Background: Observance of the patients’ bill of rights is one of the main features of moral codes in hospitals. In this regard, nurses bear great responsibility because they spend a long time with patients. Therefore, the continuous evaluation of the nurses’ performance and assessing their knowledge about the patients’ bill of rights are a need. Objectives: We aimed to determine the nurses’ awareness of the patients’ rights and measure their performance in this regard. Research design and participants: This cross-sectional study (...) was carried out in 2013. To measure the nurses’ knowledge and performance, 250 nurses and 300 patients were surveyed. The participants were selected randomly from five teaching hospitals in Tehran, Iran. Two questionnaires, one for nurses (17 questions) and the other for patients (11 questions), were applied. The data were analyzed in SPSS software using descriptive and inferential statistics. Ethical consideration: The research protocol was submitted and approved by the research and ethics committees of the participating hospitals. Additionally, the consent of all of the participants was obtained before the study. Findings: The mean score of the nurses’ knowledge regarding the patients’ rights was acceptable (69.85 ± 11.7 of 85). Furthermore, the mean score of nurses’ performance in observing the patients’ rights was relatively acceptable (11.2 ± 4.6 of 22). More experienced and educated nurses had higher knowledge regarding the patients’ rights, and patients with higher education level or experience of being hospitalized were less satisfied with the nurses’ performance. Conclusion: Nurses’ knowledge of the patients’ bill of rights was acceptable; however, observance of the patients’ rights was not. It seems that notification of the patients’ bill of rights has increased the nurses’ awareness of the patients’ rights, although improvement of the nurses’ performance needs more extensive measures. (shrink)

Patients have the right to refuse their treatment; however, this refusal should be informed. We evaluated the quality of the informed refusal process in Iranian hospitals from patients' viewpoints. To this end, we developed a questionnaire that covered four key aspects of the informed refusal process including; information disclosure, voluntariness, comprehension, and provider-patient relationship. A total of 284 patients who refused their treatment from 12 teaching hospitals in the Isfahan Province, Iran, were recruited and surveyed to produce a convenience sample. (...) Patients' perceptions about the informed refusal process were scored and the mean scores of the four components were calculated. The findings showed that the practice of information disclosure was perceived to be moderate, however, comprehension, voluntariness and provider–patient relationship were perceived to be relatively good. We found that patients, who refused their care before any treatment had commenced, reported a lower quality of information disclosure and voluntariness. Patients informed by nurses and those who had not had a previous related admission, reported lower scores for comprehension and relationship. In conclusion, the process of obtaining informed refusal was relatively satisfactory except for levels of information disclosure. To improve current practices, Iranian patients need to be better informed about; different treatment options, consequences of treatment refusal, costs of not continuing treatment and follow-ups after refusal. Developing more informative refusal forms is needed. (shrink)

Hedgehog is an important morphogenic signal that directs pattern formation during embryogenesis, but its activity also remains present through adult life. It is now becoming increasingly clear that during the reproductive phase of life and beyond it continues to direct cell renewal (which is essential to combat the chronic environmental stress to which the body is constantly exposed) and counteracts vascular, osteolytic and sometimes oncological insults to the body. Conversely, down‐regulation of hedgehog signalling is associated with ageing‐related diseases such as (...) type 2 diabetes, neurodegeneration, atherosclerosis and osteoporosis. Hence, in this essay we argue that hedgehog signalling is not only important at the start of life, but also constitutes an important anti‐geriatric influence, and that enhanced understanding of its properties may contribute to developing rational strategies for healthy ageing and prevention of ageing‐related diseases.Also watch the Video Abstract. (shrink)

Este trabajo analiza el papel de los suidos en la ritualidad protohistórica japonesa, tomando como base la aparición de una serie de restos óseos de estos animales en contextos rituales y/o con indicios de consumo ritual, especialmente en los periodos Jōmon (ca. 10,500-300 a.n.e.) y Yayoi (1,000-900 a.n.e.-250-300 d.n.e.),. Pero antes de entrar de lleno en la problemática de estos ejemplares, es necesario realizar una retrospectiva del papel de dichos animales en el archipiélago japonés desde la Prehistoria, así como de (...) la propia domesticación del cerdo en el continente asiático y su difusión por Asia Oriental hasta llegar a las islas japonesas. A este respecto, hay que tener en cuenta que existen tres ámbitos de estudio diferenciado en lo referente a los suidos en el archipiélago japonés: Hokkaidō, el archipiélago de las Ryūkyū y las islas de Kyūshū Honshū y Shikoku. (shrink)

Jābāli, one of the priest-cum-counsellors of king Daśaratha, has long been recognized as an odd character, preaching materialism in order to persuade Rāma to go back to Ayodhyā after the death of his father. The critical edition of the Vālmīki Rāmāyaṇa reveals several stanzas interpolated in the vulgate so as to denigrate Jābāli and brand him as a rank opportunist. In spite of that, whatever remains of Jābāli’s speech addressed to Rāma evinces one of the basic tenets of materialist ontology, (...) i.e., denial of the existence of any other-world, and hence the futility of performing rites for the ancestors. However, nothing is said about the epistemology,, ethics, and metaphysics of materialism as it existed at the time when the Rāmāyaṇa was redacted. Considering all this it is better to call Jābāli a proto-materialist who speaks of a philosophy akin to the teachings of Ajita Kesakambala, a senior contemporary of the Buddha, whose doctrine has been dubbed as that of annihilation in the Tipiṭaka. Both of them belong to the pre-Cārvāka materialist tradition in India. (shrink)