Health related quality of life in breast cancer patients undergoing current chemotherapy protocols

Health related quality of life is one of the important concepts that nowadays is considered along with other quantitative criteria like life expectancy and survival in health service systems, but its significance is more obvious in degenerative diseases and long term treatments such as cancers. In this study we compared health related quality of life in breast cancer patients undergoing either Docetaxel -Adriamicine - Cyclophosphamide [TAG] or 5-FU- Adriamicine - Cyclophosphamide [FAC] regimens. This study was conducted in a double blind cohort design on 100 patients with positive - node breast cancer treated by TAG or FAC regimens. The international standard questionnaire [EORTC QLQ-C30] was used to evaluate health related quality of life at the start and end points of chemotherapy period. Data were analyzed by independent t-test at the significant level of 0.05. Results showed the same scores of quality of life at the first session of chemotherapy in both groups and in 4- month follow up, at the end of chemotherapy, mean score of quality of life in both groups decreased but it reduced more in TAG group. Chemotherapy regimens can decrease patients quality of life greatly. So reinforcing the relationship between patients and their families, society and treatment team in addition with using supportive methods and counseling groups can maintain the level of patients' quality of life greatly

Economic burden of inappropriate antibiotic use for prophylactic purpose in Shiraz, Iran

Because economic data on the prophylactic usage of antibiotic in Iran are scant, we have conducted a cross-sectional study with provider perspective to measure costs and appropriate use of antibiotics in surgical wards of 6 training hospitals affiliated to Shiraz University of Medical Sciences [SUMS], Iran. Over a six-month period 1,000 consecutive patients undergoing surgical operation were enrolled and information on prophylactic antibiotic administration was collected. The information included basic patient's demographic data, types of surgery, category of antibiotic, dosage, dosage intervals, route of administration, number of doses, initiation times and duration of administration. In order to determine the agreement between prescribed antibiotics and medical indication, the American Society of Health-System Pharmacists [ASHP] guidelines were applied. Nine hundred and ninety three out of 1,000 patients [99.3%] had received at least one antibiotic and 908 patients [91.4%] received antibiotics because of a medical indication. Five out of 913 patients who had indications for antibiotic prophylaxis did not receive any antibiotic. Antibiotics were prescribed for 85 out of 87 [98%] procedures in which an antibiotic was not indicated. The average cost of antibiotic prescription per surgical procedure was 786,936 Iranian Rials [corresponding to 99.60 USD or Eng. pound 82.90]. The most frequent prescribed antibiotic was cefazoline adding 53.3% of the total cost of antibiotics. In total, 36,516,190 Iranian Rials [corresponding to 4,622.95 USD or Eng. pound 3,845.20] were spent for cefazoline alone. The results of this study showed that all surgical patients received at least one antibiotic as prophylaxis for any infection in the surgical site. Our results indicate over- and misuse of antibiotics in Iran leading to a great amount of economic burden, since in 98% of all procedures, antibiotics were used inappropriately

[Relationship between emotional intelligence with conflict management strategies among educational and research managers of Shiraz university of medical sciences]

Introduction: Successful managers integrate strong interpersonal skills with technical knowledge to improve their performances. Emotional Intelligence not only provides the basis to further these skills, but also plays an important role in efficiency of group members and solves conflicts using emotions. The aim of this study was to determine relationship between Emotional Intelligence with conflict management strategies among educational and research managers of Shiraz University of Medical Sciences

Methods: In this cross-sectional study, 81 educational and research managers from faculties and research centers were selected using random sampling. Three questionnaires including Robin's conflict management, Schering Emotional Intelligence and individual traits were used for data gathering. Data were analyzed using t-test, Chi-square, and Pierson correlation tests

Results: The mean of emotional intelligence was 115.01. About half of the managers [50.6%] used avoidance strategy, and only 47.2% used collaboration strategy. Educational managers [87.6%] and males [59.6%] tend to use avoidance strategy more. Research managers [62.86%] and females [34.5%] used control strategy more. There was no statistically significant correlation between emotional intelligence with the strategies. Among educational managers, there was a statistically significant negative relationship between control strategy and management experiences. Among males, there were significant negative relationships between emotional intelligence and avoidance/collaboration strategies

Conclusion: Emotional Intelligence is an important factor to recognize and solve conflicts. It is necessary to improve top managers' performances through learning emotional intelligence strategies to them. The continuing education of conflict management strategies would help managers to recognize and manage conflicts timely and properly

efficiency of general public hospitals in Fars province, southern Iran

Regarding the increase in expenses for health care services in inpatient settings, much effort has been made to compare the performance of hospitals in recent years and measure their efficiency. In this study, Data Envelopment Analysis [DEA] is applied to measure the technical, scale and economic efficiency of the general public hospitals in Fars Province, southern Iran. Twenty one general public hospitals in Fars province, southern Iran in the first and second six months of the years 2005 and 2006 were enrolled. There was an attempt to compare their rate of development or otherwise, using Malmequist index and also to determine their return to scale and rank during these years. The data, were collected through a questionnaire by interview and the existing documents were analyzed separately for each year by Algebraic Modeling System [GAMS] software. Fifteen hospitals [71.4%] were technically efficient and in the next three periods, 14 hospitals proved to be efficient. With respect to scale efficiency in the first 6 months of 2005, 7 hospitals were completely efficient [33.3%], but in the second 6 months of the same year, the number of efficient hospitals was reduced from 7 to 5. In the next two periods, 4 hospitals [19%] were recognized as highly efficient systems. As to the economic efficiency in all 4 studied periods, 4 hospitals [19%] were recognized as completely efficient. As to the average technical efficiency, state-run public hospitals in Fars Province are in a higher level as compared with those in other studies. However, their average of the scale efficiency is less than that reported in other studies. It seems that the hospitals under the study do not seek profitability since they are public; therefore, they lack any motivation to select a combination of inputs in order to minimize the expenses. It is recommended that hospital managers and decision makers should use DEA to determine the best method of using the available resources

Application of multiple-attribute decision making model to measure hospital efficiency

During recent years, the cost of hospital services is increased in most countries and in spite of greater volume of resources devoted to hospitals, the ineffective management of hospitals has led to wasting of resources, hence, the measurement of hospitals efficiency or comparing between the input and output in such organizations is of special importance. Comparing between two methods, Ratio analysis and Multiple-Attribute Decision Making model [MADM] to estimate the hospital efficiency. This was a descriptive analytical study carried out in 1998. The efficiency of 5 general hospitals affiliated to social security organization in Tehran province was compared using two methods named as [Ratio] and [MADM]. The results of this study showed that all hospital under investigation were facing problem with proper use of their inputs [beds] from a scale efficiency point of view. Regarding the technical efficiency, 3 out of 5 hospitals were involved in shortage of personnel. Our data shows that, the Ratio method, due to some limitations in simultaneous use of quality and quantitative criteria, is incapable to measure hospital efficiency and providing a final conclusion by which the establishment of a ranking system to compare hospital efficiency could be made