a b s t r a c tThis study was conducted to evaluate the potential of the bleached bagasse, cellulose, and nanofiber cellulose to remove methylene blue (MB) from aqueous solution. The morphology of adsorbents surface and their functional groups were examined by using scanning electron microscope and Fourier transform infrared spectroscopy techniques, respectively. In a batch mode study at 25°C temperature, the effects of initial dye concentration, contact time, adsorbent dose, and solution pH on adsorption performance were investigated. The results showed that the percent of MB removal increases by increasing pH and also by increasing sorbent dosage and decreasing initial dye concentration. The adsorption kinetics and equilibrium data were in good agreement with the pseudo-second-order kinetic model and Freundlich adsorption isotherm, respectively. The removal of MB was better and more effective with cellulose and cellulose nanofiber as compared with the bleached bagasse. The regeneration of cellulose and nanofiber cellulose loaded with MB was investigated using electrochemical method under different operating conditions. The results showed that the electrochemical process efficiency is more than 60% for regeneration adsorbents.
CONTEXT:
Selecting variables is a fundamental step in evaluating comparative efficiency because the results of measuring efficiency depend on the used variables.
AIMS:
The aim of this study is to provide a comprehensive set of input and output variables for measuring efficiency with an emphasis on application in general hospitals in Iran.
MATERIALS AND METHODS:
This study comprised a literature review followed by a Delphi survey process. After extracting the variables from the literature review in order to reach consensus on them and identify the native variables, the researchers used the Delphi technique in three rounds. Thirty Iranian hospital managers, in Alborz, Saveh, Qazvin, Qom, and Hamadan universities, participated in this study. For analysis, the interquartile range (IQR) and median were used. IQR was used to assess the agreement of Delphi panel members.
RESULTS:
After literature review, nine indicators were identified as input variables and 11 indicators were identified as output variables. After the proposed changes by Delphi members, 24 input variables and 24 output variables were identified to measure hospital efficacy. Finally, ten variables were selected as inputs and ten variables were selected as outputs to measure the performance of public hospitals in Iran by using the consensus of the members in the Delphi panel.
CONCLUSIONS:
This study proposes a framework for selecting the most appropriate variables for measuring the hospital efficiency with an emphasis on nonparametric methods. Choosing variables to measure hospital efficiency requires infrastructure such as an intelligent information system.
Background: An increase in disasters around the world like bioterrorism attacks emphasizes the need to assess healthcare workers' preparedness to respond to bioterrorism. Nurses form the majority of first responders in disasters and emergencies, thus it is important to guarantee that their knowledge and skills are adequate to respond to such events. Objectives: This study aimed at assessing the level of nurse's knowledge and attitude of Sari city of Mazandaran province about bioterrorism, in 2015. Methods: Overall, 240 nurses participated in this cross-sectional study that was conducted at the University of Mazandaran Medical Sciences. The units were selected through the accessible sampling method. Data were collected by a questionnaire in 3 sections, demographic data, knowledge, and attitude, respectively. Results and Conclusions: The results showed that 91.7% of samples had low knowledge about bioterrorism and 93.3% had no opinion in regarding attitude of bioterrorism. Little knowledge of nurses regarding bioterrorism attacks indicates inefficiencies in hospitals units. Therefore, bioterrorism preparedness should be proposed through continuing education for under graduate and postgraduate nursing curriculum.
Introduction:In the new approach, all health care providers have been obligated to maintain and improve the quality and have been accountable for it. One of the ways is the implementation of clinical governance (CG). More accurate understanding of its challenges can help to improve its performance.Aims:In this study, barriers of CG implementation are investigated from the perspective of the hospitals involved. Besides, some solutions are suggested based on stakeholders’ opinions.Materials and Methods:This study used combined method (qualitative content analysis and questionnaire) in hospitals affiliated to Isfahan University of Medical Sciences in 2014. First, experts, and stakeholders talked about CG implementation obstacles in a semi-structured interview. Interviews were confirmed by the interviewee (double check). After analyzing the interviews using reduction coding the questionnaire was drawn up. The questionnaire “validity was confirmed by Cronbach's alpha (0/891)” and its reliability was obtained using experts confirmation. Data analyzing was performed using SPSS (18) software.Results:According to results staffing and management factors were the main obstacles. After them, were factors related to organizational culture, infrastructure elements, information, sociocultural and then process factors. The learning barriers were in final rank. Thirty-four solutions was proposed by experts and divided into subset of eight major barriers. Most solutions were offered on modifying processes and minimal solutions about modifying of organizational culture, sociocultural, and educational factors.Conclusion:Removing the obstacles, especially management and human resource factors can be effective by facilitating and accelerating CG. Furthermore, use of experts and stakeholders opinions can help to remove CG barriers.
a b s t r a c tThe aim of this study was to compare the efficiency of two dimensional electrochemical (2DE), electro-Fenton (EF), three dimensional electrochemical (3DE) and three dimensional electro-Fenton (3DEF) processes in removal ciprofloxacin (CIP) from aqueous solutions. The central composite design (CCD) with response surface methodology (RSM) was used to study the effect of experimental parameters on the removal efficiency of CIP by various electrochemical processes. The results showed that obtained quadratic model had a high R-squared coefficient based on the analysis of variance (ANOVA). The optimum condition for the removal of CIP by the studied processes was pH of 3, current of 0.45 A, and electrolysis time of 60 min. The results of the comparison between the processes showed that the removal efficiency of CIP after 60 min of electrolysis time is reduced as follows: 3DEF>3DE>EF>2DE. The removal efficiency enhancement was attributed to much more hydroxyl radicals generated in the three dimensional (3D) processes because single-walled carbon nanotubes (SWCNTs) could activate molecular oxygen to produce more H 2 O 2 . These results showed that 3D systems, especially 3DEF, could be considered as an appropriate method for the treatment of persistent pollutants such as antibiotics due to good electro-catalytic activity, high efficiency, no secondary pollution.
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