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        Developing National Functional Accreditation Model for Primary Healthcares with Emphasis on Family Practice in Iran

        Tabrizi Jafar Sadegh,Gharibi Farid 대한가정의학회 2021 Korean Journal of Family Medicine Vol.42 No.3

        Background: Accreditation is an approach toward quality improvement which has been increasingly implemented in healthcare. This study aimed at developing a national functional accreditation model for primary healthcare with emphasis on family practice in Iran. Methods: This mixed-method study utilizes a set of research methods purposefully. Initially, the reference models were used for benchmarking accreditation standards through a systematic review. Then, the primary accreditation standards were developed and then they were assessed and approved by the experts of the field via Delphi technique. In the following and after developing essential parts of the standards, the necessary changes in developed model were done according to the pilot test results. Results: The results of systematic review suggested the superiority of accreditation models of the United States, Australia, Canada, and the United Kingdom globally; and the models of Jordan, Saudi Arabia, Lebanon, and Egypt in Eastern-Mediterranean region. Then, the primary standards including 39 functional standards with 231 measures were developed according to the benchmarked models, and were approved by the experts in Delphi-based study. In pilot test step, the compliance rate of developed standards by primary healthcare centers was calculated 61.61% and 26.37% for self-evaluation and external evaluation phases, respectively. Conclusion: Regarding the comprehensiveness of developed accreditation model due to its focus on all functional dimensions and the consensus over the developed standards by the experts, it can be an underlying ground for the establishment and evaluation of functional improvement programs in Iranian primary healthcare system.

      • KCI등재

        Bio-corrosion, mechanical and microstructural properties of TiTaMoVZr high-entropy alloy film on Ti-6Al-4V substrate

        Milad Gashti,Rouhollah Mehdinavaz Aghdam,Amir Motallebzadeh,Farid Gharibi Asl,Reza Soltani,Ali Ashrafi,Hassan Balaei,Alireza Razazzadeh 대한금속·재료학회 2023 METALS AND MATERIALS International Vol.29 No.12

        In recent years, high entropy alloys (HEA) have gained much attention due to their high corrosion resistance and mechanicalproperties. As a target, a high entropy TiTaMoVZr alloy with a atomic ratio of 20% was cast. Following that, the Ti–6Al–4Vsubstrate was coated using the radio frequency magnetron sputtering technique. This process took place at a temperature of400˚C under two different atmospheres of argon and air. HEA thin films’ mechanical, biological, and corrosion propertieswere investigated. The biocompatibility of these films was evaluated by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyltetrazolium bromide) assay. Based on the results, these films formed an amorphous phase with a higher hardness than thesubstrate. Also, the wettability and roughness of the surface of the films were higher compared to the substrate, whichimproved cell viability and their adhesion to the films surface. Because of their chemical compositions and unique structures,the films were more corrosion resistant than Ti6Al4V substrates were obtained. SEM investigation showed that there weremore cracks on the surface of non-oxide high entropy films compared to the high entropy oxide deposit. The oxide film hadno visible cracks, and also the thickness of the oxide high entropy film was more significant than the non-oxide film, whichresulted in improved corrosion properties. Also, the Polarization resistance of the non-oxide (176 × 104Ω.cm2) and oxide(218 × 104Ω.cm2) films increased compared to the substrate (324 × 103Ω.cm2). Furthermore, the coated samples had higherYoung’s modulus and nanohardness than Ti6Al4V samples. This was attributed to the amorphous structure and the absenceof defects such as dislocations and slip planes in the coating. Cell viability was improved for coated samples, however,atmospheric change in coating conditions did not significantly affect this cell viability.

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