client satisfaction of delivered services in private nursing homes for elderly: a survey in the provinces of Golestan, Mazandaran, Semnan and Northern Khorasan in 2012

Objective: In The last two decades, nursing homes for elderly have expanded tremendously. Client satisfaction is one of the most important indicators of service quality delivered by institutes and organizations. This study was carried out to measure client satisfaction in the private nursing homes of Golestan, Mazandaran, Semnan and Northern Khorasan Provinces in 2012

Methods: In this cross-sectional study, 89 participants from all 14 nursing homes located in the pre-mentioned provinces who met the inclusion criteria including age 60 years or older, ability to communicate, Abbreviated Mental Test scores of 6 or higher, and at least 6 months stay duration were recruited by the method of census and interviewed. Data was gathered using the questionnaire of Assessing Elderly Residents' Satisfaction of the Delivered Services in Nursing Homes. In order to analyze data, statistical parametric t-test, ANOVA, Mann-Whitney, Kruskal- Wallis test, Spearman correlation coefficient and SPSS software [version 17], were used

Results: Mean scores showed that satisfaction with the physical care [3.55] and physical environment [3.77] were higher than of satisfaction with psychological care [3.00] and social care [3.26]. The mean score of overall satisfaction with the services was 3.40 and indicative of satisfaction in the levels of moderate to good. There was a significant relation between mean scores of satisfaction and the way which clients had been admitted to nursing homes [p<0.002]

Conclusion: Lower levels of satisfaction with psychological and social care in the nursing homes points to the need of paying more attention toward these two care dimensions. Considering the significant relationship between self commitment and the level of satisfaction, psychological preparedness of older clients before committing them to nursing homes may play a role in their satisfaction with the services delivered in nursing home

[Evaluation of radiation dose received by operating room personnel during radiological procedures]

Utilization of ionizing radiation in some surgery operations [especially orthopedic operations] is inevitable. One of the main occupational hazards of physicians and other personnel could be radiation exposure risks. This study aimed to evaluate the exposure doses received by operating room personnel in such surgery operations. 30 personnel of operation room in university affiliated hospitals of Hamadan city [excluding physicians and nurses] were studied as they received radiation doses. 3 TLD [thermoluminescent dosimet ers] chips were fixed on the apron of each staff member. To estimate the high risk examinations, staff members also completed a questionnaire about the type and number of the radiological examinations that they had participated. Minimum and maximum level of doses received by the participants were between 0.24 and 0.56 mSv in a four month period. Therefore, amount of annual doses received by the personnel would be between 0.73 and 1.7 mSv, respectively [without reduction of background radiation]. As the accuracy of TL dosimeters is normally about 0.1 mSv; therefore, it can be claimed that the received doses by the personnel was very low and comparable with background radiation. The results indicated that the radiation doses received by operating room personnel were very low. They were less than maximum predicted doses reported by the International Commission of Radiation Protection. However, the use of dose recording systems for awareness about absorbed doses beyond permitted limits is necessary

[Comparison of absorbed skin dose received by patients in cone beam computed tomography, spiral and conventional computed tomography scanning]

The evaluation of absorbed dose received by patients could give useful information for radiation risk estimation. This study was performed to compare the entrance skin dose received by patients in cone beam computed tomography [CBCT], conventional and spiral computed tomography [CT]. In this experimental study, 81 calibrated TLD chips were used. The TLD chips were placed on facial, thyroid and end of sternum skin surface in patients referred for CT of the paranasal sinuses [3 TLD chips for each area] to estimate the absorbed dose received by central part of radiation field, thyroid and out of field areas, respectively. The data were analyzed using one-way ANOVA and Tukey tests. The dose delivered to the center of irradiated field was about 0.79 +/- 0.09 mGy in CBCT technique compared with 16.31 +/- 3.71 and 18.84 +/- 4.12 mGy for spiral and conventional CT, respectively. The received dose by the out of field areas was about 54 percent of central area dose. There was statistical significant relationship between the imaging modalities and absorbed dose received by patients [P=0.016]. The least absorbed dose was for CBCT and the greatest dose was for conventional CT imaging technique. The dose delivered to central area of irradiated field in conventional and spiral CT imaging modalities was about 24 times greater than of that in CBCT. Also, the highest received dose was for central areas of radiated field and the lowest dose was for the out of field areas

Evaluation of dosimetric characteristics of a grid block fabricated for mega-voltage grid therapy purposes

In conventional radiation therapy, regarding normal tissue tolerance, the treatment of bulk tumors is one of the remaining challenges. Grid Radiation Therapy [GRT] is a technique to deliver high doses, approximately 15 - 20 Gy per fraction, to several small volumes located in a large radiation field. This can be performed using a grid block. The current work has concentrated on the dosimetric characteristics of a designed mega-voltage grid, used for a unique treatment modality. All measurements performed using a Neptune linear accelerator [9 MV photon beam]. A square 16 x 16 array grid block was designed and fabricated. Several dosimetric characteristics including: depth dose, Valley To Peak [VTP] ratio, and grid out-put factor were evaluated using a calibrated diode dosimeter for a range of radiation fields. The percent depth dose curves, measured in the presence of grid block, lie within those measured for the corresponding open field and a narrow beam. At the D[max], the VTP ratio was found to be within 17% - 28%, while these ranges between 23% - 35% at a depth of 10 cm. The grid out -put factor found to be 0.78 and it slightly decreases with increasing of radiation field size. The VTP ratio found to be dependent strongly on the grid design and manufacturing properties. However, other parameters such as radiation field size and the depth of measurement should also be addressed as important factors. The measured dosimetric characteristics of grid block indicate that the mega-voltage grid therapy can be applied as a possible clinical modality for palliative cases

Radiation protection principles observance in Iranian dental schools

In recent decades many guidelines has been conducted by radiation protection organizations about radiation protection in dentistry. This study aimed to evaluate the observance of these guidelines in educational clinics of all dental schools in Iran. In this cross-sectional study a self-administered questionnaire, based on National Radiation Protection Board [NRPB] and European Commission guidelines, was conducted. The radiology departments of all dental school [18 schools] were surveyed in this study. The questionnaire was consisted of 3 sections including intraoral radiography, extraoral radiography and implementation of quality control programs. In the case of the existence of radiation protection facilities [such as lead apron, thyroid shield and lead impacted walls] the use of high speed films and existence of automatic processor in dental schools, there was a proper condition. The main problem was related to lack of regular quality control and quality assurance programs. Digital radiography systems were employed in none of the schools and it was occasionally used for research purposes at some of them. This study has emphasized on the need for further consideration of radiation protection principles in dental schools, especially on the field of quality control and quality assurance programs

prevalence of obligatory anaerobic bacteria in oral cavity infections

Many infections of the oral cavity and adjacent structures involve anaerobic bacteria. Most infections involve multiple anaerobes and in many instances facultative organisms. Present study was conducted regarding to clinical aspects and complications of anaerobic bacterial infections in oral cavity. 72 Specimens were taken from oral cavity infections. Routine culture techniques and strict anaerobic techniques were used for isolation and identification of aerobic, facultative and obligatory anaerobic bacteria respectively. Cultures of all specimens were positive. Mono- bacterial and poly bacterial infections were repored in 1/3 and 2/3 of specimens, respectively. More than 65% of isolated organisms, were obligatory anaerobic belonging to the Peptostreptococcus, Prevotella, Fusobacterium Porphyromonas and Bacteriodes as well as facultative and aerobic species include Streptococcus, Staphylococcus interobacteriacea and Actinomes Israelii are also obtained. Many infections of the oral cavity and adjacent structures involve obligatory anaerobic bacteria. Regarding to results of present study, under the anaerobic atmospheric system, obligatory anaerobic bacteria were isolated and identified from clinical specimens of oral cavity infections, especially abscesses

Study of tuberculous infection rate in townships in a Centeral Province of Iran

Tuberculosis is a continuous threat for health in all parts of the world. An estimated one-third of the world' s population is infected with the Mycobacterium tuberculosis and 7 to 8 million people develop TB disease each year. The purpose of this study was to investigate the rate of tuberculosis in the townships of Yazd province, Iran. During the study period [19971999], 3885 suspected tuberculosis patients [1820 males and 2065 females; aged 8-85 years] who had been referred to the Yazd referral polyclinic were investigated by Ziehl Neelsen staining and culture method and questionnaire was completed for each subject. Then, Collected data were analyzed by statistical package for social science [SPSS] and chi-square program. The results show that, of the total suspected tuberculosis, 604 cases were found to be positive for tuberculosis. The average annual rate of tuberculosis was 26.8 cases per 100000 population [23.1/100000 males and 31/100000 females]. The highest and lowest rates of tuberculosis were observed among Sadough [78.1/100000] and Abarkouh townships population [19.8/100000] and also among age group >/= 50 years old [111/100000] and < 10 years old [7/100000], respectively. The average annual rates of pulmonary and extra-pulmonary tuberculosis in Yazd province were 152 cases [20.2%] and 48 cases [6.4%], respectively. It seems that, despite the efforts, which have been done for prevention, diagnosis and treatment of patients with tuberculosis, it is still considered as a threat for health in the Yazd province, Iran

prevalence of infected stones in the urinary tract and their relationship to urease positive bacteria

To determine the prevalence of infected stones in the urinary tract and their relationship to urease positive bacteria and whether a positive urine culture signifies infected stone profile. This study was conducted on 168 patients [116 males and 52 females] with a mean age of 37 years. The analysis was performed on: [1] Urine specimen before operation, [2] Urine around the stone before stone retrieval and [3] Stones. Urine and stone culture was performed on blood agar [BA] and Eosin Methylene Blue [EMB] for gram staining, Brucella agar enriched with vitamin K and Thioglycolate medium for anaerobics and uroplasma urealyticum inside PPLO culture. Urease was determined on urea broth and urea agar media. Chemical analysis of the stone was done by Merck kit. Seven cases of culture were positive for infected stones [64%] while 6 cases of non-infected stones grew microorganisms [3.8%]. Infected stones comprised 6.5% of all the stones. Proteus mirabilis and Pseudomonas aeruginosa were the most commonly encountered bacteria [18%]. Urease positive bacteria were found to be 54.5% in the infected stones and 6% in the non-infected stones. Urine and stones samples showed that only 14.5% had the same type of bacteria. Other factors besides bacteria play a role in stone formation in the urinary tract and infected stones can be produced in non-infected urine also