results:

 The findings showed that the retelling of the word employment is more dominant than entrepreneurship. Imbalanced attention is paid to the components of the standard global alphabet model, and a downhill regression is seen in almost all aspects of entrepreneurial results.

Conclusions: 

The written health policies have not been effective in promoting the development of health by wealth.

This article develops an integrated model of transmitting strategies and operational activities to enhance the efficiency of supply chain management. As the second objective, this paper aims to improve supply chain performance management (SCPM) by employing proper decision-making approaches. The proposed model optimizes the performance indicator based on SCOR metrics. A process-based method is utilized for high-level decisions, while a mathematical programming method is proposed for low-level decisions. The suggested operational model takes some major supply chain properties such as multiple suppliers, multiple plants, multiple materials, and multiple produced items over several time periods into account. To solve the operational multi-objective optimization model, a goal programming approach is applied. The computational results are explained in terms of a numerical example, and a sensitivity analysis is performed to investigate how the performance of the supply chain is influenced by strategic scenario planning.

The aim of this research was to develop a model for the professional development of pre-school principals in the education. The study used a qualitative approach with a grounded theory approach. A group of experts, including senior education managers, university professors in the field of educational management, and prominent human resources consultants, were selected using the snowball sampling method. The selection of experts and interviews with them continued until theoretical saturation was reached, which occurred after the eleventh interview. The method of data collection was semi-structured interviews. Based on open, axial, and selective coding of the data, the research model was developed. In the developed model, the professional development of pre-school principals was identified as the core central concept. Causal conditions included the internal motivation of pre-school principals for professional development, their job commitment, ethical behavior, and their level of education and qualifications. The research results also showed that psychological and technical empowerment of education principals, satisfaction of pre-school education staff, parents, and students were identified as strategies and outcomes, respectively. In the developed model, parental concerns about the quality of pre-school educational management and competition between pre-school centers were identified as contextual variables, while standardization and updating of the conditions for the appointment of pre-school principals and the requirements of higher-level organizations for the professional development of pre-school principals were identified as intervention factors. The findings provide practical implications for the designing the professional development programs for pre-school principals.

The high reliance on out-of-pocket (OOP) payments for health financing in Iran have been led to different inequity problems such as catastrophic health expenditure (CHE) and impoverishment. This scoping review has been conducted to understand the variations in CHE and impoverishment, the underlying determinants of CHE, and its inequality in the past 20 years.  

This scoping review is guided by Arksey and O’Malley’s scoping review framework. systematically PubMed, Scopus, Web of Science, ProQuest, Scientific Information Database, IranMedex, IranDoc, Magiran Science, Google Scholar, and grey literature were searched systematically from 1 January 2000 to August 2021. We included studies that reported the rate of CHE, impoverishment, inequality, and its influencing factors. Simple descriptive statistics and narrative synthesis were used to present the review findings.  

From 112 included articles, the average incidence of CHE was 3.19% at the 40% threshold, and about 3.21% of the households had impoverished. We found an unfavorable status of health inequality indices, including the average of fair financial contribution (0.833), concentration (-0.01), Gini coefficient (0.42), and Kakwani (-0.149). The most widely applied key drivers influencing the rate of CHE in these studies were household economic status, place of residence, health insurance status, household size, head of the household’s gender, education level and employment status, having a household member under 5/ above 60 years old, with chronic diseases (in particular cancer and dialysis), disability, using inpatient and outpatient and dentistry services, medicines and equipment, and low insurance coverage.  

The result of this review calls for intensifying health policies and financing structures in Iran to provide more equitable access to all populations, especially the poorest and vulnerable. Moreover, the government is expected to adopt effective measures in inpatient and outpatient care, dental services, medicines, and equipment.

Within the public sector, health managers occupy positions that are typically filled by individuals with a medical, clinical, or nursing experience who are entrusted with assuming an additional role. The primary objective of this study was to employ a scoping review methodology to ascertain a cluster of prevalent subjects encompassing the development of a proficient health care manager.

The purpose of this scoping review study was to identify critical components in the field of management professionalization, as described by Arksey and O'Malley. A total of 13 studies, characterized by predefined keywords, were meticulously culled from Scopus, Web of Science, PubMed, and Embase, Magiran, and SID databases. The inclusion and exclusion criteria considered factors such as language, temporal relevance, redundancy, thematic alignment with the professionalization domain, and congruence with the overarching objectives and methodologies of the present investigation. Subsequently, the contents of the selected studies were subjected to rigorous thematic analysis and judicious categorization using a framework analysis approach.

From a total of 10,117 articles, a rigorous selection process yielded 13 articles to be included in this study. The identified dimensions are classified and elucidated across 6 overarching domains; namely, the science of management, educational trajectory, and curriculum, cultural infrastructure and ideologies, standards, professional institutions and associations, and licenses and certifications.

To enhance the efficacy of health management, policymakers and planners ought to adeptly incorporate these dimensions within the framework of the country's health system.

In some applications, the number of quality characteristics is larger than the number of observations within subgroups. Common multivariate control charts to monitor the variability of such high-dimensional processes are unsuitable because the sample covariance matrix is not positive semi-definite and invertible. Moreover, the impact of gauge imprecision on detection capability of multivariate control charts under high-dimensional setting has been clearly neglected in the literature. To overcome these shortcomings, this paper develops a ridge penalized likelihood ratio chart for Phase II monitoring of high-dimensional process in the presence of measurement system errors. The developed control chart departures from the assumption of sparse variability shifts in which the assignable cause can only affects a few elements of the covariance matrix. Then, to compensate for the adverse impact of gauge impression, the developed chart is extended by employing multiple measurements on each sampled item. Simulation studies are carried out to study the impact of imprecise measurements on detectability of the developed monitoring scheme under different shift patterns. The results show that the gauge inability negatively affects the run-length distribution of the developed control chart. It is also found that the extended chart under multiple measurements strategy can effectively reduce the error impact.

Hyperbilirubinemia is the most common cause of neonatal hospitalization in the first month after birth. Understanding the underlying causes of jaundice helps identify newborn at risk faster. The aim of this study was to determine the prevalence of jaundice in neonates with diabetic mothers on the 3rd to 5th day of after birth. 120 pregnant mothers aged 18 to 40 years who had diabetes during pregnancy (familial or gestational diabetes) and were treated with insulin were included in this descriptive epidemiological study. All demographic information of the mother and infant is recorded in the checklists and after delivery, mothers are advised to visit the clinic on a routine checkup for jaundice (jaundice visible in the sclera) on the third to fifth day after birth. After a thorough neonatal examination, a total bilirubin test will be performed. Of 120 diabetic mothers, 54 (45%) had no jaundice, 24 (20%) had clinical jaundice, and 42 (35%) needed phototherapy. Statistical analysis showed that there were no significant differences between the three groups without jaundice, clinical jaundice and need for phototherapy in terms of gender, gestational age and Rh factor incompatibility but there was a significant difference between type of feeding, birth weight and incompatibility of ABO system. . Further statistical analysis showed that only birth weight factors and blood group incompatibility were associated with icterus. Maternal diabetes and neonatal jaundice appear to be associated.

It is difficult to accurately measure the flow rate of seeds and fertilizers in grain drills, because the granules move in a continuous dense state. The purpose of this research was to monitor the mass flow of granular materials in the fall tube of the drill using a piezoelectric sensor. The laboratory system consisted of a repository box, a fluted roller metering device, a fall tube, and a piezoelectric sensor. To simulate the drill movement in the field, a vibrating stand was designed to oscillate the set-up in two perpendicular directions. The maximum amplitude stand was 8.99 cm according to the peaks and depressions available in a field after plowing. The sensor was evaluated in two static and dynamic modes for wheat seed, alfalfa seed, and triple superphosphate fertilizer with the usual drilling rate. The results showed the output signal of the sensor was proportional to all different mass flow rates in both static and dynamic states. The correlation coefficient was 0.95, 0.99, and 0.98 in static mode and 0.93, 0.86, and 0.98 in dynamic mode for wheat, alfalfa seed, and triple superphosphate fertilizer, respectively. In addition, the piezoelectric sensor could instantaneously monitor the sudden changes in the mass flow according to the reading of the digital scale. The results showed that the developed sensor can be used to monitor the mass flow rate of seeds and fertilizers in drills for calculating the drilling rate in real time.

Neonatal jaundice is a common problem that leads to many problems such as encephalopathy and hearing loss, kernicterus and death. Due to the importance of preventing the potential complications of hyperbilirubinemia, the present study was performed to determine the level of total cord bilirubin in neonates and to compare with bilirubin three days after birth in Kowsar hospital in Qazvin.

In this prospective cross-sectional study, 100 neonates were evaluated in Kowsar hospital maternity ward and required information was prepared in checklists containing maternal variables (blood group,taking medicine) and the infant's data (name, sex, birth weight, gestational age, breast feeding and formula milk feeding, Apgar score, cord blood bilirubin level, and serum bilirubin level on the third day after birth) were obtained with informed consent and entered into a file by a trained individual. Cord blood samples were also taken to measure the level of bilirubin and to determine the blood group of neonates and venous blood samples were taken on the third day after birth. Data analysis was performed by using descriptive and statistical analysis(P<0.05).

The mean levels of total and direct bilirubin of neonates in birthday and third day were 2.8 ±1.00 and 0.31±0.10 and 13.13±2.53 and 0.29±0.14 mg/dl, respectively. In addition, cord albumin was also reported to be 3.2±0.64. The mean level of total bilirubin at birth and third day was not significantly different between boys and girls (p.value=0.92). There was a significant and direct correlation between maternal age and total cord blood bilirubin level (p.value=0.04), and also total bilirubin level at the third day of birth had a significant and direct correlation with the number of abortions (p.value=0.05). Moreover, the level of total bilirubin and third day of birth were inverse correlated with albumin level.

High risk neonates need more accurate follow-up for jaundice, because timely diagnosis and very simple treatment can reduce the potential risks of neonatal jaundice. The present study showed that cord total bilirubin levels compared with bilirubin three days after birth can be used as a suitable diagnostic method to accurately track neonates at risk of jaundice.

In recent years, there have been many non-teaching hospitals that have become teaching hospitals. Although the decision to make this change is made at the policy level; But the unknown consequences can create many problems. The present study investigated the experiences of hospitals in changing the function of a non-teaching to a teaching hospital in Iran.

A Phenomenological qualitative study was conducted using semi-structured interviews with 40 hospital managers and policy makers who had the experience of changing the function of hospitals in Iran through a purposive sampling in 2021. Thematic analysis using inductive approach and MAXQDA 10 was used for data analysis.

According to the results extracted 16 main categories and 91 subcategories. Considering the complexity and instability of command unity, understanding the change of organizational hierarchy, developing a mechanism to cover client’s costs, considering increase management team’ legal and social responsibility, coordinating policy demands with Providing resources, funding the teaching mission, organizing the multiple supervisory organizations, transparent communication between hospital and colleges, understanding the complexity of processes, considering change the performance appraisal system and pay for performance were the solutions for decrease problems of changing the function of non-teaching to teaching hospital.

Important matter about the improvement of university hospitals is evaluating the performance of hospitals to maintain their role as progressive actors in hospital network and also as the main actors of teaching future professional human resources. In fact, in the world, hospital becoming teaching is based on the performance of hospitals.