Journal of

Background and Aim: Throughput improvement is a process that simultaneously increases the volume of services provided to patients, while decreasing the operating costs. The aim of the present study was to extract and prioritize the factors affecting throughput in an emergency department for heart disease patients.
Materials and Methods: This is a descriptive case study conducted through: interviews with experts, and the design of a questionnaire based on the emergency management criteria specified by the Ministry of Health and Medical Education (MOHME), and the completion of the questionnaire by academic experts in a teaching hospital in Tehran. 
Six indicators and 26 sub-indicators were extracted and the data was analyzed using multi- criteria decision analysis methods including ANP and DEMATEL.
Results: Among the 26 sub-indicators, six sub-indicators were identified as the top priority ones with a 72 percent impact on throughput. And out of the six top indicators, cardiac emergency clinical guidelines were identified as the most important in maximizing throughput for patients with chest pain in the emergency department under study. 
Conclusion: This study identified the priorities in enhancing throughput in an emergency cardiac unit. For the first time in Iran the study used a hybrid 
ANP-DEMATEL method. This study can provide insights for health system planners and policy-makers on the enhancement of throughput in care delivery 
organizations, especially teaching hospitals. 

Background and Aim: High blood pressure and increased lipid profile are risk factors for cardiovascular diseases. To improve cardiovascular health, lifestyle changes should be considered as a guide to reduce people’s inactivity and modify healthy eating patterns. Spirulina is a green alga and has been considered as a food supplement for the treatment of various diseases. This study was conducted with the aim of determining the effect of spirulina supplement and eight weeks of combined exercises on blood pressure and lipid profile in women with high blood pressure.
Materials and Methods: The study was conducted as a clinical trial in 40 women with high blood pressure (50-60 years old). People were included in the study in 4 intervention and control groups. The data were collected during two stages of pre-test and post-test in terms of changes in blood pressure and lipid profile. The supplement intervention group consumed 4.2 grams of spirulina supplement daily and had an exercise intervention of 8 weeks of combined aerobic and resistance exercises. Data analysis was conducted using SPSS software (version 23), one-way analysis of variance (ANOVA) and Tukey’s post hoc test at level 0.05.
Results: The results of ANOVA showed that there was a significant difference between systolic blood pressure, total cholesterol, and VLDL, after the test, in the study groups (P-value<0.05). The highest mean±standard deviation (SD) of systolic blood pressure (141.90±9.85), and total cholesterol (213.30±28.93), after the test, was observed in combined exercise group and the mean± SD of VLDL after the test (34.60±6.46) was observed in the control group. Also, the results of Tukey’s post hoc test showed that there was a significant difference between the mean blood pressure in the control groups-spirulina supplement, control-combined exercises, spirulina supplement-spirulina supplement and combined exercises, and combined exercises-spirulina supplement and combined exercises. Also, there was a significant difference between the mean of total cholesterol and VLDL in combined exercises-spirulina supplement, combined exercises, and control-spirulina supplement groups, respectively (P<0.05).
Conclusion: It seems that the use of spirulina supplement and eight weeks of combined exercises may have beneficial effects on blood pressure and lipid profile in women with high blood pressure.