Aims:To assess systems thinking level and its relationship with occurrence and reporting of adverse events in Iranian nurses.Background: Systems thinking has recently emerged as an important element of patient safety and quality improvement in health care systems. It helps health care professionals to understand the different elements of health care systems, the interrelatedness and interdependencies of these elements in the health care systems.Methods: This cross-sectional survey was carried out in 10 teaching hospitals in Tehran, Iran. A total of 511 nurses were selected using simple random sampling.Systems thinking was measured using the validated Systems Thinking Scale. Data analysis was performed by descriptive analyses, independent t test and logistic regression analysis. Results:The average score for total systems thinking was a mean of 49.45 (SD = 12.10; range 0-80). In total, 67.5% of participants reported the experience of the occurrence of adverse events leading to harm to patients, and 65.2% of them responded as having appropriate adverse events reporting behaviours. Nurses who had higher scores in systems thinking were found to be more likely to report adverse events (odds ratio = 1.07; 95% CI = 1.05-1.09), whereas they were less prone to experience adverse events (odds ratio = 0.97; 95% CI = 0.95-0.98). Conclusion:Our results indicated that the nurses' systems thinking level was moderate. Systems thinking had a significant role in preventing the occurrence of adverse events as well as improving the reporting of adverse events. Therefore, it is recommended to enhance the competency of nurses' systems thinking to prevent the occurrence of adverse events and to improve the reporting of adverse events.Implications for nursing management: Nursing managers need to focus on the systems thinking weaknesses and the occurrence and the reporting of adverse events in policymaking, practice and research. Also, systems thinking should be integrated with the health care system for preventing the occurrence of adverse events and

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BackgroundNF-E2-related factor2 (Nrf2)-antioxidant response element (ARE) signaling pathway is the major defensive mechanism against oxidative stress and is up regulated by specific antioxidants and oxidants to comprise the chemoptotective response. Detection of ARE-activating compounds helps to develop new drugs and identify/quantify the tension range of the oxidants.Important reasons promoting this work are high throughput, rapid and inexpensive experiments relative to the in vitro studies for ARE-Nrf2 pathway monitoring of chemicals and environmental samples.MethodsIn this study hepatoma Huh7 reporter cell line was generated which contains a luciferase gene under the control of an ARE. This is the first example of ARE construct containing one copy of extended consensus response element. The cells were treated with hydroquinone (HQ) and p-benzoquinone (BQ) (oxidative stress inducers) and the antioxidant, curcumin.ResultsThe luciferase activity was induced in a concentration-dependent manner in a concentration range of 1–2 μM for BQ and HQ. Curcumin was also validated as an ARE inducer in concentration above 10 μM. In addition, this reporter cell line provides a rapid detection as early as 4 h to respond to the ARE inducers.ConclusionIt is a powerful tool for the sensitive and selective screening of chemicals, drugs and environmental samples for their antioxidant and oxidant activities.

One of the major obstacles needed to be overcome before using cell therapy for clinical purposes is the high probability of tumor formation in patients who receive the transplants, as undifferentiated stem cells (SCs) have the potential to form teratomas/teratocarcinoma in xenotransplants. In this study the ability of dendrosomal nanocurcumin (solublized curcumin using a biodegradable non-toxic nano-carrier) to affect undifferentiated/hazardous cell, and hence increasing the safety of cell therapy (particularly in diabetes type I) by mesenchymal stem cells (MSCs) was examined. The results showed that after completion of differentiation of human mesenchymal stem cells (hMSCs) into insulin producing cells (IPCs), the expression level of insulin increases, although there remains a minority of undifferentiated cells which still express nestin (gene which is expressed in progenitor stem cells of IPCs). It indicates the emergence of a heterogeneous population containing undifferentiated and differentiated cells. Furthermore our data demonstrated that the expression level of p53 decreases during differentiation of hMSCs into IPCs which implies a more favorable microenvironment for tumor formation following the transplantation of such a heterogeneous population. After treatment with dendrosomal nanocurcumin, nestin expression eliminated, however no significant effect on the expression and secretion of insulin was observed. Together our data shows that dendrosomal nanocurcumin have the ability to affect residual undifferentiated stem cells after the completion of differentiation of MSCs induced to differentiate into IPCs; while it exerts no significant harmful effect on the survival and function of differentiated cells. With regard to the obtained results in this study, exploiting dendrosomal nanocurcumin, after completion of induced differentiation of stem cells and prior to the transplantation step, can be suggested as a very efficient, safe and cost-effective method to eliminate the residual undifferentiated stem cells in cell therapy practices in order to considerably decrease the risk of tumor development following transplantation.