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Sample records for heart program iran

  1. Process evaluation of a community-based program for prevention and control of non-communicable disease in a developing country: The Isfahan Healthy Heart Program, Iran.

    Science.gov (United States)

    Rabiei, Katayoun; Kelishadi, Roya; Sarrafzadegan, Nizal; Abedi, Heidar Ali; Alavi, Mousa; Heidari, Kamal; Bahonar, Ahmad; Boshtam, Maryam; Zare, Karim; Sadeghi, Shahryar

    2009-02-12

    Cardiovascular diseases are the most common cause of mortality in Iran. A six-year, comprehensive, integrated community-based demonstration study entitled Isfahan Healthy Heart Program (IHHP) conducted in Iran, and it started in 2000. Evaluation and monitoring are integrated parts of this quasi-experimental trial, and consists of process, as well as short and long-term impact evaluations. This paper presents the design of the "process evaluation" for IHHP, and the results pertaining to some interventional strategies that were implemented in workplaces The process evaluation addresses the internal validity of IHHP by ascertaining the degree to which the program was implemented as intended. The IHHP process evaluation is a triangulated study conducted for all interventions at their respective venues. All interventional activities are monitored to determine why and how some are successful and sustainable, to identify mechanisms as well as barriers and facilitators of implementation. The results suggest that factory workers and managers are satisfied with the interventions. In the current study, success was mainly shaped by the organizational readiness and timing of the implementation. Integrating most of activities of the project to the existing ongoing activities of public health officers in worksites is suggested to be the most effective means of implementation of the health promoting activities in workplaces. The results of our experience may help other developing countries to plan for similar interventions.

  2. Process evaluation of a community-based program for prevention and control of non-communicable disease in a developing country: The Isfahan Healthy Heart Program, Iran

    Directory of Open Access Journals (Sweden)

    Boshtam Maryam

    2009-02-01

    Full Text Available Abstract Background Cardiovascular diseases are the most common cause of mortality in Iran. A six-year, comprehensive, integrated community-based demonstration study entitled Isfahan Healthy Heart Program (IHHP conducted in Iran, and it started in 2000. Evaluation and monitoring are integrated parts of this quasi-experimental trial, and consists of process, as well as short and long-term impact evaluations. This paper presents the design of the "process evaluation" for IHHP, and the results pertaining to some interventional strategies that were implemented in workplaces Methods The process evaluation addresses the internal validity of IHHP by ascertaining the degree to which the program was implemented as intended. The IHHP process evaluation is a triangulated study conducted for all interventions at their respective venues. All interventional activities are monitored to determine why and how some are successful and sustainable, to identify mechanisms as well as barriers and facilitators of implementation. Results The results suggest that factory workers and managers are satisfied with the interventions. In the current study, success was mainly shaped by the organizational readiness and timing of the implementation. Integrating most of activities of the project to the existing ongoing activities of public health officers in worksites is suggested to be the most effective means of implementation of the health promoting activities in workplaces. Conclusion The results of our experience may help other developing countries to plan for similar interventions.

  3. Status of Iran's nuclear program and negotiations

    Science.gov (United States)

    Albright, David

    2014-05-01

    Iran's nuclear program poses immense challenges to international security. Its gas centrifuge program has grown dramatically in the last several years, bringing Iran close to a point where it could produce highly enriched uranium in secret or declared gas centrifuge plants before its breakout would be discovered and stopped. To reduce the risk posed by Iran's nuclear program, the P5+1 have negotiated with Iran short term limits on the most dangerous aspects of its nuclear programs and is negotiating long-term arrangements that can provide assurance that Iran will not build nuclear weapons. These long-term arrangements need to include a far more limited and transparent Iranian nuclear program. In advance of arriving at a long-term arrangement, the IAEA will need to resolve its concerns about the alleged past and possibly on-going military dimensions of Iran's nuclear program.

  4. Challenges of Tobacco Control Program in Iran.

    Science.gov (United States)

    Poorolajal, Jalal; Mohammadi, Younes; Mahmoodi, Azam

    2017-04-01

    This study assessed the status of cigarette marketing in Iran as well as the attitude of smokers toward smoking and the policies and tobacco control programs in the country. This cross-sectional study was conducted on 3480 volunteer smokers in six provinces, using a stratified cluster random sampling method. The study population consisted of smokers who used at least one cigarette per day. The data collection tool was an anonymous self-administered questionnaire including basic information and 20 five-choice questions related to participants' attitude toward smoking habits (Cronbach's alpha; 79.73%.). The majority (66.9%) of participants started smoking at the age of 10 to 19 years and 61.1% used foreign cigarettes. Of 160 marketed brands, 38 (23.8%) were domestic and 122 (76.2%) were foreign, including 63 (39.3%) imported and 59 (36.9%) smuggled brands. Being tempted (25.0%), getting nervous (24.1%), and seeking euphoria (24.1%) were the most common reasons for restarting cigarette smoking after cessation. The majority of participants believed that smoking in public places was a violation of the rights of others and smoking should be avoided in such places. Smoking prevention programs should focus on adolescents as the most vulnerable age group. Raising the retail price of tobacco products through increasing taxes can reduce consumption, particularly among first starters and youth. However, increasing taxes and prices of tobacco products may be effective when simultaneous effective measures are implemented to eliminate all kinds of illicit trade in all forms of tobacco products.

  5. Irans Nuclear Program: Tehrans Compliance with International Obligations

    Science.gov (United States)

    2016-04-07

    issue of concern directly affecting fulfilment of JCPOA commitments. 14 Iran has a plant for producing heavy water. Iran’s Nuclear Program: Tehran’s...U.S. official statements have consistently reiterated that Tehran has not yet decided to build nuclear weapons. 58 British Foreign Secretary...Iran’s Nuclear Program: Tehran’s Compliance with International Obligations Paul K. Kerr Analyst in Nonproliferation April 7, 2016

  6. Iran

    DEFF Research Database (Denmark)

    Elling, Rasmus Christian

    2016-01-01

    Gang på gang har Iran som stat og folk fremkaldt misforståelser, fascination og fordømmelser. Kritikere forkaster landets religiøse ledere og politiske undertrykkelse; kendere lovpriser landets dybe kulturhistorie og mangfoldighed. Men hvorfor er særligt Iran genstand for så blandede opfattelser......? Er Iran noget helt særligt – eller ganske almindelig?...

  7. Cost Effectiveness of Iran National Plasma Contract Fractionation Program

    Directory of Open Access Journals (Sweden)

    Abdol Majid Cheraghali

    2012-10-01

    Full Text Available Plasma derived medicines (PDM including immunoglobulins, clotting factors and albumin are life saving medicines which due to their high costs are inaccessible for many patients living in developing countries. By contrary substantial volume of plasma as raw materials for production of these medicines are discarded worldwide. Good quality recovered plasma, as a result of separation of donated blood into its components, could be used for production of PDM. In 2011 Iranian donors donated about 2 million units of blood. A shift fromadministration of whole blood to components therapy has resulted in the generation of over 250,000 liters of surplus of recovered plasma. This created a good opportunity for Iran’s health care system to use this plasma for production of PDM. Therefore Iran national transfusion service has started a contract fractionation program for converting recovered plasma into PDM. This program not only provided essential PDM for Iran pharmaceutical market but also has created a direct saving of about 8.5 million Euros in 2011 for national health sector. In addition this program has drastically contributed to improvement of overall quality of working procedures and services provided by Iran national blood transfusion organization.

  8. Position of the American Think Tanks on Iran's Nuclear Program

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    Natalia Viktorovna Ivkina

    2015-12-01

    Full Text Available The article examines the role of “analytical centers” in the US foreign policy agenda. From a variety of “think tanks” highlights those who have made the greatest impact on the foreign policy - the Heritage Foundation and the Center for American progress. They examine U.S. relations with other regions of the world. The marked correlation between the reports of these think tanks and the positions of the Democratic and Republican parties of the USA. Based on the publications of articles and reports from these centers, it is considered one of the directions of U.S. foreign policy. In the article there is the comparative analysis of the approaches of these centers to the problem of Iran's nuclear program. This question is particularly acute on the agenda in relations between Iran and the United States. In addition, in 2015, the negotiations between Iran and the Six mediators on the nuclear issue has entered a crucial stage, it makes this issue the most relevant. The author makes a conclusion about the extent of American influence of “think-tanks” on foreign policy decisions in general and on specific political situation.

  9. Iran.

    Science.gov (United States)

    1987-05-01

    Iran's population stood at 49.8 million in 1986, 1 1/2-2 million of which were Afghan refugees. The annual population growth rate was 4%. The infant mortality rate was 10/1000 and life expectancy was 54 years. 40% of the labor force is engaged in agriculture, 33% are employed in industry and commerce, and 27% work in services. Iran is an Islamic republic dominated by the Islamic Republican Party. By the 1970s, Iran has achieved significant industrialization and economic modernization. However, economic activity was disrupted by the 1979 revolution and more recently by the war with Iraq and the sharp decline in oil prices. All major business and industrial growth indicators are significantly below prerevolutionary levels and unemployment is over 30%. Political infighting has hampered the formulation of coherent economic policies, and purges in the civil service in the postrevolutionary phase eliminated many qualified personnel. The petroleum, mining, utilities, and transportation sectors have been nationalized, but there is dissension within the Khomeni's regime as to how to proceed with land reform. Iran's gross national product was US$75 billion in 1986, with a per capita income of $1667. Inflation is about 25-40%.

  10. 78 FR 31999 - 30-Day Notice of Proposed Information Collection: Iran Democracy Program Grants Vetting

    Science.gov (United States)

    2013-05-28

    ... Notice of Proposed Information Collection: Iran Democracy Program Grants Vetting ACTION: Notice of...: Iran Program Grants Vetting. OMB Control Number: 1405-0176. Type of Request: Extension. ] Originating... conduct this vetting, the Department collects information from grantees and sub-grantees regarding the...

  11. 75 FR 25307 - 30-Day Notice of Proposed Information Collection: DS-4100, Iran Program Grants Vetting...

    Science.gov (United States)

    2010-05-07

    ... Notice of Proposed Information Collection: DS-4100, Iran Program Grants Vetting, Information Collection... Department conduct a vetting of potential Iran programs grantees and sub-grantees for counter-terrorism purposes. To conduct this vetting the Department envisions collecting information from grantees and sub...

  12. 78 FR 15798 - 60-Day Notice of Proposed Information Collection: Iran Democracy Program Grants Vetting

    Science.gov (United States)

    2013-03-12

    ... Notice of Proposed Information Collection: Iran Democracy Program Grants Vetting ACTION: Notice of... to conduct vetting of potential Iran ] program grantees and sub-grantees for counter-terrorism purposes. To conduct this vetting, the Department collects information from grantees and sub-grantees...

  13. 75 FR 2181 - 60-Day Notice of Proposed Information Collection: DS-4100, Iran Program Grants Vetting...

    Science.gov (United States)

    2010-01-14

    ... Notice of Proposed Information Collection: DS-4100, Iran Program Grants Vetting, Information Collection... Foreign Assets Control (OFAC) mandates that the Department conduct a vetting of potential Iran programs grantees and sub-grantees for counter-terrorism purposes. To conduct this vetting the Department envisions...

  14. Sacred values and conflict over Iran's nuclear program

    Directory of Open Access Journals (Sweden)

    Morteza Dehghani

    2010-12-01

    Full Text Available Conflict over Iran's nuclear program, which involves a US-led policy to impose sanctions on Iran, is perceived by each side as a preeminent challenge to its own national security and global peace. Yet, there is little scientific study or understanding of how material incentives and disincentives, such as economic sanctions, psychologically affect the targeted population and potentially influence behaviour. Here we explore the Iranian nuclear program within a paradigm concerned with sacred values. We integrate experiments within a survey of 1997 Iranians. We find that a relatively small but politically significant portion of the Iranian population believes that acquiring nuclear energy has become a sacred value, in the sense that proposed economic incentives and disincentives result in a ``backfire effect'' in which offers of material rewards or punishment lead to increased anger and greater disapproval. This pattern was specific to nuclear energy and did not hold for acquiring nuclear weapons. The present study is the first demonstration of the backfire effect for material disincentives as well as incentives, and on an issue whose apparent sacred nature is recent rather than longstanding.

  15. Self-Care Behaviors among Patients with Heart Failure in Iran

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    Vahid Zamanzadeh

    2012-11-01

    Full Text Available Introduction: Recovery from heart failure and dealing with its effects is significantly influenced by patient’s self-care. In order to maximize the effects of behavioral interventions and for educational planning, it is essential to know how much experience and information do patients with heart failure have about their disease and self-care behaviors. The present study aimed to identify self-care behaviors in patients with heart failure. Methods: Eighty heart failure patients hospitalized in Shahid Madani Training Center in Tabriz, Iran, participated in this study. Data collection was done through Self-Care of Heart Failure Index (SCHFI that contained 22 questions in three sections including self-care behaviors, self-care management and confidence in performing self-care behaviors. Results: The patient’s self-care behaviors in three behavioral sub categories of maintaining, managing and confidence were low. The most repeated self-care behavior in the participating patients was taking medication and visiting the doctor. Conclusion: The results of the study showed low levels of self-care behaviors in patients with heart failure, which notes the need for patient empowerment. It is necessary to develop appropriate strategies in this regard by the authorities

  16. Iran’s Growing Nuclear Weapons Program: A Catalyst for Regional Instability in the Middle East

    Science.gov (United States)

    1993-03-10

    military spending . This increase has been primarily in the area of conventional forces, however there is growing evidence that Iran is also attempting to develop a nuclear weapons capability as well. This study examines Iran’s nuclear weapons program in detail, and Tehran’s increasing ability to emerge as a regional power in the Middle

  17. Risk Factors of Congenital Heart Diseases: A Case-Control Study in Northwest Iran

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    Naghavi-Behzad Mohammad

    2013-03-01

    Full Text Available Introduction: Congenital heart diseases are of immense importance and also a high prevalence. Contributing factors to developing these defects have not been abundantly studied. Therefore, the current study was conducted aiming at determining the effective factors on Congenital Heart Disease (CHD in newborn infants of Northwest Iran. Methods: A case-control study was carried out in North-West of Iran from 2002 to 2012 and a total of 473 infants entered the study. Required data were obtained through check lists completed by the information of hospital records and interview with mothers of 267 newborn infants with CHD together with medical records of mothers as the case group, and 206 medical records of healthy infants at the same period all together with those of their mothers as the control group. The obtained data were statistically analyzed using descriptive statistical methods, T-test, Spearman’s correlation coefficient, and Multi-variable Logistic Regression Model (OR with 95% CI, using SPSS.19. In the present study, P value less than 0.05 was considered statistically significant. Results: Based on the results of univariable analyses, the number of previous cesarean sections, past medical history of diseases, gestational age (GA, fetal weight at birth, diastolic blood pressure, fetal heart rate, pulse rate, fetal hemoglobin and hematocrit levels, and fetal head circumference at birth have significant relationship with incidence of congenital abnormalities (P<0.05. Family history, past cesarean sections history, past medical history and GA had significant relationship with CHD incidence. Conclusion: Based on the results of present study, in order to control and reduce the cases of CHD, it is crucial to make proper decisions and implement policies for reducing cesarean cases, lowering consanguineous marriages, providing proper pre-marriage counseling, prompt treatment of mothers’ illnesses, improving pregnancy health care and mothers

  18. Neonatal hearing screening program in Ahvaz, Southern Iran

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    Marzieh Amiri

    2014-01-01

    Full Text Available Background and Aim: American Academy of Pediatrics (AAP established standards for neonatal hearing screening programs in 1999. The main purpose of this study was to achieve exact statistical data of this program in Ahvaz, Iran, and to compare these results with the standards of American Academy of Pediatrics.Methods: In this cross-sectional descriptive study, the data of neonatal hearing program in Ahvaz west health center from 2008 to 2011 were reviewed. Data were analysed by descriptive statistics.Results: From 25073 neonates, 25 had hearing loss. The false positive and referral ratio to the diagnosis stage were 2.6 and 0.48 percent, respectively. 92 percent of hard of hearing infants were diagnosed before three months of life.Conclusion: In comparison with the standards of American Academy of Pediatrics, all of the items, except two, were included completely or relatively complete. But, more efforts must be done to achieve the whole standards which are available.

  19. Nuclear program of Iran. Towards de-escalation of a nuclear crisis. Advisory letter; Nucleair programma van Iran. Naar de-escalatie van een nucleaire crisis. Briefadvies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-04-15

    The Dutch government, partly at the request of the House of Representatives (Second Chamber), the AIV asked to give an opinion about the position of Iran in the region and the role of the nuclear program of Iran in the geopolitical relations, in view of the most recent developments [Dutch] De Nederlandse regering heeft, mede op verzoek van de Tweede Kamer der Staten-Generaal, de AIV gevraagd advies uit te brengen over de positie van Iran in de regio en de rol van het nucleaire programma van Iran in de geopolitieke verhoudingen hierin, mede gelet op de meest recente ontwikkelingen.

  20. The epidemiological aspects of congenital heart disease in central and southern district of Iran

    Directory of Open Access Journals (Sweden)

    Sara Amel-Shahbaz

    2014-01-01

    Full Text Available Background: Congenital heart disease (CHD is a major health problem and its prevalence is different around the world. The aim of study was determination of the epidemiological aspects of CHD in central and southern district of Iran. Materials and Methods: In this descriptive and analytical study, 3714 medical records were evaluated from March 21, 2001 to December 18, 2011. Medical records of inpatients from angiography and outpatients in the Heart Clinic of Afshar hospital (a referral hospital in center and south of Iran were the source of information. Types of CHD and demographic data including age, sex and residential location are collected. The data were analyzed by SPSS (version 17 software. Chi-square and Fisher′s exact tests were used to compare variables between groups. Results: At the study, the mean age of the patients at diagnosis time was 8.8 ± 11.6 year (at the range of one day to 76 years with median of 4 years. The percentage of females and males was 54.2 (n: 2014 and 43.8 (n: 1627, respectively. The chi-square test showed that there was significant difference in frequency of CHDs between females and males (P value < 0.0001. Ventricular septal defect (VSD was found to be the most frequent of CHDs (27%. Patent ductus arteriosus (PDA (16.8%, atrial septal defect (ASD (15.8%, pulmonary stenosis (PS (11% and Tetralogy of Fallot (TOF (8.9% were more prevalent in CHDs after VSD. Conclusions: The frequency of CHDs in female was more than male and VSD, PDA, ASD, PS, and TOF were most common in CHDs, respectively.

  1. Baku paper reports Armenian role in Iran's nuclear program

    CERN Multimedia

    2003-01-01

    "The war in Iraq has made the subject of nuclear research in countries of the third world a matter of current interest. Talk at this time is mostly about Iran, which has oil, and American experts believe, will in the next 3-4 years be perfectly capable of making a nuclear bomb" (1 page).

  2. Incidence of Congenital Heart Diseases Anomalies in Newborns with Oral Clefts, Zahedan, Iran

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    Noor Mohammad Noori

    2016-09-01

    Full Text Available Background Oral cleft is the most common orofacial congenital anomaly among live births. This anomaly at birth is one of the main causes of children disability and mortality.  Congenital heart disease (CHD is one of the most common anomalies in oral clefts.  This study aimed to assess the incidence of congenital heart diseases anomalies in newborns with oral clefts. Materials and Methods This study performed on 48,692 live born to estimate incidence of oral clefts from 1 st December 2013 to 31 th November 2015 from three general hospitals in Zahedan, The capital city of the Sistan & Baluchestan  province, Iran. All oral cleft patients were under echocardiography to diagnosis the incidence of CHD as associated anomaly. The collected data were processed using SPSS-16. Results The results of the analysis showed that the incidence of cleft lip was higher in boys than girls, while the cleft palate was higher in girls. Lip/palate cleft was higher for boys.  Oral clefts patients accounted of 102 (0.2% with incidence rate of 2.095 per 1000 lives. Of 102 patients 19 (18.62%, 39(35.24% and 44(43.14% were oral lip, oral palate and both respectively. The incidence of CHD in patients with oral clefts was 26.5%, while the incidences for cleft lip, cleft palate and both were 15.79%, 20.51%, and 36.36% respectively. Conclusion From the study concluded that the rate of CHD among children with oral clefts was high compared with the healthy children.  Strongly is suggested the echocardiography for these patients to have early diagnostic of CHD to manage any life-threatening.

  3. Correlation between Heart, Liver and Pancreas Hemosiderosis Measured by MRI T2* among Thalassemia Major Patients from Iran.

    Science.gov (United States)

    Azarkeivan, Azita; Hashemieh, Mozhgan; Shirkavand, Afshan; Sheibani, Kourosh

    2016-02-01

    Major thalassemia patients need lifelong transfusions. The consequence of these repeated transfusions is iron accumulation in different organs. The main aim of the present study was to investigate the correlation between heart, liver and pancreas hemosiderosis in thalassemic patients from Iran. This cross-sectional study was conducted on 164 major thalassemia patients at Zafar Adult Thalassemia Center, a referral thalassemia center in Tehran, Iran, from May to November 2014.  All patients were on regular blood transfusion at 2-4 week intervals to keep their hemoglobin at a level of 7-9 gr/dL before each transfusion. Demographic data were gathered from patients' history. MRI T2* of liver, heart and pancreas were performed for all patients. There were a moderate correlation between pancreatic T2* and cardiac T2* relaxation times (r = 0.42, P < 0.001), a moderate correlation between T2* of pancreas and liver (r = 0.41, P < 0.001), and a weak correlation between T2* relaxation times of heart and liver (r = 0.31, P < 0.001). Poor correlation between liver and heart, as well as a weak to moderate correlation between pancreas and liver T2* relaxation times indicate that relying on liver MRI T2* to predict the exact condition of pancreas or heart iron overload might not be a reliable approach in thalassemia major patients. Our findings suggest the advantage of using pancreas and heart MRI T2* as a non-invasive method for estimation of iron overload instead of relying on liver MRI T2*.

  4. A Qualitative Approach to Examining Knowledge Sharing in Iran Tax Administration Reform Program

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    Mehdi Shami Zanjanie

    2012-02-01

    Full Text Available The paper aims to examine knowledge sharing infrastructure of "Iran Tax Administration Reform Program". The qualitative approach by using case study method was applied in this research. In order to meet the research goal, four infrastructural dimensions of knowledge sharing were studied: leadership & strategy, culture, structure, and information technology. To the authors’ knowledge, this was maybe the first paper which examined knowledge sharing infrastructure in programs environment

  5. Implementation of "Heart Smart:" A Cardiovascular School Health Promotion Program.

    Science.gov (United States)

    Downey, Ann M.; And Others

    1987-01-01

    "Heart Smart," a research-based health promotion program for elementary schools, was tested in four elementary schools. The program's objectives, strategies, curriculum, and other components are described. (Author/MT)

  6. Amblyopia prevention screening program in Northwest Iran (Ardabil

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    Habib Ojaghi

    2016-01-01

    Conclusions: The present investigation showed that coverage of amblyopia screening program was not enough in Ardabil Province. To increase the screening accuracy, standard instruments and examination room must be used; more optometrists must be involved in this program and increasing the validity of obtained results for future programming.

  7. Ethnical Variations in the Incidence of Congenital Heart Defects in Gorgan, Northern Iran: A Single-Center Study

    Directory of Open Access Journals (Sweden)

    Bagher Nikyar

    2015-10-01

    Full Text Available Background: Congenital heart disease (CHD is the most common congenital anomaly in newborns. This study was performed to determine the live birth incidence of CHD by ethnicity and sex in Gorgan, Northern Iran.Methods: In this longitudinal, hospital-based study, 18162 live births in Dezyani Hospital in Gorgan, North of Iran, were screened for CHD, from 2007 through 2009. Clinical examination, echocardiography, color Doppler, and cardio catheterization were used as diagnostic tools. Sex, ethnicity, and type of CHD for each case were recorded in a pre-designed questionnaire.Results: The incidence rates of CHD in the native Fars, Sistani, and Turkmen subjects were 5.73 (95%CI: 4.53-7.15,12.27 (95%CI: 8.74-16.73, and 15.93 (95%CI: 10.00-24.02 per 1000 live births, respectively. The Turkmen to native Fars and Sistani to native Fars relative risk for congenital CHD malformations was 2.77 (95%CI: 1.73-4.44; p value < 0.001 and 1.29 (95%CI: 0.77-2.18; p value < 0.323, respectively. While atrial septal defect was the most common lesion in the native Fars subjects (2.14 per 1000 [95%CI: 1.42-3.06] and in the Sistani subjects (2.84 per 1000 [95%CI: 1.29-5.36], in the Turkmen subjects, ventricular septal defect (4.36 per 1000 [95%CI: 1.59-9.43], followed by atrial septal defect, was the most frequent lesion.Conclusion: This study showed that the incidence and pattern of CHD among live births in Gorgan, North of Iran, varied according to ethnicity. The risk of CHD was higher in the Turkmen and Sistani groups than in the Fars population

  8. Nosocomial infections and antibiotic resistance pattern in open-heart surgery patients at Imam Ali Hospital in Kermanshah, Iran.

    Science.gov (United States)

    Heydarpour, Fatemeh; Rahmani, Youssef; Heydarpour, Behzad; Asadmobini, Atefeh

    2017-01-01

    Background: Patients undergoing open heart surgery have a relatively high risk of acquiring nosocomial infections. The development of antibiotic-resistant infections is associated with prolonged hospital stays and mortalities. Objectives: The present study was conducted to investigate nosocomial infections and the antibiotic resistance pattern in bacteria causing these infections in open heart surgery patients at Imam Ali Hospital in Kermanshah in the west of Iran over a 4-year period from March 2011 to March 2014. Materials and methods: The present cross-sectional study was conducted on 135 cases of nosocomial infection among open heart surgery patients. The demographic characteristics and the risk factors of each case of infection were recorded. The antibiotic susceptibility test was carried out using the Minimum Inhibitory Concentration (MIC) method based on the Clinical and Laboratory Standards Institute (CLSI) protocol. The data collected were then analyzed in SPSS-16. Results: Out of the 6,000 patients who underwent open heart surgery during this 4-year period at the selected hospital, nosocomial infections developed in 135 patients (2.25%), 59.3% of whom were female and 40.7% male. Surgery site infection (SSI), pneumonia (PNEU), urinary tract infection (UTI) and blood stream infection (BSI) affected 52.6%, 37%, 9.6% and 0.8% of the cases, respectively. E.coli , Klebsiella spp. and S. aureus were the most common bacteria causing the nosocomial infections. E. coli was most frequently resistant to imipenem (23.3%) Klebsiella spp. to gentamicin (38.5%) S. aureus to co-trimoxazole (54.2%). Conclusion: SSI had a high prevalence in this study. Further studies should therefore be conducted to examine the risk factors associated with SSI in open heart surgery. Various studies have shown that antibiotic resistance patterns are different in different regions. Finding a definitive treatment therefore requires an antibiogram.

  9. Nosocomial infections and antibiotic resistance pattern in open-heart surgery patients at Imam Ali Hospital in Kermanshah, Iran

    Directory of Open Access Journals (Sweden)

    Heydarpour, Fatemeh

    2017-05-01

    Full Text Available Background: Patients undergoing open heart surgery have a relatively high risk of acquiring nosocomial infections. The development of antibiotic-resistant infections is associated with prolonged hospital stays and mortalities.Objectives: The present study was conducted to investigate nosocomial infections and the antibiotic resistance pattern in bacteria causing these infections in open heart surgery patients at Imam Ali Hospital in Kermanshah in the west of Iran over a 4-year period from March 2011 to March 2014.Materials and methods: The present cross-sectional study was conducted on 135 cases of nosocomial infection among open heart surgery patients. The demographic characteristics and the risk factors of each case of infection were recorded. The antibiotic susceptibility test was carried out using the Minimum Inhibitory Concentration (MIC method based on the Clinical and Laboratory Standards Institute (CLSI protocol. The data collected were then analyzed in SPSS-16.Results: Out of the 6,000 patients who underwent open heart surgery during this 4-year period at the selected hospital, nosocomial infections developed in 135 patients (2.25%, 59.3% of whom were female and 40.7% male. Surgery site infection (SSI, pneumonia (PNEU, urinary tract infection (UTI and blood stream infection (BSI affected 52.6%, 37%, 9.6% and 0.8% of the cases, respectively. , spp. and were the most common bacteria causing the nosocomial infections. was most frequently resistant to imipenem (23.3% spp. to gentamicin (38.5% to co-trimoxazole (54.2%. Conclusion: SSI had a high prevalence in this study. Further studies should therefore be conducted to examine the risk factors associated with SSI in open heart surgery. Various studies have shown that antibiotic resistance patterns are different in different regions. Finding a definitive treatment therefore requires an antibiogram.

  10. Iran's growing nuclear weapons program: A catalyst for regional instability in the Middle East. Study project

    Energy Technology Data Exchange (ETDEWEB)

    Deyermond, J.J.

    1993-03-10

    Following the end of the Cold War, the United States as well as other nations around the world now find themselves in a state of political, economic, and military transition. While the US and other nations such as the Islamic Republic of Iran are undergoing significant increases in military spending. This increase has been primarily in the area of conventional forces, however there is growing evidence that Iran is also attempting to develop a nuclear weapons capability as well. This study examines Iran's nuclear weapons program in detail, and Tehran's increasing ability to emerge as a regional power in the Middle East.

  11. Transplantation activities in Iran.

    Science.gov (United States)

    Broumand, Behrooz

    2005-06-01

    Iran is a tropical country with a land area of 1,648,000 square kilometers and a population of 68,100,000. Iran has a recorded history that dates back 2553 years. Its earliest medical school was Pasargad. Jondi Chapour University was founded 1753 years ago during the Sassanid dynasty as a center for higher education in medicine, philosophy, and pharmacology. Indeed, the idea of xenotransplantation dates back to days of Achaemenidae (Achaemenian dynasty), as evidenced by engravings of many mythologic chimeras still present in Persepolis. Avicenna (980-1037 AD), the great Iranian physician, performed the first nerve repair. Transplantation progress in Iran follows roughly the same pattern as that of the rest of the world, with some 10-20 years' delay. Modern organ transplantation dates back to 1935, when the first cornea transplant was performed at Farabi Hospital in Tehran, Iran. The first living-related kidney transplantation performed at Shiraz University Hospital dates back to 1968. The first bone marrow transplant was performed at Dr. Shariaati's Hospital in Tehran. The first heart transplant was performed 1993 in Tabriz, Iran. The first liver transplant was performed in 1993 in Shiraz. The first lung transplant was performed in 2001, and the first heart and lung transplants were performed in 2002, both at Tehran. In late 1985, the renal transplantation program was officially started in a major university hospital in Tehran and was poised to carry out 2 to 4 transplantations each week. Soon, another large center initiated a similar program. Both of these centers accepted surgical, medical, and nursing teams from other academic medical centers for training in kidney transplantation. Since 2002, Iran has grown to include 23 active renal, 68 cornea, 2 liver, 4 heart, 2 lung, and 2 bone marrow transplantation centers in different cities. In June 2000, the Organ Transplantation Brain Death Act was approved by the Parliament, followed by the establishment of the

  12. Program Evaluation of "Young at Heart": Examining Elderly Volunteers' Generativity.

    Science.gov (United States)

    Scott, Jean Pearson; Reifman, Alan; Mulsow, Miriam; Feng, Du

    2003-01-01

    Elderly volunteers in the Young at Heart child care program (n=14), Meals on Wheels (n=14), other volunteer activities (n=24), and nonvolunteers (n=49) were compared. Although child-care volunteers were expected to score highest in generativity, volunteers in other activities did, followed by Young at Heart volunteers. (Contains 10 references.)…

  13. Cost-utility analysis of neonatal screening program, shiraz university of medical sciences, shiraz, iran, 2010.

    Science.gov (United States)

    Hatam, Nahid; Shirvani, Samad; Javanbakht, Mehdi; Askarian, Mehrdad; Rastegar, Mohsen

    2013-10-01

    The most important cause of infant mortality during the first month of life is related to congenital abnormalities. Nevertheless, timely diagnosis of these diseases can reduce the severity of their effects. The present study aimed to investigate the cost-effectiveness of the neonatal screening program in Fars Province, Iran. In this study, costs of executing the screening programs, treatment of the diagnosed cases, treatment of affected, non-screened individuals, quality of life, and incremental cost-effectiveness ratios were measured in two study groups. Performing the screening programs for phenylketonuria, congenital hypothyroidism, galactosemia, and favism resulted in respectively $3386, $13078, $19641, and $1088 saving per patient. Overall, the study results revealed the cost-effectiveness of execution of the neonatal screening program. Neonatal screening program is one of the health interventions which lead to long-term beneficial outcome for the patients, financial saving for the society, and improvement of the patients' quantity as well as quality of life.

  14. Developing a blended learning program for nursing and midwifery students in Iran: Process and preliminary outcomes.

    Science.gov (United States)

    Zolfaghari, Mitra; Negarandeh, Reza; Eybpoosh, Sana

    2013-01-01

    We aimed to develop and evaluate outcomes of a blended learning (BL) program for educating nursing and midwifery students of Tehran university of medical sciences (Tehran, Iran). This was a participatory action research project. After designing BL website, providing technological infrastructures, and holding preparatory workshops, 22 blended courses were designed. BL method was implemented for one semester. Students' grade point average, participation with courses, and opinion about educational methods, and instructors' attitude and opinion about educational methods were assessed. Most students (n = 181; 72.1%) and 17 instructors (28.3%) consented to participate in the study. Students' grade point average and participation was significantly higher in BL rather than in face-to-face method (P learning outcomes and participation. The strengths and weaknesses of the program should be considered for development of next phase of the project. Lessons learned in this phase might be helpful for decision makers who tend to develop similar programs in Iran. Motivational and communicational issues and users' IT skills should be addressed in every BL program.

  15. Developing a blended learning program for nursing and midwifery students in Iran: Process and preliminary outcomes

    Science.gov (United States)

    Zolfaghari, Mitra; Negarandeh, Reza; Eybpoosh, Sana

    2013-01-01

    Background: We aimed to develop and evaluate outcomes of a blended learning (BL) program for educating nursing and midwifery students of Tehran university of medical sciences (Tehran, Iran). Materials and Methods: This was a participatory action research project. After designing BL website, providing technological infrastructures, and holding preparatory workshops, 22 blended courses were designed. BL method was implemented for one semester. Students’ grade point average, participation with courses, and opinion about educational methods, and instructors’ attitude and opinion about educational methods were assessed. Results: Most students (n = 181; 72.1%) and 17 instructors (28.3%) consented to participate in the study. Students’ grade point average and participation was significantly higher in BL rather than in face-to-face method (P learning outcomes and participation. The strengths and weaknesses of the program should be considered for development of next phase of the project. Lessons learned in this phase might be helpful for decision makers who tend to develop similar programs in Iran. Motivational and communicational issues and users’ IT skills should be addressed in every BL program. PMID:23983723

  16. Satisfaction and Dissatisfaction Toward Urban Family Physician Program: A Population Based Study in Shiraz, Southern Iran.

    Science.gov (United States)

    Honarvar, Behnam; Lankarani, Kamran Bagheri; Ghahramani, Sulmaz; Akbari, Maryam; Tabrizi, Reza; Bagheri, Zahra; Poostforoushfard, Sima

    2016-01-01

    A national project of extending a family physician program to urban areas has been started since May 2013 in Iran. The present study aimed to detect correlates of people's satisfaction and dissatisfaction about urban family physician program. This cross-sectional and population-based study was conducted in Shiraz, Southern Iran. Multistage and proportional to size random sampling were used. Different items about satisfaction and dissatisfaction toward urban family physician program were queried. Single variable and then multiple variable analyses of data were done using SPSS software (Chicago, IL. USA). Mean age of 1257 participants in the study was 38.1 ± 13.2 years. Respondents included men (634; 50.4%), married (882; 70.2%), those who were educated at universities (529; 42%) and self-employed groups (405; 32.2%). One thousand fifty-eight (84.1%) were covered by the family physician program. Mean of referral times to a family physician was 2.2 ± 2.9 during the year before the study. Satisfaction toward urban family physician program was high in 198 (15.8%), moderate in 394 (31.3%), and low in 391 (31.1%). Dissatisfaction about this program was more among younger than 51-year-old groups (for 31-50 years odds ratio [OR] =2.3, 95% confidence interval [CI] =1.4-3.7, P < 0.001 and for 18-30 years OR = 2, 95% CI = 1.2-3.4, P = 0.005), less knowledgeable ones (OR = 2.2, 95% CI = 1.3-3.6, P = 0.001), singles (OR = 2.1, 95% CI = 1.2-3.4, P = 0.003), and those with more than 4 of family members (OR = 1.3, 95% CI = 1-1.7, P = 0.05). Overall, the majority of the people are not very satisfied with the urban family physician program. This shows the need for a multi-disciplinary approach including training, improvement of infrastructures and referral system, continuous supervision, and frequent monitoring of user's and provider's feedback about this program. According the results, the family physician program should be improved prior to extending this program to other

  17. Satisfaction and dissatisfaction toward urban family physician program: A population based study in Shiraz, Southern Iran

    Directory of Open Access Journals (Sweden)

    Behnam Honarvar

    2016-01-01

    Full Text Available Background: A national project of extending a family physician program to urban areas has been started since May 2013 in Iran. The present study aimed to detect correlates of people′s satisfaction and dissatisfaction about urban family physician program. Methods: This cross-sectional and population-based study was conducted in Shiraz, Southern Iran. Multistage and proportional to size random sampling were used. Different items about satisfaction and dissatisfaction toward urban family physician program were queried. Single variable and then multiple variable analyses of data were done using SPSS software (Chicago, IL. USA. Results: Mean age of 1257 participants in the study was 38.1 ± 13.2 years. Respondents included men (634; 50.4%, married (882; 70.2%, those who were educated at universities (529; 42% and self-employed groups (405; 32.2%. One thousand fifty-eight (84.1% were covered by the family physician program. Mean of referral times to a family physician was 2.2 ± 2.9 during the year before the study. Satisfaction toward urban family physician program was high in 198 (15.8%, moderate in 394 (31.3%, and low in 391 (31.1%. Dissatisfaction about this program was more among younger than 51-year-old groups (for 31-50 years odds ratio [OR] =2.3, 95% confidence interval [CI] =1.4-3.7, P < 0.001 and for 18-30 years OR = 2, 95% CI = 1.2-3.4, P = 0.005, less knowledgeable ones (OR = 2.2, 95% CI = 1.3-3.6, P = 0.001, singles (OR = 2.1, 95% CI = 1.2-3.4, P = 0.003, and those with more than 4 of family members (OR = 1.3, 95% CI = 1-1.7, P = 0.05. Conclusions: Overall, the majority of the people are not very satisfied with the urban family physician program. This shows the need for a multi-disciplinary approach including training, improvement of infrastructures and referral system, continuous supervision, and frequent monitoring of user′s and provider′s feedback about this program. According the results, the family physician program should be

  18. Congenital Heart Disease in Children with Down syndrome in Kermanshah, West of Iran during 2002 - 2016

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    Zahra Jalili

    2017-11-01

    Full Text Available Background Down syndrome is the most common chromosomal anomaly. Dysmorphic features can occur in several organs in this syndrome. Cardiac anomalies with a prevalence of 50% are the most common anomalies responsible for death during the first two years of life. We aimed to determine the prevalence of cardiac anomalies among Down syndrome patients admitted to two tertiary hospitals in Kermanshah, Iran from 2002 to 2016. Materials and Methods In this descriptive study, the medical records of all patients with Down syndrome admitted to two university hospitals namely Imam Ali and Imam Reza, Kermanshah city located in Western part of Iran in the study period were reviewed. All patients had received Echocardiography two-dimensional (2D. The required data including cardiac anomaly type, consanguinity of parents, maternal age, surgical interventions, and survival were collected into a checklist. Results:  During the study period, 166 patients with Down syndrome had received diagnostic and therapeutic services in the studied hospitals. There were 70 males (42.2% and 96 females (57.8%. Familial consanguinity was documented in 95 patients (57.2%. Mean ± standard deviation (SD maternal age at delivery was 26.33 (±4.7 years (range, 15 to 45 years. Of 166 studied patients, 123 (74.1% had cardiac anomaly. Ventricular septal defect (VSD was the most prevalent single defect seen in 32 (26% patients, followed by atrial septal defect (ASD detected in in 22 (17.8% patients. Seventy patients (42.1% required surgical interventions. A total of 74 patients experienced relative improvement of the symptoms. Also, seven patients (10.2% died including five females and two males. Conclusion: The frequency of cardiac anomalies in the studied population of Down syndrome patients was higher than former reported figures. The pattern of the anomalies is compatible with some former reports, but contradicts other reports.

  19. Prevention of pregnancy complications in iran following implementing a national educational program.

    Directory of Open Access Journals (Sweden)

    Maryam Moghani Lankarani

    2014-09-01

    Full Text Available To determine the impact of a national intervention program on some pregnancy complications in Iran.This multicenter study was conducted in governmental sector in 14 provinces in Iran between 2003 and 2005. Intervention included education of all maternal health care providers including gynecologists, general physicians, and midwifes in the governmental sector. Time interval between the pre- (of 3,978 and 3,958 pregnancies and post- (3,958 pregnancies measurements were 18 months. Self reported data on pregnancy complications were registered. Interviews were conducted by trained personnel. Participants were interviewed when admitted for delivery or at the time attending for vaccination of their 2 month infants.The following pregnancy complications were reduced significantly as compared to before intervention: 1 bleeding or spotting, 2 urinary tract complications, 3 blurred vision and severe headache, 4 premature labor pain, 5 anemia, 6 severe vomiting, 7 inappropriate weight gain, 8 endometritis, 9 urinary incontinence, 10 breast abscess or mastitis, 11 wound infection, and 12 bleeding was significantly reduced after intervention, compared to before intervention. Premature rupture of membrane showed a significant increase. These complications did not show a significant change: 1 hypertension, 2 fever and chills, 3 convulsion, shock, and loss of consciousness, and 4 obstetric fistula.National programs may be proved to be largely effective by decreasing some of the pregnancy complications in developing countries.

  20. What can Iran gain by having a nuclear weapons program that threatens to destabilize security in the Middle East?

    DEFF Research Database (Denmark)

    Nielsen, Thomas Galasz

    In this paper, Iran’s nuclear aspiration to destabilise power in the Middle East is analysed. Iran is attempting to develop a nuclear energy program, and perhaps even a nuclear weapons program, despite assurances of the opposite. An Iranian nuclear weapon would be a game changer in the region......, and domestic challenges, caused in part by United Nations’ sanctions, lack of development and internal political power struggles. Iran balances cleverly on the edge of either further international isolation or becoming a significant local power. It uses the threat of developing nuclear weapons, in com...... and a lot of neigh- bouring countries fear such a development for security reasons. But why is Iran following a nuclear path that may further destabilise the fragile security situation in the Middle East? It is to do with Iran’s own perception of security risks, its desire for greatness in the region...

  1. Prevalence and Risk Factors of Postoperative Delirium in Patients Undergoing Open Heart Surgery in Northwest of Iran

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    Ahmadreza Jodati

    2013-09-01

    Full Text Available Introduction: Delirium as a relatively common complication following cardiac surgery remains a contributory factor in postoperative mortality and an obstacle to early discharge of patients.Methods: In the present study 329 patients who underwent open heart surgery between 1st January 2008 to 1st January 2009 in Shahid Madani Heart Center, Tabriz, Iran were enrolled.Results: Overall 4.9% of patients developed delirium after cardiac surgery. We found atrial fibrillation (P = 0.005, lung diseases (P = 0.04 and hypertension (P = 0.02 to be more common in patients who develop delirium postoperatively. Furthermore, the length of intensive care unit (ICU stay, cardiopulmonary bypass (CPB time, and ventilation period were also significantly increased. Also a statistically meaningful relationship between the female gender and development of delirium was also noted (P = 0.02. On the other hand no meaningful relationship was detected between diabetes, history of cerebral vascular diseases, peripheral vascular diseases, myocardial infarction, development of pneumonia following surgery, and laboratory levels of sodium, potassium, glucose, and complete blood cell count (CBC including white blood cells, red blood cells, platelets in the blood-hemoglobin and hematocrits. Also environmental factors like presence of other patients or companion with the patient, and objects like clock, window and calendar in the patient’s room did not affect prevention of delirium.Conclusion: Based on this and other investigations, it can be suggested to use MMPI test to recognize pathologic elements to prevented delirium after surgery and complementary treatment for coping with delirium.

  2. North Korea and Iran’s Nuclear Programs as Instability Factors in the New System of International Relations

    Science.gov (United States)

    2007-11-01

    that North Korea’s mission to increase its own offensive capabilities is overshadowed by the commercial objective to attract more potential buyers for...diplomatic compulsion ) failure. Apparently, this research will affect the future National Intelligence Council’s nuclear program evaluation of Iran, in

  3. Overview of Flour Fortification Program with Iron and Folic Acid in Iran

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    Marjan Mahdavi-Roshan

    2017-06-01

    Full Text Available Introduction and purpose: A large percentage of the world population suffers from hidden hunger, which is defined as micronutrients deficiency. Iron deficiency anemia is one of the most common complications of the micronutrients deficiency and there is a lot of effort to deal with this problem. For this purpose, this study aimed to examine the program of flour fortification with iron in Iran. Methods: The cohort, case-control, and clinical trial studies with the search strategies such as iron deficiency anemia, fortification, and micronutrients deficiency, which were conducted until 2015 were included. The data sources entailed PubMed, Ovid, Elsevier Science, Blackwell Synergy, and Google. All the selected studies were available in English and Persian. Results: In several countries, the best method for correction of the iron deficiency anemia is food fortification due to high efficacy and low adverse effects of this method. Bread is a staple food in Iran; therefore, flour fortification was performed in this country. The premix powder containing 30 ppm of iron and 1.5 ppm of folic acid was used for flour fortification. Considering the various types of wealth, the total amount of iron in flour was up to 80 to 85 ppm that may lead to iron poisoning in people with a low socio-economic status because of high bread consumption, as well as the individuals with high socio-economic status since they receive iron from the other resources. Therefore this program was stopped in several provinces due to the mentioned complication. Conclusion: Prior to the implementation of this program, it was essential to carry out abundant pilot studies to investigate the probable complications and problems of this plan. To the best of our knowledge, there is limited number of studies conducted on the adverse effects of iron fortification in Iran; therefore, further studies are recommended in this issue.

  4. Infrastructures Required for the Expansion of Family Physician Program to Urban Settings in Iran.

    Science.gov (United States)

    Doshmangir, Leila; Bazyar, Mohammad; Doshmangir, Parinaz; Mostafavi, Hakimeh; Takian, Amirhossein

    2017-09-01

    Following the implementation of Family Physician (FP) Program in rural areas and cities with populations under 20000 in 2005, the Iranian Ministry of Health and Medical Education in 2012 decided to implement urban FP in large cities with populations more than 20000. Along with the development and implementation of urban FP in Iran, local websites and newspapers reflected the viewpoints of experts in various levels of health system regarding the various stages of Family Medicine (FM) development (from agenda setting to initial stages of implementation). This study aimed to explore the major infrastructures perceived to be required to achieve desirable implementation of urban FP through analyzing experts' viewpoints reflected in the media and interviews. In a qualitative study, we analyzed the contents of health related national websites as well as transcribed interviews with key informants. Documents were collected from December 2011 to January 2014 and interviews were conducted from February 2014 to June 2015. We used mixed thematic approach (inductive and deductive) for analysis that was assisted by MAXQDA 12 software. Infrastructures needed for the implementation of FP were categorized in five main themes and 23 subthemes. The themes are: 'Stewardship/governance', 'Actors and stakeholders', 'structural infrastructure', 'technical infrastructure and needed resources', and 'information and communication infrastructure'. Expansion of FP program to urban settings needs appropriate attention to the principles of policy implementation as well as provision of robust infrastructures. Well-defined stewardship, revised approach to financial regulation and payment system, stakeholder's commitment to collaboration, policy for conflict resolution, and universal insurance coverage are pivotal for the expansion of family physician program to the urban settings in Iran.

  5. Investigation of administrative obstacles to family physician program in urban areas of Iran

    Directory of Open Access Journals (Sweden)

    Javad Javan noughabi

    2017-06-01

    Full Text Available Health is regarded as one of the basic rights of each person in society; so governments are obligated to provide it equally for everyone. The best way to achieve this goal is the establishment of health insurance with the orientation of family physician and the strategic referral system. Yet, such programs will not be successful without encouraging people to participate and changing social behaviors. The aim of the present study was to investigate the administrative obstacles and problems to family physician program in urban areas of Iran. This study was a qualitative research conducted. A purposive sampling method was employed and the data were gathered via semi-structured interview with open-ended questions and document examination. All the interviews were recorded digitally and immediately transcribed verbatim. They were finally analyzed based on framework analysis. The participants' detailed descriptions showed that systemic, environmental, and human related factors were the main obstacles to the implementation of family physician plan. Since the success and performance of each program effectively cannot be obtained without people’s acceptance and collaboration, the necessity of training and giving information rapidly and timely to the residents in urban areas is felt more than ever. Also, making authorities aware of the obstacles expressed by people can be helpful in harmonizing the program with people’s requests; and can result in overcoming the challenges and obstacles facing the program.

  6. Intervention with the Lidcombe Program for a bilingual school-age child who stutters in Iran.

    Science.gov (United States)

    Bakhtiar, Mehdi; Packman, Ann

    2009-01-01

    In this study, the immediate and extended effects of the Lidcombe Program were investigated for the first time in Iran. Treatment in the Lidcombe Program is carried out by the child's parent (or carer) in the child's everyday environment. The program has been shown to be effective with preschool children who stutter (i.e. younger than 6 years) and to a lesser extent with older children. PARTICIPANT AND METHOD: The participant was a bilingual (Baluchi-Persian) boy aged 8 years 11 months. Treatment was conducted in both languages. Stuttering severity was measured in Baluchi with the parental rating scale, and in Persian with percentage of syllables stuttered (%SS). The child completed stage 1 of the program in 13 weeks. %SS was less than 1 during the last 3 clinic visits and severity ratings made by the parent indicated no stuttering (severity rating = 1) for all days of the final week. Speech recordings made beyond the clinic in both languages also indicated stuttering at below 1%SS. The child met all criteria for stage 2 in both languages, over 10 months. This case report suggests that the Lidcombe Program could be suitable for bilingual Iranian children who stutter.

  7. The effect of sexual health education program on women sexual function in Iran.

    Science.gov (United States)

    Behboodi Moghadam, Zahra; Rezaei, Elham; Khaleghi Yalegonbadi, Fariba; Montazeri, Ali; Arzaqi, Syed Masood; Tavakol, Zeinab; Yari, Fatemeh

    2015-01-01

    Sexual dysfunction is the most common disorder in women. According to the WHO, sexual education programs are considered as a need. Therefore, this study was designed to investigate the effect of educational program on sexual function in women with sexual dysfunction. This randomized trial, was conducted in 2013 on 90 married women by convenient sampling in Qazvin, central Iran. The demographic, Female Sexual Function Index (FSFI), and Beck's Depression Inventory (BDI) questionnaires were completed during structured interviews. After completing the sample size, subjects were divided randomly into two groups by using the table of random numbers (educational and control groups), then respectively received an educational intervention in the four sessions with one week interval and routine program offered by the center and following-up was done with refilling questionnaires 8 weeks after intervention. Sexual function improved after sex educational programs in all dimensions (sexual desire (P=0.006), sexual exciting (P=0.006), vaginal moisture (P=0.002), sexual satisfaction (P=0.011), and total score of sexual function (P=0.001). Considering the importance role of sexual function in family strength, health, and development, it can be claimed that educational sex programs can help practitioners to improve sexual function of married women with sexual dysfunction.

  8. Water allocation for agriculture in southwestern Iran using a programming model

    Science.gov (United States)

    Esmaeili, Abdoulkarim; Shahsavari, Zahra

    2015-09-01

    Water pricing can play a major role in improving water allocation, encouraging users to conserve scarce water resources, and promoting improvements in productivity. In this study, the economic values of water in farms under Dorodzan Dam in southwestern Iran were calculated using linear programming models. The method was applied to three samples of farms that drew irrigation water from a canal, a well, and both a well and a canal. The results of this study revealed that the shadow prices of water in farms varied based on the water sources and time of year. Additionally, the estimated price for water is obviously higher than the price that farmers currently pay for water in the study area. Due to the different economic values of water calculated for different months, it is recommended that the price of irrigation water be adjusted accordingly during various seasons in a fashion similar to that of electrical energy.

  9. The Trend of the Extended Program of Immunization (EPI in Iran from the Beginning (1984 to 2013

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    Zohreh Arefi

    2015-07-01

    Full Text Available Introduction The extended program of immunization (EPI in Iran is started in 1984, and it played an important and effective role in controlling many infectious diseases in community. The objective of this study was to determine the time trends of vaccination coverage by the type of vaccine among children, in the age group of 0-24 months, in Iran from the beginning of EPI (1984 to 2013. Materials and Methods This study has been conducted as a descriptive analytical research to evaluate the vaccines of extended program of immunization in Iran from 1984 to 2013. The data of this study have been obtained from the World Health Organization and UNICEF. The data of this study included the percentage of coverage for routine vaccines in Iran National immunization program in children, aged 0-24 months. The data analysis has been done by STATA, Version12. Results The coverage of all vaccines has been continuously increased from 1984 to 2013, and now the coverage for all of them is about 99 percent. All coefficients in the regression models are positive and statistically significant (P

  10. Evaluation of an Urban Phase of the Specialized Care Program for Diabetes in Iran: Providers′ Perspectives

    Directory of Open Access Journals (Sweden)

    Hamid Ravaghi

    2014-01-01

    Full Text Available Background: To develop and implement more effective programs of health care delivery to prevent and control diabetes, Iran has developed and implemented the urban phase of the specialized care program for diabetic′s patients. Deeply understanding the views and experiences of various stakeholders in this program can assist policy makers to identify the program′s strengths and weaknesses and enable them to develop action plans. Hence, the present study aimed to evaluate the planning and establishing of this program from the perspective of providers. Methods: A qualitative study was applied using documents review and face-to-face semi-structured interviews with the program leads and relevant executive managers of the local medical universities. Thematic analysis was used to analyze the data. Results: Three main themes and nine subthemes were explored, including program planning (the content and the strengths, weaknesses, and corrective measures, implementation (executive mechanisms at the university level, establishment of referral system, collaboration between deputies of health and treatment, information dissemination mechanisms, satisfaction measurement and strengths, weaknesses and corrective measures, and result (implementation results. Conclusions: The urban phase of the specialized care program for diabetic′s patients has been a good base to improve continuity of care, which emphasizes on controlling and prevention of occurrence or progression of chronic complications of diabetes. This model can also be used for better management of other chronic disease. However, there are still issues that should be considered and improved such as allocation of guaranteed resources, more trained health professionals, and more evidence based guidelines and protocols, better collaboration among medical universities′ deputies, clearer payment system for program evaluation and better information management system.

  11. Injecting Drug Users Retention in Needle-Exchange Program and its Determinants in Iran Prisons

    Science.gov (United States)

    Shahbazi, Mohammad; Farnia, Marzieh; Moradi, Ghobad; Karamati, Mohammadreza; Paknazar, Fatemeh; Mirmohammad Khani, Majid

    2015-01-01

    Background: Participation and to stay in a health program depends on many factors. One of these programs is Needle Exchange Program (NEP) in prisons. Objectives: The current study aimed to evaluate the retention of injecting drug prisoners and find the related factors in Iran. Patients and Methods: This cohort study analyzed data about injecting drug male prisoners who were participated in NEP in three Iranian prisons. Data was collected from October 2009 to June 2010. A proper approach of survival analyses including Kaplan-Meier method, Log-Rank test, and Cox Proportional Hazard Model were used to evaluate Injecting Drug Users (IDUs) retention in NEP and its determinants. Results: Out of 320 prisoners, 167 were from Isfahan Central Prison, 82 from Tehran-Ghezel-Hesar Prison, and 71 from Hamadan Central Prison. Two-hundred and fifty prisoners (78.4%) had history of drug injection; and drug injection was the most common choice for 115 persons (35.9%). Participants were followed up for 29 weeks, the mean (SD) time of retention in the program was 24.1 (0.6) weeks. There was a significant relationship between age, number of used needles per week, duration of addiction, age of addiction onset, as well as imprisonment age, main method of drug use, type of main using drug, Hepatitis B Virus (HBV) infection, job status, reason of arrestment, history of involvement in harm reduction programs, and the length of retention (P addiction (P = 0.048), and retention. Conclusions: Tattooing and longer duration of addiction were two important factors that significantly increased retention in the program. In contrast, history of using harm reduction services was the factor that decreased persistence. The risk of quitting the program may decrease about 68% in those who did not involve in harm reduction programs. PMID:26405681

  12. "The Heart Game": Using Gamification as Part of a Telerehabilitation Program for Heart Patients.

    Science.gov (United States)

    Dithmer, Marcus; Rasmussen, Jack Ord; Grönvall, Erik; Spindler, Helle; Hansen, John; Nielsen, Gitte; Sørensen, Stine Bæk; Dinesen, Birthe

    2016-02-01

    The aim of this article is to describe the development and testing of a prototype application ("The Heart Game") using gamification principles to assist heart patients in their telerehabilitation process in the Teledialog project. A prototype game was developed via user-driven innovation and tested on 10 patients 48-89 years of age and their relatives for a period of 2 weeks. The application consisted of a series of daily challenges given to the patients and relatives and was based on several gamification principles. A triangulation of data collection techniques (interviews, participant observations, focus group interviews, and workshop) was used. Interviews with three healthcare professionals and 10 patients were carried out over a period of 2 weeks in order to evaluate the use of the prototype. The heart patients reported the application to be a useful tool as a part of their telerehabilitation process in everyday life. Gamification and gameful design principles such as leaderboards, relationships, and achievements engaged the patients and relatives. The inclusion of a close relative in the game motivated the patients to perform rehabilitation activities. "The Heart Game" concept presents a new way to motivate heart patients by using technology as a social and active approach to telerehabilitation. The findings show the potential of using gamification for heart patients as part of a telerehabilitation program. The evaluation indicated that the inclusion of the patient's spouse in the rehabilitation activities could be an effective strategy. A major challenge in using gamification for heart patients is avoiding a sense of defeat while still adjusting the level of difficulty to the individual patient.

  13. “The Heart Game”: Using Gamification as Part of a Telerehabilitation Program for Heart Patients

    Science.gov (United States)

    Dithmer, Marcus; Grönvall, Erik; Spindler, Helle; Hansen, John; Nielsen, Gitte; Sørensen, Stine Bæk; Dinesen, Birthe

    2016-01-01

    Abstract Objective: The aim of this article is to describe the development and testing of a prototype application (“The Heart Game”) using gamification principles to assist heart patients in their telerehabilitation process in the Teledialog project. Materials and Methods: A prototype game was developed via user-driven innovation and tested on 10 patients 48–89 years of age and their relatives for a period of 2 weeks. The application consisted of a series of daily challenges given to the patients and relatives and was based on several gamification principles. A triangulation of data collection techniques (interviews, participant observations, focus group interviews, and workshop) was used. Interviews with three healthcare professionals and 10 patients were carried out over a period of 2 weeks in order to evaluate the use of the prototype. Results: The heart patients reported the application to be a useful tool as a part of their telerehabilitation process in everyday life. Gamification and gameful design principles such as leaderboards, relationships, and achievements engaged the patients and relatives. The inclusion of a close relative in the game motivated the patients to perform rehabilitation activities. Conclusions: “The Heart Game” concept presents a new way to motivate heart patients by using technology as a social and active approach to telerehabilitation. The findings show the potential of using gamification for heart patients as part of a telerehabilitation program. The evaluation indicated that the inclusion of the patient's spouse in the rehabilitation activities could be an effective strategy. A major challenge in using gamification for heart patients is avoiding a sense of defeat while still adjusting the level of difficulty to the individual patient. PMID:26579590

  14. The evaluation of reproductive health PhD program in Iran: The input indicators analysis.

    Science.gov (United States)

    AbdiShahshahani, Mahshid; Ehsanpour, Soheila; Yamani, Nikoo; Kohan, Shahnaz

    2014-11-01

    Appropriate quality achievement of a PhD program requires frequent assessment and discovering the shortcomings in the program. Inputs, which are important elements of the curriculum, are frequently missed in evaluations. The purpose of this study was to evaluate the input indicators of reproductive health PhD program in Iran based on the Context, Input, Process, and Product (CIPP) evaluation model. This is a descriptive and evaluative study based on the CIPP evaluation model. It was conducted in 2013 in four Iranian schools of nursing and midwifery of medical sciences universities. Statistical population consisted of four groups: heads of departments (n = 5), faculty members (n = 18), graduates (n = 12), and PhD students of reproductive health (n = 54). Data collection tools were five separate questionnaires including 37 indicators that were developed by the researcher. Content and face validity were evaluated based on the experts' indications. The Cronbach's alpha coefficient was calculated in order to obtain the reliability of the questionnaires. Collected data were analyzed by SPSS software. Data were analyzed by descriptive statistics (mean, frequency, percentage, and standard deviation), and one-way analysis of variance (ANOVA) and least significant difference (LSD) post hoc tests to compare means between groups. The results of the study indicated that the highest percentage of the heads of departments (80%), graduates (66.7%), and students (68.5%) evaluated the status of input indicators of reproductive health PhD program as relatively appropriate, while most of the faculties (66.7%) evaluated that as appropriate. It is suggested to explore the reasons for relatively appropriate evaluation of input indicators by further academic researches and improve the reproductive health PhD program accordingly.

  15. The Effectiveness of Harm Reduction Programs in Seven Prisons of Iran

    Science.gov (United States)

    ROSHANFEKR, Payam; FARNIA, Marziyeh; DEJMAN, Masoumeh

    2013-01-01

    Abstract Background Starting in 1990 many programs were initiated to prevent and control the spread of HIV/AIDS in prisons in accordance with the policies of the Ministry of Health. This study attempts to evaluate the effectiveness of harm reduction programs vis-à-vis drug abuse and dependency in 7 prisons in Iran. Methods The methodology used is Before-After testing and the sample population is incarcerated prisoners in 7 large prisons in 7 provinces with diverse geographical, criminal, and numerical factors and the population sample is estimated at 2,200 inmates. Results Findings show that Drug addiction tests conducted on prisoners, right after their admittance indicated that 57% used at least one of the three drugs of morphine, amphetamines, and hashish (52% morphine, 4.5% ampheta-mines, and 3.9% hashish). Two months later, on the 2nd phase of the study, test results indicated that only 10% of subjects continued using drugs (P=0.05). Heroin and opium were the two most prevalent drugs. Smoking, oral in-take, and sniffing were the three most popular methods. Of those who continued to use drugs in prison, 95% admitted to drug use records. Conclusion Intervention policies in prisons resulted in reduction of drug consumption, from 57% of the newly admitted inmates to 10% after two months of incarceration. PMID:26060645

  16. The Effectiveness of Harm Reduction Programs in Seven Prisons of Iran.

    Science.gov (United States)

    Roshanfekr, Payam; Farnia, Marziyeh; Dejman, Masoumeh

    2013-12-01

    Starting in 1990 many programs were initiated to prevent and control the spread of HIV/AIDS in prisons in accordance with the policies of the Ministry of Health. This study attempts to evaluate the effectiveness of harm reduction programs vis-à-vis drug abuse and dependency in 7 prisons in Iran. The methodology used is Before-After testing and the sample population is incarcerated prisoners in 7 large prisons in 7 provinces with diverse geographical, criminal, and numerical factors and the population sample is estimated at 2,200 inmates. Findings show that Drug addiction tests conducted on prisoners, right after their admittance indicated that 57% used at least one of the three drugs of morphine, amphetamines, and hashish (52% morphine, 4.5% ampheta-mines, and 3.9% hashish). Two months later, on the 2nd phase of the study, test results indicated that only 10% of subjects continued using drugs (P =0.05). Heroin and opium were the two most prevalent drugs. Smoking, oral in-take, and sniffing were the three most popular methods. Of those who continued to use drugs in prison, 95% admitted to drug use records. Intervention policies in prisons resulted in reduction of drug consumption, from 57% of the newly admitted inmates to 10% after two months of incarceration.

  17. [Outpatient management program of patients with chronic heart failure].

    Science.gov (United States)

    Cacciatore, G; Menichelli, M; Albi, F; De Lio, L; Boccanelli, A

    1998-10-01

    Hospitalization of patients with heart failure is often caused by poor adherence to drug therapy, by suboptimal utilization of ACE inhibitors and beta-blockers, and by the lack of systematic monitoring of patients after discharge. The aim of the study is to verify the impact of an outpatient management program on the hospitalization rate and functional status of patients with chronic heart failure. Over a five-year period, 435 patients entered our outpatient management program, which includes adjustment in medical therapy, patient education and visits timed according to the patient's status. Fifty-six percent of the patients were in New York Heart functional class I-II; 74% were male; mean age was 62 +/- 11 years. Heart failure was due to coronary heart disease in 42%, dilated cardiomyopathy in 35%, hypertensive heart disease in 13%, other etiologies in 10%. The following changes in medical therapy were made compared to the period before referral: ACE inhibitors in 88% of the patients vs 70% (p < 0.05), mean dose of enalapril and captopril respectively 18 +/- 6 mg vs 11 +/- 4 mg (p < 0.05) and 89 +/- 28 mg vs 61 +/- 34 mg (p < 0.05); digoxin in 71 vs 70% (NS); furosemide in 90 vs 87%; beta-blockers in 16 vs 6% (p < 0.05); amiodarone in 24 vs 16% (p < 0.05); oral anticoagulants in 22 vs 12% (p < 0.05); calcium channel blockers in 10 vs 16% (p < 0.05). During the follow-up period (35 +/- 11 months), there were 111 hospital admissions compared to 518 during the year before recruitment (p < 0.05). Seventy-two patients died (65 for cardiac causes) and four patients underwent cardiac transplantation. Functional status improved (301 patients in I-II functional class and 56 in III-IV after referral compared to 225 and 132 before referral, respectively). Our results were obtained through adjustment in pharmacological therapy, intensive patient education and therapeutic continuity made possible by our outpatient heart-failure clinic organization. It is likely that the

  18. Burden of ischemic heart diseases in Iran, 1990-2010: Findings from the Global Burden of Disease study 2010

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Maracy

    2015-01-01

    Full Text Available Background: Cardiovascular diseases are viewed worldwide as one of the main causes of death.This study aims to report the burden of ischemic heart diseases (IHDs in Iran by using data of the global burden of disease (GBD study, 1990-2010. Materials and Methods: The GBD study 2010 was a systematic effort to provide comprehensive data to calculate disability-adjusted life years (DALYs for diseases and injuries in the world. Years of life lost (YLLs due to premature mortality were computed on the basis of cause-of-death estimates, using Cause of Death Ensemble model (CODEm. Years lived with disability (YLDs were assessed by the multiplication of prevalence, the disability weight for a sequel, and the duration of symptoms. A systematic review of published and unpublished data was performed to evaluate the distribution of diseases, and consequently prevalence estimates were calculated with a Bayesian meta-regression method (DisMod-MR. Data from population-based surveys were used for producing disability weights. Uncertainty from all inputs into the calculations of DALYs was disseminated by Monte Carlo simulation techniques. Results: The age-standardized IHDs DALY specified rate decreased 31.25% over 20 years from 1990 to 2010 [from 4720 (95% uncertainty interval (UI: 4,341-5,099 to 3,245 (95% UI: 2,810-3,529 person-years per 100,000]. The decrease were 38.14% among women and 26.87% among men. The age-standardized IHDs death specefied rate decreased by 21.17% [from 222 95% UI: 207-243 (to 175 (95% UI:152-190 person-years per 100,000] in both the sexes. The age-standardized YLL and YLD rates decreased 32.05% and 4.28%, respectively, in the above period. Conclusion: Despite decreasing age-standardized IHD of mortality, YLL, YLD, and DALY rates from 1990 to 2010, population growth and aging increased the global burden of IHD. YLL has decreased more than IHD deaths and YLD since 1990 but IHD mortality remains the greatest contributor to disease burden.

  19. Healthy Hearts at work: Prince Edward Island Heart Health Program CSC worksite pilot project.

    Science.gov (United States)

    Herbert, R; White, R

    1996-01-01

    Prince Edward Island experiences a higher-than-average death rate from cardiovascular disease. The Prince Edward Island Heart Health Program is a health promotion/disease prevention research project of Health Canada and the Prince Edward Island Department of Health and Social Services. This paper describes and evaluates a worksite program, based on the principles of community mobilization, that was initiated with the Civil Service Commission of the Prince Edward Island government. The building of a partnership, the risk appraisal session administered in the workplace, the establishment of an Employee Wellness Committee, and subsequent programming which has occurred in the workplace were the key components in the process. Collaboration with the partner agency and participation of employees in the planning process has resulted in the delivery of programs which could not have been achieved by one of the agencies alone, without many additional resources. It is hoped that these characteristics of collaboration and employee participation will also result in sustainability of this initiative when PEI Heart Health is no longer involved.

  20. Developing an environmental water quality monitoring program for Haraz River in Northern Iran.

    Science.gov (United States)

    Tavakol, Mitra; Arjmandi, Reza; Shayeghi, Mansoureh; Monavari, Seyed Masoud; Karbassi, Abdolreza

    2017-08-01

    Water quality management plans are an indispensable strategy for conservation and utilization of water resources in a sustainable manner. One common industrial use of water is aquaculture. The present study is an attempt to use statistical analyses in order to prepare an environmental water quality monitoring program for Haraz River, in Northern Iran. For this purpose, the analysis of a total number of 18 physicochemical parameters was performed at 15 stations during a 1-year sampling period. According to the results of the multivariate statistical methods, the optimal monitoring would be possible by only 3 stations and 12 parameters, including NH 3 , EC, BOD, TSS, DO, PO 4 , NO 3 , TDS, temperature, turbidity, coliform, and discharge. In other words, newly designed network, with a total number of 36 measurements (3 stations × 12 parameters = 36 parameters), could achieve exactly the same performance as the former network, designed based on 234 measurements (13 stations × 18 parameters = 234 parameters). Based on the results of cluster, principal component, and factor analyses, the stations were divided into three groups of high pollution (HP), medium pollution (MP), and low pollution (LP). By clustering the stations, it would be possible to track the water quality of Haraz River, only by one station at each cluster, which facilitates rapid assessment of the water quality in the river basin. Emphasizing on three main axes of monitoring program, including measurement parameters, sampling frequency, and spatial pattern of sampling points, the water quality monitoring program was optimized for the river basin based on natural conditions of the study area, monitoring objectives, and required financial resources (a total annual cost of about US $2625, excluding the overhead costs).

  1. Nine years of publications on strengths and weaknesses of Family Physician Program in rural area of Iran: A systematic review

    Directory of Open Access Journals (Sweden)

    Saber Azami-Aghdash

    2016-12-01

    Full Text Available Introduction: One of the most important duties of a family physician is to provide primary health care. This is completely considered in the Family Physician Program for a target population. The aim of this study was to systematically review the Family Physician and Referral System strength and weakness in rural area of Iran. Methods: In this systematic review, Scientific Information Database (SID, Science Direct, and PubMed databases were searched and Google search engine was employed using key words such as family medicine, family physician, and referral system for the period of January 2005 to June 2013, both in English and Persian. For identifying duplicated references, Endnote Software was used and for summarizing results of fully assessed articles extraction table was employed. Results: Strengths and weaknesses of Family Physician Program and referral system in rural areas of Iran were extracted from 28 studies. In total, 115 weaknesses (3.96 per study and 103 strengths (3.55 per study were obtained. Content analysis was used and 218 items were summarized into 29 items. Strengths of Family Physician Program were: access of villagers to health services, filling health document for clients, improving services for pregnant mothers, and family planning; while its obvious weaknesses included repeated unnecessary referral of clients as well as lack of providing job stability. Conclusion: Results of studies conducted in Iran showed that Family Physician and Referral System in rural area of Iran could not be successful enough and has many shortcomings. Therefore, a growing body of effective changes must be made for a better performance and to obtain better outcomes.

  2. Socioeconomic inequality of overweight and obesity of the elderly in Iran: Bushehr Elderly Health (BEH) Program.

    Science.gov (United States)

    Raeisi, Alireza; Mehboudi, Mohammadbagher; Darabi, Hossein; Nabipour, Iraj; Larijani, Bagher; Mehrdad, Neda; Heshmat, Ramin; Shafiee, Gita; Sharifi, Farshad; Ostovar, Afshin

    2017-01-13

    The objective of this population-based, large sample size study was to investigate the socioeconomic inequality of overweight and obesity among the elderly in Iran. Baseline data of 3000 persons aged ≥60 years who participated in the Bushehr Elderly Health (BEH) program was analyzed. Overweight and obesity were defined as a body mass index (BMI) equal to or higher than 25 and 30, respectively. Socioeconomic status (SES) was measured by an asset index, constructed using principal component analysis, income, education level, and employment status. The Concentration Index and the Lorenz curve were used to illustrate the levels of inequality for overweight and obesity by gender. The frequencies among men and women were, respectively, 840 (57.7%) and 1131 (73.2%), P < 0.001, for overweight, and 211 (14.7%) and 511 (33.7%), P < 0.001, for obesity. There were direct associations between asset index quintiles and both overweight and obesity among both genders (Ps for trend <0.01) except for obesity among men (P for trend = 0.118). The overall Concentration Indices for overweight and obesity were 0.031 (95%CI = 0.016-0.046, P < 0.001) and 0.041 (95%CI = 0.004-0.078, p = 0.028), respectively. Findings support the direct relationship between SES and obesity among women as previously reported in developing countries.

  3. Enhancing community based health programs in Iran: a multi-objective location-allocation model.

    Science.gov (United States)

    Khodaparasti, S; Maleki, H R; Jahedi, S; Bruni, M E; Beraldi, P

    2016-04-26

    Community Based Organizations (CBOs) are important health system stakeholders with the mission of addressing the social and economic needs of individuals and groups in a defined geographic area, usually no larger than a county. The access and success efforts of CBOs vary, depending on the integration between health care providers and CBOs but also in relation to the community participation level. To achieve widespread results, it is important to carefully design an efficient network which can serve as a bridge between the community and the health care system. This study addresses this challenge through a location-allocation model that deals with the hierarchical nature of the system explicitly. To reflect social welfare concerns of equity, local accessibility, and efficiency, we develop the model in a multi-objective framework, capturing the ambiguity in the decision makers' aspiration levels through a fuzzy goal programming approach. This study reports the findings for the real case of Shiraz city, Fars province, Iran, obtained by a thorough analysis of the results.

  4. North Korea and Iran's Nuclear Programs as Instability Factors in the New System of International Relations

    National Research Council Canada - National Science Library

    Romashkina, Natalia P

    2007-01-01

    ...: North Korea and Iran. Her detailed and carefully documented study goes well beyond the current rhetoric of politics and looks closely at historical developments, geopolitical factors, the scientific parameters...

  5. Iran's nuclear weapons development program : an assessment of the threat posed to its neighbors

    OpenAIRE

    Yurtsever, Himmet

    2001-01-01

    Ankara : The Department of International Relations of Bilkent University, 2001. Thesis (Master's) -- Bilkent University, 2001. Includes bibliographical references leaves 118-131. Throughout its long history, Iran has always sought to be a world power. Regardless of its regime and ideology, it has pursued an ambitious policy despite its actual weakness. In order to accomplish its perpetual goal, Iran has searched the necessary political and military means. Since late 1950s, ...

  6. HIV Programs in Iran (Persia), Iraq and Saudi Arabia: A Brief Review of Current Evidence in West and Southwest Asia.

    Science.gov (United States)

    Massah, Omid; Moradi, Afsaneh; Farhoudian, Ali; Amini-Lari, Mahmood; Joulaei, Hassan; Daneshmand, Reza

    2016-07-01

    In Western and Southwest Asia, literature is not documented on human immunodeficiency virus (HIV) programs in Iran, Iraq and Saudi Arabia. The present study is the first brief review that describes HIV programs in these three neighboring countries. Data regarding the evidence of HIV programs were gathered through a systematic literature searching. English publications were retrieved through searching online scientific databases. Grey literature was also searched online. The review was based on the studies related to the last decade. Systematic searching resulted in retrieving 21,948 studies but only 21 studies were relevant to the study aim. The review findings indicated that Iran has provided a nationwide sero-surveillance data system and has identified its key populations. Detecting HIV prevalence has been limited to case-finding in Iraq and Saudi Arabia. However, strategic plans for HIV have been provided in the three countries. HIV education, knowledge and support have been provided but still needs consideration in the three countries especially in Iraq. The low coverage of antiretroviral therapy (ART) has remained a critical gap in the provision of comprehensive HIV programs in these three countries. This issue has been followed by the lack of opiate substitution therapies for drug dependents and injecting drug users in Iraq and Saudi Arabia. Condom promotion and voluntary HIV counselling and testing have been provided for at-risk groups in the three countries but need more nationwide coverages. However, needle and syringe programs (NSPs) have been only provided in Iran. The review concluded that the provision of effective HIV programs should address training human resources and infrastructural development. This issue should be facilitated by international collaborations and governmental supports.

  7. The history of organ donation and transplantation in Iran.

    Science.gov (United States)

    Ghods, Ahad J

    2014-03-01

    The first kidney transplant in Iran was performed in 1967, and this was the first organ transplant in countries that are current members of the Middle East Society for Organ Transplantation. In 1988, in response to the long waiting list at the Iranian Ministry of Health for kidney transplant, a state-regulated living-unrelated donor kidney transplant program was adopted. By 1999, the kidney transplant waiting list in Iran was eliminated. In 1989, a fatwa (religious approval) from the Supreme Religious Leader was obtained that recognized brain death and allowed deceased-donor organ transplant. Subsequently, transplant centers began performing deceased-donor kidney, liver, and heart transplants. In 2000, the Brain Death and Organ Transplantation Act was passed by the Iranian parliament, legalizing deceased-donor organ transplant. The transplant team at Shiraz began performing more deceased-donor kidney and liver transplants and became a successful deceased-donor organ transplant model in the country. By the end of 2012, there were 34166 kidney (including 4436 deceased-donor) and 2021 liver (including 1788 deceased-donor), 482 heart, 147 pancreas, 63 lung, and several intestine and multiorgan transplants performed in Iran. In 2011, there were 2771 solid-organ transplants performed in Iran (37 transplants per million population), and Iran ranked as number 33 among the 50 most active countries worldwide. In 2011 and 2012, Iran was ahead of all country members of the Middle East Society for Organ Transplantation in performing deceased-donor kidney and liver transplants.

  8. Burden of Ischemic Heart Disease Attributable to Low Omega-3 Fatty Acids Intake in Iran: Findings from the Global Burden of Disease Study 2010

    Directory of Open Access Journals (Sweden)

    Sara Nejatinamini

    2016-07-01

    Full Text Available Background: Dietary risk factors constitute some of the leading risk factors for cardiovascular disease in Iran. The current study reports the burden of ischemic heart disease (IHD attributable to a low omega-3 fatty acids intake in Iran using the data of the Global Burden of Disease (GBD Study 2010.Methods: We used data on Iran for the years 1990, 2005, and 2010 derived from the GBD Study conducted by the Institute for Health Metrics and Evaluation (IHME in 2010. Using the comparative risk assessment, we calculated the proportion of death, years of life lost, years lived with disability, and disability-adjusted life years (DALYs caused by IHD attributable to a low omega-3 fatty acids intake in the GBD studies from 1990 to 2010. Results: In 1990, a dietary pattern low in seafood omega-3 fatty acids intake was responsible for 423 (95% uncertainty interval [UI], 300 to 559, 3000 (95% UI, 2182 to 3840, and 4743 (95% UI, 3280 to 6047 DALYs per 100000 persons in the age groups of 15 to 49 years, 50 to 69 years, and 70+ years — respectively — in both sexes.  The DALY rates decreased to 250 (95% UI, 172 to 331, 2078 (95% UI, 1446 to 2729, and 3911 (95% UI, 2736 to 5142 in 2010. The death rates per 100000 persons in the mentioned age groups were 9 (95% UI, 6 to 12, 113 (95% UI, 82 to 144, and 366 (95% UI, 255 to 469 in 1990 versus 6 (95% UI, 4 to 7, 76 (95% UI, 53 to 99, and 344 (95% UI, 241 to 453 in 2010. The burden of IHD attributable to diet low in seafood omega-3 was 1.3% (95% UI, 0.97 to 1.7 of the total DALYs in 1990 and 2.0% (95% UI, 1.45 to 2.63 in 2010 for Iran.Conclusion: The findings of the GBD Study 2010 showed a declining trend in the burden of IHD attributable to a low omega-3 fatty acids intake in a period of 20 years. Additional disease burden studies at national and sub-national levels in Iran using more data sources are suggested for public health priorities and planning public health strategies.

  9. A Qualitative Study of Community-based Health Programs in Iran: An Experience of Participation in I.R. Iran.

    Science.gov (United States)

    Eftekhari, Monir Baradaran; Mirabzadeh, Arash; Forouzan, Ameneh Setareh; Dejman, Masoumeh; Afzali, Hossein Malek; Djalalinia, Shirin; Peykari, Niloofar; Roshanfekr, Payam

    2014-06-01

    Community-based health programs (CBHPs) with participatory approaches has been recognized as an important tool in health promotion. The goal of this study was to understand the nature of participation practice in CBHP and to use the data to advocate for more participation-friendly policies in the community, academy and funding organizations. In this qualitative study, 13 CBHPs, which were active for last 5 years have been assessed using semi-structural in-depth interviews with programs principal and managers and focus group discussions with volunteers and service users. Data analysis was based on the deductive-inductive content analysis considering the participatory approaches in these programs. The results show that, the main category of participation was divided to community participation and intersectional collaboration. The community participation level was very different from "main," "advisory" or "supporting" level. The process of recruitment of volunteers by the governmental organization was centralized and in non-governmental organizations was quite different. According to respondents opinion, financial and spiritual incentives especially tangible rewards, e.g., learning skills or capacity building were useful for engaging and maintaining volunteers' participation. For intersectional collaboration, strong and dedicated partners, supportive policy environment are critical. It seems that maintaining partnership in CBHP takes considerable time, financial support, knowledge development and capacity building.

  10. Socioeconomic inequality of overweight and obesity of the elderly in Iran: Bushehr Elderly Health (BEH Program

    Directory of Open Access Journals (Sweden)

    Alireza Raeisi

    2017-01-01

    Full Text Available Abstract Background The objective of this population-based, large sample size study was to investigate the socioeconomic inequality of overweight and obesity among the elderly in Iran. Methods Baseline data of 3000 persons aged ≥60 years who participated in the Bushehr Elderly Health (BEH program was analyzed. Overweight and obesity were defined as a body mass index (BMI equal to or higher than 25 and 30, respectively. Socioeconomic status (SES was measured by an asset index, constructed using principal component analysis, income, education level, and employment status. The Concentration Index and the Lorenz curve were used to illustrate the levels of inequality for overweight and obesity by gender. Results The frequencies among men and women were, respectively, 840 (57.7% and 1131 (73.2%, P < 0.001, for overweight, and 211 (14.7% and 511 (33.7%, P < 0.001, for obesity. There were direct associations between asset index quintiles and both overweight and obesity among both genders (Ps for trend <0.01 except for obesity among men (P for trend = 0.118. The overall Concentration Indices for overweight and obesity were 0.031 (95%CI = 0.016–0.046, P < 0.001 and 0.041 (95%CI = 0.004–0.078, p = 0.028, respectively. Conclusion Findings support the direct relationship between SES and obesity among women as previously reported in developing countries.

  11. Antimicrobial Activity of Chlorhexidine, Peracetic acid/ Peroxide hydrogen and Alcohol based compound on Isolated Bacteria in Madani Heart Hospital, Tabriz, Azerbaijan, Iran

    Directory of Open Access Journals (Sweden)

    Reza Ghotaslou

    2012-06-01

    Full Text Available Purpose: The aim of present study was to investigate the effect of chemical agents on the clinical isolates in Madani Heart Hospital, Tabriz, Iran. Methods: The minimum bactericide concentration (MBC of disinfectants including chlorhexidine (Fort, peracetic acid (Micro and an alcohol based compound (Deconex on selected bacteria at various dilutions were determined by the standard suspension technique. Results: MBC of Micro, Fort and Deconex were 2-128 mg/L, 2-64 mg/L and 4 - 32 mg/L, respectively. The Gram negative bacteria were more resistance to disinfectant relation to Gram positive bacteria. Conclusion: The results showed that these agents are able to eradicate the bacteria and they can be used lonely.

  12. Bovine tuberculosis in Iran: The past, present and future of a national disease control program

    Directory of Open Access Journals (Sweden)

    Keyvan Tadayon

    2015-01-01

    Bovine TB was initially reported in Iran by a French veterinarian in local breeds of cattle. An official attempt to control the disease was started in the 1940s, which runs today on a national scale. This mini-review addresses a variety of different epidemiological issues in bTb control in the world and in Iran from an immunologist's eye to find the cure for human cases infected with M. bovis. In addition, the benefits and drawbacks of this control scheme are discussed.

  13. A Heart Failure Management Program Using Shared Medical Appointments.

    Science.gov (United States)

    Carroll, Allison J; Howrey, Hillary L; Payvar, Susan; Deshida-Such, Kristen; Kansal, Mayank; Brar, Charanjit K

    2017-04-01

    Disease management programs for heart failure (HF) effectively reduce HF-related hospitalization rates and mortality. Shared medical appointments (SMAs) offer a cost-effective delivery method for HF disease management programs. However, few studies have evaluated this cost-effective delivery method of HF disease management among Veterans with acute HF. We hypothesized that Veterans who attended a multidisciplinary HF-SMA clinic promoting HF self-management, compared those who only received individual treatment through the HF specialty clinic, would have better 12-month hospitalization outcomes. We completed a retrospective review of the VA electronic health record for HF-SMA clinic appointments (1/1/2012 to 12/31/2013). The multidisciplinary HF-SMA program comprised 4 weekly sessions covering topics including HF disease, HF medications, diet adherence, physical activity, psychological well-being, and stress management. Patients who attended the HF-SMA clinic (n=54) were compared to patients who were scheduled for an HF-SMA appointment but never attended and were followed only in the HF clinic (n=37). Outcomes were 12-month HF-related and all-cause hospitalization rates, days in the hospital, and time to first hospitalization. Of 141 patients scheduled for an HF-SMA clinic appointment, 54 met criteria for the HF-SMA clinic group and 37 were included in the HF clinic group. The groups did not significantly differ on any sociodemographic variables. Furthermore, no significant differences were observed between the HF-SMA group and the HF clinic group on demographics or hospitalization outcomes, p>.05 for all comparisons. Our results did not support our hypothesis that offering multidisciplinary, HF-SMAs promoting HF self-management skills, above and beyond the individual disease management care provided in an HF specialty clinic, would improve hospitalization outcomes among Veterans with acute HF. Limitations of the present study and recommendations for HF self

  14. Heart Rates of Elementary Physical Education Students during the Dancing Classrooms Program

    Science.gov (United States)

    Nelson, Larry; Evans, Melissa; Guess, Wendy; Morris, Mary; Olson, Terry; Buckwalter, John

    2011-01-01

    We examined how different types of dance activities, along with their duration, influenced heart rate responses among fifth-grade physical education students (N = 96) who participated in the Dancing Classrooms program. Results indicated that the overall Dancing Classrooms program elicits a moderate cardiovascular heart rate response (M = 124.4…

  15. Open access to an outpatient intravenous diuresis program in a systolic heart failure disease management program.

    Science.gov (United States)

    Hebert, Kathy; Dias, Andre; Franco, Emiliana; Tamariz, Leonardo; Steen, Dylan; Arcement, Lee M

    2011-01-01

    In order to provide efficient utilization of resources in an outpatient setting for acute exacerbation of heart failure (HF), the authors piloted an open-access outpatient intravenous (IV) diuretic program (IVDP) to evaluate utilization in an HF disease management program (HFDMP), patient characteristics for users of the program, and safety. An outpatient HFDMP at Jackson Memorial Hospital in Miami, Florida, enrolling 577 patients 18 years and older with an ejection fraction ≤40% was implemented. For symptoms or weight gain ≥5 pounds, patients were eligible to use an open-access IVDP during clinic hours. A total of 130 HFDM patients (22.5%) used the IVDP. IVDP users were more likely to be diabetic, with lower body mass indices than non-IVDP users. New York Heart Association class IV patients and previously hospitalized patients were more likely to use the IVDP. There were no documented adverse reactions for patients receiving treatment and no difference in mortality between groups. This open-access outpatient IVDP model for patients with HF was readily utilized by the HFDMP participants and appears safe for use in this population. This unique model may provide alternative access for acute HF treatment. Congest Heart Fail. © 2011 Wiley Periodicals, Inc.

  16. The National Heart, Lung, and Blood Institute Small Business Program

    Directory of Open Access Journals (Sweden)

    Kurt W. Marek, PhD

    2016-12-01

    Full Text Available Small companies working to develop products in the cardiovascular space face numerous challenges, from regulatory, intellectual property, and reimbursement barriers to securing funds to keep the lights on and reach the next development milestone. Most small companies that spin out from universities have the scientific knowledge, but product development expertise and business acumen are also needed to be successful. Other challenges include reduced interest in early-stage technologies and limited deal flow for cardiovascular products. The National Heart, Lung, and Blood Institute (NHLBI small business program is a comprehensive ecosystem designed to address these critical challenges and to provide resources and expertise to assist early-stage companies developing cardiovascular and other products within the institute’s mission. This article describes steps that NHLBI has taken to enhance our small business program to more effectively translate basic discoveries into commercial products to benefit patients and public health, including enhancing internal expertise and developing nonfinancial resources to assist small businesses as they develop their products and seek private sector investment and partnership.

  17. The Rise of Iran

    DEFF Research Database (Denmark)

    Jakobsen, Peter Viggo; Rahigh-Aghsan, Ali

    2010-01-01

    Iran is viewed by many as a rising power that poses an increasing threat to regional and even global security. This view is wrong for three reasons. Iran's hard and soft power is exaggerated by most accounts; it is too limited to allow the Iranians to dominate the Persian Gulf let alone the Middl...... regional powers and the West to balance Iran and contain its influence, even if it acquires nuclear weapons. If these limitations on Iranian power are taken into account the rise seems destined to be a short one....... East, and its brand of Shi‘ism has very limited appeal outside of Iran. Second, growing internal political and economic instability will seriously limit Iran's bid for regional dominance. Third, the failure to stop the Iranian nuclear program has led analysts to underestimate the ability of the other...

  18. The Rise of Iran

    DEFF Research Database (Denmark)

    Rahigh-Aghsan, Ali; Jakobsen, Peter Viggo

    2010-01-01

    Iran is viewed as a rising power that poses an increasing threat to regional and even global security. This view is wrong for three reasons. Iran's hard and soft power is exaggerated by most accounts; it is too limited to allow the Iranians to dominate the Persian Gulf let alone the Middle East, ...... powers and the West to balance Iran and contain its influence, even if it acquires nuclear weapons. If these limitations on Iranian power are taken into account the rise seems destined to be a short one......., and its brand of Shi‘ism has very limited appeal outside of Iran. Second, growing internal political and economic instability will seriously limit Iran's bid for regional dominance. Third, the failure to stop the Iranian nuclear program has led analysts to underestimate the ability of the other regional...

  19. The Rise of Iran

    DEFF Research Database (Denmark)

    Rahigh-Aghsan, Ali

    Iran is viewed as a rising power that poses an increasing threat to regional and even global security. This view is wrong for three reasons. Iran's hard and soft power is exaggerated by most accounts; it is too limited to allow the Iranians to dominate the Persian Gulf let alone the Middle East, ...... powers and the West to balance Iran and contain its influence, even if it acquires nuclear weapons. If these limitations on Iranian power are taken into account the rise seems destined to be a short one......., and its brand of Shi‘ism  has very limited appeal outside of Iran. Second, growing internal political and economic instability will seriously limit Iran's bid for regional dominance. Third, the failure to stop the Iranian nuclear program has led analysts to underestimate the ability of the other regional...

  20. Iran Sanctions

    Science.gov (United States)

    2016-12-14

    supply nuclear technology to Iran and expanding provisions of the USA Patriot Act (P.L. 107-56) to curb money- laundering for use to further WMD programs...a “jurisdiction of primary money laundering concern” 33 under Section 311 of the USA Patriot Act (31 U.S.C. 5318A). The Department of the Treasury...2011, the government has frequently adjusted the official rate to one that is close to the unofficial rate.  Inflation . The drop in value of the

  1. Kennedy Space Center Coronary Heart Disease Risk Screening Program

    Science.gov (United States)

    Tipton, David A.; Scarpa, Philip J.

    1999-01-01

    The number one cause of death in the U.S. is coronary heart disease (CHD). It is probably a major cause of death and disability in the lives of employees at Kennedy Space Center (KSC) as well. The KSC Biomedical Office used a multifactorial mathematical formula from the Framingham Heart Study to calculate CHD risk probabilities for individuals in a segment of the KSC population that required medical evaluation for job certification. Those assessed to be high-risk probabilities will be targeted for intervention. Every year, several thousand KSC employees require medical evaluations for job related certifications. Most medical information for these evaluations is gathered on-site at one of the KSC or Cape Canaveral Air Station (CCAS) medical clinics. The formula used in the Framingham Heart Study allows calculation of a person's probability of acquiring CHD within 10 years. The formula contains the following variables: Age, Diabetes, Smoking, Left Ventricular Hypertrophy, Blood Pressure (Systolic or Diastolic), Cholesterol, and HDL cholesterol. The formula is also gender specific. It was used to calculate the 10-year probabilities of CHD in KSC employees who required medical evaluations for job certifications during a one-year time frame. This KSC population was profiled and CHD risk reduction interventions could be targeted to those at high risk. Population risk could also be periodically reevaluated to determine the effectiveness of intervention. A 10-year CHD risk probability can be calculated for an individual quite easily while gathering routine medical information. An employee population's CHD risk probability can be profiled graphically revealing high risk segments of the population which can be targeted for risk reduction intervention. The small audience of NASA/contractor physicians, nurses and exercise/fitness professionals at the breakout session received the lecture very well. Approximately one third indicated by a show of hands that they would be

  2. Heart rates of elementary physical education students during the dancing classrooms program.

    Science.gov (United States)

    Nelson, Larry; Evans, Melissa; Guess, Wendy; Morris, Mary; Olson, Terry; Buckwalter, John

    2011-06-01

    We examined how different types of dance activities, along with their duration, influenced heart rate responses among fifth-grade physical education students (N = 96) who participated in the Dancing Classrooms program. Results indicated that the overall Dancing Classrooms program elicits a moderate cardiovascular heart rate response (M = 124.4 bpm), in which 47% of class time was spent above a 60% maximal heart rate threshold. The swing dance in particular (M = 143.4 bpm) stimulated a much higher heart rate level than all other dances in the program, with a mean heart rate change of 52.6 bpm. Girls (127.3 bpm) achieved marginally higher heart rates (p = .059) than boys (121.1 bpm).

  3. Irans Nuclear Program and Turkey: Changing Perceptions, Interests and Need for Revision

    OpenAIRE

    Caman, Efe; Dagci, and Kenan

    2015-01-01

    During the AKP era,Turkish-Iranian relations benefit from the new dynamism in regional affairs, especially in the Middle East,based on the pro-active foreign policy approach.In the decades before the AKP government, Iran was perceived by Turkish elites as the ideological other and rival. The decade after the new millennium witnessed a perception change led by Foreign Minister Davuto'luwho replaced the old mindset based on mistrust with a coursecenteredon cooperation in several significan...

  4. Walking on a delicate line between Iran and the United States : India's competing set of interests regarding Iran's nuclear program and sanctions

    OpenAIRE

    Hadian, Ahad

    2014-01-01

    India and Iran have had a centuries-long history of close relations. However, in the last decade New Delhi has been looking to develop its relations with Tehran for two main reasons. First, India’s high energy demand to keep the pace of its economic growth, for which Iran could be a reliable supplier; and second, New Delhi’s desire to have Tehran on its side as a strategic partner in Afghanistan, Pakistan, and the Persian Gulf and further in Central Asia. Despite its vote against Tehran a...

  5. A Comprehensive Look into the Instruction of Listening Skill in Academic English Programs: A Case Study of Two State Universities in Iran

    Science.gov (United States)

    Babaee, Hamidreza

    2017-01-01

    The study reported here thoroughly investigated the instruction of listening skill in academic English programs. This was researched through a semi-structured interview. In this regard, in order to obtain a picture of listening requirements across the academy, data were collected from two different state universities of Iran. To compile the data,…

  6. Iran's Economy

    National Research Council Canada - National Science Library

    Ilias, Shayerah

    2008-01-01

    .... To the extent that U.S. sanctions and other efforts to change Iranian state policy target aspects of Iran's economy as a means of influence, it is important to evaluate Iran's economic structure, strengths, and vulnerabilities...

  7. Iran's Economy

    National Research Council Canada - National Science Library

    Ilias, Shayerah

    2008-01-01

    .... To the extent that U.S. sanctions and other efforts to change Iranian state policy target aspects of Iran ssssssss economy as a means of influence, it is important to evaluate Iran's economic structure, strengths, and vulnerabilities...

  8. Impact of the national food supplementary program for children on household food security and maternal weight status in Iran

    Directory of Open Access Journals (Sweden)

    Delaram Ghodsi

    2016-01-01

    Full Text Available Background: Food aid programs are strategies that aim to improve nutritional status and to tackle food insecurity. This study aimed to evaluate the effect of a National Food Supplementary Program for Children on households′ food security. Methods: The study sample included 359 mothers of children aged 6-72 months under the coverage of the program in two provinces of Iran. Demographic and socioeconomic characteristics of the households and percentage of supplementary food items consumed by target child were assessed by a questionnaire and checklist. Data on household food security were collected by locally adapted Household Food Insecurity Access Scale at the baseline of the study and 6 months thereafter. Results: At the baseline, only 4.7% of families were food secure, while 43.5% were severely food insecure, and these proportions were changed to 7.9% and 38%, respectively (P 0.05. Conclusions: Findings show that the food supplementary program for children can also improve the household food security status. Further research is needed to assess other factors that affect the effectiveness of this kind of programs.

  9. Key Informants' Perceptions on the Implementation of a National Program for Improving Nutritional Status of Children in Iran.

    Science.gov (United States)

    Ghodsi, Delaram; Omidvar, Nasrin; Rashidian, Arash; Raghfar, Hossein; Eini-Zinab, Hassan; Ebrahimi, Marziyeh

    2016-01-01

    Childhood malnutrition is a major public health issue. Multidisciplinary approach for Improvement of Nutritional Status of Children in Iran was implemented in order to reduce malnutrition among children. This study aimed to evaluate the implementation aspect of the program and to explore key informants' perceptions and experience regarding the factors affected its implementation. Data were collected through the review of secondary data and semistructured interviews at national, province, and local levels. Four layers of key informants were selected purposefully for interviewing, including policymakers, senior nutrition officers, head of Hygiene, Remedy and Insurance Affairs in Imam Khomeini Relief Foundation, and community health workers. Qualitative content analysis was carried out based on Supporting the Use of Research Evidence framework and Tailored Implementation for Chronic Diseases' checklist to interpret the viewpoints of the study participants. Results showed that the program had successes in improving mother's knowledge on health, nutrition, and child care through health system and increased families' access to food, but there were some aspects that affected program's implementation. Some of these factors are the lack of clarity in the program's protocol and indicators, human shortage and inadequate financial resources, poor facilities, inattention to staff motivation, insufficient commitment among different sections, poor communication and supervision among different executive sections, and program protocols designing regardless of practical condition. Based on the results, top-down approach in policymaking and inadequate financial and human resources were responsible for most of the challenges encountered in the implementation.

  10. Where is Iran going; Ou va l'Iran

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    This second meeting on the problem of the nuclear activities in Iran, aims to evaluate the new situation of crisis presented by the iranian uranium enrichment programs. Three round tables were organized on the subject: the nuclear problem in Iran, the evolution of the political and economical situation and the human rights, the Iran on the international scene with the Hezbollah, the energy challenge, the russian-iranian relations. (A.L.B.)

  11. Results of a community translation of the "Women Take PRIDE" heart disease self-management program.

    Science.gov (United States)

    Gallant, Mary P; Pettinger, Tianna M; Coyle, Cassandra L; Spokane, Linda S

    2015-03-01

    This article reports the results of a community demonstration of an evidence-based heart disease self-management program for older women. Women Take PRIDE (WTP) is a group-based education and behavior modification program, based on social cognitive theory, designed to enhance heart disease self-management among older women. We implemented the program in community settings with 129 participants. Evaluation data was collected at baseline and at 4- and 12-month follow-ups. Outcomes included general health status, functional health status, and knowledge. Results showed significant improvements in self-rated health, energy, social functioning, knowledge of community resources, and number, frequency, and bother of cardiac symptoms. These results demonstrate that an evidence-based heart disease self-management program can be effective at improving health and quality of life among older women with heart disease when implemented in community settings. © The Author(s) 2013.

  12. Development and evaluation of a basic physical and sports activity program for preschool children in nursery schools in iran: an interventional study.

    Science.gov (United States)

    Kordi, Ramin; Nourian, Ruhollah; Ghayour, Mahboubeh; Kordi, Mahboubeh; Younesian, Ali

    2012-09-01

    The objectives of this study were a) to develop a physical activity program for nursery schools, and b) to evaluate the effects of this program on fundamental movement skills of preschool age children in Iran. In this quasi-experimental study 147 children from five nursery schools in five different cities in Iran were enrolled. A physical activity program was developed for nursery children. Trained nursery physical activity instructors conducted the program for 10 weeks for all subjects. The levels of gross motor development of all subjects were measured before intervention and after 10 weeks physical activity program employing the Test of Gross Motor Development-edition 2 (TGMD-2). The participants in this study had a mean (SD) age of 4.95 (0.83) years. At the end of the study, scores of subjects at all components of TGMD-2 (including locomotor, object control, sum of standard scores and gross motor quotient) were significantly improved compared to the baseline scores (P120) and after 10 weeks intervention this rate was increased to 49.7% of all subjects. It seems that the developed physical activity program conducted by trained nursery physical activity instructors could be an effective and practical way of increasing levels of fundamental movement skills of preschool children in Iran.

  13. Design and Usage of the HeartCycle Education and Coaching Program for Patients With Heart Failure.

    Science.gov (United States)

    Stut, Wim; Deighan, Carolyn; Armitage, Wendy; Clark, Michelle; Cleland, John G; Jaarsma, Tiny

    2014-12-11

    Heart failure (HF) is common, and it is associated with high rates of hospital readmission and mortality. It is generally assumed that appropriate self-care can improve outcomes in patients with HF, but patient adherence to many self-care behaviors is poor. The objective of our study was to develop and test an intervention to increase self-care in patients with HF using a novel, online, automated education and coaching program. The online automated program was developed using a well-established, face-to-face, home-based cardiac rehabilitation approach. Education is tailored to the behaviors and knowledge of the individual patient, and the system supports patients in adopting self-care behaviors. Patients are guided through a goal-setting process that they conduct at their own pace through the support of the system, and they record their progress in an electronic diary such that the system can provide appropriate feedback. Only in challenging situations do HF nurses intervene to offer help. The program was evaluated in the HeartCycle study, a multicenter, observational trial with randomized components in which researchers investigated the ability of a third-generation telehealth system to enhance the management of patients with HF who had a recent (Heart Association (NYHA) functional class III/IV symptoms despite treatment with diuretic agents. The patients were enrolled from January 2012 through February 2013 at 3 hospital sites within the United Kingdom, Germany, and Spain. Of 123 patients enrolled (mean age 66 years (SD 12), 66% NYHA III, 79% men), 50 patients (41%) reported that they were not physically active, 56 patients (46%) did not follow a low-salt diet, 6 patients (5%) did not restrict their fluid intake, and 6 patients (5%) did not take their medication as prescribed. About 80% of the patients who started the coaching program for physical activity and low-salt diet became adherent by achieving their personal goals for 2 consecutive weeks. After becoming

  14. Open-heart Surgery Complications Following Programmed Education and Nurses' Clinical Competence

    Directory of Open Access Journals (Sweden)

    Mahnaz Rakhshan

    2017-01-01

    Full Text Available Heart surgery can lead to certain complications that, if not diagnosed and treated on time, can be fatal. In view of the fact that nurses' clinical competence affects the quality of clinical judgment, the present study aimed to explore the effect of programmed education and nurses' clinical competence on complications following open-heart surgeries. The results of the present study showed that a closer attention to regular and programmed education and informing of open-heart surgery patients, especially before surgery and at the time of discharge, along with the clinical competence of nurses in ICUs, can reduce the incidence of post-surgery complications. Since the nurses' clinical competence greatly affects their clinical judgments and quality of care, paying greater attention to the nurses' education through systematic programs and increasing the clinical competence can lead to fewer post-heart-surgery complications; this, in turn, reduces the length of stay and the ensuing costs.

  15. Impact of the National Food Supplementary Program for Children on Household Food Security and Maternal Weight Status in Iran.

    Science.gov (United States)

    Ghodsi, Delaram; Omidvar, Nasrin; Eini-Zinab, Hassan; Rashidian, Arash; Raghfar, Hossein

    2016-01-01

    Food aid programs are strategies that aim to improve nutritional status and to tackle food insecurity. This study aimed to evaluate the effect of a National Food Supplementary Program for Children on households' food security. The study sample included 359 mothers of children aged 6-72 months under the coverage of the program in two provinces of Iran. Demographic and socioeconomic characteristics of the households and percentage of supplementary food items consumed by target child were assessed by a questionnaire and checklist. Data on household food security were collected by locally adapted Household Food Insecurity Access Scale at the baseline of the study and 6 months thereafter. At the baseline, only 4.7% of families were food secure, while 43.5% were severely food insecure, and these proportions were changed to 7.9% and 38%, respectively ( P food insecurity in households with medium and high wealth index was 65% and 87% lower than those with low wealth index, respectively (odds ratio [OR] = 0.35, 95% confidence interval [CI]: 0.2-0.61, and OR = 0.23, 95% CI: 0.12-0.43). Food sharing was common among more than 95% of the studied households. Mean maternal body mass index (BMI) increased significantly after 6 months ( P food security in the baseline and at the end of the study ( P > 0.05). Findings show that the food supplementary program for children can also improve the household food security status. Further research is needed to assess other factors that affect the effectiveness of this kind of programs.

  16. Continuing Education Programs within the American Heart Association

    Science.gov (United States)

    Lembright, Katherine A.

    1970-01-01

    Because it believes the nurse can and must be a participant in the co-professional health team (doctor, nurse), the American Heart Association has become increasingly concerned with planning and carrying out activities that contribute to the continuing education of nurses. (PT)

  17. Cost-Effectiveness of Multidisciplinary Management Program and Exercise Training Program in Heart Failure.

    Science.gov (United States)

    Dang, Weixiong; Yi, Anji; Jhamnani, Sunny; Wang, Shi-Yi

    2017-10-15

    Heart failure causes significant health and financial burdens for patients and society. Multidisciplinary management program (MMP) and exercise training program (ETP) have been reported as cost-effective in improving health outcomes, yet no study has compared the 2 programs. We constructed a Markov model to simulate life year (LY) gained and total costs in usual care (UC), MMP, and ETP. The probability of transitions between states and healthcare costs were extracted from previous literature. We calculated the incremental cost-effectiveness ratio (ICER) over a 10-year horizon. Model robustness was assessed through 1-way and probabilistic sensitivity analyses. The expected LY for patients treated with UC, MMP, and ETP was 7.6, 8.2, and 8.4 years, respectively. From a societal perspective, the expected cost of MMP was $20,695, slightly higher than the cost of UC ($20,092). The cost of ETP was much higher ($48,378) because of its high implementation expense and the wage loss it incurred. The ICER of MMP versus UC was $976 per LY gained, and the ICER of ETP versus MMP was $165,702 per LY gained. The results indicated that, under current cost-effectiveness threshold, MMP is cost-effective compared with UC, and ETP is not cost-effective compared with MMP. However, ETP is cost-effective compared with MMP from a healthcare payer's perspective. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Integrating a Suicide Prevention Program into the Primary Health Care Network: A Field Trial Study in Iran

    Directory of Open Access Journals (Sweden)

    Seyed Kazem Malakouti

    2015-01-01

    Full Text Available Objective. To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. Methodology. This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Western Iran. The intervention protocol called for primary care and suicide prevention collaboration at different levels of care. The outcome variables were the number of suicides committed, the number of documented suicide attempts, and the number of identified depressed cases. Results. We identified a higher prevalence of depressive disorders in the intervention site versus the control site (χ2=14.8, P<0.001. We also found a reduction in the rate of suicide completion in the intervention region compared to the control, but a higher prevalence of suicide attempts in both the intervention and the control sites. Conclusion. Integrating a suicide prevention program with the Primary Health Care network enhanced depression and suicide surveillance capacity and subsequently reduced the number of suicides, especially in rural areas.

  19. Integrating a suicide prevention program into the primary health care network: a field trial study in Iran.

    Science.gov (United States)

    Malakouti, Seyed Kazem; Nojomi, Marzieh; Poshtmashadi, Marjan; Hakim Shooshtari, Mitra; Mansouri Moghadam, Fariba; Rahimi-Movaghar, Afarin; Afghah, Susan; Bolhari, Jafar; Bazargan-Hejazi, Shahrzad

    2015-01-01

    To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Western Iran. The intervention protocol called for primary care and suicide prevention collaboration at different levels of care. The outcome variables were the number of suicides committed, the number of documented suicide attempts, and the number of identified depressed cases. We identified a higher prevalence of depressive disorders in the intervention site versus the control site (χ (2) = 14.8, P suicide completion in the intervention region compared to the control, but a higher prevalence of suicide attempts in both the intervention and the control sites. Integrating a suicide prevention program with the Primary Health Care network enhanced depression and suicide surveillance capacity and subsequently reduced the number of suicides, especially in rural areas.

  20. The Sensitivity, Specificity and Predictive Values of Snellen Chart Compared to the Diagnostic Test in Amblyopia Screening Program in Iran

    Directory of Open Access Journals (Sweden)

    Fatemeh Rivakani

    2015-12-01

    Full Text Available Introduction Amblyopia is a leading cause of visual impairment in both childhood and adult populations. Our aim in this study was to assess the epidemiological characteristics of the amblyopia screening program in Iran. Materials and Methods A cross-sectional study was done on a randomly selected sample of 4,636 Iranian children who were referred to screening program in 2013 were participated in validity study, too. From each provinces the major city were selected. Screening and diagnostic tests were done by instructors in first stage and optometrists in second stage, respectively. Finally data were analyzed by Stata version 13. Results The sensitivity was ranged from 74% to 100% among the various provinces such that Fars and Ardabil province had maximum and minimum values, respectively. The pattern of specificity was differ and ranged 44% to 84% among the provinces; Hormozgan and Fars had maximum and minimum values, respectively. The positive predictive value was also ranged from 35% to %81 which was assigned to Khuzestan and Ardabil provinces, respectively. The range of Negative Predictive value was 61% to 100% which was belonged to Ardabil and Fars provinces. Conclusion The total sensitivity (89% and negative predictive values (93% of screening test among children aged 3-6 years is acceptable, but only 51% of children refereed to second stage are true positive and this imposes considerable cost to health system.

  1. Integrating a Suicide Prevention Program into the Primary Health Care Network: A Field Trial Study in Iran

    Science.gov (United States)

    Malakouti, Seyed Kazem; Nojomi, Marzieh; Poshtmashadi, Marjan; Hakim Shooshtari, Mitra; Mansouri Moghadam, Fariba; Rahimi-Movaghar, Afarin; Afghah, Susan; Bolhari, Jafar; Bazargan-Hejazi, Shahrzad

    2015-01-01

    Objective. To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. Methodology. This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Western Iran. The intervention protocol called for primary care and suicide prevention collaboration at different levels of care. The outcome variables were the number of suicides committed, the number of documented suicide attempts, and the number of identified depressed cases. Results. We identified a higher prevalence of depressive disorders in the intervention site versus the control site (χ 2 = 14.8, P < 0.001). We also found a reduction in the rate of suicide completion in the intervention region compared to the control, but a higher prevalence of suicide attempts in both the intervention and the control sites. Conclusion. Integrating a suicide prevention program with the Primary Health Care network enhanced depression and suicide surveillance capacity and subsequently reduced the number of suicides, especially in rural areas. PMID:25648221

  2. Iran Sanctions

    Science.gov (United States)

    2012-12-07

    imposes sanctions on several key sectors of Iran’s economic infrastructure. For a broader analysis of policy on Iran, see CRS Report RL32048, Iran...oil or gas drill rig or motors or other gear that Iran will use to drill for oil or gas were not sanctionable under ISA, unless the sale is...carrying Iranian oil, but they worked around that by setting up new insurance mechanisms. Japan’s exemption has benefitted its banks, such as Mitsubishi UFJ

  3. Educational ranking of schools providing nutrition program in Iran: A strategy to identify the strengths and weaknesses

    Directory of Open Access Journals (Sweden)

    R Mojtahedzadeh

    2012-06-01

    Full Text Available Introduction: After two decades of expansion of universities of medical sciences and increasing the number of students as one of the most attainable solutions to overcome sub-standard status of Iranian workforce in health section, quality of medical education has recently taken priority in national health plans. The purpose of this study was designing a benchmark tool for determining differences in the field of education among schools offering nutrition programs in Iran by stratifying their educational services. Methods: To measure the educational performance of schools providing nutrition programs nationwide, a benchmarking tool consisting of more than 50 indicators was developed by a special committee via brainstorming and nominal group. The weight given to each indicator was defined through consensus developing methods. Each school was asked to introduce a representative who would complete a questionnaire designed to collect schools’ information. Next, all the divisions were visited by one of the project's members and the school’s representative. Then, data retrieval was performed and verified at the project’s office. The average score of each school for each indicator was calculated. Finally, a special computer software was applied to perform the final analysis. Results: A total of 50 indicators were designed in the form of tree diagram and were weighted via consensus agreement. The medical universities offering nutritional programs were compared using the designed model. Conclusion: This study defined the educational strengths and weaknesses of nutrition program in Iranian schools that could be used as a measure for authorities to devise practical strategies for qualitative and quantitative improvement in medical education.

  4. Evaluation of heart rate reserve and high-sensitivity C-reactive protein in individuals with and without metabolic syndrome in Isfahan, Iran.

    Science.gov (United States)

    Khaledi, Yosef; Aghababaei, Esmaeil; Sadeghi, Masoumeh; Hashemi, Mohammad; Sanei, Hamid

    2012-01-01

    Lack of heart rate increase proportionate to exercise causes poor prognosis. Moreover, inflammatory factors such as C-reactive protein (CRP) are associated with atherosclerosis. The current study compared these two indices in individuals with and without metabolic syndrome in Isfahan, Iran. This study was performed on 203 people without and 123 patients with metabolic syndrome who were randomly selected from the participants of the Isfahan Cohort Study. The demographic data, waist circumference, blood pressure, height, and weight of the participants were recorded. Moreover, serum tr`viglyceride (TG), fasting blood sugar (FBS), total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), and high-sensitivity CRP (hs-CRP) levels were measured. Exercise test was carried out according to the Bruce standard protocol and heart rate reserve (HRR) was determined and recorded. The age-adjusted data was analyzed using generalized linear regression and student's t-test in SPSS(15). The mean ages of participants without and with metabolic syndrome were 54.16 ± 8.61 and 54.29 ± 7.6 years, respectively. The corresponding values for mean LDL levels were 116.17 ± 24.04 and 120.12 ± 29.55 mg/dl. TG levels were 140.38 ± 61.65 and 259.99 ± 184.49 mg/dl for subjects without and with the metabolic syndrome, respectively. The mean FBS levels were 81.81 ± 9.90 mg/dl in the participants without the syndrome and 107.13 ± 48.46 mg/dl in those with metabolic syndrome. The mean systolic blood pressure was 116.06 ± 13.69 mmHg in persons without metabolic syndrome and 130.73 ± 15.15 mmHg in patients with the syndrome. The values for mean diastolic levels in the two groups were 76.52 ± 6.69 and 82.84 ± 8.7 mmHg, respectively. While the two groups were not significantly different in terms of HRR (P = 0.27), hs-CRP levels in the metabolic syndrome group was significantly higher than the other group (P = 0.02). We failed to establish a relationship between HRR and

  5. [30 years heart transplantation program in Institute for Clinical and Experimental Medicine in Prague].

    Science.gov (United States)

    Hošková, Lenka; Málek, Ivan; Melenovský, Vojtěch; Podzimková, Marianna; Hegarová, Markéta; Dorazilová, Zora; Kautzner, Josef; Netuka, Ivan; Pirk, Jan

    2014-04-01

    Heart transplantation has become in recent decades an established method for the treatment of advanced heart failure. Precisely, it was in January 2014 when 30 years have passed since the start of clinical heart transplantation program at the Institute for Clinical and Experimental Medicine. 936 heart transplants were performed by the end of 2013. The transplant program has reached considerable development since its beginnings. The knowledge of whole issue has deepened, indication criteria have been extended, new immunosuppressives are available and many of them are still in research. Life expectancy of patients has been prolonged and quality of life has improved. Nevertheless, the care of transplant patient is very complicated task for medical professionals and brings a lot of problems to solve.

  6. The effect of a resilience improvement program for adolescents with complex congenital heart disease.

    Science.gov (United States)

    Lee, Sunhee; Lee, Junga; Choi, Jae Young

    2017-04-01

    Adolescents with congenital heart disease need to increase their resilience in the face of challenges in order to preserve their health and quality of life. This study aimed to develop a resilience improvement program for adolescents with congenital heart disease and also to evaluate any change in resilience and quality of life as a measure of the effectiveness of the resilience improvement programs. A nonequivalent control group pretest-posttest study was designed. Twenty-five adolescents who attended the first resilience improvement program were included in the experimental group, and 31 adolescents who took part in the second program were placed in the control group. Adolescents with congenital heart disease completed a self-report questionnaire on three separate occasions: the pretest, the first posttest and the second posttest. The self-report questionnaire included general characteristics and instruments to measure resilience and quality of life. For the longitudinal analysis, generalized estimating equations were used to evaluate the difference in the estimated average trajectories of resilience and quality of life changes. Independent predictors of resilience improvement in adolescents with congenital heart disease were the experimental group ( p=0.02) and middle and high school students ( p=0.02). Quality of life was not associated with membership in the experimental group. However, males scored higher than females on quality of life measures ( p=0.02). It is essential for healthcare providers to apply various programs, including those targeted at accepting illness, improving autonomy and independently managing disease, to adolescents with congenital heart disease.

  7. The Effect of Empathy Training Programs on Aggression and Compatibility Students of Elementary Schools in Yazd, Center of Iran

    Directory of Open Access Journals (Sweden)

    Bi Bi Halimeh Sohravardi

    2015-08-01

    Full Text Available Introduction Empathy is believed to play an important role in fostering prosocial behavior and social competence. The purpose of this study was to evaluate the effect of empathy teaching on aggression and compatibility in female students of elementary sixth grade in yazd, center of Iran. Materials and Methods The samples were 62 girl students of grade 6 in elementary schools that were selected by available (targeted sampling among girl students of grade 6 on Yazd. They were put in two groups of control group and experiment group randomly and equally. Data were collected by using empathy questions of Isenberg, Febs, Oscolar, Carlo & Miller, Rater questionnaire about children behavioral disorder and Bus & Perry questionnaire and were analyzed with Mankoo & Ankova methods. Results The mean age of students was 13 ± 0.359 year-old. The Results showed that after controlling scores of pretests, there was a meaningful relationship between two groups in their empathy, social compatibility and aggression and its aspects (like physical aggression, verbal aggression, hostility and anger scores (P< 0.05. Conclusion The development of empathy with training programs, can have a positive effect on reduce of aggression and increasing of compatibility in students at elementary schools.

  8. Effect of moderate or intensive disease management program on outcome in patients with heart failure : Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH)

    NARCIS (Netherlands)

    Jaarsma, T.; van der Wal, Martje H.L.; Lesman-Leegte, Ivonne; Luttik, Marie-Louise; Hogenhuis, Jochem; Veeger, Nic J.; Sanderman, Robbert; Hoes, A.W.; van Gilst, Wiek H.; Lok, D.J.; Dunselman, P.H.; Tijssen, J.G.; Hillege, Hans L.; van Veldhuisen, Dirk J.

    2008-01-01

    Background:: Heart failure (HF) disease management programs are widely implemented, but data about their effect on outcome have been inconsistent. Methods: The Coordinating Stud), Evaluating Out-comes of Advising and Counseling in Heart Failure (COACH) was a multicenter, randomized, controlled trial

  9. Effectiveness of United StatesLed Economic Sanctions as a Counterproliferation Tool Against Irans Nuclear Weapons Program

    Science.gov (United States)

    2015-12-01

    These revelations exposed the broad reach of the Khan network, which included nations, like Malaysia , which are not normally associated with...Enrichment Plant in two months. Additionally, Iran could speed up the production of a nuclear weapon using 1,000 more advanced IR -2m centrifuges...If Iran feeds its IR -centrifuges with natural uranium and operates: • 9,000 centrifuges (the number now running): 6.8 months • 6,104 centrifuges

  10. A meta-analysis of psychoeduational programs for coronary heart disease patients.

    Science.gov (United States)

    Dusseldorp, E; van Elderen, T; Maes, S; Meulman, J; Kraaij, V

    1999-09-01

    In a meta-analysis of 37 studies, the effects of psychoeducational (health education and stress management) programs for coronary heart disease patients were examined. The results suggest that these programs yielded a 34% reduction in cardiac mortality; a 29% reduction in recurrence of myocardial infarction (MI); and significant (p psychoeducational programs were found in regard to coronary bypass surgery, anxiety, or depression. The results also suggest that cardiac rehabilitation programs that were successful on proximal targets (systolic blood pressure, smoking behavior, physical exercise, emotional distress) were more effective on distal targets (cardiac mortality and MI recurrences) than programs without success on proximal targets.

  11. Endoscopic findings in a mass screening program for gastric cancer in a high risk region - Guilan province of Iran.

    Science.gov (United States)

    Mansour-Ghanaei, Fariborz; Sokhanvar, Homayoon; Joukar, Farahnaz; Shafaghi, Afshin; Yousefi-Mashhour, Mahmud; Valeshabad, Ali Kord; Fakhrieh, Saba; Aminian, Keyvan; Ghorbani, Kambiz; Taherzadeh, Zahra; Sheykhian, Mohammad Reza; Rajpout, Yaghoub; Mehrvarz, Alireza

    2012-01-01

    Gastric cancer is a leading cause of cancer-related deaths in both sexes in Iran. This study was designed to assess upper GI endoscopic findings among people>50 years targeted in a mass screening program in a hot-point region. Based on the pilot results in Guilan Cancer Registry study(GCRS), one of the high point regions for GC - Lashtenesha - was selected. The target population was called mainly using two methods: in rural regions, by house-house direct referral and in urban areas using public media. Upper GI endoscopy was performed by trained endoscopists. All participants underwent biopsies for rapid urea test (RUT) from the antrum and also further biopsies from five defined points of stomach for detection of precancerous lesions. In cases of visible gross lesions, more diagnostic biopsies were taken and submitted for histopathologic evaluation. Of 1,394 initial participants, finally 1,382 persons (702 women, 680 men) with a mean age of 61.7 ± 9.0 years (range:50-87 years) underwent upper GI endoscopy. H.pylori infection based on the RUT was positive in 66.6%. Gastric adenocarcinoma and squamous cell carcinoma of esophagus were detected in seven (0.5%) and one(0.07%) persons, respectively. A remarkable proportion of studied participants were found to have esophageal hiatal hernia(38.4%). Asymptomatic gastric masses found in 1.1% (15) of cases which were mostly located in antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population. Upper endoscopy screening is an effective technique for early detection of GC especially in high risk populations. Further studies are required to evaluate cost effectiveness, cost benefit and mortality and morbidity of this method among high and moderate risk population before recommending this method for GC surveillance program at the national level.

  12. Heart Smart: a school health program meeting the 1990 Objectives for the Nation.

    Science.gov (United States)

    Butcher, A H; Frank, G C; Harsha, D W; Serpas, D C; Little, S D; Nicklas, T A; Hunter, S M; Berenson, G S

    1988-01-01

    The importance of health promotion is recognized throughout the nation. The Surgeon General's report of 1980, Promoting Health/Preventing Disease, delineates objectives for intervention in 15 health priority areas. Approximately one-third of the objectives relate directly to the health of children, and many are addressed by a comprehensive cardiovascular (CV) health promotion program for elementary school children--Heart Smart. Priority areas addressed by this program are high blood pressure control, nutrition, fluoridation and dental health, smoking, misuse of alcohol and drugs, physical fitness and exercise, and control of stress and violence. Heart Smart is a cognitive behavioral intervention designed to address health enabling and reinforcing factors within the school environment. It is based on data from the Bogalusa Heart Study which clearly document the need for CV health intervention beginning early in life. Heart Smart includes a longitudinal classroom curriculum, an aerobic fitness program taught within physical education classes, a school lunch program offering CV healthy foods, and a teacher staff development program. The goal is to reduce CV risk factors in children. With health-enhancing behavior change of the students, family, and elementary school staff, objectives for CV risk reduction in our nation can be achieved.

  13. CTCF counter-regulates cardiomyocyte development and maturation programs in the embryonic heart

    Science.gov (United States)

    Gomez-Velazquez, Melisa; Badia-Careaga, Claudio; Lechuga-Vieco, Ana Victoria; Nieto-Arellano, Rocio; Rollan, Isabel; Alvarez, Alba; Torroja, Carlos; Caceres, Eva F.; Roy, Anna R.; Galjart, Niels; Sanchez-Cabo, Fatima; Enriquez, Jose Antonio; Gomez-Skarmeta, Jose Luis

    2017-01-01

    Cardiac progenitors are specified early in development and progressively differentiate and mature into fully functional cardiomyocytes. This process is controlled by an extensively studied transcriptional program. However, the regulatory events coordinating the progression of such program from development to maturation are largely unknown. Here, we show that the genome organizer CTCF is essential for cardiogenesis and that it mediates genomic interactions to coordinate cardiomyocyte differentiation and maturation in the developing heart. Inactivation of Ctcf in cardiac progenitor cells and their derivatives in vivo during development caused severe cardiac defects and death at embryonic day 12.5. Genome wide expression analysis in Ctcf mutant hearts revealed that genes controlling mitochondrial function and protein production, required for cardiomyocyte maturation, were upregulated. However, mitochondria from mutant cardiomyocytes do not mature properly. In contrast, multiple development regulatory genes near predicted heart enhancers, including genes in the IrxA cluster, were downregulated in Ctcf mutants, suggesting that CTCF promotes cardiomyocyte differentiation by facilitating enhancer-promoter interactions. Accordingly, loss of CTCF disrupts gene expression and chromatin interactions as shown by chromatin conformation capture followed by deep sequencing. Furthermore, CRISPR-mediated deletion of an intergenic CTCF site within the IrxA cluster alters gene expression in the developing heart. Thus, CTCF mediates local regulatory interactions to coordinate transcriptional programs controlling transitions in morphology and function during heart development. PMID:28846746

  14. CTCF counter-regulates cardiomyocyte development and maturation programs in the embryonic heart.

    Science.gov (United States)

    Gomez-Velazquez, Melisa; Badia-Careaga, Claudio; Lechuga-Vieco, Ana Victoria; Nieto-Arellano, Rocio; Tena, Juan J; Rollan, Isabel; Alvarez, Alba; Torroja, Carlos; Caceres, Eva F; Roy, Anna R; Galjart, Niels; Delgado-Olguin, Paul; Sanchez-Cabo, Fatima; Enriquez, Jose Antonio; Gomez-Skarmeta, Jose Luis; Manzanares, Miguel

    2017-08-01

    Cardiac progenitors are specified early in development and progressively differentiate and mature into fully functional cardiomyocytes. This process is controlled by an extensively studied transcriptional program. However, the regulatory events coordinating the progression of such program from development to maturation are largely unknown. Here, we show that the genome organizer CTCF is essential for cardiogenesis and that it mediates genomic interactions to coordinate cardiomyocyte differentiation and maturation in the developing heart. Inactivation of Ctcf in cardiac progenitor cells and their derivatives in vivo during development caused severe cardiac defects and death at embryonic day 12.5. Genome wide expression analysis in Ctcf mutant hearts revealed that genes controlling mitochondrial function and protein production, required for cardiomyocyte maturation, were upregulated. However, mitochondria from mutant cardiomyocytes do not mature properly. In contrast, multiple development regulatory genes near predicted heart enhancers, including genes in the IrxA cluster, were downregulated in Ctcf mutants, suggesting that CTCF promotes cardiomyocyte differentiation by facilitating enhancer-promoter interactions. Accordingly, loss of CTCF disrupts gene expression and chromatin interactions as shown by chromatin conformation capture followed by deep sequencing. Furthermore, CRISPR-mediated deletion of an intergenic CTCF site within the IrxA cluster alters gene expression in the developing heart. Thus, CTCF mediates local regulatory interactions to coordinate transcriptional programs controlling transitions in morphology and function during heart development.

  15. Methadone maintenance treatment program in prisons from the perspective of medical and non-medical prison staff: a qualitative study in Iran.

    Science.gov (United States)

    Moradi, Ghobad; Farnia, Marzieh; Shokoohi, Mostafa; Shahbazi, Mohammad; Moazen, Babak; Rahmani, Khaled

    2015-03-12

    As one of the most important components of harm reduction strategy for high-risk groups, following the HIV epidemics, Methadone Maintenance Treatment (MMT) has been initiated in prisoners since 2003. In this paper, we aimed to assess the advantages and shortcomings of the MMT program from the perspective of people who were involved with the delivery of prison healthcare in Iran. On the basis of grounded theory and through conducting 14 Focus Group Discussions (FGDs), 7 FGDs among physicians, consultants, experts, and 7 FGDs among directors and managers of prisons (n= 140) have been performed. The respondents were asked about positive and negative elements of the MMT program in Iranian prisons. This study included a total of 48 themes, of which 22 themes were related to advantages and the other 26 were about shortcomings of MMT programs in the prisons. According to participants' views "reduction of illegal drug use and high-risk injection", "reduction of potentially high-risk behaviors" and "making positive attitudes" were the main advantages of MMT in prisons, while issues such as "inaccurate implementation", "lack of skilled manpower" and "poor care after release from prison" were among the main shortcomings of MMT program. MMT program in Iran's prisons has achieved remarkable success in the field of harm reduction, but to obtain much more significant results, its shortcomings and weaknesses must be also taken into account by policy-makers. © 2015 by Kerman University of Medical Sciences.

  16. [Differences between German and Turkish-speaking participants in a chronic heart failure management program].

    Science.gov (United States)

    Ernstmann, N; Karbach, U

    2017-02-01

    German and Turkish-speaking patients were recruited for a chronic heart failure management program. So far little is known about the special needs and characteristics of Turkish-speaking patients with chronic heart failure; therefore, the aim of this study was to examine sociodemographic and illness-related differences between German and Turkish-speaking patients with chronic heart failure. German and Turkish-speaking patients suffering from chronic heart failure and insured with the AOK Rheinland/Hamburg or the BARMER GEK health insurance companies and living in Cologne, Germany, were enrolled. Recruitment took place in hospitals, private practices and at information events. Components of the program were coordination of a guideline-oriented medical care, telemonitoring (e.g., blood pressure, electrocardiogram, and weight), a 24-h information hotline, attendance by German and Turkish-speaking nurses and a patient education program. Data were collected by standardized interviews in German or Turkish language. Data were analyzed with descriptive measures and tested for significance differences using Pearson's χ(2)-test and the t‑test. A total of 465 patients (average age 71 years, 55 % male and 33 % Turkish-speaking) were enrolled in the care program during the study period. Significant differences between German and Turkish-speaking patients were found for age, education, employment status, comorbidities, risk perception, knowledge on heart failure and fear of loss of independence. The response rate could be achieved with the help of specific measures for patient enrollment by Turkish-speaking integration nurses. The differences between German and Turkish-speaking patients should in future be taken into account in the care of people with chronic heart failure.

  17. Noninvasive detection of programmed cell loss with 99mTc-labeled annexin A5 in heart failure

    NARCIS (Netherlands)

    Kietselaer, Bas L J H; Reutelingsperger, Chris P M; Boersma, Hendrikus H; Heidendal, Guido A K; Liem, Ing Han; Crijns, Harry J G M; Narula, Jagat; Hofstra, Leo

    UNLABELLED: Apoptosis, or programmed cell death (PCD), contributes to the decline in ventricular function in heart failure. Because apoptosis comprises a programmed cascade of events, it is potentially reversible, and timely intervention should delay the development of cardiomyopathy.

  18. Counseling with Heart: A Relationship Violence Prevention Program for College Students

    Science.gov (United States)

    Hays, Danica G.; Michel, Rebecca E.; Bayne, Hannah B.; Neuer Colburn, Anita A.; Smith Myers, Jayne

    2015-01-01

    Relationship violence is a salient concern on college campuses today, and psychoeducational groups may be an appropriate prevention format. This article describes a study measuring the impact of college student participation in the HEART (Help End Abusive Relationships Today) program, a series of group sessions designed to increase knowledge and…

  19. Protect your heart: a culture-specific multimedia cardiovascular health education program.

    Science.gov (United States)

    Shah, Amy; Clayman, Marla L; Glass, Sara; Kandula, Namratha R

    2015-04-01

    South Asians, the second fastest growing racial/ethnic minority in the United States, have high rates of coronary heart disease. Few coronary heart disease prevention efforts target this population. The authors developed and tested a culture-specific, multimedia coronary heart disease prevention education program in English and Hindi for South Asians. Participants were recruited from community organizations in Chicago, Illinois, between June and October of 2011. Bilingual interviewers used questionnaires to assess participants' knowledge and perceptions before and after the patient education program. The change from pretest score to posttest score was calculated using a paired t test. Linear regression was used to determine the association between posttest scores and education and language. Participants' (N = 112) average age was 41 years, 67% had more than a high school education, and 50% spoke Hindi. Participants' mean pretest score was 15 (SD = 4). After the patient education program, posttest scores increased significantly among all participants (posttest score = 24, SD = 4), including those with limited English proficiency. Lower education was associated with a lower posttest score (β = -2.2, 95% CI [-0.68, -3.83]) in adjusted regression. A culture-specific, multimedia patient education program significantly improved knowledge and perceptions about coronary heart disease prevention among South Asian immigrants. Culturally salient multimedia education may be an effective and engaging way to deliver health information to diverse patient populations.

  20. Iran Sanctions

    Science.gov (United States)

    2013-10-11

    activities, including sponsorship of players , coaching, referees, and training. In some cases, such as the earthquake in Bam in 2003 and the earthquake in...Woori Bank, and its main exports to Iran have been iron and steel, as well as consumer electronics and appliances made by companies such as Samsung...and elsewhere to increasing sanctions on Iran. Iran’s only female minister, Minister of Health Marzieh Vahid Dastjerdi, was dismissed in December

  1. Iran Sanctions

    Science.gov (United States)

    2016-05-18

    The ruling incorporated major features of the Iran Digital Empowerment Act (H.R. 4301 in the 111 th Congress). The OFAC determination required a...have long maintained that Iran should build a “resistance economy” – an economy that is self - sufficient and not dependent on imported goods. In...officials who are responsible for depriving Iranian women and other groups of internationally accepted rights.  Banning Passenger Flights to and

  2. Iran: U.S. Concerns and Policy Responses

    National Research Council Canada - National Science Library

    Katzman, Kenneth

    2008-01-01

    ...." The Administration perception is generated primarily by Iran's nuclear program but is increasingly focused on Iran's military assistance to armed groups in Iraq, which is resulting in U.S. battlefield losses...

  3. Iran: U.S. Concerns and Policy Responses

    National Research Council Canada - National Science Library

    Katzman, Kenneth

    2007-01-01

    ...." That Administration perception continues, generated primarily by Iran's nuclear program but intensified by Iran's military assistance to armed groups in Iraq and Afghanistan and to Hamas and Lebanese Hezbollah...

  4. United we stand, divided we conquer: Pilot study of multidisciplinary General Medicine Heart Failure Care Program.

    Science.gov (United States)

    Wahbi Izzettin, Omar; Hopper, Ingrid; Ritchie, Edward; Nagalingam, Vathy; Aung, Ar Kar

    2017-10-11

    Heart failure care and education require a multifaceted approach to ensure appropriate transition from inpatient to outpatient care. To explore the feasibility of a multidisciplinary heart failure care model, General Medicine Heart Failure Care Program (GM-HFCP) within a General Medical Unit (GMU). Prospective non-randomised before-and-after observational quality improvement intervention over a 6-month period. All consecutive patients admitted to GMU at Alfred Hospital with diagnosis of acute decompensated heart failure were included. Main outcome measures included changes in rates of pharmacologic prescription, non-pharmacologic ward-based management, patient education and action plan provision after intervention. 108 patients were included [median age 84(IQR 80-89) years, 47(44%) females]. Significant improvements were noted in non-pharmacologic management for patient education regarding fluid restriction (12% to 30%, p = 0.04), weight monitoring (10% to 28%, p = 0.03), heart failure action plan on discharge (4% to 28%, p = 0.002) and salt restriction (6% to 32%, p = 0.002). The rates of prescription of heart failure medications remained similar between the pre- and post-implementation periods, particularly in patients with reduced ejection fraction by 'appropriateness of prescription' criteria. There were no differences in inpatient mortality or 30-day readmission rates in both groups. This prospective observational study demonstrated that it is possible to share the roles of a heart failure nurse amongst members of the multidisciplinary team, with similar rates of delivery of pharmacologic and non-pharmacologic management aspects. However, further innovative improvements are needed to address certain aspects of heart failure care. This article is protected by copyright. All rights reserved.

  5. Outcome of Congenitally Hypothyroid Screening Program in Isfahan: Iran From Prevention to Treatment

    Directory of Open Access Journals (Sweden)

    Mahin Hashemipour

    2010-01-01

    Full Text Available Objectives: Early and proper treatment is crucial to prevent neuropsychologic deficits in congenital hypothyroidism (CH. Considering the high prevalence of CH in Isfahan, the aim of this study was to evaluate the outcome of treatment in CH patients.Methods: In this study CH neonates diagnosed during screening program in Isfahan from May 2002 to September 2009 were studied. Frequent visits were performed to CH patients to monitor and follow their treatments. Quality of treatment was assessed by evaluating mean age of treatment initiation and mean TSH and T4 levels before and after treatment and during the first and second years according to their normal reference ranges.Results: Of 225,224 screened neonates, 536 were diagnosed as CH patients. The prevalence of CH was 1/420 live births. Mean age at starting treatment was 22.9  13.2 days. In 93.7% of patients, treatment was begun before the 45th day of life. In the first measurement after initiating the treatment, T4 and TSH were not in their acceptable range in 3.9% and 9.8% of CH patients, respec-tively. Mean T4 and TSH reached to normal range during the treatment period. T4 reached the normal range earlier than TSH.Conclusions: The mean age of treatment initiation was in acceptable range but the findings suggest that both early and high-dose treatments are crucial for optimal treatment, especially in patients with severe CH. Further studies are needed to determine the outcome of treatment specially regarding to different etiologies of CH.

  6. Depression and the usefulness of a disease management program in heart failure : insights from the COACH (Coordinating study evaluating Outcomes of Advising and Counseling in Heart failure) study

    NARCIS (Netherlands)

    Jaarsma, Tiny; Lesman-Leegte, Ivonne; Hillege, Hans L.; Veeger, Nic J.; Sanderman, Robbert; van Veldhuisen, Dirk J.

    2010-01-01

    Objectives Our aim was to study the possible role of depressive symptoms in the effectiveness of a disease management program (DMP) in heart failure (HF) patients. Background Disease management programs are recommended in current HF guidelines, but certain patient groups, such as those with

  7. Iran: spotlight.

    Science.gov (United States)

    Roudi, N

    1987-09-01

    Given its location between Asia and Asia Minor, Iran has been a country of strategic political importance throughout history. More than 98% of Iran's population is Moslem. During the early 20th century, as Iran gradually gained independence from the USSR and Turkey, a modernization process was begun. However, this modernization process was forced to yield to Islamic traditionalism after the 1979 Islamic Revolution. Women have been most affected by this change. The implementation of Islamic traditions has meant low job opportunity or motivation for continuing education among women. Although fertility remains high, the present government is satisfied with the current rate of population growth. Family planning is allowed if implemented within the framework of Islamic law, but abortion is illegal. Mortality fell substantially after World War II, but has not continued to decline. At present, both males and females have the same life expectancy at birth. Iran's population is growing at a rate of 4%/year, and can be expected to double in another 21 years. It has been projected that Iran, currently the 21st largest country in the world with a population of 50 million, will become the 15th largest with a population of 97 million by the year 2025. Tehran, the 20th largest city in 1985, is projected to be the 9th largest by the year 2000, with a population of 13.6 million.

  8. Hospital cost effect of a heart failure disease management program: the Specialized Primary and Networked Care in Heart Failure (SPAN-CHF) trial.

    Science.gov (United States)

    Gregory, Douglas; Kimmelstiel, Carey; Perry, Kathleen; Parikh, Amay; Konstam, Varda; Konstam, Marvin A

    2006-05-01

    Determine the effect on hospitalization cost of a heart failure disease management (HFDM) program delivered within a diverse provider network as demonstrated in the SPAN-CHF randomized controlled trial. The SPAN-CHF trial was a prospective randomized assessment of the effectiveness of HFDM delivered for 90 days across a diverse provider network in a heterogeneous population of 200 patients. Baseline clinical and demographic data were obtained on each patient, mortality was monitored, and hospitalizations were tracked for 90 days. Cost estimates for each hospitalization were based on a subsample of patients seen at Tufts-New England Medical Center for whom hospitalization costs were calculated. Heart failure disease management program costs were estimated using a programmatic budget model. Hospital utilization and cost data were combined to estimate medical costs for intervention and control groups. Heart failure disease management had a favorable effect on heart failure hospitalization, which was partially offset by noncardiac hospitalizations. The relative odds of at least one all-cause hospitalization during the intervention period trended less for the intervention group compared with the control group (0.76 [95% CI 0.38-1.51]). The point estimate of the differential hospitalization cost between control and intervention groups was a reduction in cost of $375 per patient. The net effect including the costs of the program was an increase of $488 per patient for the intervention group compared with the control group. The program would have been cost saving if HFDM costs had been 24% lower. The HFDM intervention, administered over 90 days to patients hospitalized for heart failure, succeeded in reducing the rate of heart failure hospitalizations, although this effect was partially offset by an increase in non-heart failure hospitalizations. The resulting modest reduction in all-cause hospitalization costs was exceeded by the cost of the intervention. Thus, although

  9. Procrastination and Self-Efficacy Among Intravenous Drug Users on a Methadone Maintenance Program in Sari City, Iran, 2013.

    Science.gov (United States)

    Taghizadeh, Fatemeh; Yazdani Cherati, Jamshid

    2015-12-01

    Self-efficacy is the belief that one has the ability to implement the behaviors needed to produce a desired effect. There has been growing interest in the role of self-efficacy as a predictor and/or mediator of treatment outcome in a number of domains. Procrastination is a self-regulatory failure, defined as the voluntary delay of an intended course of action despite expecting to be worse off for the delay. Behavioral procrastination is a self-sabotage strategy that allows people to shift blame and avoid action; the decisional procrastination strategy is to put off making a decision when dealing with conflicts or choices. Procrastination has a great role in quitting drug addiction. The aim of this study was to determine the relationship between procrastination and self-efficacy and other factors among intravenous drug users. This cross-sectional study was conducted on 178 intravenous drug users in the behavioral disease counseling, health center in Sari city, Mazandaran province, Iran, in 2013. The samples were selected through census sampling, descriptive and inferential statistics were used to measure the properties of distribution that depicts a set of data shown as frequency distribution tables, while for the mean and standard deviation, chi-square, Fisher and Spearman-Brown coefficients were used to analyze the data. The mean age of the participants was 43 years. Seventy-two percent of them were married and opium was the first drug used. The first substance used in them was 54% of opium, 33% cannabis and 5% alcohol and 79% smoking. The reason of the first drug use in 32% of the subjects was temptation and in 10% a friend's influence. The mean age of the first drug use was 23 years, and the frequency was 2 times per day. All of them had relapse at least once. Seven percent of them currently use other materials (2% crystal, 5% alcohol and opium and crack) both in methadone treatment. Behavioral procrastination in 60.5% of them and decisional procrastination in

  10. Iran Sanctions

    Science.gov (United States)

    2014-05-07

    Melli.24 In late 2009, the U.S. Attorney for the Southern District of New York seized the assets of the Assa Company, a UK-chartered entity. Assa...other evasion methods are discussed further in the sections below. Europe U.S. and European approaches have converged on Iran since 2002, when the...not known to have any involvement in or to supply any GM content to the Peugeot Iran activities. • Attorneys for BNP Paribas of France told the

  11. Client-Level Coverage of Needle and Syringe Program and High-Risk Injection Behaviors: A Case Study of People Who Inject Drugs in Kermanshah, Iran.

    Science.gov (United States)

    Noroozi, Mehdi; Mirzazadeh, Ali; Noroozi, Alireza; Mehrabi, Yadoallah; Hajebi, Ahmad; Zamani, Saman; Sharifi, Hamid; Higgs, Peter; Soori, Hamid

    2015-01-01

    Needle-syringe programs (NSP) have been running in Iran since 2002. However, the coverage of such program among the NSP clients at the individual level was not studies yet. This study aimed to determine the client coverage of NSP and its correlation with high injection-related risk behaviors. A cross-sectional survey was conducted in Kermanshah province, Iran, in 2014. 230 people who inject drugs (PWID) recruited from two drop-in centers (DICs) from April to September 2014, participated in a face-to-face interview to provide information related individual coverage of NSP, demographic characteristics, and injecting behaviors 30 days prior to the interview. Overall, the average of syringe coverage was 158% [95% confidence interval (CI) = 65.7-205.5], while 56% (95% CI = 40-97) have individual converge less than 100%. Needle/syringe sharing was significantly higher among individual with low NSP coverage [adjusted odds ratio (AOR) = 2.6, 95% CI = 1.3-6.2]. About 85% participants with coverage of less than 100% reported reuse of syringe within the last 30 days (AOR = 3.2, 95% CI = 1.4-7.7). PWID are different regarding their NSP individual-level converges. There are certain clusters of PWID, who do not receive sufficient number of syringes. Given that insufficient individual syringe coverage level is highly associated with injection risk behaviors, reasons for such low converge need to be assessed and addressed carefully.

  12. Heart and liver T2* assessment for iron overload using different software programs

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Juliano L. [University of Campinas, Unicamp, Campinas (Brazil); Radiologia Clinica de Campinas, Campinas (Brazil); Cardiology, Department of Internal Medicine, Campinas, SP (Brazil); Sampaio, Erika Fontana; Coelho, Otavio R. [University of Campinas, Unicamp, Campinas (Brazil); Verissimo, Monica; Pereira, Fabricio B. [Centro Infantil Boldrini, Campinas (Brazil); Silva, Jose Alvaro da; Figueiredo, Gabriel S. de; Kalaf, Jose M. [Radiologia Clinica de Campinas, Campinas (Brazil)

    2011-12-15

    To assess the level of agreement and interchangeability among different software programs for calculation of T2* values for iron overload. T2* images were analysed in 60 patients with thalassaemia major using the truncation method in three software programs. Levels of agreement were assessed using Pearson correlation and Bland-Altman plots. Categorical classification for levels of iron concentration by each software program was also compared. For the heart, all correlation coefficients were significant among the software programs (P < 0.001 for all coefficients). The mean differences and 95% limits of agreement were 0.2 (-4.73 to 5.0); 0.1 (-4.0 to 3.9); and -0.1 (-4.3 to 4.8). For the liver all correlations were also significant with P < 0.001. Bland-Altman plots showed differences of -0.02 (-0.7 to 0.6); 0.01 (-0.4 to 0.4); and -0.02 (-0.6 to 0.6). There were no significant differences in clinical classification among the software programs. All tools used in this study provided very good agreement among heart and liver T2* values. The results indicate that interpretation of T2* data is interchangeable with any of the software programs tested. (orig.)

  13. Congestive heart failure disease management program: 1-Year population experience from a tertiary center heart failure registry in Saudi Arabia.

    Science.gov (United States)

    Salem, Khal; Fallata, Dania; ElSebaie, Maha; Montasser, Ahmad; ElGedamy, Khaled; ElKhateeb, Osama

    2017-04-01

    We aimed to evaluate congestive heart failure (CHF) multidisciplinary disease management program (DMProg) impact on mortality, readmission rates, length of stay (LOS), and gender health characteristics. This was a quasi-observational, pre- and post-trial with a parallel nonequivalent group. We enrolled 174 inpatients having CHF with reduced ejection fraction and New York Heart Association (NYHA) Class II-IV, and a total of 197 hospital admissions. A comparative follow-up was performed from 15 December 2014 to 15 December 2015. Among 197 consecutive hospital admissions, 76 (39%) were included in the preintervention or usual care group and 121 (61%) were assigned to the postintervention group. After 1 year, in comparison with the preintervention group, the postintervention group had shorter average LOS in days (7.6 days vs. 11.1 days, p < 0.002), lower 1-year readmission rate (36% vs. 57%, p < 0.003), and lower in-house mortality (1.6% vs. 7.8%, p = 0.03), but similar baseline mortality scores (38.2 vs. 38.6, p = 0.7), 30-day and 90-day readmission rates (15% vs. 18.3%, p = 0.62 and 27.6% vs. 30%, p = 0.65), and 30-day readmission risk score (24.9% vs. 26.2%, p = 0.09). By regression analysis, the DMProg intervention was an independent factor for 1-year readmission reduction (p = 0.001). Kaplan-Meier survival analysis favored the postintervention group (log-rank, p < 0.001). DMProg significantly decreased 1-year readmission rates, LOS, and in-house mortality.

  14. [Computer simulation programs as an alternative for classical nerve, muscle and heart experiments using frog tissues].

    Science.gov (United States)

    Breves, G; Schröder, B

    2000-03-01

    Courses in Physiology include different methodical approaches such as exercises with living animals, experiments using organs or tissues from killed or slaughtered animals, application of diagnostic techniques in humans and theoretical seminars. In addition to these classical approaches computer programs for multimedia simulation of nerve, muscle and heart physiology are now a regular component of courses in Physiology at the School of Veterinary Medicine in Hannover. It is the aim of the present paper to give the first experiences about these new components.

  15. Effects of a community-based healthy heart program on increasing healthy women's physical activity: a randomized controlled trial guided by Community-based Participatory Research (CBPR

    Directory of Open Access Journals (Sweden)

    Seyednezami Nasrin

    2007-08-01

    Full Text Available Abstract Background Cardiovascular disease remains the leading killer of women in most developed areas of the world. Rates of physical inactivity and poor nutrition, which are two of the most important modifiable risk factors for cardiovascular disease in women, are substantial. This study sought to examine the effectiveness of a community-based lifestyle-modification program on increasing women's physical activity in a randomized trial guided by community-based participatory research (CBPR methods. Methods A total of 335 healthy, 25–64 years old women who had been selected by a multiple-stage stratified cluster random sampling method in Bushehr Port/I.R. Iran, were randomized into control and intervention groups. The intervention group completed an 8-week lifestyle modification program for increasing their physical activity, based on a revised form of Choose to Move program; an American Heart Association Physical Activity Program for Women. Audio-taped activity instructions with music and practical usage of the educational package were given to the intervention group in weekly home-visits by 53 volunteers from local non-governmental and community-based organizations. Results Among the participants, the percentage who reported being active (at lease 30 minutes of moderate intensity physical activity for at least 5 days a week, or at least 20 minutes of vigorous physical activity for at least three days a week increased from 3% and 2.7% at baseline to 13.4% and 3% (p Conclusion An intervention based on CBPR methods can be effective for the short-term adoption of physical activity behavior among women. The development of participatory process to support the adequate delivery of lifestyle-modification programs is feasible and an effective healthcare delivery strategy for cardiovascular community health promotion. Trial Registration ACTRNO12606000521527

  16. Effects of a community-based healthy heart program on increasing healthy women's physical activity: a randomized controlled trial guided by Community-based Participatory Research (CBPR).

    Science.gov (United States)

    Pazoki, Raha; Nabipour, Iraj; Seyednezami, Nasrin; Imami, Seyed Reza

    2007-08-23

    Cardiovascular disease remains the leading killer of women in most developed areas of the world. Rates of physical inactivity and poor nutrition, which are two of the most important modifiable risk factors for cardiovascular disease in women, are substantial. This study sought to examine the effectiveness of a community-based lifestyle-modification program on increasing women's physical activity in a randomized trial guided by community-based participatory research (CBPR) methods. A total of 335 healthy, 25-64 years old women who had been selected by a multiple-stage stratified cluster random sampling method in Bushehr Port/I.R. Iran, were randomized into control and intervention groups. The intervention group completed an 8-week lifestyle modification program for increasing their physical activity, based on a revised form of Choose to Move program; an American Heart Association Physical Activity Program for Women. Audio-taped activity instructions with music and practical usage of the educational package were given to the intervention group in weekly home-visits by 53 volunteers from local non-governmental and community-based organizations. Among the participants, the percentage who reported being active (at lease 30 minutes of moderate intensity physical activity for at least 5 days a week, or at least 20 minutes of vigorous physical activity for at least three days a week) increased from 3% and 2.7% at baseline to 13.4% and 3% (p physical activity per week (mean = 139.81, SE = 23.35) than women in the control group (mean = 40.14, SE = 12.65) at week 8 (p effective for the short-term adoption of physical activity behavior among women. The development of participatory process to support the adequate delivery of lifestyle-modification programs is feasible and an effective healthcare delivery strategy for cardiovascular community health promotion. ACTRNO12606000521527.

  17. Assessing Hospital Readmission Risk Factors in Heart Failure Patients Enrolled in a Telemonitoring Program

    Directory of Open Access Journals (Sweden)

    Adrian H. Zai

    2013-01-01

    Full Text Available The purpose of this study was to validate a previously developed heart failure readmission predictive algorithm based on psychosocial factors, develop a new model based on patient-reported symptoms from a telemonitoring program, and assess the impact of weight fluctuations and other factors on hospital readmission. Clinical, demographic, and telemonitoring data was collected from 100 patients enrolled in the Partners Connected Cardiac Care Program between July 2008 and November 2011. 38% of study participants were readmitted to the hospital within 30 days. Ten different heart-failure-related symptoms were reported 17,389 times, with the top three contributing approximately 50% of the volume. The psychosocial readmission model yielded an AUC of 0.67, along with sensitivity 0.87, specificity 0.32, positive predictive value 0.44, and negative predictive value 0.8 at a cutoff value of 0.30. In summary, hospital readmission models based on psychosocial characteristics, standardized changes in weight, or patient-reported symptoms can be developed and validated in heart failure patients participating in an institutional telemonitoring program. However, more robust models will need to be developed that use a comprehensive set of factors in order to have a significant impact on population health.

  18. Costs and benefits of personalized healthcare for patients with chronic heart failure in the care and education program "Telemedicine for the Heart".

    Science.gov (United States)

    Sohn, Stefan; Helms, Thomas M; Pelleter, Jörg T; Müller, Axel; Kröttinger, Annett I; Schöffski, Oliver

    2012-04-01

    A health economic analysis was conducted to evaluate the program "Telemedicine for the Heart," which the German Foundation for the Chronically Ill organizes for the Techniker Krankenkasse, one of the biggest German statutory health insurance funds. The program consists of nurse-calls to motivate patients to perform regular self-measurements (blood pressure, pulse, weight) with either their own or telemedical measuring devices provided by the program. In the case of measured values outside of set limits, calls to treating physicians were placed to allow for the initiation of therapy adjustments where applicable. To evaluate the program, a retrospective matched-pairs analysis was performed. Program participants (n=281) and regularly insured patients (n=843) were matched for demographics and morbidity status and compared according to their use of resources. Significant cost differences in favor of the study group of up to 25% in relation to total costs could be detected, particularly in the group of New York Heart Association (NYHA) classification II patients (persons with mild symptoms and slight limitation according to the NYHA classification for the extent of heart failure). In the more severe NYHA stages III and IV the cost relation differed and showed a slight cost disadvantage for the program group. Mortality was 35.1% lower in the program group than in the control group. Quality of life measures were almost constant over the observation time, compatible with a positive impact of the program on the highly impaired patient group. The findings suggest that, besides a reduction of costs, by participating in "Telemedicine for the Heart" patients with chronic heart failure experienced a reduced number of hospital stays, optimized medical therapy, better quality of life, and reduced mortality.

  19. Iran Sanctions

    Science.gov (United States)

    2016-09-21

    banking institutions to encourage their re-entry into the Iran market without fear of being sanctioned. And, Iran’s filing of its Action Plan with......investments, shielded from the view of the Iranian entities and international regulators.” In accordance with the JCPOA, EIKO-controlled companies were “ de

  20. A NUCLEAR IRAN: DID THE UNITED STATES, UNITED NATIONS AND EUROPEAN UNIONS USE OF SANCTIONS IMPACT THE IRANIAN NUCLEAR PROGRAM

    Science.gov (United States)

    2015-10-01

    I thank my family . To my Mother, who always encouraged me to chase my dreams and to my Father who taught me to continually ask why, I would not be...commodity=crude-oil-west-texas- intermediate&months=120 103 Dominique Guillaume, Roman Zytek and Mohammad Reza Farzin, “Iran-The Chronicles of the...Iranian Disease : Why a Developing Country’s Government did not listen to Economists’ Advices”, American Journal of Economics and Sociology, Vol 72 (3

  1. Implementing a Graduate Certificate Program in Cardiovascular Epidemiology: The Jackson Heart Study.

    Science.gov (United States)

    Campbell Jenkins, Brenda W; Addison, Clifton; Wilson, Gregory; Young, Lavon; Fields, Regina; Woodberry, Clevette; Payton, Marinelle

    2015-12-22

    The Jackson Heart Study (JHS) is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC) has initiated the Daniel Hale Williams Scholar (DHWS) program where students are afforded the opportunity to interact with epidemiologists and other biomedical scientists to learn to identify, predict, and prevent cardiovascular disease using the Jackson Heart Study data. This study describes the structured programs developed by JHS GTEC seeking to alleviate the shortage of trained professionals in cardiovascular epidemiology by training graduate students while they complete their academic degrees. The DHWS program provides: (1) an enrichment curriculum; (2) a learning community; (3) quarterly seminars; and (4) a Summer Institute. Students attend enrichment activities comprising: (1) Applied Biostatistics; (2) Cardiovascular Disease Epidemiology; (3) Social Epidemiology; (4) Emerging Topics; and (5) Research Writing. Training focuses on developing proficiency in cardiovascular health knowledge. The DHWS program is a unique strategy for incorporating rigorous academic and career-focused training to graduate students and has enabled the acquisition of competencies needed to impact cardiovascular disease management programs.

  2. Implementing a Graduate Certificate Program in Cardiovascular Epidemiology: The Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Brenda W. Campbell Jenkins

    2015-12-01

    Full Text Available The Jackson Heart Study (JHS is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC has initiated the Daniel Hale Williams Scholar (DHWS program where students are afforded the opportunity to interact with epidemiologists and other biomedical scientists to learn to identify, predict, and prevent cardiovascular disease using the Jackson Heart Study data. This study describes the structured programs developed by JHS GTEC seeking to alleviate the shortage of trained professionals in cardiovascular epidemiology by training graduate students while they complete their academic degrees. The DHWS program provides: (1 an enrichment curriculum; (2 a learning community; (3 quarterly seminars; and (4 a Summer Institute. Students attend enrichment activities comprising: (1 Applied Biostatistics; (2 Cardiovascular Disease Epidemiology; (3 Social Epidemiology; (4 Emerging Topics; and (5 Research Writing. Training focuses on developing proficiency in cardiovascular health knowledge. The DHWS program is a unique strategy for incorporating rigorous academic and career-focused training to graduate students and has enabled the acquisition of competencies needed to impact cardiovascular disease management programs.

  3. Predictors of time to relapse in amphetamine-type substance users in the matrix treatment program in Iran: a Cox proportional hazard model application.

    Science.gov (United States)

    Moeeni, Maryam; Razaghi, Emran M; Ponnet, Koen; Torabi, Fatemeh; Shafiee, Seyed Ali; Pashaei, Tahereh

    2016-07-26

    The aim of this study was to determine which predictors influence the risk of relapse among a cohort of amphetamine-type substance (ATS) users in Iran. A Cox proportional hazards model was conducted to determine factors associated with the relapse time in the Matrix treatment program provided by the Iranian National Center of Addiction Studies (INCAS) between March 2010 and October 2011. Participating in more treatment sessions was associated with a lower probability of relapse. On the other hand, patients with less family support, longer dependence on ATS, and those with an experience of casual sex and a history of criminal offenses were more likely to relapse. This study broadens our understanding of factors influencing the risk of relapse in ATS use among an Iranian sample. The findings can guide practitioners during the treatment program.

  4. Project Clean Sweep: A Study of the U.S. Air Force International Logistics Center’s Role in the Termination of Iran’s FMS Program

    Science.gov (United States)

    1982-09-01

    and Iran was limited. The first reported contact between the countries occurred in 1829 when two American missionaries arrived in Iran. During...efforts to initiate a formal relationship with Iran, then known as Persia . Success was achieved in 1856 with the signing of treaties of friendship

  5. Outpatient nursing clinic for congenital heart disease patients: Copenhagen Transition Program.

    Science.gov (United States)

    Berg, Selina Kikkenborg; Hertz, Pernille Grarup

    2007-01-01

    Adolescents with congenital heart disease need support transitioning from childhood to adulthood. To become independent, adolescents need to possess knowledge about the disease and how to handle life with congenital heart disease. Outpatient nursing clinics can address issues relevant for adolescents. Creating an environment in which worries and questions can be discussed better prepares adolescents to meet the struggles of living with congenital heart disease. The Copenhagen Transition Program was established in 2004. This outpatient nursing clinic was established by (1) defining the target group, (2) conducting a literature review, (3) collaborating with interdisciplinary colleagues, (4) scheduling visits to the transition-nursing clinic, (5) arranging clinic visits, (6) charting, and (7) testing and evaluating the clinic. Adolescents with congenital heart disease are invited to a consultation with a specially trained nurse, and it is the patients themselves who decide the content of the consultation. Topics such as knowledge about the disease, endocarditis, acute situations, nutrition, contraception, alcohol/drugs, smoking, physical activity, sleep/rest, and education may be discussed. Parents are asked not to participate.

  6. A genome resource to address mechanisms of developmental programming: determination of the fetal sheep heart transcriptome.

    Science.gov (United States)

    Cox, Laura A; Glenn, Jeremy P; Spradling, Kimberly D; Nijland, Mark J; Garcia, Roy; Nathanielsz, Peter W; Ford, Stephen P

    2012-06-15

    The pregnant sheep has provided seminal insights into reproduction related to animal and human development (ovarian function, fertility, implantation, fetal growth, parturition and lactation). Fetal sheep physiology has been extensively studied since 1950, contributing significantly to the basis for our understanding of many aspects of fetal development and behaviour that remain in use in clinical practice today. Understanding mechanisms requires the combination of systems approaches uniquely available in fetal sheep with the power of genomic studies. Absence of the full range of sheep genomic resources has limited the full realization of the power of this model, impeding progress in emerging areas of pregnancy biology such as developmental programming. We have examined the expressed fetal sheep heart transcriptome using high-throughput sequencing technologies. In so doing we identified 36,737 novel transcripts and describe genes, gene variants and pathways relevant to fundamental developmental mechanisms. Genes with the highest expression levels and with novel exons in the fetal heart transcriptome are known to play central roles in muscle development. We show that high-throughput sequencing methods can generate extensive transcriptome information in the absence of an assembled and annotated genome for that species. The gene sequence data obtained provide a unique genomic resource for sheep specific genetic technology development and, combined with the polymorphism data, augment annotation and assembly of the sheep genome. In addition, identification and pathway analysis of novel fetal sheep heart transcriptome splice variants is a first step towards revealing mechanisms of genetic variation and gene environment interactions during fetal heart development.

  7. Effects of a 14-month low-cost maintenance training program in patients with chronic systolic heart failure

    DEFF Research Database (Denmark)

    Prescott, Eva; Hjardem-Hansen, Rasmus; Ørkild, Bodil

    2009-01-01

    Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning.......Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning....

  8. Heart failure severity, inappropriate ICD therapy, and novel ICD programming: a MADIT-RIT substudy.

    Science.gov (United States)

    Daimee, Usama A; Vermilye, Katherine; Rosero, Spencer; Schuger, Claudio D; Daubert, James P; Zareba, Wojciech; McNitt, Scott; Polonsky, Bronislava; Moss, Arthur J; Kutyifa, Valentina

    2017-12-01

    The effects of heart failure (HF) severity on risk of inappropriate implantable cardioverter-defibrillator (ICD) therapy have not been thoroughly investigated. We aimed to study the association between HF severity and inappropriate ICD therapy in MADIT-RIT. MADIT-RIT randomized 1,500 patients to three ICD programming arms: conventional (Arm A), high-rate cut-off (Arm B: ≥200 beats/min), and delayed therapy (Arm C: 60-second delay for ≥170 beats/min). We evaluated the association between New York Heart Association (NYHA) class III (n = 256) versus class I-II (n = 251) and inappropriate ICD therapy in Arm A patients with ICD-only and cardiac resynchronization therapy with defibrillator (CRT-D). We additionally assessed benefit of novel ICD programming in Arms B and C versus Arm A by NYHA classification. In Arm A, the risk of inappropriate therapy was significantly higher in those with NYHA III versus NYHA I-II for both ICD (hazard ratio [HR] = 2.55, confidence interval [CI]: 1.51-4.30, P programming significantly reduced inappropriate therapy in patients with both NYHA III (Arm B vs Arm A: HR = 0.08, P programming with high-rate cut-off or delayed detection reduces inappropriate ICD therapies in both mild and moderate HF. © 2017 Wiley Periodicals, Inc.

  9. Iran’s Post-9/11 Grand Bargain: Missed Opportunity for Strategic Rapprochement Between Iran and the United States

    Science.gov (United States)

    2013-05-23

    American corporations (e.g., Boeing, Microsoft, and Coca Cola ) were publicly interested in expanding operations to Iran. In a bid to accelerate...trade with Iran (a new source of economic growth that Iran relied upon). But the United States was unable to pressure Russia and China to restrict arms...with uranium samples provided by Pakistan and China . In late 2003, Iran agreed to fully disclose its nuclear research program, suspend enrichment of

  10. Do heart failure disease management programs make financial sense under a bundled payment system?

    Science.gov (United States)

    Eapen, Zubin J; Reed, Shelby D; Curtis, Lesley H; Hernandez, Adrian F; Peterson, Eric D

    2011-05-01

    Policy makers have proposed bundling payments for all heart failure (HF) care within 30 days of an HF hospitalization in an effort to reduce costs. Disease management (DM) programs can reduce costly HF readmissions but have not been economically attractive for caregivers under existing fee-for-service payment. Whether a bundled payment approach can address the negative financial impact of DM programs is unknown. Our study determined the cost-neutral point for the typical DM program and examined whether published HF DM programs can be cost saving under bundled payment programs. We used a decision analytic model using data from retrospective cohort studies, meta-analyses, 5 randomized trials evaluating DM programs, and inpatient claims for all Medicare beneficiaries discharged with an HF diagnosis from 2001 to 2004. We determined the costs of DM programs and inpatient care over 30 and 180 days. With a baseline readmission rate of 22.9%, the average cost for readmissions over 30 days was $2,272 per patient. Under base-case assumptions, a DM program that reduced readmissions by 21% would need to cost $477 per patient to be cost neutral. Among evaluated published DM programs, 2 of the 5 would increase provider costs (+$15 to $283 per patient), whereas 3 programs would be cost saving (-$241 to $347 per patient). If bundled payments were broadened to include care over 180 days, then program saving estimates would increase, ranging from $419 to $1,706 per patient. Proposed bundled payments for HF admissions provide hospitals with a potential financial incentive to implement DM programs that efficiently reduce readmissions. Copyright © 2011 Mosby, Inc. All rights reserved.

  11. Physician-directed heart failure transitional care program: a retrospective case review.

    Science.gov (United States)

    Ota, Ken S; Beutler, David S; Gerkin, Richard D; Weiss, Jessica L; Loli, Akil I

    2013-10-01

    Despite a variety of national efforts to improve transitions of care for patients at risk for rehospitalization, 30-day rehospitalization rates for patients with heart failure have remained largely unchanged. This is a retrospective review of 73 patients enrolled in our hospital-based, physican-directed Heart Failure Transitional Care Program (HFTCP). This study evaluated the 30- and 90- day readmission rates before and after enrollment in the program. The Transitionalist's services focused on bedside consultation prior to hospital discharge, follow-up home visits within 72 hours of discharge, frequent follow-up phone calls, disease-specific education, outpatient intravenous diuretic therapy, and around-the-clock telephone access to the Transitionalist. The pre-enrollment 30-day readmission rates for acute decompensated heart failure (ADHF) and all-cause readmission was 26.0% and 28.8%, respectively, while the post-enrollment rates for ADHF and all-cause readmission were 4.1% (P < 0.001) and 8.2% (P = 0.002), respectively. The pre-enrollment 90-day all-cause and ADHF readmission rates were 69.8%, and 58.9% respectively, while the post-enrollment rates for all-cause and ADHF were 27.3% (P < 0.001) and 16.4% (P < 0.001) respectively. Our physician-implemented HFTCP reduced rehospitalization risk for patients enrolled in the program. This program may serve as a model to assist other hospital systems to reduce readmission rates of patients with HF.

  12. 'THE UNVEILED HEART' a teaching program in cardiovascular nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Itti, Roland E-mail: roland.itti@univ-lyon1.fr; Merabet, Yasmina; Roca, Ramona; Bontemps, Laurence; Itti, Emmanuel

    2004-07-11

    The functional investigation of cardiac diseases using nuclear techniques involves several variables, such as myocardial perfusion, cellular viability or mechanical contraction. The combined, topographical and quantitative assessment of these variables can characterize the functional state of the heart in terms of normal myocardium, ischemia, hibernation or necrosis. The teaching program, 'The Unveiled Heart', has been designed in order to help nuclear physicians or cardiologists approaching these concepts and their implications for diagnosis of coronary artery disease, optimization of therapeutic strategies and prognosis evaluation. Anatomical correlations with coronary angiographic results obtained during balloon occlusion at the time of coronary angioplasty demonstrate the complementary role of imaging techniques and highlight the patient to patient variability of risk areas. A sectorial model derived from a polar projection of the myocardium presents for each sector the probability of involvement of a given coronary artery.

  13. Coping with a Nuclearizing Iran

    Science.gov (United States)

    2011-01-01

    Blechman, Brumberg , and Heydemann, 2010. 2 Lindsay and Takeyh, 2010. 3 Davis et al., 2011. 2 Coping with a Nuclearizing Iran ally half-hearted...implications that the Iranian elections could have for U.S. policy, see Sadjadpour, 2009. 17 Brumberg and Blechman, 2010. 78 Coping with a...2011: http://www.csmonitor.com/2007/0116/p06s02-wome.html Blechman, Barry M., Daniel Brumberg , and Steven Heydemann, Engagement, Coercion, and

  14. Association of the Hospital Readmissions Reduction Program Implementation With Readmission and Mortality Outcomes in Heart Failure.

    Science.gov (United States)

    Gupta, Ankur; Allen, Larry A; Bhatt, Deepak L; Cox, Margueritte; DeVore, Adam D; Heidenreich, Paul A; Hernandez, Adrian F; Peterson, Eric D; Matsouaka, Roland A; Yancy, Clyde W; Fonarow, Gregg C

    2018-01-01

    Public reporting of hospitals' 30-day risk-standardized readmission rates following heart failure hospitalization and the financial penalization of hospitals with higher rates have been associated with a reduction in 30-day readmissions but have raised concerns regarding the potential for unintended consequences. To examine the association of the Hospital Readmissions Reduction Program (HRRP) with readmission and mortality outcomes among patients hospitalized with heart failure within a prospective clinical registry that allows for detailed risk adjustment. Interrupted time-series and survival analyses of index heart failure hospitalizations were conducted from January 1, 2006, to December 31, 2014. This study included 115 245 fee-for-service Medicare beneficiaries across 416 US hospital sites participating in the American Heart Association Get With The Guidelines-Heart Failure registry. Data analysis took place from January 1, 2017, to June 8, 2017. Time intervals related to the HRRP were before the HRRP implementation (January 1, 2006, to March 31, 2010), during the HRRP implementation (April 1, 2010, to September 30, 2012), and after the HRRP penalties went into effect (October 1, 2012, to December 31, 2014). Risk-adjusted 30-day and 1-year all-cause readmission and mortality rates. The mean (SD) age of the study population (n = 115 245) was 80.5 (8.4) years, 62 927 (54.6%) were women, and 91 996 (81.3%) were white and 11 037 (9.7%) were black. The 30-day risk-adjusted readmission rate declined from 20.0% before the HRRP implementation to 18.4% in the HRRP penalties phase (hazard ratio (HR) after vs before the HRRP implementation, 0.91; 95% CI, 0.87-0.95; P service Medicare beneficiaries discharged after heart failure hospitalizations, implementation of the HRRP was temporally associated with a reduction in 30-day and 1-year readmissions but an increase in 30-day and 1-year mortality. If confirmed, this finding may require reconsideration of the HRRP in

  15. Iran Sanctions

    Science.gov (United States)

    2016-11-16

    reduction was further compounded by a fall in oil prices since mid-2014. Sanctions also made inaccessible about $120 billion in Iranian reserves held in...December 2, 2011, that the provision could lead to a rise in oil prices that would benefit Iran, the Administration accepted the legislation. In the...confirmed. Instead, a portion of the Iranian oil China buys is reportedly sent to North Korea. South Asia: India, Pakistan , and Afghanistan India

  16. Economic Modeling of Heart Failure Telehealth Programs: When Do They Become Cost Saving?

    Directory of Open Access Journals (Sweden)

    Sheena Xin Liu

    2016-01-01

    Full Text Available Telehealth programs for congestive heart failure have been shown to be clinically effective. This study assesses clinical and economic consequences of providing telehealth programs for CHF patients. A Markov model was developed and presented in the context of a home-based telehealth program on CHF. Incremental life expectancy, hospital admissions, and total healthcare costs were examined at periods ranging up to five years. One-way and two-way sensitivity analyses were also conducted on clinical performance parameters. The base case analysis yielded cost savings ranging from $2832 to $5499 and 0.03 to 0.04 life year gain per patient over a 1-year period. Applying telehealth solution to a low-risk cohort with no prior admission history would result in $2502 cost increase per person over the 1-year time frame with 0.01 life year gain. Sensitivity analyses demonstrated that the cost savings were most sensitive to patient risk, baseline cost of hospital admission, and the length-of-stay reduction ratio affected by the telehealth programs. In sum, telehealth programs can be cost saving for intermediate and high risk patients over a 1- to 5-year window. The results suggested the economic viability of telehealth programs for managing CHF patients and illustrated the importance of risk stratification in such programs.

  17. Methadone Maintenance Treatment Program in Prisons from the Perspective of Medical and non-Medical Prison Staff: A Qualitative Study in Iran

    Directory of Open Access Journals (Sweden)

    Ghobad Moradi

    2015-09-01

    Full Text Available Background As one of the most important components of harm reduction strategy for high-risk groups, following the HIV epidemics, Methadone Maintenance Treatment (MMT has been initiated in prisoners since 2003. In this paper, we aimed to assess the advantages and shortcomings of the MMT program from the perspective of people who were involved with the delivery of prison healthcare in Iran. Methods On the basis of grounded theory and through conducting 14 Focus Group Discussions (FGDs, 7 FGDs among physicians, consultants, experts, and 7 FGDs among directors and managers of prisons (n= 140 have been performed. The respondents were asked about positive and negative elements of the MMT program in Iranian prisons. Results This study included a total of 48 themes, of which 22 themes were related to advantages and the other 26 were about shortcomings of MMT programs in the prisons. According to participants’ views “reduction of illegal drug use and high-risk injection”, “reduction of potentially high-risk behaviors” and “making positive attitudes” were the main advantages of MMT in prisons, while issues such as “inaccurate implementation”, “lack of skilled manpower” and “poor care after release from prison” were among the main shortcomings of MMT program. Conclusions MMT program in Iran’s prisons has achieved remarkable success in the field of harm reduction, but to obtain much more significant results, its shortcomings and weaknesses must be also taken into account by policy-makers.

  18. Efficiency of Nested-PCR in Detecting Asymptomatic Cases toward Malaria Elimination Program in an Endemic Area of Iran.

    Science.gov (United States)

    Turki, Habibollah; Raeisi, Ahmad; Malekzadeh, Kianoosh; Ghanbarnejad, Amin; Zoghi, Samaneh; Yeryan, Masoud; Abedi Nejad, Masoumeh; Mohseni, Fatemeh; Shekari, Mohammad

    2015-01-01

    The aim of this study was to detect low parasite and asymptomatic malaria infections by means of three malaria diagnostic tests, in a low transmission region of Minab district, Hormozgan Province, southern Iran. Blood samples of 200 healthy volunteers from Bagh-e-Malek area were evaluated using microscopic, rapid diagnostic tests (RDT) and nested-PCR to inspect malaria parasite. The results showed no Plasmodium parasite in subjects by means of microscopy and RDT. However, 3 P. vivax positive samples (1.5%) were discovered by Nested-PCR while microscopy and RDT missed the cases. Microscopy as the gold standard method and RDT correctly identified 98.5% of cases, and molecular analysis is sensitive and reliable, especially in the detection of "asymptomatic" infections for active case surveillance. Regarding the existence of asymptomatic malaria in endemic area of Hormozgan, Iran, nested-PCR could be considered as a sensitive tool to interrupt malaria transmission in the country, beside the microscopic and RDT methods.

  19. Applying an Educational-participatory Program based on the PRECEDE Model for Promoting Self-esteem and Mental Health of Students in Iran.

    Science.gov (United States)

    Moshki, Mahdi; Atarodi, B Alireza; Moslem, Alireza; Taheri, Mahdokht

    2012-04-01

    The students' vulnerability to different problems can have an impact on their mental health. Regarding the lack of evidence on the effectiveness of interventional programs based on health education planning models in this area in developing countries, an educational-participatory program based on the PRECEDE model was used, to promote the medical science students' self-esteem and mental health status, in Iran. In this experimental study, 154 students from the universities of medical sciences in the north east of Iran were selected by stratified random sampling method. Then, they were randomly assigned to two groups of case and control. The questionnaires, including the enabling, reinforcing, and predisposing factors, the Rosenberg self-esteem scale, and the GHQ-28 were used for data collection. Then, an intervention plan, including focus group discussions and training of selected life skills, based on the PRECEDE model, was conducted for the case group. The predisposing, reinforcing, and enabling factors, and the self-esteem and mental health of the students showed a significant difference between the case and control groups. The Pearson correlation coefficient showed that there was a correlation between mental health and knowledge (P =0.008), between self-esteem and knowledge (P =0.02), self-esteem and attitude (P =0.01), and mental health and attitude (P = 0.03). Health promotion planning by using life skills training based on the PRECEDE model can result in participation and empowerment, in order to promote the self-esteem and mental health of the students.

  20. Mortality benefit of a comprehensive heart failure disease management program in indigent patients.

    Science.gov (United States)

    Hebert, Kathy A; Horswell, Ronald L; Dy, Sydney; Key, Ira J; Butler, Michael K; Cerise, Frederick P; Arcement, Lee M

    2006-02-01

    Heart failure (HF) produces significant morbidity and mortality. Although HF disease management (HFDM) programs have been shown to decrease this morbidity, there is still a paucity of data on their effect on mortality. The objective of this study was to determine whether participation in an HFDM program would reduce mortality in an indigent population from rural Louisiana. Proportional hazards modeling was used to determine whether patients participating in the HFDM program had improved survival compared with patients receiving traditional outpatient care at the same institution. Inclusion criteria consisted of an index hospitalization with discharge occurring between July 1, 1997, and May 30, 2002, hospital discharge diagnosis of HF, left ventricular systolic dysfunction documented during hospitalization, and at least 1 subsequent outpatient visit. Data from patients having participated in the HFDM program before their index hospitalization were excluded. Compared with patients who were given traditional care (n = 100), HFDM patients (n = 156) were younger (56.7 vs 60 years, P = .031), more likely to be African American (48.7% vs 33.0%, P = .014), more likely to be uninsured (47.4% vs 27%, P = .001), and more likely to have an ejection fraction of HFDM program was associated with a significant reduction in mortality compared with traditional care (adjusted hazard ratio .33, P HFDM program was associated with decreased mortality compared with traditional follow-up care.

  1. Program evaluation of remote heart failure monitoring: healthcare utilization analysis in a rural regional medical center.

    Science.gov (United States)

    Riley, William T; Keberlein, Pamela; Sorenson, Gigi; Mohler, Sailor; Tye, Blake; Ramirez, A Susana; Carroll, Mark

    2015-03-01

    Remote monitoring for heart failure (HF) has had mixed and heterogeneous effects across studies, necessitating further evaluation of remote monitoring systems within specific healthcare systems and their patient populations. "Care Beyond Walls and Wires," a wireless remote monitoring program to facilitate patient and care team co-management of HF patients, served by a rural regional medical center, provided the opportunity to evaluate the effects of this program on healthcare utilization. Fifty HF patients admitted to Flagstaff Medical Center (Flagstaff, AZ) participated in the project. Many of these patients lived in underserved and rural communities, including Native American reservations. Enrolled patients received mobile, broadband-enabled remote monitoring devices. A matched cohort was identified for comparison. HF patients enrolled in this program showed substantial and statistically significant reductions in healthcare utilization during the 6 months following enrollment, and these reductions were significantly greater compared with those who declined to participate but not when compared with a matched cohort. The findings from this project indicate that a remote HF monitoring program can be successfully implemented in a rural, underserved area. Reductions in healthcare utilization were observed among program participants, but reductions were also observed among a matched cohort, illustrating the need for rigorous assessment of the effects of HF remote monitoring programs in healthcare systems.

  2. Heart Rate Variability Biofeedback Stress Relief Program for Depression*. A Replicated Single-Subject Design.

    Science.gov (United States)

    Hartogs, Bregje M A; Bartels-Velthuis, Agna A; Van der Ploeg, Karen; Bos, Elske H

    2017-07-19

    Depressive disorders often have a chronic course and the efficacy of evidence-based treatments may be overestimated. To examine the effectiveness of the Heart Rate Variability Stress Reduction Program (SRP) as a supplement to standard treatment in patients with depressive disorders. The SRP was individually administered in eight weekly sessions. Seven participants completed the full protocol and were enrolled in a single-subject ABA multiple baseline experimental design. To perform interrupted time-series analyses, daily measures were completed in a diary (depression, resilience, happiness, heart coherence and a personalized outcome measure). Five out of seven patients improved in depressed mood and/or a personalized outcome measure. The effect of treatment was reversed in four patients during the withdrawal phase. One patient reliably improved on depression, whereas two patients recovered on autonomy and one on social optimism. No consistent relationship was found between the heart rate variability-related level of coherence and self-reported mood levels. The SRP is beneficial in some domains and for some patients. A prolonged treatment or continued home practice may be required for enduring effects. The intervention had more clinical impact on resilience-related outcome measures than on symptoms. The small sample size does not permit generalization of the results. We recommend future investigation of the underlying mechanisms of the SRP.

  3. Student Day in Iran

    DEFF Research Database (Denmark)

    Elling, Rasmus Christian

    2008-01-01

    Om Studerendes Dag i Iran der blev markeret med demonstrationer og protester mod statens undertrykkelse af den pro-demokratiske studenterbevægelse i Iran. Udgivelsesdato: 6/12......Om Studerendes Dag i Iran der blev markeret med demonstrationer og protester mod statens undertrykkelse af den pro-demokratiske studenterbevægelse i Iran. Udgivelsesdato: 6/12...

  4. Touching Hearts, Touching Minds: Using Emotion-Based Messaging to Promote Healthful Behavior in the Massachusetts WIC Program

    Science.gov (United States)

    Colchamiro, Rachel; Ghiringhelli, Kara; Hause, Judith

    2010-01-01

    The "Touching Hearts, Touching Minds" initiative was funded through a 2003 United States Department of Agriculture Special Projects grant to revitalize nutrition education and services in the Massachusetts Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program. The 30 nutrition education materials and…

  5. Are grown-ups with congenital heart disease willing to participate in an exercise program? : willingness of GUCH to exercise

    NARCIS (Netherlands)

    Elke S. Hoendermis; Wybe Nieuwland; Marlies Feenstra; Mathieu H.G. de Greef; Manon L. Dontje

    2013-01-01

    OBJECTIVE: To examine the willingness of grown-ups with congenital heart disease (GUCH) to participate in the GUCH Training Program-Individualised (GTI), an exercise program specifically designed for GUCH, and to identify factors affecting their willingness to participate. In this cross-sectional

  6. Heart smart: a multifaceted cardiovascular risk reduction program for grade school students.

    Science.gov (United States)

    Hunter, S M; Johnson, C C; Little-Christian, S; Nicklas, T A; Harsha, D; Arbeit, M L; Webber, L S; Berenson, G S

    1990-05-01

    Abstract Heart Smart Program is a health education intervention for grades kindergarten through six which encourages the acquisition and maintenance of health-enhancing behaviors. These include nutritious eating habits; physical fitness and exercise; saying "no" to cigarette smoking, alcohol, and drugs; and control of stress. Social Cognitive Theory is used to derive the necessary training concepts for children with reinforcement of these concepts occurring in six areas: the curriculum, school lunch, staff development, physical activity, environment, and parental support. The necessary training mechanisms provide mastery experiences, knowledge transfer, role modeling, and emotional and physiological feedback. The program incorporates the influence of the social environment on learning and builds support from parents, teachers and school staff.

  7. Impact of a Pediatric Cardiology Clinical Program on Congenital Heart Disease Outcomes in Guyana.

    Science.gov (United States)

    Isaac, Debra; Nagesh, Vikhashni; Bell, Alexandra; Soto, Rodrigo; Seepersaud, Marisa; Myers, Kimberley; Zahir, Saif

    2017-01-01

    Background: Children with congenital heart disease (CHD) in Guyana have not historically been managed with timely intervention, increasing the likelihood of serious, irreversible complications. In 2014, a pediatric cardiology clinical program (Guyana Paediatric Cardiology Steering Committee [GPCSC]) and partnership with International Children's Heart Foundation (BabyHeart) was developed to improve CHD care. Objectives: To describe the characteristics of CHD in Guyanese children and to determine the impact of GPCSC on CHD outcomes. Methods: Qualitative comparison between CHD patients sent for surgery prior to GPCSC (pre-GPCSC cohort) and those managed through GPCSC (post-GPCSC cohort). Findings: Eighty-eight pre-GPHC patients were identified from 2005 to 2014. A total of 319 CHD patients were referred post-GPCSC. In all, 114 patients required surgical or catheterization procedures, with 74 patients prioritized for interventions within 29 months post-GPCSC. Mean age at surgery was 77 months in both cohorts, with younger children represented in the post-GPCSC cohort. Postoperative follow-up was more frequent post-GPCSC (100% vs 35%). Vital status of 48% of pre-GPCSC patients is unknown, with more pre-GPCSC patients known to be deceased compared with post-GPCSC (9% vs 5%). Pre-GPCSC patients had more incorrect diagnosis and inoperable disease when sent for surgery. Interpretation: Patients undergoing surgery post-GPCSC had more appropriate and timely interventions, better follow-up, and increased survival. The feasibility and positive impact of this collaborative pediatric cardiology clinical program in Guyana is demonstrated, with potential applicability for other low- and middle-income countries. Obstacles to referral of children with CHD in Guyana can begin to be addressed, with the goal of more complete access to timely intervention, and improved outcomes for these children.

  8. Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure.

    Science.gov (United States)

    Reed, Shelby D; Neilson, Matthew P; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H; Polsky, Daniel E; Graham, Felicia L; Bowers, Margaret T; Paul, Sara C; Granger, Bradi B; Schulman, Kevin A; Whellan, David J; Riegel, Barbara; Levy, Wayne C

    2015-11-01

    Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Direct Telephonic Communication in a Heart Failure Transitional Care Program: An observational study.

    Science.gov (United States)

    Ota, Ken S; Beutler, David S; Sheikh, Hassam; Weiss, Jessica L; Parkinson, Dallin; Nguyen, Peter; Gerkin, Richard D; Loli, Akil I

    2013-10-01

    This study investigated the trend of phone calls in the Banner Good Samaritan Medical Center (BGSMC) Heart Failure Transitional Care Program (HFTCP). The primary goal of the HFTCP is to reduce 30-Day readmissions for heart failure patients by using a multi-pronged approach. This study included 104 patients in the HFTCP discharged over a 51-week period who had around-the-clock telephone access to the Transitionalist. Cellular phone records were reviewed. This study evaluated the length and timing of calls. A total of 4398 telephone calls were recorded of which 39% were inbound and 61% were outbound. This averaged to 86 calls per week. During the "Weekday Daytime" period, Eighty-five percent of the totals calls were made. There were 229 calls during the "Weekday Nights" period with 1.5 inbound calls per week. The "Total Weekend" calls were 10.2% of the total calls which equated to a weekly average of 8.8. Our experience is that direct, physician-patient telephone contact is feasible with a panel of around 100 HF patients for one provider. If the proper financial reimbursements are provided, physicians may be apt to participate in similar transitional care programs. Likewise, third party payers will benefit from the reduction in unnecessary emergency room visits and hospitalizations.

  10. Inappropriate ICD shocks in pediatrics and congenital heart disease patients: Risk factors and programming strategies.

    Science.gov (United States)

    Garnreiter, Jason M; Pilcher, Thomas A; Etheridge, Susan P; Saarel, Elizabeth V

    2015-05-01

    Inappropriate implantable cardioverter-defibrillator (ICD) shocks are a common and significant problem in pediatric patients and patients with congenital heart disease (CHD). The purpose of this study was to evaluate the effect of programming high detection rates and long detection duration on inappropriate shocks in this population. We performed a retrospective review of all patients with ICDs at a single pediatric center. Inappropriate shocks were defined as a shock for any rhythm except ventricular tachycardia or fibrillation. A total of 144 patients were included, 63 (44%) with CHD. At implant, mean age and weight were 17 ± 10 years and 57 ± 23 kg. ICDs were single chamber in 35 (24%), dual chamber in 97 (67%), and biventricular in 12 (8%). The mean follow-up duration was 42 ± 39 months. Appropriate shocks occurred in 29 (20.1%) and inappropriate shocks in 14 (9.7%). Causes of inappropriate shocks were supraventricular tachycardia (n = 6), lead malfunction (n = 4), sinus tachycardia (n = 3), and T-wave oversensing (n = 1). The mean ventricular fibrillation detection rate was 222 ± 15 beats/min, and the detection duration was 18 ± 12 beats. Patients with shocks programmed in the ventricular tachycardia zone were more likely to receive an inappropriate shock (P = .03). There were no associations between inappropriate shocks and age or weight at implant, presence of CHD, dual-chamber vs single-chamber device, history of supraventricular tachycardia, or antiarrhythmic use. There were no adverse events as a result of programming. Programming high detection rates and long detection duration resulted in a low rate of inappropriate shocks without associated adverse events in this large cohort of pediatric and CHD patients with ICDs. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  11. Effect of Educational Program on Quality of Life of Patients with Heart Failure: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mohammad Khajegodary

    2013-02-01

    Full Text Available Introduction: Heart failure is one of the most common cardiovascular diseases which decrease the quality of life. Most of the factors influencing the quality of life can be modified with educational interventions. Therefore, this study examined the impact of a continuous training program on quality of life of patients with heart failure. Methods: This randomized clinical trial study was conducted during May to August 2011. Forty four participants with heart failure referred to Shahid Madani's polyclinics of Tabriz were selected through convenient sampling method and were randomly allocated to two groups. The intervention group (n = 22 received ongoing training including one-to-one teaching, counseling sessions and phone calls over 3 months. The control group (n = 22 received routine care program. Data on quality of life was collected using the Minnesota Living with Heart Failure Questionnaire at baseline as well as three months later. Results: The statistical tests showed significant differences in the physical, emotional dimensions and total quality of life in intervention group. But in control group, no significant differences were obtained. There was not any significant association in demographic characteristics and quality of life. Conclusion: Ongoing training programs can be effective in improving quality of life of patients with heart failure. Hence applying ongoing educational program as a non-pharmacological intervention can help to improve the quality of life of these patients.

  12. Moving towards universal prenatal detection of critical congenital heart disease in southern Nevada: a community-wide program.

    Science.gov (United States)

    Evans, William; Castillo, William; Rollins, Robert; Luna, Carlos; Kip, Katrinka; Ludwick, Joseph; Madan, Nitin; Ciccolo, Michael; Galindo, Alvaro; Rothman, Abraham; Mayman, Gary; Cass, Kathleen; Thomas, Vincent; Restrepo, Humberto; Acherman, Ruben

    2015-02-01

    This study compares the current, prenatal detection rate for critical congenital heart disease in Southern Nevada with the previously reported rate, after developing and expanding a comprehensive, community-wide fetal cardiology program. For the current-period analysis, we inquired our database and electronic health records for patients born in Clark County, Nevada, with critical congenital heart disease between May 2012 and April 2014, and we compared the results with the previous period between May 2003 and April 2006. The major components of the community-wide program include fetal congenital heart disease screening via general obstetric ultrasound studies performed in obstetrician's offices, radiology imaging centers, or maternal-fetal medicine specialty practices; subsequent referral for comprehensive fetal echocardiography performed in maternal-fetal medicine offices under the on-site supervision by fetal cardiologists; and recurring community educational programs teaching the 5-axial plane, fetal echocardiographic screening protocol to general obstetric sonographers and instructing perinatal sonographers in advanced imaging topics. For the current period, the prenatal detection rate for critical congenital heart disease in Southern Nevada was 71 versus 36% for the previous period (p congenital heart disease may be related to our expanded decentralized, community-wide fetal cardiology program, and our experiences may be applicable to other metropolitan areas.

  13. Heart failure remote monitoring: evidence from the retrospective evaluation of a real-world remote monitoring program.

    Science.gov (United States)

    Agboola, Stephen; Jethwani, Kamal; Khateeb, Kholoud; Moore, Stephanie; Kvedar, Joseph

    2015-04-22

    Given the magnitude of increasing heart failure mortality, multidisciplinary approaches, in the form of disease management programs and other integrative models of care, are recommended to optimize treatment outcomes. Remote monitoring, either as structured telephone support or telemonitoring or a combination of both, is fast becoming an integral part of many disease management programs. However, studies reporting on the evaluation of real-world heart failure remote monitoring programs are scarce. This study aims to evaluate the effect of a heart failure telemonitoring program, Connected Cardiac Care Program (CCCP), on hospitalization and mortality in a retrospective database review of medical records of patients with heart failure receiving care at the Massachusetts General Hospital. Patients enrolled in the CCCP heart failure monitoring program at the Massachusetts General Hospital were matched 1:1 with usual care patients. Control patients received care from similar clinical settings as CCCP patients and were identified from a large clinical data registry. The primary endpoint was all-cause mortality and hospitalizations assessed during the 4-month program duration. Secondary outcomes included hospitalization and mortality rates (obtained by following up on patients over an additional 8 months after program completion for a total duration of 1 year), risk for multiple hospitalizations and length of stay. The Cox proportional hazard model, stratified on the matched pairs, was used to assess primary outcomes. A total of 348 patients were included in the time-to-event analyses. The baseline rates of hospitalizations prior to program enrollment did not differ significantly by group. Compared with controls, hospitalization rates decreased within the first 30 days of program enrollment: hazard ratio (HR)=0.52, 95% CI 0.31-0.86, P=.01). The differential effect on hospitalization rates remained consistent until the end of the 4-month program (HR=0.74, 95% CI 0

  14. Changes in functional health status of older women with heart disease: evaluation of a program based on self-regulation.

    Science.gov (United States)

    Clark, N M; Janz, N K; Dodge, J A; Schork, M A; Fingerlin, T E; Wheeler, J R; Liang, J; Keteyian, S J; Santinga, J T

    2000-03-01

    This study involving 570 women aged 60 years or older with heart disease, assessed the effects of a disease management program on physical functioning, symptom experience, and psychosocial status. Women were randomly assigned to control or program groups. Six to eight women met weekly with a health educator and peer leader over 4 weeks to learn self-regulation skills with physical activity as the focus. Evaluative data were collected through telephone interviews, physical assessments, and medical records at baseline and 4 and 12 months post baseline. At 12 months, compared with controls, program women were less symptomatic (p weight (p program that was provided to older women with heart disease and that focused on physical activity and disease management problems salient to them, improved their physical functioning and symptom experience. Psychosocial benefit was not evident and may be a result of measurement error or due to insufficient program time spent on psychosocial aspects of functioning.

  15. The effect of family training and support on the quality of life and cost of hospital readmissions in congestive heart failure patients in Iran.

    Science.gov (United States)

    Hasanpour-Dehkordi, Ali; Khaledi-Far, Arsalan; Khaledi-Far, Borzoo; Salehi-Tali, Shahriar

    2016-08-01

    This study was conducted to investigate the effects of family training and support on quality of life and cost of hospital readmissions in congestive heart failure patients. In this single-blinded, randomized, controlled trial, the participants were heart failure patients hospitalized in an Iranian hospital. Data were collected from available hospitalized patients. The participants were enrolled through randomized sampling and were divided randomly into two groups, an intervention group and a control group. The intervention group received extra training package for the disease. Training was provided at discharge and three months after. A standard questionnaire to assess the QoL was filled out by both groups at discharge and six months after. Mean scores of QoL domains at the beginning of the study decreased in control group and increased in intervention in comparison with six months after (p<0.01). Nursing care follow-up according to heart failure patients' needs promoted their QoL. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Factors Affecting Leave out of General Practitioners from Rural Family Physician Program: A Case of Kerman, Iran

    Directory of Open Access Journals (Sweden)

    Mohammadreza Amiresmaili

    2014-01-01

    Conclusions: Physician retention in family physician program is faced with serious doubts due to different reasons. The success of the program is endangered because of the pivotal role of human resources. Hence, the revision of human resources policies of the program seems necessary in order to reduce physicians leave out and improving its effectiveness.

  17. Effects of multidisciplinary Internet-based program on management of heart failure

    Directory of Open Access Journals (Sweden)

    Machiko R Tomita

    2008-12-01

    Full Text Available Machiko R Tomita1, Bin-Min Tsai2, Nadine M Fisher1, Neeraj A Kumar1, Greg Wilding3, Kathy Stanton1, Bruce J Naughton41Department of Rehabilitation Science, University at Buffalo, Buffalo, New York, USA; 2Department of Occupational Therapy, I-Shou University, Taiwan; 3Department of Biostatistics, University at Buffalo, Buffalo, New York, USA; 4Department of Medicine, University at Buffalo, Buffalo, New York, USAObjectives: To develop and test the effectiveness of an Internet-based self management program by multidisciplinary health care professionals for patients with heart failure (HF.Methods: The comprehensive educational material for HF was created and posted on a website. A computer with Internet connection and computer training were provided first. A secure and simple web-based recording system of vital signs and health behaviors and a mechanism for feedback regarding each participant’s record were developed. A randomized controlled trial with a one-year intervention was conducted using a total of 40 patients who were assessed three times in their homes. An intention-to-treat analysis used multivariate statistics.Results: The treatment group had a high (85% adherence to the intervention. Only the treatment group showed a significant improvement in the knowledge level (p < 0.001, amount of exercise (p = 0.001, and quality of life (p = 0.001, and reduction in HF related symptoms (dyspnea, p = 0.001; fatigue, p = 0.003; functional emotion, p < 0.001, blood pressure (systolic, p = 0.002; diastolic, p < 0.001, frequency of emergency room visit, and length of hospital stay (both p = 0.001.Conclusions: An effective program to change one’s behaviors in managing HF takes a multidisciplinary approach to create and provide feedback regarding a patient’s daily record, which can be accomplished through Internet use.Keywords: e-health, self-management, Internet, heart failure, older adults, exercise

  18. Referral to a Commercial Weight Management Program in Patients With Coronary Heart Disease: A PILOT STUDY IN THE NETHERLANDS

    NARCIS (Netherlands)

    Minneboo, Madelon; Peters, Ron J. G.; Miller-Kovach, Karen; Lemmens, Jeanine; Bucx, Jeroen J. J.

    2015-01-01

    To quantify the impact of a commercial weight management program on weight change in obese patients with coronary heart disease. An observational, single-center pilot study in the Netherlands. Forty-five patients diagnosed with a recent acute coronary syndrome and a body mass index of >30 kg/m2 were

  19. Decrease in heart rate after longitudinal participation in the Groningen Active Living Model (GALM) recreational sports program

    NARCIS (Netherlands)

    Dr. Johan de Jong

    2009-01-01

    To investigate changes in heart rate during submaximal exercise as an index of cardiovascular function in older adults participating in the GALM recreational sports program who were sedentary or underactive at baseline. Page 15 in book of abstract ECSS Oslo 2009

  20. Nuclear-Powered Artificial Heart Prototype System Development Program: Phase III. Quarterly progress report, October 1, 1976--December 31, 1976

    Energy Technology Data Exchange (ETDEWEB)

    1976-01-01

    Technical progress and accomplishments on the active program tasks 49 through 62 on the development of a nuclear-powered artificial heart are reported. The tasks include waste heat rejection, systems studies, IVBM modification design, IVBM fabrication, IVBM performance testing, IVBM system life testing, field support, reliability and quality assurance, Mark I thermal insulation design, and Mark I thermal converter design. (TFD)

  1. Effect of Educational Program to Encourage Safe Sexual Behaviors Among Addicted Men Refered to Substance Abuse Treatment Centers in Hamadan, Western Iran: Applying the Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Babak Moeini

    2014-06-01

    Full Text Available Introduction: Unsafe sexual behaviors as important risky behaviors can expose individuals and society to dangerous infectious disease such as AIDS and viral hepatitis. Considering the high prevalence of unsafe sexual behaviors, this study aimed to determine the effect of educational programs to encourage safe sexual behaviors among substance abusers referred to substance abuse treatment centers in Hamadan, Western Iran by applying the theory of planned behavior. Materials & Methods: This quasi-experimental study was performed on 104 men substance abusers (52 participants in each of the control and intervention groups referred to substance abuse treatment centers in Hamadan. Data collection tool was a questionnaire containing demographic information and the theory of planned behavior constructs. Before the educational program, questionnaires were completed by both groups. After the pretest in both groups, participants in the intervention group participated in four educational sessions designed based on the theory of planned behavior. Two months after the end of program, posttest was performed. Data was analyzed using independent T-test, chi-square, fisher exact test, McNemar’s test and multiple linear regressions using SPSS-16. Results: After educational intervention, the mean scores of the theory constructs (attitude toward behavior, subjective norms, behavioral control, behavioral intention and behaviors, in the intervention group increased significantly (P<0.05, despite the fact, changes were not significant in the control group. Conclusion: Implementation of educational courses to encourage safe sexual behaviors based on the theory of planned behavior can be beneficial for substance abusers referred to substance abuse treatment centers.

  2. A Self Directed Adherence Management Program for Patients' with Heart Failure Completing Combined Aerobic and Resistance Exercise Training

    OpenAIRE

    Duncan, Kathleen; Pozehl, Bunny; Norman, Joseph F.; Hertzog, Melody

    2009-01-01

    This study measured the impact of the Exercise Adherence Management Program (EAMP) provided to 20 patients with heart failure (HF) who participated in a combined resistance and aerobic exercise training program during two, 12 week phases. The EAMP included strategies designed to support exercise self-efficacy and adherence. Results indicate an improvement in exercise self-efficacy occurred during the study period while exercise adherence declined during the unsupervised phase. The highest rat...

  3. Comparative cost-effectiveness of the HeartWare versus HeartMate II left ventricular assist devices used in the United Kingdom National Health Service bridge-to-transplant program for patients with heart failure.

    Science.gov (United States)

    Pulikottil-Jacob, Ruth; Suri, Gaurav; Connock, Martin; Kandala, Ngianga-Bakwin; Sutcliffe, Paul; Maheswaran, Hendramoorthy; Banner, Nicholas R; Clarke, Aileen

    2014-04-01

    Patients with advanced heart failure may receive a left ventricular assist device (LVAD) as part of a bridge-to-transplant (BTT) strategy. The United Kingdom National Health Service (UK NHS) has financed a BTT program in which the predominant LVADs used have been the HeartMate II (HM II; Thoratec, Pleasanton, CA) and HeartWare (HW; HeartWare International, Inc. Framingham, MA). We aimed to compare the cost-effectiveness of the use of these within the NHS program. Individual patient data from the UK NHS Blood and Transplant Data Base were analyzed with Kaplan-Meier and competing outcomes methodologies. Outcomes were time to death, time to heart transplant (HT), and cumulative incidences of HT, death on LVAD support, and LVAD explantation. A semi-Markov multistate economic model was built to assess cost-effectiveness. The perspective was from the NHS, discount rates were 3.5%. Outcomes were quality-adjusted life-years (QALYs) and incremental cost (2011 prices in GB£) per QALY (ICER) for HW vs HM II. Survival was better with HW support than with HM II. Cumulative incidence of HT was low for both groups (11% at ~2 years). HW patients accrued 4.99 lifetime QALYs costing £258,913 ($410,970), HM II patients accrued 3.84 QALYs costing £231,871 ($368,048); deterministic and probabilistic ICERs for HW vs HM II were £23,530 ($37,349) and £20,799 ($33,014), respectively. Patients In the UK BTT program who received the HW LVAD had a better clinical outcome than those who received the HM II, and the HW was more cost-effective. This result needs to be reassessed in a randomized controlled trial comparing the 2 devices. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  4. Infection Control Practices and Program Management in Labor and Delivery Units: A Cross-Sectional Study From Iran

    OpenAIRE

    Tabatabaei; Behmanesh Pour; Azadeh

    2016-01-01

    Background Although Iranian women increasingly attend hospitals for childbirth, no information is available on programs and practices related to infection control in labor and delivery units. Objectives This study aims to investigate infection control program management and midwives’ practices in labor and delivery units. Patients and Methods We analyzed data related to infection c...

  5. Key Stakeholdersí Attitudes towards Teacher Education Programs in TEFL: A Case Study of Farhangian University in Iran

    Science.gov (United States)

    Gholami, Javad; Qurbanzada, Isa

    2016-01-01

    Recently, teacher training courses have attracted the researchers' special attention, while teacher education programs have not received as much attention. The present study investigated the attitudes key stakeholders in a teacher education program (i.e., student teachers, in-service teachers, and teacher educators) hold toward the appropriateness…

  6. Work-Related Low Back Pain Treatment: A Randomized Controlled Trial from Tehran, Iran, Comparing Multidisciplinary Educational Program versus Physiotherapy Education.

    Science.gov (United States)

    Ghadyani, Leila; Tavafian, Sedigheh Sadat; Kazemnejad, Anoshirvan; Wagner, Joan

    2016-08-01

    Clinical trial. To compare the multidisciplinary educational program versus physiotherapy education among Iranian nurses. Low back pain (LBP) can accompany significant occupational injuries in the nursing profession. There is no agreement on the most effective educational practice. This study was conducted from August 17, 2014 to September 22, 2014 in Tehran, Iran. Eligible nurses with chronic mechanical LBP (n=136) were classified into an intervention group (n=66) or the control group (n=70). The intervention group received physiotherapy education for 120-minutes followed by a 120-minute health education session based on predictive constructs of social cognitive theory (SCT). The control group received the 120-minute physiotherapy education. Disability rate, pain severity and back pain prevention behavior were measured at initially and 3 months after intervention using visual analogue scale, Roland-Morris disability questionnaire and nursing low back pain preventive behaviors questionnaire. The two groups were the same in terms of all studied variables at the initiation of the study. At the 3-month follow up, predictive constructs of LBP preventive behaviors of participants in the intervention were improved (pevident at 3 months in pain severity (p=0.03) and disability (p=0.003). The designed multidisciplinary educational intervention could decrease chronic mechanical LBP in nurses.

  7. Greater prognostic value of peak VO2 after exercise training program completion in heart failure patients.

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    Tabet, Jean-Yves; Meurin, Philippe; Benzidi, Younes; Beauvais, Florence; Ben Driss, Ahmed; Weber, Hélène; Renaud, Nathalie; Dumaine, Raphaelle; Grosdemouge, Anne; Cohen Solal, Alain

    2013-10-09

    Exercise capacity, best reflected by peak exercise oxygen consumption (peak VO(2)), is a powerful prognostic factor in patients with chronic heart failure (CHF). However, the optimal time to assess exercise capacity for prognosis remains unclear and whether an exercise training program (ETP) to improve exercise capacity alters the prognostic value of cardiopulmonary exercise (CPX) testing variables in CHF is unknown. CHF patients who underwent an ETP in two cardiac rehabilitation centers between 2004 and 2009 were prospectively included, and CPX testing was performed before and after ETP completion. We included 285 consecutive patients who underwent an ETP (19.4 ± 8.7 training sessions in 4 to 10 weeks), including segmental gymnastics and cycling sessions. During follow-up (12 months), 14 patients died, 6 underwent cardiac transplantation and 15 were hospitalized for acute heart failure. Univariate analysis and receiver operating characteristic (ROC) curve analysis showed that CPX variables, especially peak oxygen consumption and circulatory power (product of peak VO(2) × peak systolic blood pressure) before and after ETP completion predicted prognosis. However, CPX data obtained after ETP completion had the best prognostic value (area under the ROC curve = 0.79 ± 0.03 for peak VO(2) after ETP completion vs 0.64 ± 0.04 before ETP completion, p < 0.0001). The results did not change even when considering only deaths. In patients with stable CHF who can exercise, the prognostic value of CPX data seems greater after versus before completion of a hospital-based ETP. Therefore, CPX capacity for prognostic purposes should at best be assessed after cardiac rehabilitation. © 2013.

  8. Aldosterone inhibits the fetal program and increases hypertrophy in the heart of hypertensive mice.

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    Feriel Azibani

    Full Text Available BACKGROUND: Arterial hypertension (AH induces cardiac hypertrophy and reactivation of "fetal" gene expression. In rodent heart, alpha-Myosin Heavy Chain (MyHC and its micro-RNA miR-208a regulate the expression of beta-MyHC and of its intronic miR-208b. However, the role of aldosterone in these processes remains unclear. METHODOLOGY/PRINCIPAL FINDINGS: RT-PCR and western-blot were used to investigate the genes modulated by arterial hypertension and cardiac hyperaldosteronism. We developed a model of double-transgenic mice (AS-Ren with cardiac hyperaldosteronism (AS mice and systemic hypertension (Ren. AS-Ren mice had increased (x2 angiotensin II in plasma and increased (x2 aldosterone in heart. Ren and AS-Ren mice had a robust and similar hypertension (+70% versus their controls. Anatomical data and echocardiography showed a worsening of cardiac hypertrophy (+41% in AS-Ren mice (P<0.05 vs Ren. The increase of ANP (x 2.5; P<0.01 mRNA observed in Ren mice was blunted in AS-Ren mice. This non-induction of antitrophic natriuretic peptides may be involved in the higher trophic cardiac response in AS-Ren mice, as indicated by the markedly reduced cardiac hypertrophy in ANP-infused AS-Ren mice for one month. Besides, the AH-induced increase of ßMyHC and its intronic miRNA-208b was prevented in AS-Ren. The inhibition of miR 208a (-75%, p<0.001 in AS-Ren mice compared to AS was associated with increased Sox 6 mRNA (x 1.34; p<0.05, an inhibitor of ßMyHC transcription. Eplerenone prevented all aldosterone-dependent effects. CONCLUSIONS/SIGNIFICANCE: Our results indicate that increased aldosterone in heart inhibits the induction of atrial natriuretic peptide expression, via the mineralocorticoid receptor. This worsens cardiac hypertrophy without changing blood pressure. Moreover, this work reveals an original aldosterone-dependent inhibition of miR-208a in hypertension, resulting in the inhibition of β-myosin heavy chain expression through the induction

  9. TEAM-HF Cost-Effectiveness Model: A Web-Based Program Designed to Evaluate the Cost-Effectiveness of Disease Management Programs in Heart Failure

    Science.gov (United States)

    Reed, Shelby D.; Neilson, Matthew P.; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H.; Polsky, Daniel E.; Graham, Felicia L.; Bowers, Margaret T.; Paul, Sara C.; Granger, Bradi B.; Schulman, Kevin A.; Whellan, David J.; Riegel, Barbara; Levy, Wayne C.

    2015-01-01

    Background Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. Methods We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics, use of evidence-based medications, and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model (SHFM). Projections of resource use and quality of life are modeled using relationships with time-varying SHFM scores. The model can be used to evaluate parallel-group and single-cohort designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. Results The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. Conclusion The TEAM-HF Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. PMID:26542504

  10. Effectiveness of health education programs on exercise behavior among patients with heart disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhu, Li-Xia; Ho, Shuk-Ching; Wong, Thomas K S

    2013-11-01

    Regular exercise has been shown to be beneficial to patients with heart disease. Previous studies have indicated that health education can effectively increase participants' physical activity. However, no systematic review was conducted to evaluate the effectiveness of health education programs on changing exercise behavior among patients with heart disease. The aim of this study was to examine the effectiveness of health education programs on exercise behavior among heart disease patients. Potential studies were retrieved in the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, EMbase, PsycINFO, the British Nursing Index and Archive, Science Direct, and ERIC via EBSCOhost. Meta-analysis was done using the random-effect model. Thirty-seven studies were identified. Only 12 studies delivered health education based on various theories/models. Twenty-eight studies were included in the meta-analyses. The results showed that health education had significantly positive effects on exercise adherence (risk ratio = 1.35 to 1.48), exercise duration (SMD = 0.25 to 0.69), exercise frequency (MD = 0.54 to 1.46 session/week), and exercise level (SMD = 0.25), while no significant effects were found on exercise energy expenditure and cognitive exercise behavior. Health education has overall positive effects on changing exercise behavior among heart disease patients. Few theoretical underpinning studies were conducted for changing exercise behavior among heart disease patients. The findings suggest that health education improves exercise behavior for heart disease patients. Health professionals should reinforce health education programs for them. © 2013 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

  11. Integration of Gender-sensitive Approach to Safe Motherhood Program for the Prevention of STD/ HIV in Iran: A Qualitative Study

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    Fatemeh Rahmanian

    2017-07-01

    Full Text Available Background & aim: Sexually transmitted infections (STIs present a serious public health burden, which are considered as the factors contributing to acute illnesses, infertility, long-term disability, and mortality. The aim of the present study was to provide an in-depth understanding of the participants' perceptions about the integration of gender-sensitive approach to safe motherhood program for the prevention of STIs/human immunodeficiency virus (HIV in Iran. Methods: This qualitative exploratory study was conducted on 32 male and female key informants, including health managers, health policy makers, and reproductive health providers. The participants were selected through the purposive sampling method, followed by the snowball sampling technique. The data collection was performed using the semi-structured interviews. The data were analyzed through the content analysis. Results: Based on the results, the participants’ perceptions were categorized into two categories, namely the STIs/HIV prevention among males in safe motherhood and gender-sensitivity in primary maternal STIs/HIV prevention. Each of the patients was further divided into codes. The first category includes accountability to men's own sexual health needs’ and prevention of ill-health effects of men on women’s STIs/HIV status and the second category includes (1 condom negotiation skills in women (2 mandatory pre-marital HIV test policy, (3 partner notification guidelines, (4 STI/HIV risk assessment in safe motherhood services, and (5 women’s right-based instruction for prenatal HIV screening in private services. Conclusion: As the findings of the present study indicated, the health policy makers were not adequately sensitive to gender sensitivity, which is particularly crucial for STIs/HIV prevention in the safe motherhood programs.

  12. A Comprehensive Look into the instruction of Listening Skill in Academic English Programs: A Case Study of two State Universities in Iran

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    Hamidreza Babaee

    2017-04-01

    Full Text Available The study reported here thoroughly investigated the instruction of listening skill in academic English programs. This was researched through a semi-structured interview. In this regard, in order to obtain a picture of listening requirements across the academy, data were collected from two different state universities of Iran. To compile the data, five listening lecturers from these two universities were invited to participate in the study. Topics investigated through the interviews included; the importance and objectives of English as a Foreign Language (EFL listening in university study, the nature of listening in academic English programs, quantity and type of listening prescribed on courses, the integration of listening with other skills, and the evolution of changes in students’ listening requirements and practices. The analysis of the interviews revealed the two types of the courses; academic English-oriented courses and general English-oriented courses, each of them having their own perspectives regarding the various aspects of the listening. Regarding the changes in students’ practices, two types of transformations were found; transformation of the processes from bottom-up to top-down and transformation of the materials from textbook-oriented to more internet-oriented perspectives. The findings of the present study suggest some practical implications for the EFL students and teachers. In this regard, students need to equip and accustom themselves with more interpretive skills of listening and internet-oriented materials in their classes. Teachers are also required to balance between different types of skills and course materials in their classes according to their students’ needs.

  13. Genetic epidemiology, hematological and clinical features of hemoglobinopathies in Iran.

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    Rahimi, Zohreh

    2013-01-01

    There is large variation in the molecular genetics and clinical features of hemoglobinopathies in Iran. Studying structural variants of hemoglobin demonstrated that the β-chain variants of hemoglobin S and D-Punjab are more prevalent in the Fars (southwestern Iran) and Kermanshah (western Iran) provinces, respectively. Also, α-chain variants of Hb Q-Iran and Hb Setif are prevalent in western Iran. The molecular basis and clinical severity of thalassemias are extremely heterogenous among Iranians due to the presence of multiethnic groups in the country. β-Thalassemia is more prevalent in northern and southern Iran. Among 52 different β-thalassemia mutations that have been identified among Iranian populations, IVSII-1 G:A is the most frequent mutation in most parts of the country. The presence of IVS I-5 G:C mutation with high frequency in southeastern Iran might reflect gene flow from neighboring countries. A wide spectrum of α-thalassemia alleles has been detected among Iranians with -α(3.7 kb) as the most prevalent α-thalassemia mutation. The prevention program of thalassemia birth in Iran has reduced the birth rate of homozygous β-thalassemia since the implementation of the program in 1997. In this review genetic epidemiology, clinical and hematological aspects of hemoglobinopathies, and the prevention programs of β-thalassemia in Iran will be discussed.

  14. Genetic Epidemiology, Hematological and Clinical Features of Hemoglobinopathies in Iran

    Science.gov (United States)

    Rahimi, Zohreh

    2013-01-01

    There is large variation in the molecular genetics and clinical features of hemoglobinopathies in Iran. Studying structural variants of hemoglobin demonstrated that the β-chain variants of hemoglobin S and D-Punjab are more prevalent in the Fars (southwestern Iran) and Kermanshah (western Iran) provinces, respectively. Also, α-chain variants of Hb Q-Iran and Hb Setif are prevalent in western Iran. The molecular basis and clinical severity of thalassemias are extremely heterogenous among Iranians due to the presence of multiethnic groups in the country. β-Thalassemia is more prevalent in northern and southern Iran. Among 52 different β-thalassemia mutations that have been identified among Iranian populations, IVSII-1 G:A is the most frequent mutation in most parts of the country. The presence of IVS I-5 G:C mutation with high frequency in southeastern Iran might reflect gene flow from neighboring countries. A wide spectrum of α-thalassemia alleles has been detected among Iranians with −α 3.7 kb as the most prevalent α-thalassemia mutation. The prevention program of thalassemia birth in Iran has reduced the birth rate of homozygous β-thalassemia since the implementation of the program in 1997. In this review genetic epidemiology, clinical and hematological aspects of hemoglobinopathies, and the prevention programs of β-thalassemia in Iran will be discussed. PMID:23853772

  15. Comparing the effect of two educational programs on the quality of life of hemodialysis patients in iran.

    Science.gov (United States)

    Baraz, Shahram; Zarea, Kourosh; Dashtbozorgi, Bahman

    2014-08-01

    Various researchers have shown that the health level, performance status, and quality of life (QOL) are often less than expected especially in hemodialysis (HD) patients. This study aimed to determine the effect of the two methods of educational programs on health- related QOL (HRQOL) in Iranian HD patients. In this quasi-experimental, pretest-posttest interventional study, we employed each subject as his/her own control. The study was conducted at the dialysis units in three major general hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences. A total of 90 HD patients were randomly allocated to two 45-patient groups of oral and video education programs, respectively. The educational programs included dietary and fluid regimens, the care of fistula and skin, and stress management. HRQOL was assessed in both groups using a Farsi version of the Short Form Health Survey (SF-36) before and after the educational programs. Repeated measures analysis of variance and ANOVA were used for data analysis through SPSS. SF-36 domains of physical functioning (P education groups after the interventions. There was no difference in the effectiveness of the two educational programs. Appropriate interventions may potentially lead to improvement in the HRQOL of these patients. Therefore, video education as an effective, inexpensive, simple, and attractive method is recommended for HD patients.

  16. A self-directed adherence management program for patients with heart failure completing combined aerobic and resistance exercise training.

    Science.gov (United States)

    Duncan, Kathleen; Pozehl, Bunny; Norman, Joseph F; Hertzog, Melody

    2011-11-01

    This study measured the impact of the Exercise Adherence Management Program (EAMP) provided to 20 patients with heart failure (HF) who participated in a combined resistance and aerobic exercise training program during two 12-week phases. The EAMP included strategies designed to support exercise self-efficacy and adherence. Results indicate that an improvement in exercise self-efficacy occurred during the study period, whereas exercise adherence declined during the unsupervised phase. The highest rated adherence strategy for helpfulness and self-efficacy was group sessions. The study supports the use of adherence strategies based on self-efficacy in exercise programs for patients with HF. Published by Elsevier Inc.

  17. The burden of disease and injury in Iran 2003

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    Vaseghi Sanaz

    2009-06-01

    causes of DALYs in females were ischemic heart disease (438 thousand, major depressive disorder (420 thousand, natural disasters (419 thousand, and road traffic accidents (235 thousand. The burden of disease at the province level showed marked variability. DALY estimates by Iran's NBD study were higher than those for EMR-B by WHO. Conclusion The health and disease profile in Iran has made the transition from the dominance of communicable diseases to that of noncommunicable diseases and road traffic injuries. NBD results are to be used in health program planning, research, and resource allocation and generation policies and practices.

  18. Hemodynamic-guided heart-failure management using a wireless implantable sensor: Infrastructure, methods, and results in a community heart failure disease-management program.

    Science.gov (United States)

    Jermyn, Rita; Alam, Amit; Kvasic, Jessica; Saeed, Omar; Jorde, Ulrich

    2017-03-01

    The real-world impact of remote pulmonary artery pressure (PAP) monitoring on New York Heart Association (NYHA) class improvement and heart failure (HF) hospitalization rate is presented here from a single center. METHODS: Seventy-seven previously hospitalized outpatients with NYHA class III HF were offered PAP monitoring via device implantation in a multidisciplinary HF-management program. Prospective effectiveness analyses compared outcomes in 34 hemodynamically monitored patients to a group of similar patients (n = 32) who did not undergo device implantation but received usual care. NYHA class and 6-minute walk testing were assessed at baseline and 90 days. All hospitalizations were collected after 6 months of the implantation date (average follow-up, 15 months) and compared with the number of hospitalizations experienced prior to hemodynamic monitoring. Patients in both groups had similar distributions of age, sex, and ejection fraction. After 90 days, 61.8% of the monitored patients had NYHA class improvement of ≥1, compared with 12.5% in the controls (P management leads to significant improvements in NYHA class and HF hospitalization rate in a real-world setting compared with usual care delivered in a comprehensive disease-management program. © 2016 Wiley Periodicals, Inc.

  19. Severe asthma: lessons learned from the National Heart, Lung, and Blood Institute Severe Asthma Research Program.

    Science.gov (United States)

    Jarjour, Nizar N; Erzurum, Serpil C; Bleecker, Eugene R; Calhoun, William J; Castro, Mario; Comhair, Suzy A A; Chung, Kian Fan; Curran-Everett, Douglas; Dweik, Raed A; Fain, Sean B; Fitzpatrick, Anne M; Gaston, Benjamin M; Israel, Elliot; Hastie, Annette; Hoffman, Eric A; Holguin, Fernando; Levy, Bruce D; Meyers, Deborah A; Moore, Wendy C; Peters, Stephen P; Sorkness, Ronald L; Teague, W Gerald; Wenzel, Sally E; Busse, William W

    2012-02-15

    The National Heart, Lung, and Blood Institute Severe Asthma Research Program (SARP) has characterized over the past 10 years 1,644 patients with asthma, including 583 individuals with severe asthma. SARP collaboration has led to a rapid recruitment of subjects and efficient sharing of samples among participating sites to conduct independent mechanistic investigations of severe asthma. Enrolled SARP subjects underwent detailed clinical, physiologic, genomic, and radiological evaluations. In addition, SARP investigators developed safe procedures for bronchoscopy in participants with asthma, including those with severe disease. SARP studies revealed that severe asthma is a heterogeneous disease with varying molecular, biochemical, and cellular inflammatory features and unique structure-function abnormalities. Priorities for future studies include recruitment of a larger number of subjects with severe asthma, including children, to allow further characterization of anatomic, physiologic, biochemical, and genetic factors related to severe disease in a longitudinal assessment to identify factors that modulate the natural history of severe asthma and provide mechanistic rationale for management strategies.

  20. [Healthy heart: Results of a community education program on cardiovascular health].

    Science.gov (United States)

    Madridejos Mora, Rosa; Majem Fabres, Lourdes; Puig Acebal, Helena; Sanz Latorre, Inma; Llobet Traveset, Eva; Arce Casas, Mar; Ruiz Morilla, Dolors; Mercadal Dalmau, Angel; Pañart Sánchez, Dani

    2014-11-01

    To improve the knowledge of the population about heart-healthy habits through a training program supplemented by a web site and community activities. A controlled clinical trial with intervention done through participation in the Cardiovascular Health Training Classroom (CHTC) LOCATION: A town of 80,000 inhabitants. both sexes, aged 55 to 70 years, with at least one cardiovascular risk factor (CVRF). The intervention group (IG) consisted of patients who participated in the CHTC. Intervention was carried out through a 20-hour presential group course in which a support web site was offered and complementary activities were organized. Classes were taught by three Primary Care nurses. The primary endpoint was knowledge of CVRF. The secondary variables were age, sex, CVRF, lifestyle, visits to health centers, pharmaceutical use adherence, and satisfaction with the program. Data from patients in the first 10 courses (n=150) were evaluated. A statistically significant improvement was observed in overall knowledge of CVRF in the IG (87.3% to 100%) compared with control group (GC) (84.5% to 92.7%), p<.001, as well as an improvement in physical activity is (IG: 71.2% to 83.1% versus CG: 72.6% to 78.2%), p=.05. The total number of Primary Care visits (medical and nursing) decreased in the IG more than in the CG. The satisfaction rate of the course was very high. This experience is effective in improving cardiovascular health knowledge and promoting some healthy habits. Copyright © 2012 Elsevier España, S.L.U. All rights reserved.

  1. Instrument to assess educational programs for parents of children with congenital heart disease undergoing cardiac surgery.

    Science.gov (United States)

    Pino Armijo, Paola; Ramírez León, Muriel; Clavería Rodríguez, Cristian

    2017-10-01

    To design and validate an instrument to assess the relevance of educational programs for parents of children with congenital heart disease (CHD) undergoing cardiac surgery. In October 2011, an instrument was designed based on Kaufman's model and on the bibliography, and a survey was developed in the form of a checklist with 32 close-ended questions about received education and desired education, categorized into 5 items: educator, time, place, means, and content. The survey was reviewed by 4 academic professionals and 9 experts in the care of children with CHD, and the checklist was extended to include 42 close-ended questions and 5 open questions. The instrument was administered on the day before discharge to the parents of children with CHD undergoing cardiac surgery at the Department of Pediatrics between February and August 2013. The survey was self-administered by the first participants and administered by the investigator among the remaining participants. Fifty-five children met inclusion criteria; a total of 60 parents took part in the study. Agreement was observed between received education and desired education, which was statistically significant only in terms of education provided by a cardiologist (p= 0.000, K= 0.659) and in the hall (p= 0.000, K= 0.655). Statistically significant differences were observed between the 19 self-administered surveys and the 41 surveys administered by the investigator. Among the latter, a greater level of completion was observed for all items. A validated instrument was developed to assess the relevance of educational programs for parents of children with CHD undergoing cardiac surgery. This survey should be administered by a health care provider for a better understanding of information.

  2. Economic Evaluation of Exercise-Based Cardiac Rehabilitation Programs for Chronic Heart Failure Patients in Colombia.

    Science.gov (United States)

    Rincón, Mónica; Rojas, Maria Ximena; Rodriguez Romero, Viviana Alejandra; Tamayo, Diana Carolina; Franco, Camilo; Castro, Hector; Brophy, James; Dennis, Rodolfo

    2016-01-01

    Cardiac rehabilitation (CR) in patients with chronic heart failure (CHF) has met with resistance from third-party payers in low- and middle-income countries because of lack of evidence regarding its cost-effectiveness. We aimed to provide information to help better inform this decision-making process. Costs associated with a 12-week exercise-based rehabilitation program in Colombia for patients with CHF were estimated. We collected data on all medical resources used in ambulatory care and data on hospital costs incurred for treating patients with uncompensated CHF. A literature search to establish the hospitalization rates because of uncompensated CHF, death because of CHF, and potential decreases in these data because of the utilization of CR was conducted. We modeled incremental costs and effectiveness over a period of 5 years from the perspective of the third-party payer. All costs were converted from Colombian pesos to US dollars. For an exercise-based CR program of 12-week duration (36 sessions), costs ranged from US$265 to US$369 per patient. Monthly costs associated with ambulatory care of CHF averaged US$128 ± US$321 per patient, and hospitalization costs were US$3621 ± US$5 444 per event. Yearly hospitalization incidence rates with and without CR were 0.154 and 0.216, respectively. The incremental cost of CR would be US$998 per additional quality-adjusted life-year. Sensitivity analysis did not significantly change these results. Cardiac rehabilitation in patients with CHF in settings such as Colombia can be a cost-effective strategy, with minimal incremental costs and better quality of life, mainly because of decreased rates of hospitalization.

  3. Disease management 360 degrees: a scorecard approach to evaluating TRICARE's programs for asthma, congestive heart failure, and diabetes.

    Science.gov (United States)

    Yang, Wenya; Dall, Timothy M; Zhang, Yiduo; Hogan, Paul F; Arday, David R; Gantt, Cynthia J

    2010-08-01

    To assess the effect of TRICARE's asthma, congestive heart failure, and diabetes disease management programs using a scorecard approach. EVALUATION MEASURES: Patient healthcare utilization, financial, clinical, and humanistic outcomes. Absolute measures were translated into effect size and incorporated into a scorecard. Actual outcomes for program participants were compared with outcomes predicted in the absence of disease management. The predictive equations were established from regression models based on historical control groups (n = 39,217). Z scores were calculated for the humanistic measures obtained through a mailed survey. Administrative records containing medical claims, patient demographics and characteristics, and program participation status were linked using an encrypted patient identifier (n = 57,489). The study time frame is 1 year prior to program inception through 2 years afterward (October 2005-September 2008). A historical control group was identified with the baseline year starting October 2003 and a 1-year follow-up period starting October 2004. A survey was administered to a subset of participants 6 months after baseline assessment (39% response rate). Within the observation window--24 months for asthma and congestive heart failure, and 15 months for the diabetes program--we observed modest reductions in hospital days and healthcare cost for all 3 programs and reductions in emergency visits for 2 programs. Most clinical outcomes moved in the direction anticipated. The scorecard provided a useful tool to track performance of 3 regional contractors for each of 3 diseases and over time.

  4. Effectiveness and cost of a transitional care program for heart failure: a prospective study with concurrent controls.

    Science.gov (United States)

    Stauffer, Brett D; Fullerton, Cliff; Fleming, Neil; Ogola, Gerald; Herrin, Jeph; Stafford, Pamala Martin; Ballard, David J

    2011-07-25

    Randomized controlled trials have demonstrated the efficacy of nurse-led transitional care programs to reduce readmission rates for patients with heart failure; the effectiveness of these programs in real-world health care systems is less well understood. We performed a prospective study with concurrent controls to test an advanced practice nurse-led transitional care program for patients with heart failure who were 65 years or older and were discharged from Baylor Medical Center Garland (BMCG) from August 24, 2009, through April 30, 2010. We compared the effect of the program on 30-day (from discharge) all-cause readmission rate, length of stay, and 60-day (from admission) direct cost for BMCG with that of other hospitals within the Baylor Health Care System. We also performed a budget impact analysis using costs and reimbursement experience from the intervention. The intervention significantly reduced adjusted 30-day readmission rates to BMCG by 48% during the postintervention period, which was better than the secular reductions seen at all other facilities in the system. The intervention had little effect on length of stay or total 60-day direct costs for BMCG. Under the current payment system, the intervention reduced the hospital financial contribution margin on average $227 for each Medicare patient with heart failure. Preliminary results suggest that transitional care programs reduce 30-day readmission rates for patients with heart failure. This underscores the potential of the intervention to be effective in a real-world setting, but payment reform may be required for the intervention to be financially sustainable by hospitals.

  5. Novel insights on effect of atrioventricular programming of biventricular pacemaker in heart failure – a case series

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    Rafique Asim M

    2006-10-01

    Full Text Available Abstract Background Echocardiography plays an integral role in the diagnosis of congestive heart failure including measurement of left heart pressure as well as mechanical dyssynchrony. Methods In this report we describe novel therapeutic uses of echo pulsed wave Doppler in atrioventricular pacemaker optimization in patients who had either not derived significant symptomatic benefit post biventricular pacemaker implantation or deteriorated after deriving initial benefit. In these patients atrioventricular optimization showed novel findings and improved cardiac output and symptoms. Results In 3 patients with Cheyne Stokes pattern of respiration echo Doppler showed worsening of mitral regurgitation during hyperpneac phase in one patient, marked E and A fusion in another patient and exaggerated ventricular interdependence in a third patient thus highlighting mechanisms of adverse effects of Cheyne Stokes respiration in patients with heart failure. All 3 patients required a very short atrioventricular delay programming for best cardiac output. In one patient with recurrent congestive heart failure post cardiac resynchronization, mitral inflow pulse wave Doppler showed no A wave until a sensed atrioventricular delay of 190 ms was reached and showed progressive improvement in mitral inflow pattern until an atrioventricular delay of 290 ms. In 2 patients atrioventricular delay as short as 50 ms was required to allow E and A separation and prevent diastolic mitral regurgitation. All patients developed marked improvement in congestive heart failure symptoms post echo-guided biv pacemaker optimization. Conclusion These findings highlight the value of echo-guided pacemaker optimization in symptomatic patients post cardiac resynchronization treatment.

  6. Effectiveness of Educational Programs on Nutritional Behavior in Addicts Referring to Baharan Hospital, Zahedan (Eastern of IR Iran)

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    Karajibani, Mansour; Montazerifar, Farzaneh; Dashipour, Alireza; Lashkaripour, Kobra; Abery, Maryam; Salari, Sajedeh

    2014-01-01

    Background: There are many factors which affect nutritional status of addicted such as lack o f knowledge, incorrect attitude toward modification of food pattern, and careless to food intake. Objectives: The aim of this study was to determine the effectiveness of educational program on nutritional behavior in addicts referring to Baharan hospital in Zahedan. Patients and Methods: Thirty-six addict patients were selected randomly. After recording general demographic data of patients, nutrition...

  7. Comparison of the Incidence of Perinatal Asphyxia before and after the Health Improvement Program in Bentolhoda Hospital of Bojnurd, Iran

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    Mahvan Khodaparast

    2016-12-01

    Full Text Available Background: Perinatal asphyxia is a common cause of infant morbidity and mortality and long-term neurological disabilities. Due to the high costs of admission, a large proportion of births and neonatal deaths occur in non-hospital settings. This study aimed to evaluate the incidence rate of perinatal asphyxia before and after the implementation of the health improvement program. Methods: This descriptive-analytical study was conducted on all the infants with moderate and severe asphyxia during April 2013-2015. Subjects were divided into two groups of A and B (born after and before the health improvement program, respectively. Maternal and neonatal data were recorded in checklists and compared between these  groups. Data analysis was performed in SPSS version 17. Results: In total, 111 asphyxiated neonates were classified into two groups of A and B, and incidence rate of asphyxia was estimated at 0.54% and 1.05%, respectively. Severe asphyxia was observed in 35.7% and 28.9% of the infants in groups A and B, respectively. Moreover, mean duration of mechanical ventilation was 25 and 79 hours in groups A and B, respectively. Conclusion: According to the results of this study, implementation of the health improvement program reduced the incidence of perinatal asphyxia. In addition, number of cesarean cases due to previous C-section was observed to decrease. Therefore, it could be concluded that high-quality resuscitation efforts and restricted rules in the health improvement program lower the risk of long-term complications in asphyxiated neonates. However, no significant difference was observed in the mortality rate of the asphyxiated newborns in this study.

  8. Evaluation of a Community Health Service Center-Based Intervention Program for Managing Chronic Heart Failure.

    Science.gov (United States)

    Gu, Moli; Ma, Yanlan; Zhou, Ti; Xia, Yunfeng

    2016-01-01

    Although the role of primary care for the management of patients with chronic heart failure (CHF) has been highly recommended, structural involvement of primary care in heart failure (HF) management programs is extremely limited. To examine the feasibility and applicability of two most recommended forms of care delivery mode, home visit and telephone support, for CHF management in the setting of community health service center (CHSC). Prospective study. This study was conducted in two CHSCs in Beijing, China. Care delivery was led by trained general practitioners or community nurses via home visits in one CHSC and telephone support in the other. Data regarding the change in mortality and hospitalization rate during 12 months and self-care level at 6 months were prospectively collected and compared across the intervention groups. A total of 329 patients were included, with 142 in the home visit group and 187 in the telephone support group. Patients in both groups had frequent visits to CHSC (8.1±5.9 in the home visit and 7.7±4.1 in the telephone support group, p=0.45) during the follow-up period. Compared to the telephone support group, patients in the home visit group showed a reduction in all-cause mortality (14.1% versus 20.3%, p=0.14), one or more hospitalizations due to any cause (33.8% versus 44.2%, p=0.12) and one or more hospitalizations due to cardiac cause (17.6% versus 24.6%, p=0.13) in the home visit group. The absolute differences were 6.2% (95% CI: 1.9%, 14.3%), 8.4% (95% CI: 2.1%, 18.9%) and 7.3% (95% CI: 1.5%, 16.1%), respectively, although the results were not statistically significant. After 6 months of intervention, patients in both groups achieved marked improvement in self-care with reference to their own baseline values. Although no statistical difference was observed between the two care delivery approaches regarding the clinical outcomes of interest, given the high participation rates, the acceptable rate of adverse events, frequent CHSC

  9. Congenital rubella syndrome in Iran

    Directory of Open Access Journals (Sweden)

    Eftekhar Hasan

    2005-06-01

    Full Text Available Abstract Background Congenital rubella syndrome (CRS can be prevented with appropriate vaccination programs. The prevalence rates of rubella and CRS in Iran are unknown; therefore, the risk of exposure in pregnant women is not clear. The prevalence of CRS in the pre-vaccine period can be estimated by evaluating the proportion of children in the population with sensorineural hearing loss attributable to rubella. Methods This was a case-control study to estimate prevalence of CRS in Tehran (Iran by evaluating the proportion of children with sensorineural hearing loss attributable to rubella. The study used rubella antibody titer as an indicator, and compared the prevalence of rubella antibody between children with and without sensorineural hearing loss. Using these findings, the proportion of cases of sensorineural hearing loss attributable to rubella was estimated. Results A total of 225 children aged 1 to 4 years were entered into the study (113 cases and 112 controls. There was a significant difference between cases and controls with regard to rubella antibody seropositivity (19.5% vs. 8.9%, respectively, odds ratio = 2.47, 95% CI = 1.04–5.97. The proportion of sensorineural hearing loss cases attributable to rubella was found to be 12%, corresponding to a CRS prevalence of 0.2/1000. Conclusion The prevalence of CRS was approximately 0.2/1000 before rubella vaccination in Iran, Moreover; the results suggest that implementation of appropriate rubella vaccination programs could potentially prevent about 12% of cases of sensorineural hearing loss in Iranian children. This data could potentially be used as baseline data, which in conjunction with an appropriate method, to establish a surveillance system for rubella vaccination in Iran. An appropriate surveillance system is needed, because the introduction of a rubella vaccine without epidemiological data and an adequate monitoring program could result in the shifting of rubella cases to higher

  10. Meox2/Tcf15 heterodimers program the heart capillary endothelium for cardiac fatty acid uptake.

    Science.gov (United States)

    Coppiello, Giulia; Collantes, Maria; Sirerol-Piquer, María Salomé; Vandenwijngaert, Sara; Schoors, Sandra; Swinnen, Melissa; Vandersmissen, Ine; Herijgers, Paul; Topal, Baki; van Loon, Johannes; Goffin, Jan; Prósper, Felipe; Carmeliet, Peter; García-Verdugo, Jose Manuel; Janssens, Stefan; Peñuelas, Iván; Aranguren, Xabier L; Luttun, Aernout

    2015-03-03

    Microvascular endothelium in different organs is specialized to fulfill the particular needs of parenchymal cells. However, specific information about heart capillary endothelial cells (ECs) is lacking. Using microarray profiling on freshly isolated ECs from heart, brain, and liver, we revealed a genetic signature for microvascular heart ECs and identified Meox2/Tcf15 heterodimers as novel transcriptional determinants. This signature was largely shared with skeletal muscle and adipose tissue endothelium and was enriched in genes encoding fatty acid (FA) transport-related proteins. Using gain- and loss-of-function approaches, we showed that Meox2/Tcf15 mediate FA uptake in heart ECs, in part, by driving endothelial CD36 and lipoprotein lipase expression and facilitate FA transport across heart ECs. Combined Meox2 and Tcf15 haplodeficiency impaired FA uptake in heart ECs and reduced FA transfer to cardiomyocytes. In the long term, this combined haplodeficiency resulted in impaired cardiac contractility. Our findings highlight a regulatory role for ECs in FA transfer to the heart parenchyma and unveil 2 of its intrinsic regulators. Our insights could be used to develop new strategies based on endothelial Meox2/Tcf15 targeting to modulate FA transfer to the heart and remedy cardiac dysfunction resulting from altered energy substrate usage. © 2015 The Authors.

  11. Influence of sociodemographic features and general health on social capital: findings from a large population-based survey in Tehran, Iran (Urban-HEART).

    Science.gov (United States)

    Ashrafi, E; Montazeri, A; Mousavi, M; Vaez-Mahdavi, M R; Asadi-Lari, M

    2012-09-01

    Social capital is associated with a number of sociodemographic characteristics and health outcomes. This study aimed to assess the components of social capital, and determine its association with different demographic features and general health in Tehran. A large population-based cross-sectional survey was conducted using the Urban Health Equity Assessment and Response Tool (Urban-HEART). A comprehensive questionnaire containing 13 sections, including a specific tool to measure social capital, was administered to 22,300 randomly selected clustered sample households within all 22 districts in Tehran between June and September 2008. The social capital questionnaire consists of two main components - structural and cognitive - which measure collective activities, voluntary help, social cohesion, social network, reciprocity and trust. The first question of Short Form-12 was used to evaluate self-rated health. Descriptive statistics, contingency tables, independent sample t-test, analysis of variance, post-hoc test (least squares difference) and multiple linear regression were used to detect differences. A P-value <0.01 was considered to indicate significance. The social capital questionnaire and health-related quality-of-life tool were completed by 21,704 individuals (response rate 97%) in all 22 districts of Tehran. All social capital components apart from participation varied by age group and gender (P < 0.01). An improvement was seen in several social capital components with increased level of education (P < 0.01). All social capital elements apart from volunteering were associated with marital status (P < 0.01). Family size, family assets and length of residence in neighbourhood were considered to be determinants of social capital (P < 0.01), and respondents with better health showed higher levels of social capital (P < 0.0001). Various individual and household characteristics influence social capital. General health and social capital are mutually and

  12. Reassessing US Policy Toward Iran

    National Research Council Canada - National Science Library

    Russillo, Victor

    2003-01-01

    See attached file. The purpose of this paper is to review the importance of Iran to US national security interests, review past and current US policy toward Iran, outline options for future US Iran policy...

  13. A disease management program for heart failure: collaboration between a home care agency and a care management organization.

    Science.gov (United States)

    Gorski, Lisa A; Johnson, Kathy

    2003-01-01

    This article describes a collaborative approach to manage patients with heart failure between a home care agency and a care management agency. The resulting disease management program used a combination of home visits and phone contact. Care management plans emphasized patient education on increasing adherence to medical and diet regimens, and recognizing early symptoms of exacerbation that could lead to rehospitalization. Clinician activities and patient outcomes are described.

  14. The Iran nuclear ambitions and the international consequences; Les ambitions nucleaires de l'Iran et leurs consequences internationales

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-01-15

    This analysis of the Iran situation concerning the nuclear policy, is presented and discussed in three parts: the data and hypothesis of the iranian nuclear program, the regional strategy of Iran and evolution scenario and their consequences. (A.L.B.)

  15. Integrating strategic and tactical decisions in livestock supply chain using bi-level programming, case study: Iran poultry supply chain.

    Science.gov (United States)

    Teimoury, Ebrahim; Jabbarzadeh, Armin; Babaei, Mohammadhosein

    2017-01-01

    Inventory management has frequently been targeted by researchers as one of the most pivotal problems in supply chain management. With the expansion of research studies on inventory management in supply chains, perishable inventory has been introduced and its fundamental differences from non-perishable inventory have been emphasized. This article presents livestock as a type of inventory that has been less studied in the literature. Differences between different inventory types, affect various levels of strategic, tactical and operational decision-making. In most articles, different levels of decision-making are discussed independently and sequentially. In this paper, not only is the livestock inventory introduced, but also a model has been developed to integrate decisions across different levels of decision-making using bi-level programming. Computational results indicate that the proposed bi-level approach is more efficient than the sequential decision-making approach.

  16. Usefulness of frailty profile for targeting older heart failure patients in disease management programs: a cost-effectiveness, pilot study.

    Science.gov (United States)

    Pulignano, Giovanni; Del Sindaco, Donatella; Di Lenarda, Andrea; Tarantini, Luigi; Cioffi, Giovanni; Gregori, Dario; Tinti, Maria Denitza; Monzo, Luca; Minardi, Giovanni

    2010-10-01

    Disease management programs (DMP) improve outcomes in patients with heart failure. Because older heart failure patients represent a heterogeneous population, the aim of this study was to determine which patients benefit mostly from a DMP, by means of their frailty profile. Heart failure outpatient clinic. Consecutive (n = 173) patients aged more than 70 years were randomized to a multidisciplinary DMP (n = 86) or usual care (n = 87). A modified frailty score (range 1-6) was used as an index of global functional impairment. Mild to moderate frailty (frailty score = 2-3) was associated with significant improvements in outcomes (death and/or heart failure admission, heart failure admissions and all-cause admissions) in DMP patients vs. usual care. Even in more frail patients (frailty score = 4-6) a significant reduction in heart failure admissions was observed. By contrast, nonfrail patients (frailty score = 1) did not derive significant benefit. In the cost-effectiveness analysis, the mean savings per patient, stratified according to their frailty score, were -1003.31 euro for frailty score 1 (95% confidence interval -3717.00-1709.00), 1104.72 euro for frailty score 2 (-280.6-2491.00), 2635.42 euro for frailty score 3 (352.60-4917.00, P = 0.025) and 419.53 euro for frailty score 4-6 (-1909.00-2749.00). Intervention was therefore significantly cost saving in moderately frail, but not in nonfrail or severely frail patients. Thus, DMP was dominant (i.e. both less costly and more effective than usual care) in moderately frail patients. At sensitivity analysis, DMP remained dominant even to changes in cost of intervention and hospitalizations. This suggests that an intensive, hospital-based DMP appears to be more effective in older patients with mild-to-moderate levels of frailty. Thus, a multidimensional assessment of frailty seems to be a useful tool for appropriate selection of model of care.

  17. Effectiveness of Educational Programs on Nutritional Behavior in Addicts Referring to Baharan Hospital, Zahedan (Eastern of IR Iran).

    Science.gov (United States)

    Karajibani, Mansour; Montazerifar, Farzaneh; Dashipour, Alireza; Lashkaripour, Kobra; Abery, Maryam; Salari, Sajedeh

    2014-06-01

    There are many factors which affect nutritional status of addicted such as lack o f knowledge, incorrect attitude toward modification of food pattern, and careless to food intake. The aim of this study was to determine the effectiveness of educational program on nutritional behavior in addicts referring to Baharan hospital in Zahedan. Thirty-six addict patients were selected randomly. After recording general demographic data of patients, nutritional behaviors were determined. To determine the effectiveness of nutritional educational program, pre and post-tests were performed. Evaluation of nutritional behavior was determined as poor, fair and satisfactory levels. Statically analysis was performed by SPSS software. Most addict patients had a medium level of education. Improvement in knowledge, attitude and practice (KAP) of patients after intervention was observed as follows; decreasing KAP in poor level (2.8% vs. 30.6%), (3% vs. 50%), (25% vs. 80.6%), respectively; also, increasing KAP in fair level (7% vs. 55.6 %), (15% vs. 15%), (19% vs. 7%), respectively and increasing KAP in satisfactory levels (77.8% vs. 13.8%), (50% vs. 8.3%), and (22.2% vs. 0%), respectively (P education level after education (P nutritional KAP was improved in addicts. After intervention, there was a significant difference in the score of knowledge, attitude, and practice scores in patients in the current study. KAP was improved in patients after intervention including; decreased KAP in poor level and increased KAP in fair and satisfactory levels. This finding indicates that addict patients would like to modify their life style.

  18. Quality of life predicts outcome in a heart failure disease management program.

    LENUS (Irish Health Repository)

    O'Loughlin, Christina

    2012-02-01

    BACKGROUND: Chronic heart failure (HF) is associated with a poor Health Related Quality of Life (HRQoL). HRQoL has been shown to be a predictor of HF outcomes however, variability in the study designs make it difficult to apply these findings to a clinical setting. The aim of this study was to establish if HRQoL is a predictor of long-term mortality and morbidity in HF patients followed-up in a disease management program (DMP) and if a HRQoL instrument could be applied to aid in identifying high-risk patients within a clinical context. METHODS: This is a retrospective analysis of HF patients attending a DMP with 18+\\/-9 months follow-up. Clinical and biochemical parameters were recorded on discharge from index HF admission and HRQoL measures were recorded at 2 weeks post index admission. RESULTS: 225 patients were enrolled into the study (mean age=69+\\/-12 years, male=61%, and 78%=systolic HF). In multivariable analysis, all dimensions of HRQoL (measured by the Minnesota Living with HF Questionnaire) were independent predictors of both mortality and readmissions particularly in patients <80 years. A significant interaction between HRQoL and age (Total((HRQoL))age: p<0.001) indicated that the association of HRQoL with outcomes diminished as age increased. CONCLUSIONS: These data demonstrate that HRQoL is a predictor of outcome in HF patients managed in a DMP. Younger patients (<65 years) with a Total HRQoL score of > or =50 are at high risk of an adverse outcome. In older patients > or =80 years HRQoL is not useful in predicting outcome.

  19. Development of a non-heart-beating donor program and results after the first year.

    Science.gov (United States)

    Meneses, J C; Gámez, P; Mariscal, A; Marrón, C; Díaz-Hellín, V; Cortes, M; de Pablo, A; Lopez, E; Perez, V; Gonzalez, O; Juarros, L; Martinez, I; Hermoso, F; Avila, R; Zuluaga, M; de Nicolás, J L M

    2012-09-01

    Our lung transplant unit began activity in October 2008. We have performed 37 lung transplants with a hospital mortality of 2.7% (n = 1). The need for a greater number of donors and the presence of an already existent non-heart-beating donor (NHBD) program for abdominal grafts and tissues encouraged us to consider assessing lung grafts from these donors. It was necessary to develop a new multiorgan preservation methodology, "bithermia preservation." The clinical experience with which during the first year June 2010 to July 2011, including 15 NHBDs is presented herein. The chest x-ray was normal in 6 donors (40%) and 7 had pulmonary infiltrates. Bronchoscopy was normal in 8 donors (53%) but 3 had abundant bleeding airway secretions and signs of bronchoaspiration. Preservation procedures were performed in 6 donors. Pulmonary functional evaluation in 4 donors showed gas measurements to be adequate in 75% of cases. Three double-lung grafts were judged to be valid for implantation, among which we performed 3 lung transplantations, 1 bilateral and 2 unilaterals, while 2 grafts were offered to the National Transplant Organization for other units. No transplant suffered primary graft dysfunction; all 3 showed excellent function allowing early extubation in 2 cases. There was no in-hospital mortality. All 3 patients are alive and leading normal lives; none has bronchiolitis obliterans syndrome. In conclusion, the "bithermia preservation" methodology achieved adequate lung preservation in NHBDs, allowing liver, kidneys, and lungs to be obtained from the same donor. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Crimean-Congo hemorrhagic fever in Iran

    Science.gov (United States)

    Keshtkar-Jahromi, Maryam; Sajadi, Mohammad M.; Ansari, Hossein; Mardani, Masoud; Naieni, Kourosh Holakouie

    2014-01-01

    The presence of Crimean-Congo hemorrhagic fever virus (CCHFV) in Iran was first identified in studies of livestock sera and ticks in the 1970s, but the first human infection was not diagnosed until 1999. Since that time, the number of cases of CCHF in Iran has markedly increased. Through January 2012, articles in the published literature have reported a total of 870 confirmed cases, with 126 deaths, for a case fatality rate (CFR) of 17.6%. The disease has been seen in 26 of the country’s 31 provinces, with the greatest number of cases in Sistan and Baluchestan, Isfahan, Fars, Tehran, Khorasan, and Khuzestan provinces. The increase in CCHF in Iran has paralleled that in neighboring Turkey, though the number of cases in Turkey has been much larger, with an overall CFR of around 5%. In this article, we review the features of CCHF in Iran, including its history, epidemiology, animal and tick reservoirs, current surveillance and control programs, diagnostic methods, clinical features and experience with ribavirin therapy, and consider possible explanations for the difference in the CFR of CCHF between Iran and Turkey. The emergence of CCHF in Iran calls for countermeasures at many levels to protect the population, but also provides opportunities for studying the epidemiology, diagnosis and management of the disease. PMID:23872313

  1. Use and predictors of heart failure disease management referral in patients hospitalized with heart failure: insights from the Get With the Guidelines Program.

    Science.gov (United States)

    Gharacholou, S Michael; Hellkamp, Anne S; Hernandez, Adrian F; Peterson, Eric D; Bhatt, Deepak L; Yancy, Clyde W; Fonarow, Gregg C

    2011-05-01

    Heart failure disease management (HFDM) may be beneficial in heart failure (HF) patients at risk for readmission or post-discharge mortality. However, characteristics of hospitalized HF patients referred to HFDM are not known. Get With the Guidelines (GWTG) program data was used to analyze 57,969 patients hospitalized with HF from January 2005 through January 2010 from 235 sites. Factors associated with referral to HFDM and rates of HF quality measures by referral status were studied. Mean age of patients was 69.7 ± 14.5 years, 52% were men, and 65% were white. HFDM referral occurred in 11,150 (19.2%) patients. The median rate of HFDM referral among all hospitals was 3.5% (25th-75th percentiles 0%-16.7%) and 8.7% (2.8%-27.7%) among hospitals with at least one previous HFDM referral. Quality and performance measures were higher in patients referred to HFDM. HFDM referral was associated with atrial fibrillation, implanted cardiac device, depression, and treatment at larger hospitals. Patients at higher 90-day mortality risk were paradoxically less likely to receive HFDM referral. HFDM referral occurred in less than one-fifth of hospitalized HF patients and was more frequently recommended to lower-risk patients. Increasing use and optimizing selection of patients for HFDM referral is a potential target for quality improvement. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. The effect of on-site and outreach-based needle and syringe programs in people who inject drugs in Kermanshah, Iran.

    Science.gov (United States)

    Nazari, Seyed Saeed Hashemi; Noroozi, Mehdi; Soori, Hamid; Noroozi, Alireza; Mehrabi, Yadollah; Hajebi, Ahmad; Sharifi, Hamid; Higgs, Peter; Mirzazadeh, Ali

    2016-01-01

    Needle and syringe programs (NSPs) are widely used to reduce harms associated with drug injecting. This study assessed the effect of facility-based (on-site services at drop-in centre) and outreach models of NSP on injection risk behaviours. Self-reported data from 455 people who injected drugs (PWID) during 2014 in Kermanshah, Iran, were examined to measure demographic characteristics and risk behaviors. Self-reported and program data were also assessed to identify their main source of injection equipment. Participants were divided into three sub-groups: facility-based NSP users, outreach NSP users and non-users (comparison group). Coarsened exact matching was used to make the three groups statistically equivalent based on age, place of residence, education and income, and groups were compared regarding the proportion of borrowing or lending of syringes/cookers, reusing syringes and recent HIV testing. Overall, 76% of participants reported any NSP service use during the two months prior to interview. Only 23% (95%CI: 17-27) reported outreach NSP as their main source of syringes. Using facility-based NSP significantly decreased recent syringe borrowing (OR: 0.27, 95%CI: 0.10-0.70), recent syringe reuse (OR: 0.38, 95%CI: 0.23-0.68) and increased recent HIV testing (OR: 2.60, 95%CI: 1.48-4.56). Similar effects were observed among outreach NSP users; in addition, the outreach NSP model significantly reduced the chance of lending syringes (OR: 0.31, 95%CI: 0.15-0.60), compared to facility-based NSP (OR: 1.25, 95%CI: 0.74-2.17). These findings suggest that the outreach NSP model is as effective as facility-based NSP in reducing injection risk behaviours and increasing the rate of HIV testing. Outreach NSP was even more effective than facility-based in reducing the lending of syringes to others. Scaling up outreach NSP is an effective intervention to further reduce transmission of HIV via needle sharing. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. A study on oral health of children with cardiac diseases in mashhad, iran in 2004

    National Research Council Canada - National Science Library

    Talebi, Maryam; Khordi Mood, Maryam; Mahmoudi, Mohammad; Alidad, Shaili

    2007-01-01

    .... In this descriptive cross-sectional study, case group consisting of 100 patients 2-12 years old with heart disease were examined for oral and dental status in Pediatric Cardiac Center in Mashhad, Iran, in 2004...

  4. Effects of a community-based healthy heart program on increasing healthy women\\'s physical activity: a randomized controlled trial guided by Community-based Participatory Research (CBPR

    Directory of Open Access Journals (Sweden)

    Iraj Nabipour

    2007-02-01

    Full Text Available Background: Cardiovascular disease remains the leading killer of women in most areas of the world. Rates of physical inactivity and poor nutrition, which are two of the most important modifiable risk factors for cardiovascular disease in women, are substantial. This study sought to examine the effectiveness of a community-based lifestyle-modification program on increasing women's physical activity in a randomized trial guided by community-based participatory research (CBPR methods. Methods: A total of 335 healthy, 25-64 years old women who had been selected by a multiple-stage stratified cluster random sampling method in Bushehr Port/I.R.Iran, were randomized into control and intervention groups. The intervention group completed an 8-week lifestyle modification program for increasing their physical activity, based on a revised form of Choose to Move program an American Heart Association Physical Activity Program for Women. Audio-taped activity instructions with music and practical usage of the educational package were given to the intervention group in weekly home-visits by 53 volunteers from local non-governmental and community-based organizations. Results: Among the participants, the percentage of those who reported being active (practicing at lease 30 minutes of moderate intensity physical activity for at least 5 days a week, or at least 20 minutes of vigorous physical activity for at least three days a week increased from 3% and 2.7% at baseline to 13.4% and 3% (P<0.0001 at the ending of the program in the intervention and control groups, respectively. The participants in the intervention group reported more minutes of physical activity per week (mean=139.81, SE=23.35 than women in the control group (mean=40.14, SE=12.65 at week 8 (P<0.0001.The intervention group subjects exhibited a significantly greater decrease in systolic blood pressure (-10.0 mmHg than the control group women (+2.0. mmHg. The mean ranks for posttest healthy heart

  5. Effects of an exercise program on the functional capacity of patients with chronic Chagas' heart disease, evaluated by cardiopulmonary testing

    Directory of Open Access Journals (Sweden)

    Paloma Hargreaves Fialho

    2012-04-01

    Full Text Available INTRODUCTION: Despite all efforts to restrict its transmission, Chagas' disease remains a severe public health problem in Latin America, affecting 8-12 million individuals. Chronic Chagas' heart disease, the chief factor in the high mortality rate associated with the illness, affects more than half a million Brazilians. Its evolution may result in severe heart failure associated with loss of functional capacity and quality of life, with important social and medical/labor consequences. Many studies have shown the beneficial effect of regular exercise on cardiac patients, but few of them have focused on chronic Chagas' heart disease. METHODS: This study evaluated the effects of an exercise program on the functional capacity of patients with chronic Chagas' disease who were treated in outpatient clinics at the Evandro Chagas Institute of Clinical Research and the National Institute of Cardiology, Rio de Janeiro, Brazil. The exercises were performed 3 times a week for 1 h (30 min of aerobic activity and 30 min of resistance exercises and extension over 6 months in 2010. Functional capacity was evaluated by comparing the direct measurement of the O2 uptake volume (VO2 obtained by a cardiopulmonary exercise test before and after the program (p 10% (p = 0.01949. CONCLUSIONS: The results suggest a statistically significant improvement in functional capacity with regular exercise of the right intensity.

  6. Effects of an exercise program on the functional capacity of patients with chronic Chagas' heart disease, evaluated by cardiopulmonary testing.

    Science.gov (United States)

    Fialho, Paloma Hargreaves; Tura, Bernardo Rangel; Sousa, Andréa Silvestre de; Oliveira, Claudia Rosa de; Soares, Carla Cristiane Santos; Oliveira, Juliana Rega de; Souza, Marcus Vinícius; Coelho, Marina Pereira; Souza, Fernando César de Castro e; Cunha, Ademir Batista da; Kopiler, Daniel Arkader

    2012-01-01

    Despite all efforts to restrict its transmission, Chagas' disease remains a severe public health problem in Latin America, affecting 8-12 million individuals. Chronic Chagas' heart disease, the chief factor in the high mortality rate associated with the illness, affects more than half a million Brazilians. Its evolution may result in severe heart failure associated with loss of functional capacity and quality of life, with important social and medical/labor consequences. Many studies have shown the beneficial effect of regular exercise on cardiac patients, but few of them have focused on chronic Chagas' heart disease. This study evaluated the effects of an exercise program on the functional capacity of patients with chronic Chagas' disease who were treated in outpatient clinics at the Evandro Chagas Institute of Clinical Research and the National Institute of Cardiology, Rio de Janeiro, Brazil. The exercises were performed 3 times a week for 1 h (30 min of aerobic activity and 30 min of resistance exercises and extension) over 6 months in 2010. Functional capacity was evaluated by comparing the direct measurement of the O₂ uptake volume (VO₂) obtained by a cardiopulmonary exercise test before and after the program (p maximum ages of 30 and 72 years, respectively. We observed an average increase of VO(2peak) > 10% (p = 0.01949). The results suggest a statistically significant improvement in functional capacity with regular exercise of the right intensity.

  7. Characteristics, quality of care, and in-hospital outcomes of Asian-American heart failure patients: Findings from the American Heart Association Get With The Guidelines-Heart Failure Program.

    Science.gov (United States)

    Qian, Feng; Fonarow, Gregg C; Krim, Selim R; Vivo, Rey P; Cox, Margueritte; Hannan, Edward L; Shaw, Benjamin A; Hernandez, Adrian F; Eapen, Zubin J; Yancy, Clyde W; Bhatt, Deepak L

    2015-01-01

    Because little was previously known about Asian-American patients with heart failure (HF), we compared clinical profiles, quality of care, and outcomes between Asian-American and non-Hispanic white HF patients using data from the American Heart Association Get With The Guidelines-Heart Failure (GWTG-HF) program. We analyzed 153,023 HF patients (149,249 whites, 97.5%; 3774 Asian-Americans, 2.5%) from 356 U.S. centers participating in the GWTG-HF program (2005-2012). Baseline characteristics, quality of care metrics, in-hospital mortality, discharge to home, and length of stay were examined. Relative to white patients, Asian-American HF patients were younger, more likely to be male, uninsured or covered by Medicaid, and recruited in the western region. They had higher prevalence of diabetes, hypertension, and renal insufficiency, but similar ejection fraction. Overall, Asian-American HF patients had comparable quality of care except that they were less likely to receive aldosterone antagonists at discharge (relative risk , 0.88; 95% confidence interval , 0.78-0.99), and anticoagulation for atrial fibrillation (RR, 0.91; 95% CI, 0.85-0.97) even after risk adjustment. Compared with white patients, Asian-American patients had comparable risk adjusted in-hospital mortality (RR, 1.11; 95% CI, 0.91-1.35), length of stay>4 days (RR, 1.01; 95% CI, 0.95-1.08), and were more likely to be discharged to home (RR, 1.08; 95% CI, 1.06-1.11). Despite some differences in clinical profiles, Asian-American patients hospitalized with HF receive very similar quality of care and have comparable health outcomes to their white counterparts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. All Eyes on Iran

    DEFF Research Database (Denmark)

    Elling, Rasmus Christian

    2009-01-01

    Review Article. I artiklen anmeldes fem nye bøger om Irans præsident Ahmadinejad og om den Islamiske Republiks atomprogram. Udgivelsesdato: 1/10......Review Article. I artiklen anmeldes fem nye bøger om Irans præsident Ahmadinejad og om den Islamiske Republiks atomprogram. Udgivelsesdato: 1/10...

  9. Healthy Bread Initiative: Methods, Findings, and Theories—Isfahan Healthy Heart Program

    Science.gov (United States)

    Talaei, Mohammad; Khaje, Mohammad-Reza; Sarrafzadegan, Nizal; Sajjadi, Firoozeh; Alikhasi, Hasan; Maghroun, Maryam; Iraji, Farhad; Ehteshami, Shahram

    2013-01-01

    The scientific evidences show that the content, baking methods, and types of bread can make health impacts. Bread, as a major part of Iranian diet, demonstrates a significant potential to be targeted as health promotion subject. Healthy Food for Healthy Communities (HFHC) was a project of Isfahan Healthy Heart Program (IHHP), consisting of a wide variety of strategies, like Healthy Bread (HB) Initiative. The HB Initiative was designed to improve the behaviour of both producers and consumers, mainly aiming at making high-fibre, low-salt bread, eliminating the use of baking soda, providing enough rest time for dough before baking (at least one hour), and enough baking time (at least one minute in oven). A workshop was held for volunteer bakers, and a baker-to-baker training protocol under direct supervision was designed for future volunteers. Cereal Organization was persuaded to provide less refined flour that contained more bran. Health messages in support of new breads were disseminated by media and at bakeries by health professionals. Evaluation of the HB Initiative was done using before-after assessments and population surveys. While HB was baked in 1 (0.01%) bakery at baseline, 402 (41%) bakeries in the intervention area joined the HB Initiative in 2009. Soda was completely eliminated and fibre significantly increased from 4±0.4 g% before study to 12±0.6 g% after the intervention (p<0.001). The preparation and baking times remarkably increased. Wastage of bread decreased from 13±1.8 g% to 2±0.5 g% and was expressed as the most important advantage of this initiative by consumers. People who lived in Isfahan city consumed whole bread 6 times more than those who lived in reference area Arak (p<0.001). The HB Initiative managed to add new breads as a healthy choice that were compatible with local dishes and made a model to solve the long-standing problems of bread. It used various health promotion approaches but was best consistent with Beattie's model. PMID

  10. The effectiveness of loyalty rewards to promote the use of an Internet-based heart health program.

    Science.gov (United States)

    Liu, Sam; Hodgson, Corinne; Zbib, Ahmad M; Payne, Ada Y M; Nolan, Robert P

    2014-07-02

    Internet-based health programs have been shown to be effective in reducing risk for cardiovascular disease. However, their rates of enrollment and engagement remain low. It is currently unclear whether rewards from established loyalty programs can serve as a conditioned stimulus to improve the use of a freely available Internet-based program. The objectives of the study were to (1) examine enrollment rates and levels of engagement with the My Health eSupport program between a Conditioned Reward group and a Control group, and (2) investigate the influence of loyalty rewards and participant characteristics on levels of enrollment and program engagement. The study sample (n=142,726) consisted of individuals who were offered enrollment in an Internet-based health intervention (My Health eSupport) after completing the Heart&Stroke Risk Assessment on the Heart and Stroke Foundation website. My Health eSupport programs provided encouragement and tips for lifestyle change. This is a free, self-guided, fully automated program that proactively delivers tailored email messages at 2-week intervals based on the participant's stage of motivational "readiness" and priority for lifestyle change. Participants in the Conditioned Reward group were offered a single exposure of 20 loyalty reward points from the Air Miles loyalty program for completing the Heart&Stroke Risk Assessment (10 reward points) and enrolling in the Internet-based program (10 reward points). Meanwhile, no rewards were given to the Control group participants. All data were collected between February 1, 2011 and February 10, 2012. In total, 51.38% (73,327/142,726) of individuals in the Conditioned Reward group and 48.62% (69,399/142,726) of individuals in the Control group completed the Heart&Stroke Risk Assessment. Subsequently, significantly more individuals from the Conditioned Reward group (52.96%, 38,835/73,327) enrolled in the My Health eSupport program than Controls (4.07%, 2826/69,399). Regression analyses

  11. HerzMobil Tirol network: rationale for and design of a collaborative heart failure disease management program in Austria.

    Science.gov (United States)

    Von der Heidt, Andreas; Ammenwerth, Elske; Bauer, Karl; Fetz, Bettina; Fluckinger, Thomas; Gassner, Andrea; Grander, Willhelm; Gritsch, Walter; Haffner, Immaculata; Henle-Talirz, Gudrun; Hoschek, Stefan; Huter, Stephan; Kastner, Peter; Krestan, Susanne; Kufner, Peter; Modre-Osprian, Robert; Noebl, Josef; Radi, Momen; Raffeiner, Clemens; Welte, Stefan; Wiseman, Andreas; Poelzl, Gerhard

    2014-11-01

    Heart failure (HF) is approaching epidemic proportions worldwide and is the leading cause of hospitalization in the elderly population. High rates of readmission contribute substantially to excessive health care costs and highlight the fragmented nature of care available to HF patients. Disease management programs (DMPs) have been implemented to improve health outcomes, patient satisfaction, and quality of life, and to reduce health care costs. Telemonitoring systems appear to be effective in the vulnerable phase after discharge from hospital to prevent early readmissions. DMPs that emphasize comprehensive patient education and guideline-adjusted therapy have shown great promise to result in beneficial long-term effects. It can be speculated that combining core elements of the aforementioned programs may substantially improve long-term cost-effectiveness of patient management.We introduce a collaborative post-discharge HF disease management program (HerzMobil Tirol network) that incorporates physician-controlled telemonitoring and nurse-led care in a multidisciplinary network approach.

  12. Financial implications of a model heart failure disease management program for providers, hospital, healthcare systems, and payer perspectives.

    Science.gov (United States)

    Whellan, David J; Reed, Shelby D; Liao, Lawrence; Gould, Stuart D; O'connor, Christopher M; Schulman, Kevin A

    2007-01-15

    Although heart failure disease management (HFDM) programs improve patient outcomes, the implementation of these programs has been limited because of financial barriers. We undertook the present study to understand the economic incentives and disincentives for adoption of disease management strategies from the perspectives of a physician (group), a hospital, an integrated health system, and a third-party payer. Using the combined results of a group of randomized controlled trials and a set of financial assumptions from a single academic medical center, a financial model was developed to compute the expected costs before and after the implementation of a HFDM program by 3 provider types (physicians, hospitals, and health systems), as well as the costs incurred from a payer perspective. The base-case model showed that implementation of HFDM results in a net financial loss to all potential providers of HFDM. Implementation of HFDM as described in our base-case analysis would create a net loss of US dollars 179,549 in the first year for a physician practice, US dollars 464,132 for an integrated health system, and US dollars 652,643 in the first year for a hospital. Third-party payers would be able to save US dollars 713,661 annually for the care of 350 patients with heart failure in a HFDM program. In conclusion, although HFDM programs may provide patients with improved clinical outcomes and decreased hospitalizations that save third-party payers money, limited financial incentives are currently in place for healthcare providers and hospitals to initiate these programs.

  13. Cost-effectiveness of a transitional home-based palliative care program for patients with end-stage heart failure.

    Science.gov (United States)

    Wong, Frances Kam Yuet; So, Ching; Ng, Alina Yee Man; Lam, Po-Tin; Ng, Jeffrey Sheung Ching; Ng, Nancy Hiu Yim; Chau, June; Sham, Michael Mau Kwong

    2018-02-01

    Studies have shown positive clinical outcomes of specialist palliative care for end-stage heart failure patients, but cost-effectiveness evaluation is lacking. To examine the cost-effectiveness of a transitional home-based palliative care program for patients with end-stage heart failure patients as compared to the customary palliative care service. A cost-effectiveness analysis was conducted alongside a randomized controlled trial (Trial number: NCT02086305). The costs included pre-program training, intervention, and hospital use. Quality of life was measured using SF-6D. The study took place in three hospitals in Hong Kong. The inclusion criteria were meeting clinical indicators for end-stage heart failure patients including clinician-judged last year of life, discharged to home within the service area, and palliative care referral accepted. A total of 84 subjects (study = 43, control = 41) were recruited. When the study group was compared to the control group, the net incremental quality-adjusted life years gain was 0.0012 (28 days)/0.0077 (84 days) and the net incremental costs per case was -HK$7935 (28 days)/-HK$26,084 (84 days). The probability of being cost-effective was 85% (28 days)/100% (84 days) based on the cost-effectiveness thresholds recommended both by National Institute for Health and Clinical Excellence (£20,000/quality-adjusted life years) and World Health Organization (Hong Kong gross domestic product/capita in 2015, HK$328117). Results suggest that a transitional home-based palliative care program is more cost-effective than customary palliative care service. Limitations of the study include small sample size, study confined to one city, clinic consultation costs, and societal costs including patient costs and unpaid care-giving costs were not included.

  14. Evaluating the Fabreville Heart Health Program in Laval, Canada: a dialogue between two paradigms, positivism and constructivism.

    Science.gov (United States)

    Nguyen, Minh Nguyet; Otis, Joanne

    2003-06-01

    As part of the Canadian Federal-Provincial Initiative in Heart Health, the goal of the Fabreville Heart Health Program was to sensitize a district of Laval, Quebec's second most populous city, to heart-healthy behaviours. The program was planned and implemented by a committee composed of Fabreville community leaders and professionals from the Public Health Department. Between 1992 and 1994, intervention objectives were defined by the department in terms of changing individual behaviours associated with cardiovascular risk factors, namely diet, sedentariness and smoking, as well as adapting physical and social environments to facilitate these changes. However, from 1994 to its conclusion in 1997, the program was re-oriented to engage the population in mobilizing their own community and taking charge of interventions themselves. Actions then became dependent on the interests and motivation of Fabreville residents to transform their lifestyles and aspects of their physical environment. The initial evaluation process, based on the positivist paradigm, was designed to measure changes in individual behaviours and certain physical environments, such as an increase in designated non-smoking areas. However, following the re-orientation towards community mobilization, it was decided that evaluation should go beyond the professional production of data to include a process of the collective construction of knowledge. Evaluation methodology then became based on the constructivist paradigm. Yet field constraints such as lack of community involvement in both leadership and process evaluation, and the need to ensure evaluation standards and fulfil sponsor obligations, compelled the Public Health Department to return to using a certain number of positivist methods. The ensuing inter-paradigm dialogue helped broaden the scope of evaluation and contributed to gaining a more in-depth understanding of the processes and outcomes of community mobilization.

  15. The effect of the cardiac rehabilitation program on obese and non-obese females with coronary heart disease

    Directory of Open Access Journals (Sweden)

    Fatemeh Esteki Ghashghaei

    2012-01-01

    Full Text Available Introduction: Obesity is strongly associated with coronary heart disease and it is known as an independent risk factor. So, the aim of this study was to investigate the effects of phase II comprehensive cardiac rehabilitation program on obesity indexes, functional capacity, lipid profiles, and fasting blood sugar in obese and non-obese female patients with coronary heart disease and to compare changes in these groups. Materials and Methods: Two hundred and five women with coronary heart disease participated in our study. At the beginning of study, body mass index, functional capacity, and lipid profiles and fasting blood sugar were evaluated; then, these patients were divided into two groups, patients who had BMI≥30 were known as obese and who had BMI<30 were known as non-obese patients. All of them completed the period of cardiac rehabilitation program, and 2 months later, all risk factors were examined for the second time in each group. Data were analyzed with SPSS software version 15. For comparing the mean of outcomes, independent t-tests and paired t-tests were used. Results: Data revealed that unless in weight (P=0.00 and functional capacity (P=0.001, there were no significant differences in obese and non-obese female patients, at baseline. As a result of the cardiac rehabilitation program, both groups had significant improvement in functional capacity (P=0.00, weight reduction (P=0.00, triglyceride (P=0.01 and P=0.02, respectively, low-density lipoprotein cholesterol (P=0.01, and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (P=0.00 and P=0.003, respectively. As well, significant improvement was observed in high-density lipoprotein (P=0.01 only in obese female, and non-obese female had significant differences in total cholesterol (P=0.003. However, there were not significant changes in total cholesterol (P=0.05 and fasting blood sugar (P=0.09 in obese female. Also, non-obese females didn′t have

  16. Short-term outcomes following implementation of a dedicated young adult congenital heart disease transition program.

    Science.gov (United States)

    Vaikunth, Sumeet S; Williams, Roberta G; Uzunyan, Merujan Y; Tun, Han; Barton, Cheryl; Chang, Philip M

    2018-01-01

    Transition from pediatric to adult care is a critical time for patients with congenital heart disease. Lapses in care can lead to poor outcomes, including increased mortality. Formal transition clinics have been implemented to improve success of transferring care from pediatric to adult providers; however, data regarding outcomes remain limited. We sought to evaluate outcomes of transfer within a dedicated transition clinic for young adult patients with congenital heart disease. We performed a retrospective analysis of all 73 patients seen in a dedicated young adult congenital heart disease transition clinic from January 2012 to December 2015 within a single academic institution that delivered pediatric and adult care at separate children's and adult hospitals, respectively. Demographic characteristics including congenital heart disease severity, gender, age, presence of comorbidities, presence of cardiac implantable electronic devices, and type of insurance were correlated to success of transfer. Rate of successful transfer was evaluated, and multivariate analysis was performed to determine which demographic variables were favorably associated with transfer. Thirty-nine percent of patients successfully transferred from pediatric to adult services during the study period. Severe congenital heart disease (OR 4.44, 95% CI 1.25-15.79, P = .02) and presence of a cardiac implantable electronic device (OR 4.93, 95% CI 1.18-20.58, P = .03) correlated with transfer. Trends favoring successful transfer with presence of comorbidities and private insurance were also noted. Despite a dedicated transition clinic, successful transfer rates remained relatively low though comparable to previously published rates. Severity of disease and presence of implantable devices correlated with successful transfer. Other obstacles to transfer remain and require combined efforts from pediatric and adult care systems, insurance carriers, and policy makers to improve transfer outcomes.

  17. Women's Heart Disease: Join the Heart Truth Community

    Science.gov (United States)

    ... Feature: Women's Heart Disease Join The Heart Truth Community Past Issues / Winter 2014 Table of Contents National ... Heart Truth ®, in partnership with many national and community organizations. The program's goal is to raise awareness ...

  18. Exploring the effectiveness of a computer-based heart rate variability biofeedback program in reducing anxiety in college students.

    Science.gov (United States)

    Henriques, Gregg; Keffer, Steven; Abrahamson, Craig; Horst, S Jeanne

    2011-06-01

    Given the pervasiveness of stress and anxiety in our culture it is important to develop and implement interventions that can be easily utilized by large numbers of people that are readily available, inexpensive and have minimal side effects. Two studies explored the effectiveness of a computer-based heart rate variability biofeedback program on reducing anxiety and negative mood in college students. A pilot project (n = 9) of highly anxious students revealed sizable decreases in anxiety and negative mood following utilizing the program for 4 weeks. A second study (n = 35) employing an immediate versus delayed treatment design replicated the results, although the magnitude of the impact was not quite as strong. Despite observing decreases in anxiety, the expected changes in psychophysiological coherence were not observed.

  19. Great Sensations: A Program to Encourage Heart Healthy Snacking by High School Students.

    Science.gov (United States)

    Simons-Morton, Bruce G.; And Others

    1984-01-01

    Classroom instruction, parent outreach, and media campaigns were strategies used by the Great Sensations program, designed to teach high school students good snacking habits. The program focused on salt and high blood pressure. Program design and results are discussed. (Author/DF)

  20. A randomized controlled trial to assess effectiveness of a nurse-led home-based heart failure management program

    Directory of Open Access Journals (Sweden)

    Mamata Rai

    2017-01-01

    Full Text Available Introduction: The burden of cardiovascular disease is increasing in India. It is a chronic condition, and poor management can increase the risk and frequency of acute episodes resulting in poor quality of life (QOL, frequent hospital admissions, and mortality. Disease management programs can improve medication adherence and patient's QOL. Objective: The aim of this study is to assess the effectiveness of nurse-led home-based heart failure management program (HOME-N. Materials and Methods: This randomized controlled trial was conducted among fifty outpatient heart failure (HF patients visiting a tertiary care hospital. The control group received usual routine care, whereas the experimental group received HOME-N, which included formal health teaching, a HF checklist (Hriday card, telemonitoring of vital parameters (blood pressure, heart rate, and weight weekly through a mobile application named as “Dhadkan” and telephonic follow-up for 3 months. Kansas City Cardiomyopathy Questionnaire (KCCQ and adherence to refills and medications scale were used to assess QOL and drug adherence, respectively, in the study patients. The outcome measures were the QOL, drug compliance, hospitalization, and mortality rate. Results: At baseline, the demographic and morbidity profile, and QOL and drug compliance scores of both groups were comparable. After intervention, the QOL domain score of KCCQ as well as drug compliance improved significantly both within the experimental group (P = 0.001, P = 0.001 and as compared to control group (P = 0.001, P = 0.004, respectively. Conclusion: The HOME-N was significantly effective in improving QOL and drug compliance in HF patients.

  1. Optimal Cropping Pattern Based on Multiple Economic, Regional, and Agricultural Sustainability Criteria in Sari, Iran: Application of a Consolidated Model of AHP and Linear Programming

    Directory of Open Access Journals (Sweden)

    E. Fallahi

    2016-10-01

    Full Text Available Introduction: Determining a suitable cropping pattern is an important task for planners and requires an exact and realistic decision-making process based on several goals and criteria corresponding to secure the interest of agricultural beneficiaries in long-term. Accordingly, this study reviews the current pattern operated by farmers in Sari, Iran, and intends to provide a cropping pattern that considers the multifold regional and agricultural sustainability criteria along with economic considerations. Materials and Methods: In order to achieve the study goals, a consolidated model of AHP and Linear Programming was applied. For this purpose, we constructed a three-level AHP, including a goal (determining the weight of each crop, seven criteria, and seven alternatives. Profitability, compatibility with regional and geographical conditions, water consumption, environmental effects of cropping, job creation opportunities, skill and proficiency required for producing a crop, and risk taken to cultivate a crop were considered as the criteria in the model. Seven alternative crops including rice, wheat, rapeseed, barley, soybean, clover, and vegetables were considered too. The next step is determining the weight of each criterion with regard to the goal and the weight of each alternative with regard to each criteria. By multiplying these weights, final weights for various crops were obtained from the model. Derived weights for each crop were then applied as objective function coefficients in the Linear Programming model and the model was solved subject to the constraints. Results and Discussion: Optimal cropping pattern determined based on the consolidated model of AHP and Linear Programming and the results compared to a scenario that only looks forward to maximizing the economic interests. Due to the low profitability of rapeseed and barley, these crops eliminated from the pattern in the profit-maximizing scenario. According to the results, the

  2. Outcomes of a multi-community hypertension implementation study: the American Heart Association's Check. Change. Control. program.

    Science.gov (United States)

    Anderson, Monique L; Peragallo Urrutia, Rachel; O'Brien, Emily C; Allen LaPointe, Nancy M; Christian, Alexander J; Kaltenbach, Lisa A; Webb, Laura E; Alexander, Angel M; Saha Chaudhuri, Paramita; Crawford, Juliana; Wayte, Patrick; Peterson, Eric D

    2017-05-01

    Single-site, intensive, community-based blood pressure (BP) intervention programs have led to BP improvements. The authors examined the American Heart Association's Check. Change. (CCC) program (4069 patients/18 cities) to determine whether BP interventions can effectively be scaled to multiple communities, using a simplified template and local customization. Effectiveness was evaluated at each site via site percent enrollment goals, participant engagement, and BP change from first to last measurement. High-enrolling sites frequently recruited at senior residential institutions and service organizations held hypertension management classes and utilized established and new community partners. High-engagement sites regularly held hypertension education classes and followed up with participants. Top-performing sites commonly distributed BP cuffs, checked BP at engagement activities, and trained volunteers. CCC demonstrated that simplified community-based hypertension intervention programs may lead to BP improvements, but there was high outcomes variability among programs. Several factors were associated with BP improvement that may guide future program development. ©2017 Wiley Periodicals, Inc.

  3. Heart Rate and Perceived Exertion in Healthy Weight and Obese Children During a Self-Selected Physical Activity Program.

    Science.gov (United States)

    Tompkins, Connie L; Flanagan, Timothy; Lavoie, John; Brock, David W

    2015-07-01

    Compared with structured/organized activities, unstructured, self-selected physical activity (PA) may be more appealing for children in particular obese (OB) children. We examined whether both healthy-weight (HW) and OB children would engage in moderate to vigorous intensity PA during an unstructured PA program and compared heart rate (HR) and rate of perceived exertion (RPE) between the children. Twenty-one children [9 OB (≥95th BMI percentile, 12 HW (5th - child wore a Polar E600 HR monitor and was provided a vigorous, age-targeted heart rate (THR) of 70%. Mean HR ≥ vigorous THR for all children in 65.3% of the sessions and exceeded moderate intensity in 100%. Over the 18-weeks, no significant difference was observed in the overall mean HR between the HW (171.4 ± 12.0) and OB (169.3 ± 13.0), however the OB reported significantly lower RPEs than the HW (16.9 ± 2.6 vs. 17.6 ± 1.5, respectively; P programs.

  4. Iran approaches CERN

    CERN Multimedia

    2002-01-01

    Members of Parliament from the Islamic Republic of Iran visit SM18. From left to right : Ali Mojtahed-Shabestari, Deputy Ambassador of the Islamic Republic of Iran in Geneva, Diether Blechschmidt, from CERN, Abdol-Rahim Baharvand and Hossain Amiri, from the Iranian Parliament, Norbert Siegel, from CERN, Hossain Afarideh, Rasool Seddighi and Ahmad Shirzad from the Iranian Parliament. Five members of the Parliament of the Islamic Republic of Iran visited CERN for three days at the beginning of May. All of them have PhD's in Physics, as well as holding their job in politics. They are involved in legislation for science, research and education funding in Iran. Apart from their interest in CERN in general, they were especially attracted to the CMS detector, since an Iranian contribution to the LHC is now starting through a collaboration with the Institute for Studies in Theoretical Physics and Mathematics in Tehran.

  5. Cigarette Smoking in Iran

    OpenAIRE

    Zhand, N; R Ghaletaki; Meysamie, A; Abbasi, M.

    2012-01-01

    Background: Cigarette smoking is the largest preventable cause of death worldwide. No systematic review is available on the situation of the smoking in Iran, so we decided to provide an overview of the studies in the field of smoking in Iranian populations. Methods: Published Persian-language papers of all types until 2009 indexed in the IranMedex (http://www.iranmedex.com) and Magiran (http://www.magiran.com). Reports of World Health Organization were also searched and optionally employed. T...

  6. Antidiabetic Plants of Iran

    OpenAIRE

    Ashrafeddin Goushegir; Fataneh Hashem Dabaghian; Asie Shojaii; Mehri Abdollahi Fard

    2011-01-01

    To identify the antidiabetic plants of Iran, a systematic review of the published literature on the efficacy of Iranian medicinal plant for glucose control in patients with type 2 diabetes mellitus was conducted. We performed an electronic literature search of MEDLINE, Science Direct, Scopus, Proquest, Ebsco, Googlescholar, SID, Cochrane Library Database, from 1966 up to June 2010. The search terms were complementary and alternative medicine (CAM), diabetes mellitus, plant (herb), Iran, patie...

  7. Mortality attributable to excess body mass Index in Iran: Implementation of the comparative risk assessment methodology

    Directory of Open Access Journals (Sweden)

    Shirin Djalalinia

    2015-01-01

    Conclusions: Despite the priority of the problem, there is currently no comprehensive program to prevention or control obesity in Iran. The present results show a growing need to comprehensive implications for national and sub-national health policies and interventional programs in Iran.

  8. Heart Health - Brave Heart

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

  9. A combined aerobic and resistance exercise program improves physical functional performance in patients with heart failure: a pilot study.

    Science.gov (United States)

    Gary, Rebecca A; Cress, M Elaine; Higgins, Melinda K; Smith, Andrew L; Dunbar, Sandra B

    2012-01-01

    Recent guidelines for exercise in patients with heart failure (HF) recommended aerobic and resistance exercise as being safe and effective; however, the clinical and functional significance of these combined training modalities has not been established. In this pilot study, combined aerobic and resistance training was hypothesized to improve physical function, muscle strength, and health-related quality of life (HRQOL) compared with an attention control wait list (ACWL). The 10-item Continuous Scale Physical Functional Performance Test (CS-PFP10), which simulates common household chores; muscle strength (handgrip and knee extension); and HRQOL (Kansas City Cardiomyopathy Questionnaire) were evaluated at baseline (T1) and at 12 weeks (T2). The home-based moderate-intensity walking and resistance training program was performed 5 days a week. Twenty-four New York Heart Association class II to III HF patients (mean [SD] age, 60 [10] years; mean [SD] left ventricular ejection fraction, 25% [9%]) were randomized to a combined aerobic and resistance exercise program or to an ACWL group. Of the total group, 58% were New York Heart Association class III HF patients, 50% were white, and 50% were female. The CS-PFP10 total scores were significantly increased in the exercise group, from 45 (18) to 56 (16). The Kansas City Cardiomyopathy Questionnaire overall summary score was significantly improved (P exercise intervention group compared with the ACWL group. Participants provided the home-based, combined aerobic and resistance exercise program had significantly improved physical function, muscle strength, symptom severity, and HRQOL compared with the ACWL group. The findings of this study must be interpreted cautiously owing to the limitations of a small sample, data collection from a single center, and differences between control and interventions groups at baseline. A combined aerobic and resistance exercise approach may improve physical function in stable HF patients, but

  10. Echinococcosis /hydatidosis in Iran

    Directory of Open Access Journals (Sweden)

    MB Rokni

    2009-05-01

    Full Text Available "nCystic echinococcosis caused by Echinococcus spp. is considered endemic in Iran. To clarify the pre­sent status of hydatidosis in Iran the present review article is presented. Authentic databases and search engines from 1996 onwards were utilized to enquire the situation of the disease in Iran. Human hydati­dosis is responsible for approximately 1% of admission to surgical wards and the rate of human infec­tion is 0.6-1.2/100000. The usual order of involvement, i.e. liver, lung, and other organs, respectively is documented here as well. Risk factors include contact with dog, eating vegetable, geophagy and con­tact with sheep. Dogs play a critical role in transition the hydatidosis. The rate of infec­tion with E. granulo­sus in stray dogs shows a prevalence of 5% to 49% in different parts of Iran. Followed by sheep with 88% fertilized cysts, camel with 70%, and cattle with 19% have been considered as the most important and the weakest intermediate host of E. granulosus, respectively. Molecular analyses clearly indicate that the camel/dog strain (G6 genotype of E. granulosus as well as the cosmopolitan, common sheep strain (G1 genotype occurs in Iran. A wide variety of livestock including sheep, cattle, goat, camel and buffalo also harbor the disease.  E. multilocularis another agent of human hydatidosis (alveolar cyst is reported here as well and from 1946 to 1993, 37 cases of human alveo­lar echinococcosis were reported from northwestern Iran.  Hydatidosis must be consid­ered as a dilemma in Iran because of its endemicity in the country.

  11. Effectiveness of Educational Program Based on the Theory of Reasoned Action to Decrease the Rate of Cesarean Delivery Among Pregnant Women in Fasa, Southern Iran

    Directory of Open Access Journals (Sweden)

    Ali Khan-Jeihooni

    2014-06-01

    Full Text Available Introduction: Cesarean section is considered as a major surgery accompanied by several complications. The present study aimed to determine the effect of educational intervention based on the theory of reasoned action to reduce the rate of cesarean section among pregnant women in Fasa, Southern Iran. Materials and Methods: This quasi-experimental study was performed on 100 (50 participants in each of the control and intervention groups primiparous women in the third trimester of pregnancy admitted to health centers of Fasa city, Fars province, Iran. The data-gathering tool was a multipart questionnaire containing demographic variables and the theory of reasoned action structures. After the pretest, the intervention group underwent exclusive training based on the theory of reasoned action. Then, after 3 months, both groups took part in the posttest. Data was analyzed by paired T-test, independent T-test and chi-square using SPSS-18 software. Results: A significant difference was found between the two groups regarding knowledge, evaluations behavioral outcomes, Behavioral beliefs and intention (P<0.001. Chi-square analysis showed a significant difference between the two groups regarding their performance (P<0.001. Conclusion: The present intervention was effective in increasing the pregnant women’s knowledge, evaluation of outcomes, attitude and strengthening their intention as well as performance. Therefore, it is suggested to use this model and other systematic straining for pregnant women to decrease the rate of cesarean section.

  12. Irritable bowel syndrome in Iran: SEPAHAN systematic review no. 1

    Directory of Open Access Journals (Sweden)

    Pegah Jahangiri

    2012-01-01

    Conclusions: In Iran, the incidence of IBS was in the wide range. Since there are not enough population-based studies, researchers should focus on developing well-designed population-based studies to determine the epidemiology of IBS in Iran. Moreover, cohort studies should be conducted in order to investigate the natural history of IBS. Investigating the etiology of IBS and attempt to organize health promotion programs are highly suggested.

  13. Impact of cardiac rehabilitation and exercise training programs in coronary heart disease.

    Science.gov (United States)

    Kachur, Sergey; Chongthammakun, Vasutakarn; Lavie, Carl J; De Schutter, Alban; Arena, Ross; Milani, Richard V; Franklin, Barry A

    Cardiovascular rehabilitation (CR) is the process of developing and maintaining an optimal level of physical, social, and psychological well-being in order to promote recovery from cardiovascular (CV) illness. It is a multi-disciplinary approach encompassing supervised exercise training, patient counseling, education and nutritional guidance that may also enhance quality of life. Beneficial CV effects may include improving coronary heart disease risk factors; particularly exercise capacity, reversing cardiac remodeling, and favorably modifying metabolism and systemic oxygen transport. We review the historical basis for contemporary CR, the indications and critical components of CR, as well as the potential salutary physiological and clinical effects of exercise-based CR. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Feasibility of Recruiting Families into a Heart Disease Prevention Program Based on Dietary Patterns

    Directory of Open Access Journals (Sweden)

    Tracy L. Schumacher

    2015-08-01

    Full Text Available Offspring of parents with a history of cardiovascular disease (CVD inherit a similar genetic profile and share diet and lifestyle behaviors. This study aimed to evaluate the feasibility of recruiting families at risk of CVD to a dietary prevention program, determine the changes in diet achieved, and program acceptability. Families were recruited into a pilot parallel group randomized controlled trial consisting of a three month evidence-based dietary intervention, based on the Mediterranean and Portfolio diets. Feasibility was assessed by recruitment and retention rates, change in diet by food frequency questionnaire, and program acceptability by qualitative interviews and program evaluation. Twenty one families were enrolled over 16 months, with fourteen families (n = 42 individuals completing the study. Post-program dietary changes in the intervention group included small daily increases in vegetable serves (0.8 ± 1.3 and reduced usage of full-fat milk (−21%, cheese (−12% and meat products (−17%. Qualitative interviews highlighted beneficial changes in food purchasing habits. Future studies need more effective methods of recruitment to engage families in the intervention. Once engaged, families made small incremental improvements in their diets. Evaluation indicated that feedback on diet and CVD risk factors, dietetic counselling and the resources provided were appropriate for a program of this type.

  15. Artificial heart development program. Volume II. System support. Phase III summary report. Period covered: July 1, 1973--September 30, 1977

    Energy Technology Data Exchange (ETDEWEB)

    1977-01-01

    Appendix A covers major activities of the Artificial Heart Development program that supported the design, fabrication, and test of the system demonstration units. Section A.1.0 provides a listing beyond that of the body of the report on the components needed for an implantation. It also presents glove box sterilization calibration results and results of an extensive mock circulation calibration. Section A.2.0 provides detail procedures for assembly, preparing for use, and the use of the system and major components. Section A.3.0 covers the component research and development activities undertaken to improve components of the existing system units and to prepare for a future prototype system. Section A.4.0 provides a listing of the top assembly drawings of the major systems variations fabricated and tested.

  16. Artificial heart development program. Volume II. System support. Phase III summary report, July 1, 1973--September 30, 1977

    Energy Technology Data Exchange (ETDEWEB)

    1977-01-01

    Volume 2 covers major activities of the Artificial Heart Development program that supported the design, fabrication, and test of the system demonstration units. Section A.1.0 provides a listing beyond that of the body of the report on the components needed for an implantation. It also presents glove box sterilization calibration results and results of an extensive mock circulation calibration. Section A.2.0 provides detailed procedures for assembly, preparing for use, and the use of the system and major components. Section A.3.0 covers the component research and development activities undertaken to improve components of the existing system units and to prepare for a future prototype system. Section A.4.0 provides a listing of the top assembly drawings of the major systems variations fabricated and tested.

  17. Anxiety but not depression is associated with metabolic syndrome: The Isfahan healthy heart program

    Directory of Open Access Journals (Sweden)

    Hamed Akbari

    2017-01-01

    Full Text Available Background: Only a few studies have carried out to evaluate the association of depression and anxiety with metabolic syndrome (MetS. The aim of this study was to investigate whether the depression and anxiety are associated with MetS and its different components. Materials and Methods: This cross-sectional study forms part of the prospective Isfahan Cohort Study. A total of 470 participants were chosen. Anxiety and depression symptoms were measured using hospital anxiety and depression scale (HADS. The MetS was diagnosed according to the American Heart Association and National Heart, Lung, and Blood Institute. One-way analysis of variance and binary logistic regression were used. Results: The mean age of participants was 55.7 ± 9.3. The prevalence of MetS in female participants with symptoms of depression (P < 0.0001, concurrent anxiety and depression (P = 0.004, anxiety (P < 0.0001, and asymptomatic individuals (P = 0.001 was significantly different when compared to male participants. Moreover, the analysis showed that having anxiety symptoms is in a negative relationship with MetS (odds ratio [OR] = 0.31; 95% confidence interval [CI] = 0.12–0.78. In addition, with each 10-year increase in age, the probability of MetS will decrease 40% (OR = 0.59; 95%Cl = 0.53–0.72. Body mass index (OR = 1.29; 95%CI = 1.21–1.37, and gender (higher age for women (OR = 0.34; 95%CI = 0.11–0.98 had positive relationship with MetS. Conclusion: The study findings revealed that the prevalence of MetS in patients with anxiety was lower than the healthy subjects, while no significant association was found between depression, concurrent depression, an anxiety with MetS.

  18. The Health Benefits of a 12-Week Home-Based Interval Training Cardiac Rehabilitation Program in Patients With Heart Failure.

    Science.gov (United States)

    Safiyari-Hafizi, Hedieh; Taunton, Jack; Ignaszewski, Andrew; Warburton, Darren E R

    2016-04-01

    Recently, high-intensity interval training has been advocated for the rehabilitation of persons living with heart failure (HF). Home-based training is more convenient for many patients and could augment compliance. However, the safety and efficacy of home-based interval training remains unclear. We evaluated the safety and efficacy of a supervised home-based exercise program involving a combination of interval and resistance training. Measures of aerobic power, endurance capacity, ventilatory threshold, and quality of life in 40 patients with HF, were taken at baseline and after 12 weeks. Patients were matched and randomized to either control (CTL; n = 20) or experimental (EXP; n = 20) conditions. The EXP group underwent a 12-week high-intensity interval and resistance training program while the CTL group maintained their usual activities of daily living. In the EXP group, we found a significant improvement in aerobic power, endurance capacity, ventilatory threshold, and quality of life. There were no significant changes in the CTL group. We have shown that a home-based cardiac rehabilitation program involving interval and resistance training is associated with improved aerobic capacity and quality of life in patients with HF. This research has important implications for the treatment of HF. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  19. Impact of a Telehealth Program With Voice Recognition Technology in Patients With Chronic Heart Failure: Feasibility Study.

    Science.gov (United States)

    Lee, Heesun; Park, Jun-Bean; Choi, Sae Won; Yoon, Yeonyee E; Park, Hyo Eun; Lee, Sang Eun; Lee, Seung-Pyo; Kim, Hyung-Kwan; Cho, Hyun-Jai; Choi, Su-Yeon; Lee, Hae-Young; Choi, Jonghyuk; Lee, Young-Joon; Kim, Yong-Jin; Cho, Goo-Yeong; Choi, Jinwook; Sohn, Dae-Won

    2017-10-02

    Despite the advances in the diagnosis and treatment of heart failure (HF), the current hospital-oriented framework for HF management does not appear to be sufficient to maintain the stability of HF patients in the long term. The importance of self-care management is increasingly being emphasized as a promising long-term treatment strategy for patients with chronic HF. The objective of this study was to evaluate whether a new information communication technology (ICT)-based telehealth program with voice recognition technology could improve clinical or laboratory outcomes in HF patients. In this prospective single-arm pilot study, we recruited 31 consecutive patients with chronic HF who were referred to our institute. An ICT-based telehealth program with voice recognition technology was developed and used by patients with HF for 12 weeks. Patients were educated on the use of this program via mobile phone, landline, or the Internet for the purpose of improving communication and data collection. Using these systems, we collected comprehensive data elements related to the risk of HF self-care management such as weight, diet, exercise, medication adherence, overall symptom change, and home blood pressure. The study endpoints were the changes observed in urine sodium concentration (uNa), Minnesota Living with Heart Failure (MLHFQ) scores, 6-min walk test, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) as surrogate markers for appropriate HF management. Among the 31 enrolled patients, 27 (87%) patients completed the study, and 10 (10/27, 37%) showed good adherence to ICT-based telehealth program with voice recognition technology, which was defined as the use of the program for 100 times or more during the study period. Nearly three-fourths of the patients had been hospitalized at least once because of HF before the enrollment (20/27, 74%); 14 patients had 1, 2 patients had 2, and 4 patients had 3 or more previous HF hospitalizations. In the total study

  20. Heart MRI

    Science.gov (United States)

    Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

  1. Generational Accounting in Iran

    Directory of Open Access Journals (Sweden)

    Mahdi Salehi

    2013-09-01

    Full Text Available The aim of this paper is to study of the generation accounts for Iranian’s generation. We applied the method of Auerbach, Gokhale and Kotlihoff (1991 on the period 1967-2008 in Iran. Our calculation shows with compare to industrial countries, fiscal burden for Iranian’s population is very chip and that depend on fiscal system in Iran. Except the recent years the rate of tax in Iran has been very low. The generation account for the old people (40 olds is 2117 $ but the future generation (t+1 is 36985 $. The share of male and female, during the years, in this burden is similar. Fiscal burden for Iranian’s generation is low but this population should support other burden that calls inflation. Because when the government do not receive the tax income, a low generation account transfer to price general level.

  2. Minorities in Iran

    DEFF Research Database (Denmark)

    Elling, Rasmus Christian

    Contrary to the popular understanding of Iran as a Persian nation, half of the country's population consists of minorities, among whom there has been significant ethnic mobilization at crucial stages in Iranian history. One such stage is now: suppressed minority demands, identity claims, and deba......Contrary to the popular understanding of Iran as a Persian nation, half of the country's population consists of minorities, among whom there has been significant ethnic mobilization at crucial stages in Iranian history. One such stage is now: suppressed minority demands, identity claims......, and debates on diversity have entered public discourse and politics. In 2005–2007, Iran was rocked by the most widespread ethnic unrest experienced in that country since the revolution. The same period was also marked by the re-emergence of nationalism. This interdisciplinary book takes a long-overdue step...

  3. ISFAHAN HEALTHY HEART PROGRAM:A COMPREHENSIVE INTEGRATED COMMUNITY-BASED PROGRAM FOR CARDIOVASCULAR DISEASE PREVENTION AND CONTROL. DESIGN, METHODS AND INITIAL EXPERIENCE 2000-2001

    Directory of Open Access Journals (Sweden)

    N MOHAMMADI FARD

    2002-03-01

    Full Text Available Isfahan Healthy Heart Program (IHHP is a five to six year comprehensive integrated community based program for preventing and controlling of cardiovascular diseases (CVD via reducing CVD risk factors and improvement of cardiovascular healthy behavior in target population. IHHP has been started in 1999 and will be last since 2004. Primary survey was done to collect baseline data from interventional (Isfahan and Najafabad Cities and reference (Arak communities. In a multistage sampling method, we select randomly 5 to 10 percent of households in clusters. Then individuals aged equal or higher than 19 years old were selected for entering to survey. In this way, data from 12600 individuals (6300 in interventional counties and 6300 in reference county was collected and stratified due to their living area (urban vs. rural and different age and sex groups. Cardiovascular risk factors (Hypercholesterolemia, Smoking, Hypertension, Diabetes Mellitus, Obesity were investigated by laboratory tests (Lipid profile, FBS, OGTT, physical exam and standard questionnaires, in all ones. Nutritional habits, socioeconomic states, physical activity profiles and other healthy behaviors regarding to cardiovascular disease were assessed by validated questionnaires via interviewing to all individuals. Twelve leads electrocardiogram was done in all persons older than 35 years old. The prevalence of CVDs and distribution of CVD risk factors were estimated in this phase. In the 2nd phase, based on primary survey findings, we arranged a series of teams (worksite, children, women, health personnel, high risk patients, nutrition for planning and implementation of program through interventional community for a 5-year period. Every team has its own target population and objectives and monitors its process during the study. At intervals (annually, some local and small surveys with a random sampling will be conducted to assess and monitor the program and its potency to cope with

  4. Seasonal Distribution Of Wind In Iran

    Directory of Open Access Journals (Sweden)

    Mokhtar Karami

    2015-08-01

    Full Text Available In this study an attempt has been made to evaluate long-term average variation and fluctuation of Seasonal wind in Iran. For this purpose wind database network was initially formed over Iran. Then data from the base of a 30-year period the daily period of 1011982 to 31122012 was supposed as the basis of the present study and a cell with dimensions of 15 15 km of the studied area was spread. In order to achieve the wind seasonal changes in Iran modern methods of spatial statistics such as Moran global spatial autocorrelation Moran Local insulin index and Hot spots by using of programming in GIS environment were accomplished. The results of this study showed that the spatial distribution of wind in Iran has the cluster pattern. In the meantime based on Moran local index and Hot spots wind patterns in the South South-East East South West and North West have spatial autocorrelation positive pattern and parts of the Caspian Sea coast north and center of the country have negative spatial autocorrelation. During the study period a large part of the country almost half of the total area had a significant pattern or spatial autocorrelation.

  5. Feasibility of recruiting families into a heart disease prevention program based on dietary patterns

    Science.gov (United States)

    Offspring of parents with a history of cardiovascular disease (CVD) inherit a similar genetic profile and share diet and lifestyle behaviors. This study aimed to evaluate the feasibility of recruiting families at risk of CVD to a dietary prevention program, determine the changes in diet achieved, an...

  6. Reducing Children Behavior Problems: A Pilot Study of Tuning in to Kids in Iran

    Directory of Open Access Journals (Sweden)

    Fateme Aghaie Meybodi

    2017-09-01

    Discussion: The Tuning in to Kids program appears to be a promising parenting intervention for mothers and children with disruptive behavior problems, offering a useful addition to usual programs used in Iran.

  7. Artificial heart development program. Volume I. System development. Phase III summary report

    Energy Technology Data Exchange (ETDEWEB)

    1977-01-01

    The report documents efforts and results in the development of the power system portions of a calf implantable model of nuclear-powered artificial heart. The primary objective in developing the implantable model was to solve the packaging problems for total system implantation. The power systems portion is physically that portion of the implantable model between the Pu-238 heat sources and the blood pump ventricles. The work performed had two parallel themes. The first of these was the development of an integrated implantable model for bench and animal experiments plus design effort on a more advanced model. The second was research and development on components of the system done in conjunction with the development of the implantable model and to provide technology for incorporation into advanced models plus support to implantations, at the University of Utah, of the systems blood pumping elements when driven by electric motor. The efforts and results of implantable model development are covered, mainly, in the text of the report. The research and development efforts and results are reported, primarily, in the appendices (Vol. 2).

  8. Heart Truth for Latinas

    Science.gov (United States)

    ... quit and, just one year later, your heart disease risk will drop by more than half. It’s not easy to quit but make a plan and you can do it. Or, try an organized program or ... your risk of heart disease, stroke, and con- gestive heart failure. Even levels ...

  9. The Lucent-Takes-Heart cardiovascular health management program. Successful workplace screening.

    Science.gov (United States)

    Guico-Pabia, Christine J; Cioffi, Laura; Shoner, Lawrence G

    2002-08-01

    This prospective, pre- and post-evaluation of a worksite cardiovascular health management program consisted of employee education, measurement of cardiovascular risk factors, and onsite individual counseling for all employees, along with follow up screening for high risk participants. Of 1,099 employees (16.4% of those eligible) who participated in the initial screening, 596 (54.2%) were classified as high risk. A total of 167 (28.0%) high risk participants completed the 6 month follow up screening. Most high risk participants in the 6 month follow up screening reported they had increased their exercise (64.7%), improved their diet (71.3%), and visited a physician (61.7%). A minority of the participants (16.8%) began new cardiovascular medications, and 2.4% were diagnosed with diabetes. In addition, there were statistically significant decreases in the percentages of participants with elevated systolic blood pressure, diastolic blood pressure, low density lipoprotein cholesterol, and total cholesterol to high density lipoprotein ratio. Almost all (99.7%) of the 909 participants (82.7% of all participants) who completed the satisfaction survey were satisfied or very satisfied with the overall program. Screening in the workplace can identify individuals at high risk for cardiovascular disease. In this study, more than half of the participants were classified as high risk. Most high risk individuals who attended the 6 month follow up screening had improved their cardiovascular health, but attrition remains a challenge for worksite programs.

  10. Iran’s Economy

    Science.gov (United States)

    2008-06-12

    20 Tehran Stock Exchange . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21...privatize nearly 50 state-run oil and gas companies, estimated to be worth $90 billion, by 2014 through the Tehran Stock Exchange . Both domestic and...in order to issue participation papers.80 Tehran Stock Exchange . In 1967, Iran began operating its stock exchange - the Tehran Stock Exchange (TSE

  11. 1990 Northern, Iran Images

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — A magnitude 7.7 earthquake occurred in the Gilan Province between the towns of Rudbar and Manjil in northern Iran on Thursday, June 21, 1990 (June 20 at 21:00 GMT)....

  12. Vil USA angribe Iran?

    DEFF Research Database (Denmark)

    Elling, Rasmus Christian

    2007-01-01

    Sammen med Mogens Lykketoft, Søren Espersen og Herbert Pundik stilles Rasmus Chr. Elling en række spørgsmål om hvordan Vesten bør handle ift. Irans atomenergiprogram og om faren for et amerikansk angreb på den islamiske republik....

  13. Antidiabetic Plants of Iran

    Directory of Open Access Journals (Sweden)

    Ashrafeddin Goushegir

    2011-10-01

    Full Text Available To identify the antidiabetic plants of Iran, a systematic review of the published literature on the efficacy of Iranian medicinal plant for glucose control in patients with type 2 diabetes mellitus was conducted. We performed an electronic literature search of MEDLINE, Science Direct, Scopus, Proquest, Ebsco, Googlescholar, SID, Cochrane Library Database, from 1966 up to June 2010. The search terms were complementary and alternative medicine (CAM, diabetes mellitus, plant (herb, Iran, patient, glycemic control, clinical trial, RCT, natural or herbal medicine, hypoglycemic plants, and individual herb names from popular sources, or combination of these key words. Available Randomized Controlled Trials (RCT published in English or Persian language examined effects of an herb (limited to Iran on glycemic indexes in type 2 diabetic patients were included. Among all of the articles identified in the initial database search, 23 trials were RCT, examining herbs as potential therapy for type 2 diabetes mellitus. The key outcome for antidiabetic effect was changes in blood glucose or HbA1 c, as well as improves in insulin sensitivity or resistance. Available data suggest that several antidiabetic plants of Iran need further study. Among the RCT studies, the best evidence in glycemic control was found in Citrullus colocynthus, Ipomoea betatas, Silybum marianum and Trigonella foenum graecum.

  14. Bam Earthquake in Iran

    CERN Multimedia

    2004-01-01

    Following their request for help from members of international organisations, the permanent Mission of the Islamic Republic of Iran has given the following bank account number, where you can donate money to help the victims of the Bam earthquake. Re: Bam earthquake 235 - UBS 311264.35L Bubenberg Platz 3001 BERN

  15. [Post-operative cardiac rehabilitation programs for early returning to daily life activities: self-measurement of heart rate and blood pressure during staying at home trial].

    Science.gov (United States)

    Nagashio, Mami; Suzuki, Yoshiko; Onishi, Yumiko; Tomatsu, Ayumi; Shimada, Yoko; Okamura, Shizuko; Shirai, Midori

    2003-02-01

    Recently, early mobilization and discharge after cardiac surgery have been recommended. However, many patients are anxious about returning to daily life soon after undergoing heart operations. To resolve this problem, an individualized rehabilitation plan for each patient is important. Rehabilitation programs must estimate the level of cardiac function in daily life. This study evaluated self-measurements of heart rate and blood pressure during home-based exercise training. Thirty-six patients, 28 men and 8 women (mean age 58 +/- 19 years) who underwent cardiac operations were enrolled in this study. None of the patients experienced postoperative complications. Changes in heart rate and blood pressure during daily activities at home were measured by the patients. This data was then used to plan individual rehabilitation programs. The blood pressure rose from 114 +/- 17 to 139 +/- 21 mmHg (mean increase of 25 +/- 15 mmHg) when the patients were asked to walk up and down a set of stairs. Thirteen patients (36%) exhibited an increase in blood pressure of 30 mmHg or more while ascending the stairs. The patients' blood pressure returned to its pre-exercise level after 5 min. The heart rate rose from 84 +/- 15 to 113 +/- 14 beats/min (mean increase of 29 +/- 8 beats/min) during the exercise. During the home-based training period, the maximum blood pressure was 133 +/- 22 mmHg, and the maximum heart rate was 97 +/- 13 beats/min. The patients were very careful during their trial outpatient period, as this was their first post-cardiac surgery experience. Consequently, the degree of exercise at home was even more mild than in hospital. Self-measurement of heart rate and blood pressure was feasible. By referring to these measurements, the patients were able to monitor and increase their level of exercise. This post-cardiac surgery rehabilitation program is helpful for early returning to daily life activities.

  16. The Iranian century: the tension between Iran and the Gulf States

    OpenAIRE

    Al Kaabi, Yousef H.; Al Kaabi, Khaled M.

    2011-01-01

    The Arabian Gulf represents a significant part in the world because of its oil wealth. During the last thirty years, three wars have taken place in the region resulting in regional and global instability: the Iran-Iraq war; the Persian Gulf War of 1990-1991, and the U.S. led invasion of Iraq in 2003. The fall of Iraq made Iran more powerful in the region, and as a domination strategy, Iran launched its nuclear program. Iran represents a major power in the region; it can destabilize the region...

  17. Heart murmurs

    Science.gov (United States)

    Chest sounds - murmurs; Heart sounds - abnormal; Murmur - innocent; Innocent murmur; Systolic heart murmur; Diastolic heart murmur ... The heart has 4 chambers: Two upper chambers (atria) Two lower chambers (ventricles) The heart has valves that close ...

  18. Long-term impact of a chronic disease management program on hospital utilization and cost in an Australian population with heart disease or diabetes.

    Science.gov (United States)

    Hamar, G Brent; Rula, Elizabeth Y; Coberley, Carter; Pope, James E; Larkin, Shaun

    2015-04-22

    To evaluate the longitudinal value of a chronic disease management program, My Health Guardian (MHG), in reducing hospital utilization and costs over 4 years. The MHG program provides individualized support via telephonic nurse outreach and online tools for self-management, behavior change and well-being. In follow up to an initial 18-month analysis of MHG, the current study evaluated program impact over 4 years. A matched-cohort analysis retrospectively compared MHG participants with heart disease or diabetes (treatment, N = 4,948) to non-participants (comparison, N = 28,520) on utilization rates (hospital admission, readmission, total bed days) and hospital claims cost savings. Outcomes were evaluated using regression analyses, controlling for remaining demographic, disease, and pre-program admissions or cost differences between the study groups. Over the 4 year period, program participation resulted in significant reductions in hospital admissions (-11.4%, P costs (and savings) in Australia's risk equalization system for private insurers. Results confirm and extend prior program outcomes and support the longitudinal value of the MHG program in reducing hospital utilization and costs for individuals with heart disease or diabetes and demonstrate the increasing program effect with continued participation over time.

  19. Case Study: Iran, Islam, the NPT, and the Bomb

    Energy Technology Data Exchange (ETDEWEB)

    Saunders, E .

    2011-04-01

    The goals of this case study are: (1) To examine the correlation between Iran's nuclear program and clerical statements; (2) To evaluate the importance of these statements; (3) To understand the relationship between policy and fatwas (Islamic decrees); (4) To address the issue of a 'nuclear fatwa'; and (5) To examine how, if at all, Sharia (Islamic law) has influenced Iran's actions or inactions with respect to the Non-Proliferation Treaty (NPT), the International Atomic Energy Agency (IAEA), and Iran's adherence to its IAEA Safeguards Agreements and the Additional Protocol. The Islamic Republic of Iran (hereinafter Iran) is one of two theocracies in the world, the second being Vatican City. Iran's government derives its constitutional, moral, and political legitimacy from Islam. As a result of this theocratic culture, rules are set and interpreted with a much different calibrator than that of the Western world. Islam affects all aspects of Iranian life. This is further complicated by the fact that Islam is not a nationalistic faith, in that many people all over the world believe in and adhere to Islamic principles. As a result, a political system that derives much of its fervor from being nationalistic is caught between two worlds, one within the land boundaries of Iran and the other within a faith that transcends boundaries. Thus, any understanding of Islamic law must first be understood within this delicate balance of nationalism and transcendence. Iran has found itself on the international stage concerning its nuclear program. Because Iran is a theocratic state, it is imperative to examine its political moves, speeches, rights, and obligations through the lens of Islam. This study will examine how Islam plays a role in Iran's dealing with the International Atomic Energy Agency (IAEA), its understanding of the Nuclear Non-Proliferation Treaty (NPT), including parties obligations under Safeguards Agreements and the Additional

  20. Acute Rheumatic Fever in the North East of Iran: A Study of 80 Cases

    Directory of Open Access Journals (Sweden)

    Saeed Talebi

    2006-08-01

    Full Text Available Background: To evaluate the frequency, clinical presentation and cardiac involvement of children with RF in the North-East of Iran. Methods: A case series analysis was conducted on 80 patients with acute rheumatic fever (ARF, who were hospitalized at Ghaem hospital in Mashad between 1994 and 2000, were studied. Laboratory tests and results from echocardiographic examinations, and clinical findings were analyzed. All patients received standard care for children with ARF. The X2 test was used for comparison of binary data. Results: When compared to similar studies from developed countries, our study demonstrates a decreased frequency of RF in North-East Iran over the past few years. However, it is still a major health problem and the most common cause of acquired heart disease in childhood. The distribution of the major modified Jones criteria in our study is slightly different from that described in the literature, with a higher incidence of carditis. Conclusion: It appears that carditis is endemic in this region. Considering the high morbidity and complications involved in this disease, there is an immediate need for effective preventive programs for the initiating cause streptococcal infections, especially since it is treatable.

  1. High Insecticides Resistance in Culex pipiens (Diptera: Culicidae from Tehran, Capital of Iran

    Directory of Open Access Journals (Sweden)

    Yaser Salim-Abadi

    2016-10-01

    Full Text Available Background: During recent years transmission of Dirofilaria immitis (dog heart worm by Culex pipiens and West Nile virus have been reported from Iran. The present study was preformed for evaluating the susceptibility status of Cx. pipiens collected from capital city of Tehran, Iran.Methods: Four Insecticides including: DDT 4%, Lambdacyhalothrin 0.05%, Deltamethrin 0.05% and Cyfluthrin 0.15 % according to WHO standard  methods were used for evaluating the susceptibility status of Cx. pipiens from Tehran moreover  For comparison susceptibility status a Laboratory strain also was used.  Bioassay data were ana­lyzed using Probit program. The lethal time for 50% and 90% mortality (LT50 and LT90 values were calculated from regression line.Results: The susceptibility status of lab strain of Cx. pipiens revealed that it is susceptible to Lambdacyhalothrin, Deltamethrin, Cyfluthrin and resistant to DDT. Moreover cyfluthrin with LT50=36 seconds and DDT with LT50=3005 seconds had the least and most LT50s. Field population was resistance to all tested insecticides and DDT yielded no mortality.Conclusion: Highly resistance level against all WHO recommended imagicides were detected in field populations. We suggest more biochemical and molecular investigations to detect resistance mechanisms in the field population for further decision of vector control.

  2. Association of Animal and Plant Proteins Intake with Hypertension in Iranian Adult Population: Isfahan Healthy Heart Program.

    Science.gov (United States)

    Mehrabani, Sanaz; Asemi, Mehdi; Najafian, Jamshid; Sajjadi, Firouzeh; Maghroun, Maryam; Mohammadifard, Noushin

    2017-01-01

    There is evidence regarding the relationship between dietary proteins intake and blood pressure (BP), but they had inconsistent results. Therefore, this study was designed to assess the association between different kinds of protein intake (animal and plant protein) and BP. Data were collected from Isfahan Healthy Heart Program. We performed a cross-sectional study among 9660 randomly selected Iranian adults aged ≥19-year-old that they were selected from three large Iranian regions in 2007. A simplified validated 48-item-food frequency questionnaire was used to assess dietary intake including all kinds of protein. Systolic and diastolic BPs were measured in duplicate by trained personnel using a standard protocol. Multivariable regressions were applied to assess the relationship between protein intake and BP levels and the presence of hypertension (HTN). More frequent consumption of animal, plant, and total protein intake were inversely associated with BP in a crude model (P protein (P = 0.04). The risk of HTN occurrence decreased in the highest quintile of total and plant protein consumption by 19% (odds ratio [OR] = 0.81; confidence interval [CI]: [0.65-0.96]; P for trend = 0.004) and 18% (OR = 0.82; [CI: (0.67-0.94]; P for trend = 0.03), respectively. More frequent protein intake, especially plant protein consumption was inversely associated with BP and risk of HTN among Iranian adults.

  3. Risk analysis of coronary heart diseases in Korean adults by using the National Cholesterol Education Program Adult Treatment Panel III.

    Science.gov (United States)

    Lee, Yong-Wha; Min, Won-Ki; Lee, Woochang; Chun, Sail; Park, Hyosoon; Lee, Do-Hoon; Lee, You Kyoung

    2007-01-01

    The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), updated in 2001, quantified the risk factors and made it possible to assess risks for metabolic syndrome (MS) and coronary heart diseases (CHD). Many reported the prevalence of MS by NCEP ATP III in Orientals but few did risk analysis of CHD. We investigated the risk of CHD in Korean adults and the distribution of population for therapeutic lifestyle change (TLC) and drug therapy according to the NCEP ATP III guidelines. Based on ATP III risk factors, estimates of the 10-year risk for CHD on 16,383 Koreans and the distributions of population for the TLC and additional drug therapy by sex and age were calculated. High-, intermediate-, and low-risk groups were 8.1%, 24.1%, and 67.8%, respectively; 12.1% (high-, intermediate-, and low-risk groups: 32.0%, 45.1%, and 6.0%, respectively) needed TLC and 6.1% (high-, intermediate-, and low-risk groups: 39.4%, 16.6%, and 1.3%, respectively) needed additional drug therapy. The groups with higher risk needed more TLC and drug therapy. In the same age group, the rates of high risk in men showed a 1.0-6.6 fold increase compared with those in women. In Koreans, those who needed TLC and drug therapy were substantially lower than those in Americans. (c) 2007 Wiley-Liss, Inc.

  4. Fetal programming as a predictor of adult health or disease: the need to reevaluate fetal heart function.

    Science.gov (United States)

    Miranda, Joana O; Ramalho, Carla; Henriques-Coelho, Tiago; Areias, José Carlos

    2017-11-01

    Epidemiologic and experimental evidence suggests that adverse stimuli during critical periods in utero permanently alters organ structure and function and may have persistent consequences for the long-term health of the offspring. Fetal hypoxia, maternal malnutrition, or ventricular overloading are among the major adverse conditions that can compromise cardiovascular development in early life. With the heart as a central organ in fetal adaptive mechanisms, a deeper understanding of the fetal cardiovascular physiology and of the echocardiographic tools to assess both normal and stressed pregnancies would give precious information on fetal well-being and hopefully may help in early identification of special risk groups for cardiovascular diseases later in life. Assessment of cardiac function in the fetus represents an additional challenge when comparing to children and adults, requiring advanced training and a critical approach to properly acquire and interpret functional parameters. This review summarizes the basic fetal cardiovascular physiology and the main differences from the mature postnatal circulation, provides an overview of the particularities of echocardiographic evaluation in the fetus, and finally proposes an integrated view of in utero programming of cardiovascular diseases later in life, highlighting priorities for future clinical research.

  5. Fetal growth restriction and the programming of heart growth and cardiac insulin-like growth factor 2 expression in the lamb.

    Science.gov (United States)

    Wang, Kimberley C W; Zhang, Lei; McMillen, I Caroline; Botting, Kimberley J; Duffield, Jaime A; Zhang, Song; Suter, Catherine M; Brooks, Doug A; Morrison, Janna L

    2011-10-01

    Reduced growth in fetal life together with accelerated growth in childhood, results in a ~50% greater risk of coronary heart disease in adult life. It is unclear why changes in patterns of body and heart growth in early life can lead to an increased risk of cardiovascular disease in adulthood. We aimed to investigate the role of the insulin-like growth factors in heart growth in the growth-restricted fetus and lamb. Hearts were collected from control and placentally restricted (PR) fetuses at 137-144 days gestation and from average (ABW) and low (LBW) birth weight lambs at 21 days of age. We quantified cardiac mRNA expression of IGF-1, IGF-2 and their receptors, IGF-1R and IGF-2R, using real-time RT-PCR and protein expression of IGF-1R and IGF-2R using Western blotting. Combined bisulphite restriction analysis was used to assess DNA methylation in the differentially methylated region (DMR) of the IGF-2/H19 locus and of the IGF-2R gene. In PR fetal sheep, IGF-2, IGF-1R and IGF-2R mRNA expression was increased in the heart compared to controls. LBW lambs had a greater left ventricle weight relative to body weight as well as increased IGF-2 and IGF-2R mRNA expression in the heart, when compared to ABW lambs. No changes in the percentage of methylation of the DMRs of IGF-2/H19 or IGF-2R were found between PR and LBW when compared to their respective controls. In conclusion, a programmed increased in cardiac gene expression of IGF-2 and IGF-2R may represent an adaptive response to reduced substrate supply (e.g. glucose and/or oxygen) in order to maintain heart growth and may be the underlying cause for increased ventricular hypertrophy and the associated susceptibility of cardiomyocytes to ischaemic damage later in life.

  6. West Nile Virus lineage-2 in Culex specimens from Iran.

    Science.gov (United States)

    Shahhosseini, Nariman; Chinikar, Sadegh; Moosa-Kazemi, Seyed Hassan; Sedaghat, Mohammad Mehdi; Kayedi, Mohammad Hassan; Lühken, Renke; Schmidt-Chanasit, Jonas

    2017-10-01

    Screening of mosquitoes for viruses is an important forecasting tool for emerging and re-emerging arboviruses. Iran has been known to harbour medically important arboviruses such as West Nile virus (WNV) and dengue virus (DENV) based on seroepidemiological data. However, there are no data about the potential mosquito vectors for arboviruses in Iran. This study was performed to provide mosquito and arbovirus data from Iran. A total of 32 317 mosquitos were collected at 16 sites in five provinces of Iran in 2015 and 2016. RT-PCR for detection of flaviviruses was performed. The PCR amplicons were sequenced, and 109 WNV sequences, including one obtained in this study, were used for phylogenetic analyses. The 32 317 mosquito specimens belonging to 25 species were morphologically distinguished and distributed into 1222 pools. Culex pipiens s.l. comprised 56.429%. One mosquito pool (0.08%), containing 46 unfed Cx. pipiens pipiens form pipiens (Cpp) captured in August 2015, was positive for flavivirus RNA. Subsequent sequencing and phylogenetic analyses revealed that the detected Iranian WNV strain belongs to lineage 2 and clusters with a strain recently detected in humans. No flaviviruses other than WNV were detected in the mosquito pools. Cpp could be a vector for WNV in Iran. Our findings indicate recent circulation of WNV lineage-2 strain in Iran and provide a solid base for more targeted arbovirus surveillance programs. © 2017 John Wiley & Sons Ltd.

  7. Cook with Heart-Healthy Foods

    Science.gov (United States)

    ... of Events Wellness Lives Here Awareness Programs Hispanic Heritage Month African American Programs Latino Programs Asian Americans, ... sodium. Patient Education Materials — Protect Your Heart: Make Smart Food Choices This two-page introduction to heart- ...

  8. An after-school dance and lifestyle education program reduces risk factors for heart disease and diabetes in elementary school children.

    Science.gov (United States)

    Hogg, Jeannette; Diaz, Alejandro; Del Cid, Margareth; Mueller, Charles; Lipman, Elizabeth Grace; Cheruvu, Sunita; Chiu, Ya-lin; Vogiatzi, Maria; Nimkarn, Saroj

    2012-01-01

    Forty-three percent of New York City's (NYC) school-age children are overweight or obese, placing them at risk for heart disease and type 2 diabetes mellitus (T2DM). The objective of this study was to determine if an intensive after-school dance and lifestyle education program would reduce risk factors for heart disease, T2DM, and improve lifestyle choices. Subject include 64 fourth- and fifth-grade students at an elementary school in NYC. Students received freestyle dance and lifestyle classes for 16 weeks and were evaluated for changes in body composition, endurance, biochemical measurements, and lifestyle choices. Significant improvements in BMI percentiles were found among children in the overweight and obese categories as well as in endurance and biochemical measurements that reflect heart disease and diabetes risk. Improvement was also reported in lifestyle choices. An intensive after-school dance and lifestyle education program can reduce risk factors for heart disease and T2DM and improve lifestyle choices among elementary school children.

  9. [Individualization of exercise load control for inpatient cardiac rehabilitation. Development and evaluation of a HRV-based intervention program for patients with ischemic heart failure].

    Science.gov (United States)

    Behrens, K; Hottenrott, K; Weippert, M; Montanus, H; Kreuzfeld, S; Rieger, A; Lübke, J; Werdan, K; Stoll, R

    2015-03-01

    The effective use of rehabilitation programs is of primary importance in order to improve the physical performance of cardiac disease patients. A modular program has been developed which is intended to structure and individualize conventional, exercise-based rehabilitation programs according to the individual needs and physical condition of each patient. The individualization of the program is based on detailed diagnostics before patients enter the program and daily measurements of heart rate variability (HRV) during cardiac rehabilitation. A total of 30 patients with ischemic heart disease were randomly assigned either to the intervention group (IG), completing the modular individualized rehabilitation program [n=15, mean age 54.4±4.2 years and mean left ventricular ejection fraction (LVEF) 28.53±6.25%) or to the control group (CG) taking part in the conventional rehabilitation program (n=15, mean age 56.4±4.4 years and mean LVEF 27.63±5.62). Before and after the intervention, cardiorespiratory fitness was assessed by measurement of maximal oxygen consumption (relative VO2max) during bicycle ergometry and the 6-minute walk test (6-MWT). Pre-post comparisons of cardiorespiratory fitness indicators were used to evaluate the effectiveness of the rehabilitation program. In addition to the results of the basic clinical investigations and the cardiorespiratory testing, results of standardized HRV measurements of 10 min at morning rest served as criteria for program individualization. The relative VO2max increased significantly (pmaximum power output during bicycle ergometry (pmaximum performance matrix in cardiac rehabilitation. Individualization should be based on clinical and performance diagnostics before and accompanying assessments of training condition, e.g. by HRV measurements, during rehabilitation programs. Each patient should only perform those intervention programs which match the results of the basic clinical investigation and additional analyses during

  10. Iran’s Economy

    Science.gov (United States)

    2008-08-22

    to subsidies, President Ahmadinejad has handed out cash to the needy. The government has provided low-interest loans for agriculture, tourism , and... tourism . Since 1991, the MJF has invested in energy, business, engineering, and agricultural activities in Europe, Russia, Asia, the Middle East, and...supply gas to Switzerland for the foreseeable future because no pipeline connects Iran to Europe at present. In April 2007, OMV, the Austrian partially

  11. Conceiving IVF in Iran

    Directory of Open Access Journals (Sweden)

    Soraya Tremayne

    2016-06-01

    Full Text Available Since the 19th century the Iranian state has been concerned with the size of its population, and policies directed to its increase or decrease have been closely involved with the purpose of nation building. None of these policies have been particularly successful, except for the effective family planning campaign of the 1980s that led to a remarkable drop in population growth, which currently stands at 1.3 per annum, below the replacement level. However, all the policies have failed to address the issue of infertility, which is widespread in Iran. It was against the background of such oversight that, from 1987, some pioneering physicians introduced IVF practices to the country and engaged with the Islamic jurists, whose endorsement of infertility treatment through IVF was deemed crucial to give the practices legitimacy. This article explores the process by which assisted reproductive technologies were legitimized in Iran in all their forms and which have placed the country in the lead among the Muslim countries in the Middle East in this respect. Within Iran, following the state’s latest pronatalist policies, assisted reproductive technologies have been acknowledged as a means to help the state meet its new ambition of higher population growth.

  12. Effect of an office worksite-based yoga program on heart rate variability: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Chang Dennis

    2011-07-01

    Full Text Available Abstract Background Chronic work-related stress is a significant and independent risk factor for cardiovascular and metabolic diseases and associated mortality, particularly when compounded by a sedentary work environment. Heart rate variability (HRV provides an estimate of parasympathetic and sympathetic autonomic control, and can serve as a marker of physiological stress. Hatha yoga is a physically demanding practice that can help to reduce stress; however, time constraints incurred by work and family life may limit participation. The purpose of the present study is to determine if a 10-week, worksite-based yoga program delivered during lunch hour can improve resting HRV and related physical and psychological parameters in sedentary office workers. Methods and design This is a parallel-arm RCT that will compare the outcomes of participants assigned to the experimental treatment group (yoga to those assigned to a no-treatment control group. Participants randomized to the experimental condition will engage in a 10-week yoga program delivered at their place of work. The yoga sessions will be group-based, prescribed three times per week during lunch hour, and will be led by an experienced yoga instructor. The program will involve teaching beginner students safely and progressively over 10 weeks a yoga sequence that incorporates asanas (poses and postures, vinyasa (exercises, pranayama (breathing control and meditation. The primary outcome of this study is the high frequency (HF spectral power component of HRV (measured in absolute units; i.e. ms2, a measure of parasympathetic autonomic control. Secondary outcomes include additional frequency and time domains of HRV, and measures of physical functioning and psychological health status. Measures will be collected prior to and following the intervention period, and at 6 months follow-up to determine the effect of intervention withdrawal. Discussion This study will determine the effect of worksite

  13. Effects of a 14-month low-cost maintenance training program in patients with chronic systolic heart failure: a randomized study

    DEFF Research Database (Denmark)

    Prescott, Eva; Hjardem-Hansen, Rasmus; Dela, Flemming

    2009-01-01

    BACKGROUND: Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning. METHODS: Study base consisted of all patients diagnosed with CHF...... in a 3-year period. Sixty-six patients with systolic CHF (ejection fraction Heart Association II-III) were randomized to 12 months of either usual care orhome-based maintenance exercise with group training sessions every 2 weeks after an initial 8-week training program. The primary endpoint...... was maximum workload; secondary endpoints were 6-min walk test, incremental shuttle walk test, sit-to-stand test, quality of life, and serological markers. RESULTS: Six patients died and 43 completed the study. The initial 8-week training was associated with small but significant improvement in all...

  14. The fetal heart rate collaborative practice project: situational awareness in electronic fetal monitoring-a Kaiser Permanente Perinatal Patient Safety Program Initiative.

    Science.gov (United States)

    MacEachin, S Rachel; Lopez, Connie M; Powell, Kimberly J; Corbett, Nancy L

    2009-01-01

    Electronic fetal monitoring has historically been interpreted with wide variation between and within disciplines on the obstetric healthcare team. This leads to inconsistent decision making in response to tracing interpretation. To implement a multidisciplinary electronic fetal monitoring training program, utilizing the best evidence available, enabling standardization of fetal heart rate interpretation to promote patient safety. Local multidisciplinary expertise along with an outside consultant collaborated over a series of meetings to create a multimedia instructional electronic fetal monitoring training program. After production was complete, a series of conferences attended by nurses, certified nurse midwives, and physician champions, from each hospital, attended to learn how to facilitate training at their own perinatal units. All healthcare personnel across the Kaiser Permanente perinatal program were trained in NICHD nomenclature, emergency response, interpretation guidelines, and how to create local collaborative practice agreements. Metrics for program effectiveness were measured through program evaluations from attendees, the Safety Attitudes Questionnaire. Program evaluations rendered very positive scores from both physicians and clinicians. Comparing baseline to 4 years later, the perception of safety from the staff has increased over 10% in 5 out of the 6 factors analyzed. Active participation from all disciplines in this training series has highlighted the importance of teamwork and communication. The Fetal Heart Rate Collaborative Practice Project continues to evolve utilizing other educational modalities, such as online EFM education and unit-based interdisciplinary tracing reviews.

  15. Astronomy in Iran

    Science.gov (United States)

    Sobouti, Y.

    2006-08-01

    Institute for Advanced Studies in Basic Sciences, Zanjan, Iran In spite of her renowned pivotal role in the advancement of astronomy on the world scale during 9th to 15th centuries, Iran's rekindled interest in modern astronomy is a recent happening. Serious attempts to introduce astronomy into university curricula and to develop it into a respectable and worthwhile field of research began in the mid 60's. The pioneer was Shiraz University. It should be credited for the first few dozens of astronomy- and astrophysics- related research papers in international journals, for training the first half a dozen of professional astronomers and for creating the Biruni Observatory. Here, I take this opportunity to acknowledge the valuable advice of Bob Koch and Ed Guinan, then of the University of Pennsylvania, in the course of the establishment of this observatory. At present the astronomical community of Iran consists of about 65 professionals, half university faculty members and half MS and PhD students. The yearly scientific contribution of its members has, in the past three years, averaged to about 15 papers in reputable international journals, and presently has a healthy growth rate. Among the existing observational facilities, Biruni Observatory with its 51 cm Cassegrain, CCD cameras, photometers and other smaller educational telescopes, is by far the most active place. Tusi Observatory of Tabriz University has 60 and 40 cm Cassegrains, and a small solar telescope. A number of smaller observing facilities exist in Meshed, Zanjan, Tehran, Babol and other places. The Astronomical Society of Iran (ASI), though some 30 years old, has expanded and institutionalized its activities since early 1990's. ASI sets up seasonal schools for novices, organizes annual colloquia and seminars for professionals and supports a huge body of amateur astronomers from among high school and university students. Over twenty of ASI members are also members of IAU and take active part in its

  16. Study protocol for the FITR Heart Study: Feasibility, safety, adherence, and efficacy of high intensity interval training in a hospital-initiated rehabilitation program for coronary heart disease

    Directory of Open Access Journals (Sweden)

    Jenna Taylor

    2017-12-01

    Conclusions: This study aims to address the ongoing concerns regarding the practicality and safety of HIIT in CR programs. We anticipate study findings will lead to the development of a standardized protocol to facilitate CR programs to incorporate HIIT as a standard exercise option for appropriate patients.

  17. Iran, reform, revolution or resignation?; Iran: reforme, revolution ou resignation?

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This document is an information report made by the French commission of economic affairs after a visit of a delegation of members of the French parliament in Iran in April 15-18, 2003. The report describes: 1 - the international political situation of Iran; 2 - the domestic political situation of Iran: political institutions, yearn of change; 3 - the economic trades that would be possible to develop: economic and financial situation of Iran, fossil fuel resources, economic reforms to be implemented; 4 - the French-Iranian economical cooperation to be strengthened: French companies in Iran, towards a new era in bilateral economic relations, the challenge of the adhesion to the world trade organization (WTO). (J.S.)

  18. Celebrities Gather to Fight Heart Disease

    Science.gov (United States)

    ... Current Issue Past Issues Celebrities Gather to Fight Heart Disease Past Issues / Spring 2007 Table of Contents For ... Kit to offer community education programs on women's heart disease. Organize heart-health screening events and health fairs ...

  19. Rationale and design of PICNIC study: nutritional intervention program in hospitalized patients with heart failure who are malnourished.

    Science.gov (United States)

    Gámez-López, Antonio L; Bonilla-Palomas, Juan L; Anguita-Sánchez, Manuel; Moreno-Conde, Mirian; López-Ibáñez, Cristina; Alhambra-Expósito, Rosa; Castillo-Domínguez, Juan C; Villar-Ráez, Antonia; Suárez de Lezo, José

    2014-04-01

    Hospitalized patients with heart failure who are malnourished present a worse prognosis than those with an adequate nutritional status. It is unknown whether a nutritional intervention can modify the prognosis of these patients. The aim of this study is to assess the efficacy of a nutritional intervention on morbidity and mortality in hospitalized patients with heart failure who are malnourished. PICNIC is a multicentre, randomized, controlled trial in which hospitalized patients with heart failure and malnutrition, as defined by the Mini Nutritional Assessment, are randomly assigned to conventional management of heart failure or conventional management of heart failure and an individualized nutritional intervention consisting of 3 points: optimization of diet, specific recommendations, and prescription, if deemed necessary, of nutritional supplements. A sample size of 182 patients for a maximum follow-up of 12 months has been estimated. The primary endpoint is time to death from any cause or rehospitalization because of heart failure. Analysis is by intention to treat. PICNIC study will determine the prognostic impact of a nutritional intervention in hospitalized patients with heart failure who are malnourished. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  20. Association of Animal and Plant Proteins Intake with Hypertension in Iranian Adult Population: Isfahan Healthy Heart Program

    Directory of Open Access Journals (Sweden)

    Sanaz Mehrabani

    2017-01-01

    Full Text Available Background: There is evidence regarding the relationship between dietary proteins intake and blood pressure (BP, but they had inconsistent results. Therefore, this study was designed to assess the association between different kinds of protein intake (animal and plant protein and BP. Materials and Methods: Data were collected from Isfahan Healthy Heart Program. We performed a cross-sectional study among 9660 randomly selected Iranian adults aged ≥19-year-old that they were selected from three large Iranian regions in 2007. A simplified validated 48-item-food frequency questionnaire was used to assess dietary intake including all kinds of protein. Systolic and diastolic BPs were measured in duplicate by trained personnel using a standard protocol. Multivariable regressions were applied to assess the relationship between protein intake and BP levels and the presence of hypertension (HTN. Results: More frequent consumption of animal, plant, and total protein intake were inversely associated with BP in a crude model (P < 0.001; however, after adjustment for potential confounders this relationship remained only for plant protein (P = 0.04. The risk of HTN occurrence decreased in the highest quintile of total and plant protein consumption by 19% (odds ratio [OR] = 0.81; confidence interval [CI]: [0.65–0.96]; P for trend = 0.004 and 18% (OR = 0.82; [CI: (0.67–0.94]; P for trend = 0.03, respectively. Conclusions: More frequent protein intake, especially plant protein consumption was inversely associated with BP and risk of HTN among Iranian adults.

  1. Development and evaluation of a basic physical and sports activity program for preschool children in nursery schools in iran: an interventional study

    National Research Council Canada - National Science Library

    Kordi, Ramin; Nourian, Ruhollah; Ghayour, Mahboubeh; Kordi, Mahboubeh; Younesian, Ali

    2012-01-01

    .... The levels of gross motor development of all subjects were measured before intervention and after 10 weeks physical activity program employing the Test of Gross Motor Development-edition 2 (TGMD-2...

  2. Heart Disease

    Science.gov (United States)

    ... type of heart disease you have. Symptoms of heart disease in your blood vessels (atherosclerotic disease) Cardiovascular disease ... can sometimes be found early with regular evaluations. Heart disease symptoms caused by abnormal heartbeats (heart arrhythmias) A ...

  3. IRAN IN DIE INTERNASIONALE MAGSTRYD

    African Journals Online (AJOL)

    which enjoy significant support in the workforce of the manufacturing and oil industries. Inleiding. The comparison of force is not only ... suide, Afganistan en Pakistan in die ooste be}:lrens. Iran vorm tans 'n buffertussen die ..... sive, militant on oil prices and conservationist in production policy. Ten einde Iran se'posisle in die ...

  4. Natural gas industry in Iran

    Energy Technology Data Exchange (ETDEWEB)

    Omidvar, Hedayat

    2010-09-15

    Iran holds the second largest gas reserves in the word with over 27.5 trillion cubic meters (TCM) of natural gas. Due to lack of geological surveys in certain geographical regions in Iran, it is likely to explore further reserves in the future.

  5. Five Common Cancers in Iran

    NARCIS (Netherlands)

    Kolandoozan, Shadi; Sadjadi, Alireza; Radmard, Amir Reza; Khademi, Hooman

    Iran as a developing nation is in epidemiological transition from communicable to non-communicable diseases. Although, cancer is the third cause of death in Iran, ifs mortality are on the rise during recent decades. This mini-review was carried out to provide a general viewpoint on common cancers

  6. Effectiveness and Factors Determining the Success of Management Programs for Patients With Heart Failure: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Oyanguren, Juana; Latorre García, Pedro María; Torcal Laguna, Jesús; Lekuona Goya, Iñaki; Rubio Martín, Susana; Maull Lafuente, Elena; Grandes, Gonzalo

    2016-10-01

    Heart failure management programs reduce hospitalizations. Some studies also show reduced mortality. The determinants of program success are unknown. The aim of the present study was to update our understanding of the reductions in mortality and readmissions produced by these programs, elucidate their components, and identify the factors determining program success. Systematic literature review (1990-2014; PubMed, EMBASE, CINAHL, Cochrane Library) and manual search of relevant journals. The studies were selected by 3 independent reviewers. Methodological quality was evaluated in a blinded manner by an external researcher (Jadad scale). These results were pooled using random effects models. Heterogeneity was evaluated with the I 2 statistic, and its explanatory factors were determined using metaregression analysis. Of the 3914 studies identified, 66 randomized controlled clinical trials were selected (18 countries, 13 535 patients). We determined the relative risks to be 0.88 for death (95% confidence interval [95%CI], 0.81-0.96; P < .002; I 2 , 6.1%), 0.92 for all-cause readmissions (95%CI, 0.86-0.98; P < .011; I 2 , 58.7%), and 0.80 for heart failure readmissions (95%CI, 0.71-0.90; P < .0001; I 2 , 52.7%). Factors associated with program success were implementation after 2001, program location outside the United States, greater baseline use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, a higher number of intervention team members and components, specialized heart failure cardiologists and nurses, protocol-driven education and its assessment, self-monitoring of signs and symptoms, detection of deterioration, flexible diuretic regimen, early care-seeking among patients and prompt health care response, psychosocial intervention, professional coordination, and program duration. We confirm the reductions in mortality and readmissions with heart failure management programs. Their success is associated with various structural and

  7. Estimation of radiation exposure in low-dose multislice computed tomography of the heart and comparison with a calculation program

    Energy Technology Data Exchange (ETDEWEB)

    Hohl, C.; Muehlenbruch, G.; Wildberger, J.E.; Schmidt, T.; Guenther, R.W.; Mahnken, A.H. [University of Technology of Aachen, Department of Diagnostic Radiology, Aachen (Germany); Leidecker, C. [University of Erlangen-Nuremberg, Institute of Medical Physics, Erlangen (Germany); Suess, C. [Siemens Medical Solutions Computed Tomography, Forchheim (Germany)

    2006-08-15

    The purpose of this study was to evaluate the achievable organ dose savings in low-dose multislice computed tomography (MSCT) of the heart using different tube voltages (80 kVp, 100 kVp, 120 kVp) and compare it with calculated values. A female Alderson-Rando phantom was equipped with thermoluminescent dosimeters (TLDs) in five different positions to assess the mean doses within representative organs (thyroid gland, thymus, oesophagus, pancreas, liver). Radiation exposure was performed on a 16-row MSCT scanner with six different routine scan protocols: a 120-kV and a 100-kV CT angiography (CTA) protocol with the same collimation, two 120-kV Ca-scoring (CS) protocols with different collimations and two 80-kV CS protocols with the same collimation as the 120-kV CS protocols. Each scan protocol was repeated five times. The measured dose values for the organs were compared with the values calculated by a commercially available computer program. Directly irradiated organs, such as the esophagus, received doses of 34.7 mSv (CTA 16 x 0.75 120 kVp), 21.9 mSv (CTA 16 x 0.75 100 kVp) and 4.96 mSv (CS score 12 x 1.5 80 kVp), the thyroid as an organ receiving only scattered radiation collected organ doses of 2.98 mSv (CTA 16 x 0.75 120 kVp), 1.97 mSv (CTA 16 x 0.75 100 kVp) and 0.58 mSv (CS score 12 x 1.5 80 kVp). The measured relative organ dose reductions from standard to low-kV protocols ranged from 30.9% to 55.9% and were statistically significant (P<0.05). The comparison with the calculated organ doses showed that the calculation program can predict the relative dose reduction of cardiac low photon-energy protocols precisely. (orig.)

  8. Effect of an office worksite-based yoga program on heart rate variability: outcomes of a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Chronic work-related stress is an independent risk factor for cardiometabolic diseases and associated mortality, particularly when compounded by a sedentary work environment. The purpose of this study was to determine if an office worksite-based hatha yoga program could improve physiological stress, evaluated via heart rate variability (HRV), and associated health-related outcomes in a cohort of office workers. Methods Thirty-seven adults employed in university-based office positions were randomized upon the completion of baseline testing to an experimental or control group. The experimental group completed a 10-week yoga program prescribed three sessions per week during lunch hour (50 min per session). An experienced instructor led the sessions, which emphasized asanas (postures) and vinyasa (exercises). The primary outcome was the high frequency (HF) power component of HRV. Secondary outcomes included additional HRV parameters, musculoskeletal fitness (i.e. push-up, side-bridge, and sit & reach tests) and psychological indices (i.e. state and trait anxiety, quality of life and job satisfaction). Results All measures of HRV failed to change in the experimental group versus the control group, except that the experimental group significantly increased LF:HF (p = 0.04) and reduced pNN50 (p = 0.04) versus control, contrary to our hypotheses. Flexibility, evaluated via sit & reach test increased in the experimental group versus the control group (p yoga sessions (n = 11) to control (n = 19) yielded the same findings, except that the high adherers also reduced state anxiety (p = 0.02) and RMSSD (p = 0.05), and tended to improve the push-up test (p = 0.07) versus control. Conclusions A 10-week hatha yoga intervention delivered at the office worksite during lunch hour did not improve HF power or other HRV parameters. However, improvements in flexibility, state anxiety and musculoskeletal fitness were noted with high adherence

  9. Ingen panik - Iran kan balanceres

    DEFF Research Database (Denmark)

    Rahigh-Aghsan, Ali

    2010-01-01

    Iran anses af mange som en voksende magtfaktor i Mellemøsten, der i stigende grad truer den regionale og endda globale sikkerhed. Irans hårde magt (atomprogrammet) og bløde magt (den politiske shi’a islam) betragtes som fundamentet til udviklingen af Irans stormagtsstatus og dets indflydelse....../trussel i regionen. Dette fundament er imidlertid skrøbeligt, og der er ingen grund til panik. Selv et Iran med atomvåben kan inddæmmes og balanceres og Iran’s bløde magt er meget begrænset. At bombe Iran vil derfor være en stor fejltagelse....

  10. Strengthening Injury Surveillance System in Iran

    Directory of Open Access Journals (Sweden)

    Motevalian Seyed Abbas

    2012-02-01

    Full Text Available 【Abstract】Objective: To strengthen the current Injury Surveillance System (IS System in order to better monitor injury conditions, improve protection ways and promote safety. Methods: At first we carried out a study to evaluate the frameworks of IS System in the developed countries. Then all the available documents from World Health Organization, Eastern Mediterranean Regional Organization, as well as Minister of Health and Medical Education concerning Iran were reviewed. Later a national stakeholder抯 consultation was held to collect opinions and views. A national workshop was also intended for provincial representatives from 41 universities to identify the barriers and limitations of the existing program and further to strengthen injury surveillance. Results: The evaluation of the current IS System revealed many problems, mainly presented as lack of accurate pre- and post-hospital death registry, need of precise injury data registry in outpatient medical centers, incomplete injury data registry in hospitals and lack of accuracy in definition of variables in injury registry. The five main characteristics of current IS System including flexibility, acceptability, simplicity, usefulness and timeliness were evaluated as moderate by experts. Conclusions: Major revisions must be considered in the current IS System in Iran. The following elements should be added to the questionnaire: identifier, manner of arrival to the hospital, situation of the injured patient, consumption of alcohol and opioids, other involved participants in the accident, intention, severity and site of injury, side effects of surgery and medication, as well as one month follow-up results. Data should be collected from 10% of all hospitals in Iran and analyzed every 3 months. Simultaneously data should be online to be retrieved by researches. Key words: Wounds and injuries; Population surveillance; Registries; Iran

  11. Design and implementation of pay-for-quality in primary healthcare: A case study from Iran

    National Research Council Canada - National Science Library

    Jafar Sadegh Tabrizi; Mostafa Farahbakhsh; Shabnam Iezadi; Alireza Mahboub Ahari

    2017-01-01

    ...) in East Azerbaijan Province, Iran. Methods The present study is a case study that describes the process of designing and implementing the P4Q program in PHC in East-Azerbaijan province in 2015...

  12. The Influence of Psycho-social Factors on Participation Levels in Community-based Breast Cancer Prevention Programs in Tehran, Iran

    Science.gov (United States)

    Ahmadian, Maryam; Samah, Asnarulkhadi Abu; Redzuan, Ma’rof; Emby, Zahid

    2012-01-01

    Background: Although significant consideration has been devoted to women participation in breast cancer prevention programs, our understanding about the psychosocial factors which influence participation remains incomplete. Method: The study applied a quantitative approach based on the cross-sectional survey design and multistage cluster random sampling. A total of 400 women aged 35-69 years, were surveyed at 4 obstetric and gynecologic clinics affiliated to Tehran University of Medical Sciences in Tehran: the participation levels of 86 women who have had a mammogram were analyzed based on their self-efficacy, belief, social influence, and barriers concerning mammography utilization. Results: Consistent with the study framework, in bivariate analysis, the higher level of women’s participation in breast cancer prevention programs was significantly related to more positive belief about mammography (pwomen’s participation levels in breast cancer prevention programs might be associated with the specific psychosocial factors on breast cancer preventive behavior such as mammography screening. PMID:22980116

  13. Human rabies in Iran.

    Science.gov (United States)

    Farahtaj, Firouzeh; Fayaz, Ahmad; Howaizi, Nader; Biglari, Peyvand; Gholami, Alirez

    2014-10-01

    Like most Asian and African countries, Iran is highly endemic for rabies, which is a preventable disease with the timely utilisation of post-exposure prophylaxis (PEP). With the availability of affordable vaccination in Iran, there are still several rabies deaths which are assumed misdiagnosed or received ineffective PEP. We reviewed the files of 16 human rabies deaths, consisting of two groups: 1, ineffective treatment; and 2, erroneous PEP. Most of the studied cases were male and were from rural areas. Stray dogs were found to be the common biting animal (68.75%). Of the patients, 10/16 (62.5%) who had injuries on their head and/or face demonstrated shorter incubation periods. The incubation period was longer in a 4-year-old boy who sustained injuries in his abdomen and back. All the patients in group 1 received four doses of vaccine and administration of human rabies immune globulin (HRIG), and death occurred with the mean of 49 days after the bite. This mean was 27 days in three patients in group 2, who received vaccine without administration of HRIG. In a total of 1,188,579 cases of PEP given in Iran during: 2002-2011, it is not known whether all PEPs were correctly administered by World Health Organization standards. Extending rabies awareness programmes and timely PEP education in the community in accordance with the implementation of rabies control measures might lead to a decrease in these unfortunate scenarios and heavy financial burden of vaccination required due to the prevalence of rabies. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  14. Higher education initiatives for disaster and emergency health in iran.

    Science.gov (United States)

    Ardalan, Ali; Mesdaghinia, Alireza; Masoumi, Gholamreza; Holakouie Naieni, Kourosh; Ahmadnezhad, Elham

    2013-01-01

    Iran's health system is expanding the disaster and emergency higher education programs over the country to enhance the capacity of human resources for effective and efficient disaster mitigation, preparedness, response and recovery. In this article we present an overview about the initiatives and progress of disaster and emergency health higher education in Iran. Following the Bam earthquake, in collaboration with the Ministry of Health & Medical Education and National Institute of Health Research, School of Public Health at the Tehran University of Medical Sciences, Iran took the initiative to develop a Master of Public Health (MPH) with disaster concentration in 2006, a PhD in disaster and emergency health in 2011, and a well constructed certificate course in 2008 entitled Disaster Health Management and Risk Reduction (DHMR). Iran, Kerman and Shahid Beheshti Universities of Medical Sciences and University of Social Welfare and Rehabilitation are other academia that joined this initiative. Regarding the importance of programs evaluation, we have planned for a comprehensive evaluation of MPH and DHMR programs in 2013-4 and the Accreditation and Evaluation Board of Disaster & Emergency Health, based in MOH&ME, is responsible for evaluation of the PhD program in 3-5 years from initiation.

  15. Mujeres Fuertes y Corazones Saludables: adaptation of the StrongWomen -healthy hearts program for rural Latinas using an intervention mapping approach.

    Science.gov (United States)

    Perry, Cynthia K; McCalmont, Jean C; Ward, Judy P; Menelas, Hannah-Dulya K; Jackson, Christie; De Witz, Jazmyne R; Solanki, Emma; Seguin, Rebecca A

    2017-12-28

    To describe our use of intervention mapping as a systematic method to adapt an evidence-based physical activity and nutrition program to reflect the needs of rural Latinas. An intervention mapping process involving six steps guided the adaptation of an evidence based physical activity and nutrition program, using a community-based participatory research approach. We partnered with a community advisory board of rural Latinas throughout the adaptation process. A needs assessment and logic models were used to ascertain which program was the best fit for adaptation. Once identified, we collaborated with one of the developers of the original program (StrongWomen - Healthy Hearts) during the adaptation process. First, essential theoretical methods and program elements were identified, and additional elements were added or adapted. Next, we reviewed and made changes to reflect the community and cultural context of the practical applications, intervention strategies, program curriculum, materials, and participant information. Finally, we planned for the implementation and evaluation of the adapted program, Mujeres Fuertes y Corazones Saludables, within the context of the rural community. A pilot study will be conducted with overweight, sedentary, middle-aged, Spanish-speaking Latinas. Outcome measures will assess change in weight, physical fitness, physical activity, and nutrition behavior. The intervention mapping process was feasible and provided a systematic approach to balance fit and fidelity in the adaptation of an evidence-based program. Collaboration with community members ensured that the components of the curriculum that were adapted were culturally appropriate and relevant within the local community context.

  16. A meta-review of evidence on heart failure disease management programs: the challenges of describing and synthesizing evidence on complex interventions

    Directory of Open Access Journals (Sweden)

    Thompson David R

    2011-08-01

    Full Text Available Abstract Background Despite favourable results from past meta-analyses, some recent large trials have not found Heart Failure (HF disease management programs to be beneficial. To explore reasons for this, we evaluated evidence from existing meta-analyses. Methods Systematic review incorporating meta-review was used. We selected meta-analyses of randomized controlled trials published after 1995 in English that examined the effects of HF disease management programs on key outcomes. Databases searched: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews (CDSR, DARE, NHS EED, NHS HTA, Ageline, AMED, Scopus, Web of Science and CINAHL; cited references, experts and existing reviews were also searched. Results 15 meta-analyses were identified containing a mean of 18.5 randomized trials of HF interventions +/- 10.1 (range: 6 to 36. Overall quality of the meta-analyses was very mixed (Mean AMSTAR Score = 6.4 +/- 1.9; range 2-9. Reporting inadequacies were widespread around populations, intervention components, settings and characteristics, comparison, and comparator groups. Heterogeneity (statistical, clinical, and methodological was not taken into account sufficiently when drawing conclusions from pooled analyses. Conclusions Meta-analyses of heart failure disease management programs have promising findings but often fail to report key characteristics of populations, interventions, and comparisons. Existing reviews are of mixed quality and do not adequately take account of program complexity and heterogeneity.

  17. (SPartners for Heart Health: a school-based program for enhancing physical activity and nutrition to promote cardiovascular health in 5th grade students

    Directory of Open Access Journals (Sweden)

    Sehnert Scott T

    2008-12-01

    Full Text Available Abstract Background The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA. In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU faculty, clinicians, and health profession students was formed to "(Spartner" with elementary school physical education (PE teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5th grade students. This (Spartnership is intended to augment and improve the existing 5th grade PE, health and nutrition curriculum by achieving the following aims: 1 improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2 increase the number of students achieving national recommendations for PA and nutrition; and 3 increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit. Methods/Design This pilot effectiveness study was approved by the MSU IRB. At the beginning and the end of the school year students undergo a CVD risk factor assessment conducted by MSU medical students and graduate students. Key intervention components include eight lesson plans (conducted bi-monthly designed to promote heart healthy nutrition and PA behaviors conducted by PE teachers with assistance from MSU undergraduate dietetic and kinesiology students

  18. HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT IN IRAN.

    Science.gov (United States)

    Mohtasham, Farideh; Majdzadeh, Reza; Jamshidi, Ensiyeh

    2017-08-17

    Hospitals with health technology assessment (HTA) programs have reported its positive effects on the management of resources and costs. This study aimed to identify the barriers faced by hospital-based HTA (HBHTA) in Iran by inductive content analysis of stakeholders' and decision-makers' points of view. The key individuals and organizations that could provide rich, relevant, and diverse data in response to the research question were purposively selected for the interviews and focus group discussion. Twelve stakeholders from seven public hospitals participated in the interviews. Another eighteen stakeholders from twelve HBHTA-related organizations took part in the focus group discussion. Most of the hospitals' senior management team did not feel the need for HBHTA and believed that in Iran a systematic process like HTA faces many challenges. The stakeholders participating in this study highlighted the significance of certain points that needed to be addressed before establishing HBHTA in Iran.

  19. Medical oncology, history and its future in Iran.

    Science.gov (United States)

    Mirzania, Mehrzad; Ghavamzadeh, Ardeshir; Asvadi Kermani, Iraj; Ashrafi, Farzaneh; Allahyari, Abolghasem; Rostami, Nematollah; Razavi, Seyed Mohsen; Ramzi, Mani; Nemanipour, Gholamreza

    2015-11-01

    Systemic therapy is one of the cornerstones of cancer treatment. In 1972, following representations by American Society of Clinical Oncology (ASCO), the American Board of Internal Medicine (ABIM) recognized medical oncology as a new subspecialty of internal medicine. Subspecialty of Hematology and Medical Oncology was emerged in Iran in 1983. In the past, modern medical treatments and education were started in Dar Al-fonun school and then in Tehran University; now six universities in Iran are training in Subspecialty of Hematology and Medical Oncology. There are also ten active hematopoietic stem cell transplantation centers, thirty-one provincial medical schools use their specialized services. Future goals for Hematology and Medical Oncology in Iran include expansion and reinforcement of multidisciplinary teams across the country, early detection and prevention of cancer, providing educational program and conducting cancer researches. To achieve these goals, it is necessary to establish Cancer Hospitals in each province that link together through a network.

  20. The EU and the International Sanctions against Iran

    DEFF Research Database (Denmark)

    Seeberg, Peter

    2016-01-01

    In July 2015 an agreement on the so-called Joint Comprehensive Plan of Action regarding Iran’s nuclear program was announced between Iran and the permanent members of the UNSC, Germany and the EU. The Iranian decision to comply with the results of the negotiations attracted much focus, both...... at the policy level and in scholarly debates. However, the foreign and security policy interests and possibilities of Iran in the MENA region have not been discussed very intensively, nor has there been much attention paid to how the international actors and in particular the EU were able to influence...... the Iranian policies and decisions. This article seeks to take up this challenge: firstly by analyzing to what degree the sanctions influenced the Iranian decisions on the nuclear issue; and secondly, by discussing how the sanctions regime affected the relations between Iran and the international actors...

  1. Iran, the choice of arms?; Iran, le choix des armes?

    Energy Technology Data Exchange (ETDEWEB)

    Heisbourg, F

    2007-09-15

    This book treats of the acceptation of the proliferation logics in the Middle-East and in the rest of the world through the example of the nuclear ambitions of Iran and the reactions and actions of the international community.

  2. Application of Transformational Leadership Principles in the Development and Integration of Palliative Care Within an Advanced Heart Failure Program.

    Science.gov (United States)

    George, Susan; Leasure, A Renee

    2016-01-01

    Heart failure (HF) is a major health problem in United States, and it has reached epidemic proportions. Heart failure is associated with significant morbidity, mortality, and cost. Although the prognosis of HF is worse than many forms of cancer, many patients, families, and clinicians are unaware of the dire prognosis. As the disease progress to advanced HF, patients are faced with many challenges, such as poor quality of life due to worsening symptoms and frequent hospitalizations. Heart failure management adds significant financial burden to the health care system. Palliative care can be integrated into HF care to improve quality of life and symptom management and to address physical, spiritual, and psychosocial needs of patients and families. Palliative care can be used concurrently with or independent of curative or life-prolonging HF therapies. Transformational leadership principles were used to guide the development of a plan to enhance integration of palliative care within traditional advanced HF care.

  3. Bovine viral diarrhea (BVD: A review emphasizing on Iran perspective

    Directory of Open Access Journals (Sweden)

    Mohammad Khezri

    2015-09-01

    Full Text Available Bovine viral diarrhea (BVD is one of the most important diseases of cattle responsible for major economic losses in dairy industries of Iran. So far, no nationwide program has been taken in Iran to control and eradicate the disease. Moreover, until now, no vaccination program has been practiced against BVD in Iran, although the disease is prevailing in the country. For effective controlling of BVD, it is necessary to cull the affected animals, and new entry of BVD in the farm should be prevented. Focusing on biosecurity in systematic control programs of BVD can also reduce the risks of introduction and spread of other epizootic and zoonotic diseases, thereby improving both cattle health and welfare in general. In this review paper, an overview on BVD emphasizing on Iran perspective has been discussed focusing on clinical manifestations of BVD, routes of transmission of BVD virus (BVDV, its diagnostic methods and possible prevention strategies. [J Adv Vet Anim Res 2015; 2(3.000: 240-251

  4. Heart Failure

    Science.gov (United States)

    Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

  5. The effect of the training program on the quality of life in patients with asthma based on the Precede model in Ahvaz, Iran.

    Science.gov (United States)

    Nejad, Mina Motaghi; Nejad, Ghodratollah Shakeri; Tavakol, Heshmatollah; Cheraghi, Maria

    2017-06-01

    The aim of the study was to determine the effect of the training program based on the Precede model and its main components on improving the quality of life in patients with asthma. It was a randomized quasi-experimental study done on 120 patients with asthma who were referred to the Imam Khomeini hospital in Ahvaz who were selected using the convenience sampling method and were randomly divided into intervention and control groups. The data collection tool consisted of two questionnaires. The first questionnaire evaluated the quality of life in patients with asthma and the other one was developed by the researcher based on the structures of the Precede model. Training intervention was conducted during four sessions twice a week and each session was carried out for an hour based on the structures of the Precede model. In order to achieve the results, SPSS software, even t-test, and χ(2) were used. The results showed that after the training intervention in the experimental group, the mean scores of predisposing factors (p quality of life in two groups after the intervention (p quality of life of patients in the experimental group was improved after the training intervention. The design and implementation of the training program based on the Precede model can have a positive effect on the improvement of quality of life in patients with asthma.

  6. The prospective environmental impacts of Iran nuclear energy expansion

    Energy Technology Data Exchange (ETDEWEB)

    Beheshti, Hamed, E-mail: Beheshti@zedat.fu-berlin.de [Renewable Energy Policy Planning, Freie Universitaet Berlin BC CARE, Berlin Center for Caspian Region Energy and Environment Studies, Ihnestrasse 22, 14195 Berlin (Germany)

    2011-10-15

    Nuclear energy has direct impacts on the environment. Uranium mining, milling, and enrichment affect the livelihoods around and stress on the water resources. In addition, nuclear power plants consume huge amount of water and elevate the water temperature of the ambient water resources. The Iranian nuclear program has pledged for 20,000 MW of nuclear energy by 2025. The fulfillment of such ambitious target stresses the environment and increases the environmental degradation cost of the country. Iran central semi-arid area and the Persian Gulf are the major regions with high risk of impacts from the current nuclear program. - Highlights: > Fragile ecosystem of the Persian Gulf would not tolerate the ambitious nuclear programs of its coastal countries. > Water resources in Iran inland area are depleting fast due to the unsustainable development on the past. > Iranian nuclear program is going to put an additional serious stress on the water resources of the country.

  7. PSYCHOLOGICAL FEATURES IN PATIENTS WITH CORONARY HEART DISEASE (MEN AND WOMEN PRIOR TO CORONARY ARTERY BYPASS GRAFTING DEPENDING ON THEIR INVOLVEMENT IN THE INDIVIDUAL PSYCHO-CORRECTION PROGRAM

    Directory of Open Access Journals (Sweden)

    D. A. Starunskaya

    2017-01-01

    Full Text Available Importance. The study of psychological characteristics of patients is important for the creation and planning of psychological correction and improve the efficiency of the treatment of coronary heart disease.Тhe purpose. This research is devoted to the study of the psychological features in patients with coronary artery disease (CHD in the preoperative period, depending on their involvement in psycho-correction program.Material and methods. We observed 30 patients with coronary heart disease before coronary bypass surgery. Clinical-psychological method (observation, conversation and psychological testing were used.Results  and conclusions. We found that patients who participated in psycho-correction program had lower values of «anxiety», «phobic anxiety» and «obsessive-compulsive» symptoms. In both groups of patients, on average, we identified the prevalence  of the coping-strategies «self-control» and «planning solution». Furthermore, on average, the «self-awareness» and «extraversion» were more manifested features in the structure of the personality traits of the surveyed patients. The revealed features should be taken into account in planning the programs of psycho-correction for patients with CHD prior to CABG surgery.

  8. A systematic review of the effectiveness of primary health education or intervention programs in improving rural women's knowledge of heart disease risk factors and changing lifestyle behaviours.

    Science.gov (United States)

    Crouch, Rosanne; Wilson, Anne; Newbury, Jonathan

    2011-09-01

    Cardiovascular disease is the leading cause of death and disability for women in Australia. Women living in rural areas are at greater risk of heart disease, because of limited access and availability of healthcare in rural areas. Lifestyle is a major determinant to the risk of heart disease. Risk factors such as smoking, hypertension, diet, physical activity and alcohol intake can be controlled or modified by lifestyle changes. As heart disease develops over many years, women need to be following healthy lifestyle practices and reduce their chance of a first or recurrent heart attack. To determine the effectiveness of primary health education or intervention programs for cardiac risk reduction in healthy women living in rural areas. Types of participants. Women aged 16-65 years, living in rural areas, who participated in primary healthcare education programs. Types of interventions. Primary health education or intervention programs aimed at improving rural women's knowledge of their risk of heart disease, for example group work, videos, telephone, workshops, educational material and counselling. Types of outcomes. Primary outcomes included: • Knowledge level of heart disease risk factors. • Lifestyle modification, for example dietary improvements such as reduced daily salt intake, increased intake of fruit and vegetables and decreased intake of fat, increased frequency of exercise, decreased levels of smoking, alcohol intake within national guidelines. • Health assessment measures, for example blood pressure, body weight, cholesterol levels. Types of studies. Any randomised controlled trials, other experimental studies, as well as cohort, case-control and cross-sectional studies were considered for inclusion. Search strategy. A search for published and unpublished studies in the English language was undertaken. Each study was appraised independently by two reviewers using the standard Joanna Briggs Institute instruments. Information was extracted from

  9. Effect of a multidisciplinary supportive program for family caregivers of patients with heart failure on caregiver burden, quality of life, and depression: A randomized controlled study.

    Science.gov (United States)

    Hu, Xiaolin; Dolansky, Mary A; Su, Yonglin; Hu, Xiuying; Qu, Moying; Zhou, Lingjuan

    2016-10-01

    Caregivers of patients with heart failure experience burden and negative health outcomes. Adequate support for family caregivers improves their well-being and the quality of care provided to the patients. However, little is known about the benefits of interventions for caregivers of patients with heart failure in China. To test the effects of a multidisciplinary supportive program for family caregivers on caregiver burden, quality of life, and depression. A randomized controlled design with repeated measures was used in this study. A total of 118 participants were randomized into experimental (n=59) and control groups (n=59) from May to December 2014 in one hospital in Chengdu, People's Republic of China. Participants in the experimental group received a 3-month multidisciplinary supportive program, consisting of three 60-min sessions of group classes, three 30-min peer support groups, and regular telephone follow-ups and consultations, while participants in the control group received usual care only. Outcomes were caregiver burden, quality of life, and depression. Data were collected at baseline, post-test (3 months after discharge), and 3 months after post-test (6 months after discharge). The repeated measures analysis of variance was used to examine the effects of groups, changes over time, and time-group interaction on outcome variables. There were significant improvements in caregiver burden, mental health, and depression after post-test and 3 months after post-test in the experimental group. However, there was no significant improvement in caregivers' physical health at either 3 or 6 months following discharge. A multidisciplinary supportive program for caregivers of heart failure patients had positive effects and provides a unique perspective of an intervention considering Chinese culture and customs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Responding to a Nuclear Iran

    National Research Council Canada - National Science Library

    Hemmer, Christopher

    2007-01-01

    ...? Despite the recent resumption of high-level contacts between Iran and the International Atomic Energy Agency, and the potential for stronger action by the United Nations Security Council, an Iranian...

  11. The Iran Sanctions Act (ISA)

    National Research Council Canada - National Science Library

    Katzman, Kenneth

    2007-01-01

    ... (the Iran Freedom Support Act, P.L. 109-293) extended it until December 31, 2011, terminated application to Libya, and added provisions, although with substantial Administration flexibility in implementation...

  12. Irans Foreign and Defense Policies

    Science.gov (United States)

    2016-12-21

    operated exclusively by the regular Air Force, which has the required pilots and sustainment infrastructure for air force operations. As noted, the...and the sustained and frequent engagement with Iran exhibited by Oman. Qatar maintains periodic high-level contact with Iran; the speaker of Iran’s...buses, restaurants , and other civilian targets inside Israel. However, in 2012, their differing positions on the ongoing Syria conflict caused a rift

  13. The effect of the training program on the quality of life in patients with asthma based on the Precede model in Ahvaz, Iran

    Directory of Open Access Journals (Sweden)

    Mina Motaghi Nejad

    2017-05-01

    Full Text Available Aim: The aim of the study was to determine the effect of the training program based on the Precede model and its main components on improving the quality of life in patients with asthma. Material and methods: It was a randomized quasi-experimental study done on 120 patients with asthma who were referred to the Imam Khomeini hospital in Ahvaz who were selected using the convenience sampling method and were randomly divided into intervention and control groups. The data collection tool consisted of two questionnaires. The first questionnaire evaluated the quality of life in patients with asthma and the other one was developed by the researcher based on the structures of the Precede model. Training intervention was conducted during four sessions twice a week and each session was carried out for an hour based on the structures of the Precede model. In order to achieve the results, SPSS software, even t-test, and 2 were used. Results: The results showed that after the training intervention in the experimental group, the mean scores of predisposing factors (p < 0.001, enabling factors, reinforcing factors and behavioral factors were significantly increased (p < 0.001 as compared to the control group. A significant difference was observed in the mean scores of quality of life in two groups after the intervention (p < 0.001, and the quality of life of patients in the experimental group was improved after the training intervention. Conclusions : The design and implementation of the training program based on the Precede model can have a positive effect on the improvement of quality of life in patients with asthma.

  14. COCHLEAR IMPLANTATION IN IRAN

    Directory of Open Access Journals (Sweden)

    M.H. Khalessi

    1996-07-01

    Full Text Available Deafness has been considered a non - resolving problem until the invention of cochlear implantation (CI. We are reporting the pre- and post-operative results of 14 patients underwent CI, for the first time in Iran, at the cochlear implantation Clinic of Tehran University of Medical Sciences. Four of our patients were able to hold a telephone conversation without difficulty 3 months post-operatively and the rest achieved considerable scores on audiologic tests and a remarkable improvement over 9 month interval between the two sets of tests. Also we have addressed the dramatic improvement in the quality of life of these patients in this paper as well as the results of promontory stimulation and audiometry.

  15. Heart Anatomy

    Science.gov (United States)

    ... kilometers), which is far enough to circle the earth more than twice! See also on other sites: ... For the Public Heart Information Center Project Heart Women’s Heart Health Clinical Trials 6770 Bertner Avenue Houston, ...

  16. Heart Transplant

    Science.gov (United States)

    ... your transplanted heart. You should also have routine medical checkups to maintain overall health. Activity Restrictions Heart transplant recipients have no specific activity restrictions. Discuss activity ideas with your ... to some medical and dental procedures to prevent endocarditis, most heart ...

  17. Synteserapport & 1. Indenrigspolitiske forhold i Den Islamiske Republik Iran

    DEFF Research Database (Denmark)

    Pedersen, Claus Valling

    Rapport til Udenrigsministeriet om de indenrigspolitiske forhold i Iran samt et syntese af hele rapporten: Iran som regional og international medspiller i den globale verdensorden samt Irans indenrigspolitik......Rapport til Udenrigsministeriet om de indenrigspolitiske forhold i Iran samt et syntese af hele rapporten: Iran som regional og international medspiller i den globale verdensorden samt Irans indenrigspolitik...

  18. "The Heart Game"

    DEFF Research Database (Denmark)

    Dithmer, Marcus; Rasmussen, Jack Ord; Grönvall, Erik

    2016-01-01

    Objective: The aim of this article is to describe the development and testing of a prototype application (“The Heart Game”) using gamification principles to assist heart patients in their telerehabilitation process in the Teledialog project. Materials and Methods: A prototype game was developed via...... (interviews, participant observations, focus group interviews, and workshop) was used. Interviews with three healthcare professionals and 10 patients were carried out over a period of 2 weeks in order to evaluate the use of the prototype. Results: The heart patients reported the application to be a useful...... activities. Conclusions: “The Heart Game” concept presents a new way to motivate heart patients by using technology as a social and active approach to telerehabilitation. The findings show the potential of using gamification for heart patients as part of a telerehabilitation program. The evaluation indicated...

  19. Iran's Land Suitability for Agriculture.

    Science.gov (United States)

    Mesgaran, Mohsen B; Madani, Kaveh; Hashemi, Hossein; Azadi, Pooya

    2017-08-09

    Increasing population has posed insurmountable challenges to agriculture in the provision of future food security, particularly in the Middle East and North Africa (MENA) region where biophysical conditions are not well-suited for agriculture. Iran, as a major agricultural country in the MENA region, has long been in the quest for food self-sufficiency, however, the capability of its land and water resources to realize this goal is largely unknown. Using very high-resolution spatial data sets, we evaluated the capacity of Iran's land for sustainable crop production based on the soil properties, topography, and climate conditions. We classified Iran's land suitability for cropping as (million ha): very good 0.4% (0.6), good 2.2% (3.6), medium 7.9% (12.8), poor 11.4% (18.5), very poor 6.3% (10.2), unsuitable 60.0% (97.4), and excluded areas 11.9% (19.3). In addition to overarching limitations caused by low precipitation, low soil organic carbon, steep slope, and high soil sodium content were the predominant soil and terrain factors limiting the agricultural land suitability in Iran. About 50% of the Iran's existing croplands are located in low-quality lands, representing an unsustainable practice. There is little room for cropland expansion to increase production but redistribution of cropland to more suitable areas may improve sustainability and reduce pressure on water resources, land, and ecosystem in Iran.

  20. Evaluating the effectiveness of psychosocial resilience training for heart health, and the added value of promoting physical activity: a cluster randomized trial of the READY program

    Directory of Open Access Journals (Sweden)

    Pakenham Kenneth I

    2009-11-01

    Full Text Available Abstract Background Depression and poor social support are significant risk factors for coronary heart disease (CHD, and stress and anxiety can trigger coronary events. People experiencing such psychosocial difficulties are more likely to be physically inactive, which is also an independent risk factor for CHD. Resilience training can target these risk factors, but there is little research evaluating the effectiveness of such programs. This paper describes the design and measures of a study to evaluate a resilience training program (READY to promote psychosocial well-being for heart health, and the added value of integrating physical activity promotion. Methods/Design In a cluster randomized trial, 95 participants will be allocated to either a waitlist or one of two intervention conditions. Both intervention conditions will receive a 10 × 2.5 hour group resilience training program (READY over 13 weeks. The program targets five protective factors identified from empirical evidence and analyzed as mediating variables: positive emotions, cognitive flexibility, social support, life meaning, and active coping. Resilience enhancement strategies reflect the six core Acceptance and Commitment Therapy processes (values, mindfulness, defusion, acceptance, self-as-context, committed action and Cognitive Behavior Therapy strategies such as relaxation training and social support building skills. Sessions include psychoeducation, discussions, experiential exercises, and home assignments. One intervention condition will include an additional session and ongoing content promoting physical activity. Measurement will occur at baseline, two weeks post intervention, and at eight weeks follow-up, and will include questionnaires, pedometer step logs, and physical and hematological measures. Primary outcome measures will include self-reported indicators of psychosocial well-being and depression. Secondary outcome measures will include self-reported indicators of

  1. Evaluating the effectiveness of psychosocial resilience training for heart health, and the added value of promoting physical activity: a cluster randomized trial of the READY program.

    Science.gov (United States)

    Burton, Nicola W; Pakenham, Kenneth I; Brown, Wendy J

    2009-11-23

    Depression and poor social support are significant risk factors for coronary heart disease (CHD), and stress and anxiety can trigger coronary events. People experiencing such psychosocial difficulties are more likely to be physically inactive, which is also an independent risk factor for CHD. Resilience training can target these risk factors, but there is little research evaluating the effectiveness of such programs. This paper describes the design and measures of a study to evaluate a resilience training program (READY) to promote psychosocial well-being for heart health, and the added value of integrating physical activity promotion. In a cluster randomized trial, 95 participants will be allocated to either a waitlist or one of two intervention conditions. Both intervention conditions will receive a 10 x 2.5 hour group resilience training program (READY) over 13 weeks. The program targets five protective factors identified from empirical evidence and analyzed as mediating variables: positive emotions, cognitive flexibility, social support, life meaning, and active coping. Resilience enhancement strategies reflect the six core Acceptance and Commitment Therapy processes (values, mindfulness, defusion, acceptance, self-as-context, committed action) and Cognitive Behavior Therapy strategies such as relaxation training and social support building skills. Sessions include psychoeducation, discussions, experiential exercises, and home assignments. One intervention condition will include an additional session and ongoing content promoting physical activity. Measurement will occur at baseline, two weeks post intervention, and at eight weeks follow-up, and will include questionnaires, pedometer step logs, and physical and hematological measures. Primary outcome measures will include self-reported indicators of psychosocial well-being and depression. Secondary outcome measures will include self-reported indicators of stress, anxiety and physical activity, and objective

  2. Evaluating causes of death and morbidity in Iran, global burden of diseases, injuries, and risk factors study 2010.

    Science.gov (United States)

    Forouzanfar, Mohammad Hossein; Sepanlou, Sadaf G; Shahraz, Saeid; Dicker, Daniel; Naghavi, Paria; Pourmalek, Farshad; Mokdad, Ali; Lozano, Rafael; Vos, Theo; Asadi-Lari, Mohsen; Sayyari, Ali-Akbar; Murray, Christopher J L; Naghavi, Mohsen

    2014-05-01

    we aimed to recap and highlight the major results of the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 by mortality and morbidity to clarify the current health priorities and challenges in Iran. We estimated Iran's mortality and burden of 289 diseases with 67 risk factors and 1160 sequelae, which were used to clinically present each disease and its disability or cause of death. We produced several measures to report health loss and status: all-cause mortality, cause-specific mortality, years of life lost due to death (YLL), healthy years of life lost due to disability (YLD), disability-adjusted life years (DALYs), life expectancy, and healthy life expectancy, for three time periods: 1990, 2005, and 2010. We found out that life expectancy at birth was 71.6 years in men and 77.8 years in women. Almost 350 thousand deaths occurred in both sexes and all age groups in 2010. In both males and females and all age groups, ischemic heart disease was the main cause of death, claiming about 90 thousand lives. The main contributors to DALYs were: ischemic heart disease (9.1%), low back pain (9.0%), road injuries (7.3%), and unipolar depressive disorders (6.3%). The main causes of death under 5 years of age included: congenital anomalies (22.4%), preterm birth complications (18.3%), and other neonatal disorders (13.5%). The main causes of death among 15 - 49 year olds in both sexes included: injuries (23.6%) and ischemic heart disease (12.7%) The highest rates of YLDs were observed among 70+ year olds for both sexes (27,365 per 100,000), mainly due to low back pain, osteoarthritis, diabetes, falls, and major depressive disorder. The main risk factors to which deaths were attributable among children under 5 years included: suboptimal breast feeding, ambient PM pollution, tobacco smoking, and underweight. The most important risk factors among 15 to 49 year olds were: dietary risks, high blood pressure, high body mass index, physical inactivity, smoking, and

  3. Inverse association between the frequency of nut consumption and obesity among Iranian population: Isfahan Healthy Heart Program.

    Science.gov (United States)

    Mohammadifard, Noushin; Yazdekhasti, Narges; Stangl, Gabriele I; Sarrafzadegan, Nizal

    2015-09-01

    Recently, controversies have arisen concerning the association between nut intake and obesity. This study was performed to investigate the relationship between nut consumption and obesity among Iranian adults. In a cross-sectional survey, 9,660 randomly chosen adults aged ≥19 years were selected based on gender, age and their settlement distributions in three districts of central Iran in 2007. Nutritional behaviors including regular intake of walnuts, almonds, pistachios, hazelnuts and sunflower seed were assessed by validated 48-item-food-frequency questionnaire and a 24-h recall questionnaire. Using hierarchical logistic regression test, odds ratio (OR) 95% CI of obesity based on nut consumption was determined in an unadjusted and four adjusted models. The results showed a significant association between high nut consumption and lower prevalence of overweight or general obesity as well as abdominal obesity in women (p = 0.01 and p = 0.047, respectively), but not men. The frequency of nut consumption was associated with lower risk of overweight or general obesity [OR (95% CI) 0.57 (0.38-0.86)] and abdominal obesity [OR (95% CI) 0.51 (0.28-0.95)] only in women. After adjusting for gender, age and other potential confounders, the strength of the associations was blunted, but they were still significant. Frequent nuts and seeds consumption, particularly ≥1 time/day, had an inverse association with all classes of obesity among women.

  4. The comparison of the effects of education provided by nurses on the quality of life in patients with congestive heart failure (CHF) in usual and home-visit cares in Iran.

    Science.gov (United States)

    Mehralian, Hossein; Salehi, Shahriar; Moghaddasi, Jafar; Amiri, Masoud; Rafiei, Hossin

    2014-04-11

    Quality of life (QOL) can be considered as a quality indicator of health care systems and nurses can play an important role to improve QOL in patients with congestive heart failure (CHF). The aim of this study was to determine the effects of education provided by nurses on the QOL in patients with CHF in home-visit care compared to usual care. In a single-blind randomized controlled trial conducted from September 2011 to June 2012, 110 patients with CHF were randomly assigned into two groups. While patients in group I were received usual education at the time of hospital discharge, patients in Group II, in addition to usual education, were received special education regards to their illness by nurses who visited patients in their homes. The 36-item short-form (SF-36) questionnaire was used to evaluate the patient's QOL at the time of discharge and also six months after hospital discharge. At the time of hospital discharge, mean score of all 8 sub-score of SF-36 questionnaire was 63.4±7.8 in patients of group II and 61.1±6.4 in patients of group I, respectively (P> 0.05). QOL was decreased in group I and increased in group II compared to the time of hospital discharge. After six months, mean score of QOL was higher in group II than in group I. QOL of patients with CHF were decreased after hospital discharge. Education provided by nurses in home-visit care could improve the QOL in patients with CHF, based on the findings of this study.

  5. Effects of an osteoporosis prevention training program on physical activity-related stages of change and self-efficacy among university students, Shiraz, Iran: a Randomized Clinical Trial.

    Science.gov (United States)

    Kaveh, Mohammad Hossien; Golij, Monire; Nazari, Mahin; Mazloom, Zohreh; Rezaeian Zadeh, Abbas

    2014-10-01

    Osteoporosis is a major problem in today's world, being characterized by decreased bone mass and bone change. Due to deficiency of theory-based studies in young population, especially in students, there are significant knowledge gaps of effective planning. Thepresent study was performed in response to this need. The present study investigated the effect of an empowerment program on physical activity related stages of change and self-efficacyin preventing osteoporosis among university students. In this randomized controlled trial (IRCT: IRCT201212016261N2), 152 female students of Shiraz University of Medical Sciences were selected through multi-stages cluster sampling and were randomly assigned to an experimental (n=76) and a control (n=76) group.The pre-and post-intervention data were collected using the Stages of Exercise Change Questionnaire (SECQ) of Marcos with Cronbach's alpha reliability of 0.89 and also the self-efficacy scale with a Cronbach's alpha reliability of 0.88 and Test-Retest Correlation Coefficient of 0.80. The educational intervention for the experimental group took place through problem-based learning method, small group discussion, and training manuals. In addition, training CDs and brochures were given to the subjects and short SMSs were sent to them. The data were analyzed throughSPSS, version 14, usingMann-Whitney test, Chi-square test, Wilcoxon and regression tests. Pre-intervention findings showed that participants had behavioral constructs below the expected levels. The results showed that the experimental group received significant statisticalincrease after the intervention in stage of change. Before the intervention, the mean scores of stages of changes in the experimental groups was 2.28±0.86 but this rose to 3±0.84 in the first post-test and 3.22±0.84 in the second post-test. The control group showed a significant increase in stage of change without intervention (pre-test 2.04±0.82, first post-test 2.18±0.87 and second post

  6. Efferocytosis and Outside-In Signaling by Cardiac Phagocytes. Links to Repair, Cellular Programming, and Intercellular Crosstalk in Heart

    Directory of Open Access Journals (Sweden)

    Matthew DeBerge

    2017-11-01

    Full Text Available Phagocytic sensing and engulfment of dying cells and extracellular bodies initiate an intracellular signaling cascade within the phagocyte that can polarize cellular function and promote communication with neighboring non-phagocytes. Accumulating evidence links phagocytic signaling in the heart to cardiac development, adult myocardial homeostasis, and the resolution of cardiac inflammation of infectious, ischemic, and aging-associated etiology. Phagocytic clearance in the heart may be carried out by professional phagocytes, such as macrophages, and non-professional cells, including myofibrolasts and potentially epithelial cells. During cardiac development, phagocytosis initiates growth cues for early cardiac morphogenesis. In diseases of aging, including myocardial infarction, heightened levels of cell death require efficient phagocytic debridement to salvage further loss of terminally differentiated adult cardiomyocytes. Additional risk factors, including insulin resistance and other systemic risk factors, contribute to inefficient phagocytosis, altered phagocytic signaling, and delayed cardiac inflammation resolution. Under such conditions, inflammatory presentation of myocardial antigen may lead to autoimmunity and even possible rejection of transplanted heart allografts. Increased understanding of these basic mechanisms offers therapeutic opportunities.

  7. A cost-effectiveness analysis of a program to control rheumatic fever and rheumatic heart disease in Pinar del Rio, Cuba.

    Science.gov (United States)

    Watkins, David A; Mvundura, Mercy; Nordet, Porfirio; Mayosi, Bongani M

    2015-01-01

    Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) persist in many low- and middle-income countries. To date, the cost-effectiveness of population-based, combined primary and secondary prevention strategies has not been assessed. In the Pinar del Rio province of Cuba, a comprehensive ARF/RHD control program was undertaken over 1986-1996. The present study analyzes the cost-effectiveness of this Cuban program. We developed a decision tree model based on the natural history of ARF/RHD, comparing the costs and effectiveness of the 10-year Cuban program to a "do nothing" approach. Our population of interest was the cohort of children aged 5-24 years resident in Pinar del Rio in 1986. We assessed costs and health outcomes over a lifetime horizon, and we took the healthcare system perspective on costs but did not apply a discount rate. We used epidemiologic, clinical, and direct medical cost inputs that were previously collected for publications on the Cuban program. We estimated health gains as disability-adjusted life years (DALYs) averted using standard approaches developed for the Global Burden of Disease studies. Cost-effectiveness acceptability thresholds were defined by one and three times per capita gross domestic product per DALY averted. We also conducted an uncertainty analysis using Monte Carlo simulations and several scenario analyses exploring the impact of alternative assumptions about the program's effects and costs. We found that, compared to doing nothing, the Cuban program averted 5051 DALYs (1844 per 100,000 school-aged children) and saved $7,848,590 (2010 USD) despite a total program cost of $202,890 over 10 years. In the scenario analyses, the program remained cost saving when a lower level of effectiveness and a reduction in averted years of life lost were assumed. In a worst-case scenario including 20-fold higher costs, the program still had a 100% of being cost-effective and an 85% chance of being cost saving. A 10-year program to

  8. Britiske søfolk splitter Iran

    DEFF Research Database (Denmark)

    Pedersen, Claus Valling

    2007-01-01

    Om Iran, indenrigspolitiske forhold som udtrykt gennem landets forhold til Vesten/USA Udgivelsesdato: 30. marts......Om Iran, indenrigspolitiske forhold som udtrykt gennem landets forhold til Vesten/USA Udgivelsesdato: 30. marts...

  9. Requirements for effective academic leadership in Iran: A Nominal Group Technique exercise

    OpenAIRE

    Shoghli Alireza; Brommels Mats; Bikmoradi Ali; Sohrabi Zohreh; Masiello Italo

    2008-01-01

    Abstract Background During the last two decades, medical education in Iran has shifted from elite to mass education, with a considerable increase in number of schools, faculties, and programs. Because of this transformation, it is a good case now to explore academic leadership in a non-western country. The objective of this study was to explore the views on effective academic leadership requirements held by key informants in Iran's medical education system. Methods A nominal group study was c...

  10. Bahrain-Iran Relations in Modern Times

    Science.gov (United States)

    2014-09-01

    called the Gulf Consultative Council 6 Iran Chamber Society, “History of Iran: Islamic conquest,” http://www.iranchamber.com/history/ islamic_conquest...up against the occupation forces the bloody clashes have continued on daily basis. This sectarian vendetta has now spread through Lebanon and even...253131. Iran Chamber Society. History of Iran: Islamic conquest, 2005. http://www.iranchamber.com/history/islamic_conquest/islamic_conquest.php

  11. Heart Diseases

    Science.gov (United States)

    ... you're like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the ... of disability. There are many different forms of heart disease. The most common cause of heart disease ...

  12. Heart Transplantation

    Science.gov (United States)

    A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

  13. Heart Attack

    Science.gov (United States)

    Each year almost 800,000 Americans have a heart attack. A heart attack happens when blood flow to the heart suddenly ... it's important to know the symptoms of a heart attack and call 9-1-1 if you or ...

  14. The American Heart Association and Heart Health Education in the Young.

    Science.gov (United States)

    Tevis, Betty

    1979-01-01

    Several of the American Heart Association's education programs are described. The newest program is Heart Health Education in the Young, designed to stress the importance of early risk factor education. (JMF)

  15. Prevalence of metabolic syndrome in Qazvin Metabolic Diseases Study (QMDS), Iran: a comparative analysis of six definitions.

    Science.gov (United States)

    Esmailzadehha, N; Ziaee, A; Kazemifar, A M; Ghorbani, A; Oveisi, S

    2013-07-01

    The aim of the present study was to compare the prevalence of metabolic syndrome (MS) according to six definitions and evaluate the agreement between them in an urban sample in Qazvin, Iran. In a cross sectional study, 529 men and 578 women in age of 20-78 years were attended from September 2010 to April 2011 in Qazvin, Iran. Standardized measurements were available for waist circumference, blood pressure, fasting serum high-density lipoprotein cholesterol, triglycerides, glucose, and insulin. The diagnostic criteria proposed by World Health Organization (WHO), National cholesterol education program third Adult Treatment Panel (ATPIII 2001, 2004), International Diabetes Federation (IDF), American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI), and new Joint Interim Societies (JIS) were applied. The degree of agreement between different definitions was assessed by kappa statistic. The prevalence of MS was found to be 28% (WHO), 26.2% (ATPIII 2001), 30.6% (ATPIII 2004), 34.2% (IDF), 33% (AHA/NHLBI), and 39.3% (JIS). With regards to the gender, the prevalence of MS according to ATPIII 2001 and IDF was significantly greater in women than men. However, using other definitions, the prevalence of MS was similar in both genders. The agreement of JIS criteria with IDF and AHA/NHLBI definitions was excellent (IDF: 0.902; AHA/NHLBI: 0.862), while the agreement of IDF criteria with ATPIII 2004 and AHA/NHLBI was good (ATPIII 2004:0.719; AHA/NHLBI: 0.756). Although JIS definition resulted in a higher prevalence of MS than other definitions, an excellent agreement has been seen between these criteria. Widespread acceptance of JIS definition may lead to management and therapy in a greater part of the population.

  16. 15 CFR 746.7 - Iran.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Iran. 746.7 Section 746.7 Commerce and... § 746.7 Iran. The Treasury Department's Office of Foreign Assets Control (OFAC) administers a comprehensive trade and investment embargo against Iran. This embargo includes prohibitions on exports and...

  17. Artificial heart development program. Volume I. System development. Phase III summary report, July 1, 1973--September 30, 1977

    Energy Technology Data Exchange (ETDEWEB)

    1977-01-01

    Efforts and results in the development of the power system portions of a calf implantable model of nuclear-powered artificial heart are discussed. The primary objective in developing the implantable model was to solve the packaging problems for total system implantation. The power system's portion is physically that portion of the implantable model between the /sup 238/Pu heat sources and the blood pump ventricles. The /sup 238/Pu heat sources and blood pump ventricles were provided as Government Furnished Equipment as developed and fabricated by other contractors.

  18. [Clinical and Economic Aspects of Meldonium as Part of Physical Rehabilitation Programs in Patients With Coronary Heart Disease After Percutaneous Coronary Interventions].

    Science.gov (United States)

    Lyamina, N P; Razborov, I B; Karpov, E S

    2016-08-01

    to analyze clinical and economical effectiveness of meldonium as component of integrated program of cardio-rehabilitation in patients with ischemic heart disease (IHD) in the early period after percutaneous coronary intervention (PCI) with incomplete revascularization. A program of controlled physical training (CPT) was carried out in patients with stable IHD and positive post PCI exercise test (n=48, age less or equal 65 years) starting 8-10 days after PCI. CRT program consisted of 2 phases - inhospital (exercise on treadmill with max heart rate [HR] 80% of that achieved in initial test, 10 times during 2 weeks) and home (exercise on treadmill with max HR 60% of HR achieved in initial test, 3 times a week for 2 months). Before initiation of CRT patients were distributed into 2 groups: CRT without (n=23; 56.7+/-7.1 years) and with (n=25; 54.6+/-6.8 years) administration of meldonium (1000 mg/day intravenously). Control group (n=24; 50+/-8.4 years) consisted of patients who were under outpatient observation, received similar drug therapy, but were not subjected to CRT. After completion of CRT (in 2.5 months) all patients underwent clinical-instrumental examination with determination of exercise tolerance. Exercise duration and metabolic equivalent (MET) increased by 43.9, 36.6, 4.1% and 42.1, 34.8, 3.4% in CRT+ meldonium, CRT only, and control groups, respectively. In patients with documented ischemia after PCI inclusion of meldonium in the scheme of rehabilitation was associated with improved physical performance and optimal cost-effectiviness.

  19. Evaluation of a self-management patient education program for patients with chronic heart failure undergoing inpatient cardiac rehabilitation: study protocol of a cluster randomized controlled trial.

    Science.gov (United States)

    Meng, Karin; Musekamp, Gunda; Seekatz, Bettina; Glatz, Johannes; Karger, Gabriele; Kiwus, Ulrich; Knoglinger, Ernst; Schubmann, Rainer; Westphal, Ronja; Faller, Hermann

    2013-08-23

    Chronic heart failure requires a complex treatment regimen on a life-long basis. Therefore, self-care/self-management is an essential part of successful treatment and comprehensive patient education is warranted. However, specific information on program features and educational strategies enhancing treatment success is lacking. This trial aims to evaluate a patient-oriented and theory-based self-management educational group program as compared to usual care education during inpatient cardiac rehabilitation in Germany. The study is a multicenter cluster randomized controlled trial in four cardiac rehabilitation clinics. Clusters are patient education groups that comprise HF patients recruited within 2 weeks after commencement of inpatient cardiac rehabilitation. Cluster randomization was chosen for pragmatic reasons, i.e. to ensure a sufficient number of eligible patients to build large-enough educational groups and to prevent contamination by interaction of patients from different treatment allocations during rehabilitation. Rehabilitants with chronic systolic heart failure (n = 540) will be consecutively recruited for the study at the beginning of inpatient rehabilitation. Data will be assessed at admission, at discharge and after 6 and 12 months using patient questionnaires. In the intervention condition, patients receive the new patient-oriented self-management educational program, whereas in the control condition, patients receive a short lecture-based educational program (usual care). The primary outcome is patients' self-reported self-management competence. Secondary outcomes include behavioral determinants and self-management health behavior (symptom monitoring, physical activity, medication adherence), health-related quality of life, and treatment satisfaction. Treatment effects will be evaluated separately for each follow-up time point using multilevel regression analysis, and adjusting for baseline values. This study evaluates the effectiveness of a

  20. The monetary burden of cystic echinococcosis in Iran.

    Science.gov (United States)

    Fasihi Harandi, Majid; Budke, Christine M; Rostami, Sima

    2012-01-01

    Cystic echinococcosis (CE) is a globally distributed parasitic infection of humans and livestock. The disease is of significant medical and economic importance in many developing countries, including Iran. However, the socioeconomic impact of the disease, in most endemic countries, is not fully understood. The purpose of the present study was to determine the monetary burden of CE in Iran. Epidemiological data, including prevalence and incidence of CE in humans and animals, were obtained from regional hospitals, the scientific literature, and official government reports. Economic data relating to human and animal disease, including cost of treatment, productivity losses, and livestock production losses were obtained from official national and international datasets. Monte Carlo simulation methods were used to represent uncertainty in input parameters. Mean number of surgical CE cases per year for 2000-2009 was estimated at 1,295. The number of asymptomatic individuals living in the country was estimated at 635,232 (95% Credible Interval, CI 149,466-1,120,998). The overall annual cost of CE in Iran was estimated at US$232.3 million (95% CI US$103.1-397.8 million), including both direct and indirect costs. The cost associated with human CE was estimated at US$93.39 million (95% CI US$6.1-222.7 million) and the annual cost associated with CE in livestock was estimated at US$132 million (95% CI US$61.8-246.5 million). The cost per surgical human case was estimated at US$1,539. CE has a considerable economic impact on Iran, with the cost of the disease approximated at 0.03% of the country's gross domestic product. Establishment of a CE surveillance system and implementation of a control program are necessary to reduce the economic burden of CE on the country. Cost-benefit analysis of different control programs is recommended, incorporating present knowledge of the economic losses due to CE in Iran.

  1. The monetary burden of cystic echinococcosis in Iran.

    Directory of Open Access Journals (Sweden)

    Majid Fasihi Harandi

    Full Text Available Cystic echinococcosis (CE is a globally distributed parasitic infection of humans and livestock. The disease is of significant medical and economic importance in many developing countries, including Iran. However, the socioeconomic impact of the disease, in most endemic countries, is not fully understood. The purpose of the present study was to determine the monetary burden of CE in Iran. Epidemiological data, including prevalence and incidence of CE in humans and animals, were obtained from regional hospitals, the scientific literature, and official government reports. Economic data relating to human and animal disease, including cost of treatment, productivity losses, and livestock production losses were obtained from official national and international datasets. Monte Carlo simulation methods were used to represent uncertainty in input parameters. Mean number of surgical CE cases per year for 2000-2009 was estimated at 1,295. The number of asymptomatic individuals living in the country was estimated at 635,232 (95% Credible Interval, CI 149,466-1,120,998. The overall annual cost of CE in Iran was estimated at US$232.3 million (95% CI US$103.1-397.8 million, including both direct and indirect costs. The cost associated with human CE was estimated at US$93.39 million (95% CI US$6.1-222.7 million and the annual cost associated with CE in livestock was estimated at US$132 million (95% CI US$61.8-246.5 million. The cost per surgical human case was estimated at US$1,539. CE has a considerable economic impact on Iran, with the cost of the disease approximated at 0.03% of the country's gross domestic product. Establishment of a CE surveillance system and implementation of a control program are necessary to reduce the economic burden of CE on the country. Cost-benefit analysis of different control programs is recommended, incorporating present knowledge of the economic losses due to CE in Iran.

  2. Remote sensing classification of the arid watersheds of Iran

    Science.gov (United States)

    Solaimani, Karim; Habibnejad-Roshan, Mahmud

    2002-01-01

    Iran's most obvious hydroclimatic problems are compounded of the disadvantages of scanty and highly seasonal precipitation and a surface configuration which tends to concentrate moisture on the periphery of the country, leaving its vast heart an area of irreconcilable sterility. Most of the central Iran has arid conditions with dry and hot summer months, when streams with and the land is parched. Nowhere in Iran is there an annual surplus of water, and significant seasonal surpluses occur in only the wishbone of high mountains that encloses the central plateau on the north and west. In most parts (about 80 percent of the total of country) the nature of human activity depends upon the availability of surface water that can be tapped by wells and qantas. Runoff is episodic and occurs only because the precipitation, meagre as it is momentarily exceeds the infiltration capability of the surface. Such precipitation is not of course capricious in terms of quantity, location and distribution in time. For more accurate investigation, remote sensing data was used to overcome the large area. Finally for arid basins, combined data from remote sensing (Cosmos and Aerial photographs) data and topography maps provided significant results.

  3. The first isolation of Trichosporon coremiiforme from soil in Iran

    Science.gov (United States)

    Jamali, S; Gharaei, M

    2015-01-01

    Background and Purpose: Trichosporon is a genus of anamorphic basidiomycetous yeast which is widely distributed in nature and is found in tropical and temperate areas. The aim of this work was to study the isolation, identification and molecular analysis of Trichosporon species in soil. Materials and Methods: In order to isolate and identify Trichosporon species in soil, 30 samples were collected from 30 different locations across Iran. The isolates were identified by means of the standard methods of yeast identification. To confirm morphological identification, genomic DNA was extracted and the hypervariable D1/D2 domain of the large-subunit (LSU) ribosomal DNA (rDNA) gene was amplified by polymerase chain reaction (PCR), using primer pair NL-1/NL-4, and then the sequences were analyzed. Results: According to the morphological and physiological assessments, isolates were identified as T. coremiiforme. The isolates formed chlamydospore after one week on yeast-malt (YM) agar medium. Using Blast program, we found that the D1/D2 sequences of the T. coremiiforme isolates from Iran (accession no: KP055040 and KP055041) showed 99% homology with the T. coremiiforme deposited in GenBank. All the T. coremiiforme isolates placed in the Ovoides cluster were well-supported by bootstrap values. Conclusion: The present study is the first attempt to survey Trichosporon in soil of Iran. To the best of our knowledge, this is the first investigation of T. coremiiforme in Iran. PMID:28680990

  4. Type B Hepatitis in Iran

    Directory of Open Access Journals (Sweden)

    M. Tabarestani

    1977-01-01

    Full Text Available Hepatitis B surface antigen CHBsAg was found in 1% of controls, 2.1% of professional blood donors, 2.0% of leprosy patients and 76.1% of acute hepatitis in Tehran and Mashhad, Iran. All HBsAg positive samples also possessed antibody to the hepatitis B core antigen and all were subtype ayw. Type B hepatitis and the HBsAg state aloe frequent in Iran, but most must be accounted for by u nonparenter- al" or "rnapparent'' parenteral exposure.

  5. Autism Spectrum Disorders in Iran

    OpenAIRE

    Mohammadi, Mohammad Reza; Salmanian, Maryam; AKHONDZADEH, Shahin

    2011-01-01

    How to Cite this Article: Mohammadi MR, Salmanian M, Akhondzadeh Sh. Autism Spectrum Disorders in Iran. Iranian Journal of Child Neurology2011;5(4):1-9.ObjectiveAutistic disorder, Asperger syndrome, and PDD-Not Otherwise Specified are subsets of autism spectrum disorders (ASDs), which are characterized by impairments in social communication and stereotyped behavior. This article reviews the prevalence, etiology, diagnosis, and treatment of ASDs in Iran.Materials & MethodsWe searched PubMe...

  6. Structures, processes and outcomes of the Aussie Heart Guide Program: A nurse mentor supported, home based cardiac rehabilitation program for rural patients with acute coronary syndrome.

    Science.gov (United States)

    Frohmader, Terence J; Lin, Frances; Chaboyer, Wendy P

    2018-03-01

    Cardiac rehabilitation has a number of benefits for patients, yet participation in it is sub-optimal, especially in regional Australia. Innovative models of cardiac rehabilitation are needed to improve participation. Providing nurse mentors to support patients transitioning from hospital to home represents a new model of service delivery in Australia. To explore the impact of a home-based cardiac rehabilitation program in assisting patients to recover from Acute Coronary Syndrome and meeting the expectations of nurse mentors delivering the program. This case study was underpinned by the structure, process and outcomes model and occurred in three Australian hospitals 2008-2011. Thirteen patients recovering from acute coronary syndrome were interviewed by telephone and seven nurse mentors completed a survey after completing the program. Mentor perceptions concerning the structures of the home-based CR program included the timely recruitment of patients, mentor training to operationalise the program, commitment to development of the mentor role, and the acquisition of knowledge and skills about cognitive behavioural therapy and patient centred care. Processes included the therapeutic relationship between mentors and patients, suitability of the program and the promotion of healthier lifestyle behaviours. Outcomes identified that patients were satisfied with the program's audiovisual resources, and the level of support and guidance provided by their nurse mentors. Mentors believed that the program was easy to use in terms of its delivery. Patients believed the program assisted their recovery and were satisfied with the information, guidance and support received from mentors. There were positive signs that the program influenced patients' decisions to change unhealthy lifestyle behaviours. Outcomes highlighted both rewards and barriers associated with mentoring patients in their homes by telephone. Experience gained from developing a therapeutic relationship with

  7. Tissue and organ donation and transplantation in Iran.

    Science.gov (United States)

    Goodarzi, Parisa; Aghayan, Hamid Reza; Larijani, Bagher; Rafiee, Alireza Baradaran; Falahzadeh, Khadijeh; Sahebjam, Mehrnaz; Ghaderi, Firoozeh; Arjmand, Babak

    2015-06-01

    Tissue and organ transplantation is one of the most promising treatments for some incurable diseases. Nowadays, transplantation is the common therapy in many countries. Unfortunately, availability of donated tissues and organs is limited. There are several factors which may affect donation rate for instance; social factors, culture, religion, and family decision. Accordingly, religious beliefs have a crucial role in tissue and organ donation and transplantation. Islam as a code of life has a comprehensive road map to lead mankind. Spiritual view of human life is considered to be much more valuable in Islam. Therefore, saving a human life is one of the most important Islamic teachings. In Iran as a Muslim country, tissue and organ transplantation program was established based on religious scholars' permission which has an essential role towards considerable development of the program in Iran.

  8. The Office Guidelines Applied to Practice program improves secondary prevention of heart disease in Federally Qualified Healthcare Centers

    Directory of Open Access Journals (Sweden)

    Adesuwa Olomu

    2016-12-01

    Office-GAP resulted in increased use of guideline-based medications for secondary CVD prevention in underserved populations. The Office-GAP program could serve as a model for implementing guideline-based care for other chronic diseases.

  9. Buenos hábitos alimenticios para una buena salud : evaluation of a nutrition education program to improve heart health and brain health in Latinas.

    Science.gov (United States)

    Otilingam, Poorni G; Gatz, Margaret; Tello, Elizabeth; Escobar, Antonio Jose; Goldstein, Aviva; Torres, Mina; Varma, Rohit

    2015-02-01

    The goal of this research was to evaluate nutrition education targeting Latinas, a group at particular risk of obesity and diabetes, which predict to later life cardiovascular disease and dementia. Culturally tailored, theory-based nutrition education was provided to Mexican origin Latinas aged 48 to 84. The randomized design compared participants in workshops incorporating the connection between dietary fat and brain health, participants in workshops focusing only on dietary fat and heart health, a waitlist control group, and a posttest only control group. Among those assigned to either intervention, there was statistically significant gain in health literacy, knowledge about dietary fat, and behaviors to reduce dietary fat compared with waitlist control. There was no difference in outcomes between those given the module about diet and brain health and those not provided that module. A program to encourage dietary fat modification in Latinas proved feasible and modestly effective. © The Author(s) 2014.

  10. Familial Characteristics of Street Children in Tehran, Iran

    OpenAIRE

    Ahmad Khaniha, Ahmad Reza; Hakim Shooshtari, Mitra; Mohammadian, Mehrdad; Bidaki, Reza; Pourrashidi Boshrabadi, Ahmad

    2014-01-01

    Objective: The phenomenon of street children is one of the most important concerns facing global community. Identifying risk factors in such children could lead to crucial investigations to find their essential needs by intervention programs. The present study examined the family profile of street children in Tehran, Iran. Methods: The sample consisted of 576 street children who were evaluated by 15 examiners. Using multi-stage sampling, twenty-seven different areas of Tehran were divided int...

  11. From Framingham to North Karelia to U.S. Community Prevention Programs: Negotiating Research Agendas for Coronary Heart Disease in the Second Half of the 20th Century

    Directory of Open Access Journals (Sweden)

    Henry Blackbuen

    2011-01-01

    Full Text Available In the United States in 1948, the newly formed National Heart Institute (NHI responded to what its data showed as a rising tide of coronary heart disease (CHD by underwriting new approaches to the elucidation of chronic disorders. In the process, it funded the application of epidemiology, previously almost exclusively concerned with communicable disease, to study CHD. With federal encouragement, CHD epidemiologists enriched research designs, helped develop the randomized controlled trial, and played a pioneering role in chronic disease prevention at the individual and population levels. While government funding was critical to the evolution of this rich scientific work, a vibrant epidemiological imagination was able to capitalize on decades of national political commitment to chronic disease research. Epidemiologists developed longitudinal studies meant to determine the relationship between well-measured clinical variables and subsequent CHD events. Here, consistent associations within and across populations, eventually reinforced by analyses of pooled data from multiple cohort investigations, demonstrated the existence of well-founded risk factors, but left open the question of causal inference based on observed relationships. After substantial ambivalence, the U.S. government, under pressure from epidemiologists, committed to an agenda of clinical trials to test that proposition. In addition, the results of the cohort studies elicited a demand by epidemiologists for a broader, population-wide approach,testing whether community-level models of risk factor modification through broad cultural change would demonstrate a reduction in the probability of disability and premature death from heart attack.To tell the story of the community studies and to analyze outcomes, we focus on the Minnesota Heart Health Program and the Finnish North Karelia Project. From the North Karelia experience, we find that health promotion campaigns in communities at

  12. 31 CFR 535.433 - Central Bank of Iran.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Central Bank of Iran. 535.433 Section... § 535.433 Central Bank of Iran. The Central Bank of Iran (Bank Markazi Iran) is an agency, instrumentality and controlled entity of the Government of Iran for all purposes under this part. (Secs. 201-207...

  13. Heart transplantation.

    Science.gov (United States)

    Cheng, Allen; Slaughter, Mark S

    2014-08-01

    Heart failure remains a major global problem with approximately 6 million individuals suffering from heart failure in the United States alone. The surgical technique of heart transplantation, popularized by Dr. Norman Shumway, has led to its success and currently remains the best treatment options for patients with end-stage. However, with the continued limitation of donor organs and the rapid development of ventricular assist device technology, the number of patients bridged to transplant with mechanical circulatory support has increased significantly. This has created some new technical challenges for heart transplantation. Therefore, it is now important to be familiar with multiple new technical challenges associated with the surgical techniques of heart transplantation with an ultimate goal in reducing donor heart ischemic time, recipient cardiopulmonary bypass time and post-operative complications. In this review, we described our technique of heart transplantation including the timing of the operation, recipient cardiectomy and donor heart implantation.

  14. Enlarged Heart

    Science.gov (United States)

    ... the valves are damaged by conditions such as rheumatic fever, a heart defect, infections (infectious endocarditis), connective tissue disorders, certain medications or radiation treatments for cancer, your heart may ...

  15. Heart Truth

    Science.gov (United States)

    ... health! Get a free badge or banner to post to your website or blog. Are you at risk for heart disease? Here's how to find out . Planning to use The Heart Truth logo? Check out our logo guidelines and downloads. ...

  16. Heart Failure

    Science.gov (United States)

    ... heart failure due to systolic dysfunction. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ... patient with heart failure or cardiomyopathy. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ...

  17. Multidimensional child deprivation in Iran

    NARCIS (Netherlands)

    Yousefzadeh Faal Daghati, Sepideh; Mideros-Mora, Andrés; De Neubourg, Chris; Minujin, Alberto; Nandy, Shailen

    The chapter analyses children's multidimensional deprivation in Iran in 2009 and explores inequalities in different regions. The study focused on outcome indicators, with the level of analysis focusing on the individual child as well as the household. A child rights approach is applied to define

  18. IRAN IN DIE INTERNASIONALE MAGSTRYD

    African Journals Online (AJOL)

    which enjoy significant support in the workforce of the manufacturing and oil industries. Inleiding. The comparison of ...... Press, Princeton, 1964. 3. Burrell, A.M., Cottrell, A.J.: Iran, The Arabian Peninsula and the. Indian Ocean,. 1ste uitgawe. Strategy Papers no 14, National. Strategy Information. Center Inc., New York, 1972.

  19. Heart Failure

    DEFF Research Database (Denmark)

    Jorsal, Anders; Wiggers, Henrik; McMurray, John J V

    2018-01-01

    This article briefly discusses the epidemiology of heart failure and diabetes and summarizes the key findings from the recent cardiovascular outcome trials in patients with type 2 diabetes, with a focus on heart failure as an endpoint.......This article briefly discusses the epidemiology of heart failure and diabetes and summarizes the key findings from the recent cardiovascular outcome trials in patients with type 2 diabetes, with a focus on heart failure as an endpoint....

  20. Priority Setting for Improvement of Cervical Cancer Prevention in Iran

    Directory of Open Access Journals (Sweden)

    Azam Majidi

    2016-04-01

    Full Text Available Background Cervical cancer is the fourth most common cancer among women worldwide. Organized cervical screening and vaccination against human papilloma virus (HPV have been successful interventions for prevention of invasive cervical cancer (ICC. Because of cultural and religious considerations, ICC has low incidence in Iran and many other Muslim countries. There is no organized cervical screening in these countries. Therefore, ICC is usually diagnosed in advanced stages with poor prognosis in these countries. We performed a priority setting exercise and suggested priorities for prevention of ICC in this setting. Methods We invited experts and researchers to a workshop and asked them to list important suggestions for ICC prevention in Iran. After merging similar items and removing the duplicates, we asked the experts to rank the list of suggested items. We used a strategy grid and Go-zone analysis to determine final list of priorities for ICC prevention in Iran. Results From 26 final items suggested as priorities for prevention of ICC, the most important priorities were developing national guidelines for cervical screening and quality control protocol for patient follow-up and management of precancerous lesions. In addition, we emphasized considering insurance coverage for cervical screening, public awareness, and research priorities, and establishment of a cervical screening registry. Conclusion A comprehensive approach and implementation of organized cervical screening program is necessary for prevention of ICC in Iran and other low incidence Muslim countries. Because of high cost for vaccination and low incidence of cervical cancer, we do not recommend HPV vaccination for the time being in Iran.

  1. Nuclear-powered artificial heart prototype system development program. Quarterly progress report, April 1, 1976--June 30, 1976

    Energy Technology Data Exchange (ETDEWEB)

    1976-01-01

    Research progress and accomplishments on the active program tasks (35-46) are reported. The tasks include thermal insulation and thermal protection; thermal converter; blood pump and power coupling; thermal and hydraulics; system integration and interfacing; IVBM system performance; IVBM system fabrications; added IVBM blood pump fabrication; IVBM system life testing; and reliability and quality assurance. (TFD)

  2. The National Heart, Lung, and Blood Institute Recipient Epidemiology and Donor Evaluation Study (REDS-III): A research program striving to improve blood donor and transfusion recipient outcomes

    Science.gov (United States)

    Kleinman, Steven; Busch, Michael P; Murphy, Edward L; Shan, Hua; Ness, Paul; Glynn, Simone A.

    2014-01-01

    Background The Recipient Epidemiology and Donor Evaluation Study -III (REDS-III) is a 7-year multicenter transfusion safety research initiative launched in 2011 by the National Heart, Lung, and Blood Institute. Study design The domestic component involves 4 blood centers, 12 hospitals, a data coordinating center, and a central laboratory. The international component consists of distinct programs in Brazil, China, and South Africa which involve US and in-country investigators. Results REDS-III is using two major methods to address key research priorities in blood banking/transfusion medicine. First, there will be numerous analyses of large “core” databases; the international programs have each constructed a donor/donation database while the domestic program has established a detailed research database that links data from blood donors and their donations, the components made from these donations, and data extracts from the electronic medical records of the recipients of these components. Secondly, there are more than 25 focused research protocols involving transfusion recipients, blood donors, or both that are either in progress or scheduled to begin within the next 3 years. Areas of study include transfusion epidemiology and blood utilization; transfusion outcomes; non-infectious transfusion risks; HIV-related safety issues (particularly in the international programs); emerging infectious agents; blood component quality; donor health and safety; and other donor issues. Conclusions It is intended that REDS-III serve as an impetus for more widespread recipient and linked donor-recipient research in the US as well as to help assure a safe and available blood supply in the US and in international locations. PMID:24188564

  3. HEART RETRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    R. Sh. Saitgareev

    2016-01-01

    Full Text Available The number of patients with transplanted heart is continuously increasing; therefore, the number of patients requiring heart retransplantation grows. Analysis of the results of published studies focused on safety of cardiac retransplantation and risk factors for adverse events in perioperative, early and late postoperative periods is presented in our review. The results of published studies suggest that heart retransplantation is the main radical treatment option for cardiac allograft dysfunction, but the results of heart retransplantation are slightly worse than those of primary cardiac transplantation. On the other hand, the favorable long-term prognosis after heart retransplantation should be expected in carefully selected recipients. 

  4. Iran and Strategic Power Projection: The Iran-Iraq War as a Foundation of Understanding

    National Research Council Canada - National Science Library

    Knight, Darric M

    2007-01-01

    .... Using the Iran-Iraq War as a lens through which to examine Iran during a stressful conventional conflict, the research illustrates a number of characteristics and trends still representative of the regime today...

  5. Peer mentoring is associated with positive change in physical activity and aerobic fitness of grades 4, 5, and 6 students in the heart healthy kids program.

    Science.gov (United States)

    Spencer, Rebecca A; Bower, Jenna; Kirk, Sara F L; Hancock Friesen, Camille

    2014-11-01

    Only 7% of Canadian children achieve activity recommendations, contributing to obesity and preventable disease. The Heart Healthy Kids (H2K) program was designed to test the relationship between peer mentoring, physical activity, and cardiovascular fitness. Participants from 10 schools (5 control, 5 intervention) were enrolled in the program. In control schools, H2K included a physical activity challenge and education sessions. Intervention schools included the addition of a peer-mentoring component. Physical activity was measured through daily pedometer recording. Cardiovascular fitness was evaluated using the PACER (Progressive Aerobic Cardiovascular Endurance Run) protocol to calculate maximal oxygen uptake (VO2 max). Participants included 808 children (average age 9.9 ± 1.0 years). Although control and intervention schools did not differ at baseline, participants with peer mentoring logged significantly more steps per school day, on average, than those in control schools (6,785 ± 3,011 vs. 5,630 ± 2,586; p < .001). Male participants logged significantly more steps per school day than female participants. A significant improvement in VO2 max was also noted in intervention schools, with an average increase of 1.72 ml/mg/min. H2K was associated with positive change in physical activity and cardiovascular fitness, suggesting that peer mentoring shows promise for application in health promotion interventions. © 2014 Society for Public Health Education.

  6. The StrongWomen–Healthy Hearts Program: Reducing Cardiovascular Disease Risk Factors in Rural Sedentary, Overweight, and Obese Midlife and Older Women

    Science.gov (United States)

    Lichtenstein, Alice H.; Seguin, Rebecca A.; Goldberg, Jeanne P.; Kuder, Julia F.; Nelson, Miriam E.

    2009-01-01

    Objectives. We tested a community-based intervention designed to reduce cardiovascular disease risk in sedentary midlife and older women who were overweight or obese. Methods. In a randomized controlled trial conducted in 8 counties in Arkansas and Kansas, counties were assigned to the intervention (a 12-week twice-weekly heart health program) group or to the delayed-intervention control group. Ten to fifteen women were selected from each site, and participants' weight, waist circumference, diet, physical activity, and self-efficacy were measured before and after the intervention. Data were analyzed with multiple regressions. Results. Compared with the control group, participants in the intervention group had a significant decrease in body weight (−2.1 kg; 95% confidence interval [CI] = −3.2, −1.0), waist circumference (–2.3 in; 95% CI = −4.2, −0.5), and energy intake (–390 kcal/day; 95% CI = −598, −183); an increase in activity (+1637 steps/day; 95% CI = 712, 2562); and an increase in self-efficacy for dietary and physical activity behaviors. Conclusions. Our results suggest that a community-based program can improve self-efficacy, increase physical activity, and decrease energy intake, resulting in decreased waist circumference and body weight among at-risk women. PMID:19443826

  7. The StrongWomen-Healthy Hearts program: reducing cardiovascular disease risk factors in rural sedentary, overweight, and obese midlife and older women.

    Science.gov (United States)

    Folta, Sara C; Lichtenstein, Alice H; Seguin, Rebecca A; Goldberg, Jeanne P; Kuder, Julia F; Nelson, Miriam E

    2009-07-01

    We tested a community-based intervention designed to reduce cardiovascular disease risk in sedentary midlife and older women who were overweight or obese. In a randomized controlled trial conducted in 8 counties in Arkansas and Kansas, counties were assigned to the intervention (a 12-week twice-weekly heart health program) group or to the delayed-intervention control group. Ten to fifteen women were selected from each site, and participants' weight, waist circumference, diet, physical activity, and self-efficacy were measured before and after the intervention. Data were analyzed with multiple regressions. Compared with the control group, participants in the intervention group had a significant decrease in body weight (-2.1 kg; 95% confidence interval [CI] = -3.2, -1.0), waist circumference (-2.3 in; 95% CI = -4.2, -0.5), and energy intake (-390 kcal/day; 95% CI = -598, -183); an increase in activity (+1637 steps/day; 95% CI = 712, 2562); and an increase in self-efficacy for dietary and physical activity behaviors. Our results suggest that a community-based program can improve self-efficacy, increase physical activity, and decrease energy intake, resulting in decreased waist circumference and body weight among at-risk women.

  8. Nuclear-Powered Artificial Heart Prototype System Development Program: Phase III. Quarterly progress report, January 1, 1976--March 31, 1976

    Energy Technology Data Exchange (ETDEWEB)

    1976-01-01

    Research progress is reported on tasks 35 through 46 of phase III of the program. The tasks include: thermal insulation and thermal protection; thermal converter; blood pump and power coupling; thermal and hydraulic R and D; system integration and interfacing; IVBM system performance testing; IVBM system fabrication and fabrication support; added IVBM blood pump fabrication; IVBM system life testing; IVBM field support; and reliability and quality assurance. (TFD)

  9. A prospective study of the health effects of alcohol consumption in middle-aged and elderly men. The Honolulu Heart Program.

    Science.gov (United States)

    Goldberg, R J; Burchfiel, C M; Reed, D M; Wergowske, G; Chiu, D

    1994-02-01

    The study objective was to determine the association between reported alcohol consumption and total mortality, mortality from selected causes, and incident nonfatal chronic disease events in middle-aged (51 to 64 years old) and elderly (65 to 75 years old) men during an approximate 15-year follow-up period. We conducted a prospective epidemiological study of Japanese-American men who were participating in the Honolulu Heart Program and were free from coronary heart disease, cerebrovascular disease, and cancer at baseline examination and at subsequent reexamination 6 years later. Self-reported alcohol consumption was determined twice: at the baseline examination in 1965 through 1968 and at reexamination approximately 6 years later (1971 through 1974). Four primary alcohol consumption groups who reported similar alcohol intake at the time of these two clinical examinations were considered: abstainers and light (1 to 14 mL of alcohol per day), moderate (15 to 39 mL of alcohol per day), and heavy (> or = 40 mL of alcohol per day) drinkers. Study end points were also determined in very light (1 to 4.9 mL of alcohol per day) drinkers and in men who reported a change in their alcohol intake between examinations. Longitudinal follow-up was carried out through the end of 1988 with determination of selected fatal and nonfatal events according to alcohol intake. After controlling for several potentially confounding factors, total mortality exhibited a J-shaped pattern in relation to alcohol consumption in middle-aged and elderly men. There was a trend for lower rates of occurrence of combined fatal and nonfatal coronary heart disease events with increasing alcohol consumption in both middle-aged and elderly men. Increasing alcohol consumption was related to an increased risk of fatal and nonfatal strokes in middle-aged men, whereas elderly light and moderate drinkers were at increased risk for fatal and nonfatal strokes. Heavy drinkers were at increased risk for fatal and

  10. Beta Globin Frameworks in Thalassemia Major Patients from North Iran

    Science.gov (United States)

    Akhavan-Niaki, Haleh; Banihashemi, Ali; Azizi, Mandana

    2012-01-01

    Objective Four combinations of five neutral sequence changes at rs713040, rs10768683, rs7480526, rs7946748, and rs1609812 occurring in the human beta globin gene defined as frameworks have been reported in beta globin gene. Here we report for the frequency of these frameworks in thalassemia major patients of North Iran. Methods Beta globin gene frameworks of 46 thalassemia major patients of North Iran were determined using Denaturing Gradient Gel Electrophoresis. Findings All these frameworks called framework 1, 2, 3, 3a were present at the frequency of 23.9%, 45.7%, 6.5% and 23.9% respectively. Conclusion These frameworks may be used for tracking mutant alleles in prenatal diagnosis programs. PMID:23399541

  11. First case report of primary Actinomycosis of the breast due to Actinomyces Israelii from Iran

    Directory of Open Access Journals (Sweden)

    Daie Ghazvini R

    2003-06-01

    Full Text Available Present paper reports a case of breast actinomycosis due to Actinomyces israelii in a 31-year-ol female nurse from Shahrekord, in Iran. Diagnosis was based on the observation of short and very fine gram-positive filaments in direct examination of aspirates from fistulas, as well as isolation of organism in sodium thioglycolate and brain heart infusion blood agar (BHIB culture media, under anaerobic conditions and complementary phyiologic tests.

  12. Development of Motivate4Change Using the Intervention Mapping Protocol: An Interactive Technology Physical Activity and Medication Adherence Promotion Program for Hospitalized Heart Failure Patients.

    Science.gov (United States)

    Oosterom-Calo, Rony; Te Velde, Saskia J; Stut, Wim; Brug, Johannes

    2015-07-20

    It is important that heart failure (HF) patients adhere to their medication regimen and engage in physical activity. Evidence shows that adherence to these HF self-management behaviors can be improved with appropriate interventions. To further promote medication adherence and physical activity among HF patients, we developed an intervention for hospitalized HF patients. The intervention mapping protocol was applied in the development of the intervention. This entailed performing a needs assessment, defining change objectives, selecting determinants and strategies, and developing the materials. The resulting intervention, Motivate4Change, makes use of interactive technology and provides HF patients with personalized feedback and advice. Specific change objectives were defined. The relevant behavioral determinants for the physical activity program were practical knowledge on physical activity performance and self-efficacy for, and perceived benefits of, physical activity. For medication-taking, the selected determinants were practical knowledge on medication-taking, perceived barriers to medication-taking, beliefs about the necessity and harm regarding the medication prescribed, and beliefs about overprescribing and harm of medication in general. The change objectives and behavior change determinants were translated in feedback and advice strategies in an interactive technology program that included tailored feedback and advice, and role models in videos in which the behaviors and overcoming barriers were demonstrated. Relevant stakeholders were involved in the interventions development process. The intervention was pretested among HF patients and adjustments were made accordingly. The interactive technology physical activity and medication adherence promotion program for hospitalized HF patients was systematically developed using the intervention mapping protocol and was based on the available theory and evidence regarding HF self-management behavior change. The

  13. A new flea from Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi Darvishi

    2014-04-01

    Full Text Available Fleas are obligatory ectoparsites of humans and animals. These tiny insects are hematophagous and they can transmit a wide varity of disease agents to humans and domesticated animals. Indeed, this pest causes a considerable economic damages and health dangers particularly in tropical and subtropical. During an investigation on ectoparasites of five Mus muscuuls in Semnan province, Iran, 15 fleas (8 males and 7 females were collected. The extracted fleas mounted using clearing, dehydrating, mounting process and preserved with Canada balsam. After precise study, all of examined specimens were recognized as Leptopsylla aethiopicus aethiopicus using available systematic keys. This is the first report of this genus and species in Iran. And this country is new locality for Leptopsylla aethiopicus aethiopicus.

  14. The National Heart, Lung, and Blood Institute Small Business Program: A Comprehensive Ecosystem for Biomedical Product Development.

    Science.gov (United States)

    Marek, Kurt W

    2016-12-01

    Small companies working to develop products in the cardiovascular space face numerous challenges, from regulatory, intellectual property, and reimbursement barriers to securing funds to keep the lights on and reach the next development milestone. Most small companies that spin out from universities have the scientific knowledge, but product development expertise and business acumen are also needed to be successful. Other challenges include reduced interest in early stage technologies (Pharma & Biotech 2015 in Review, EP Vantage) and limited deal flow for cardiovascular products (Gormley B., Wall Street Journal, September 15, 2014). The NHLBI small business program is a comprehensive ecosystem designed to address these critical challenges and to provide resources and expertise to assist early stage companies developing cardiovascular and other products within the institute's mission. This article describes steps that NHLBI has taken to enhance our small business program to more effectively translate basic discoveries into commercial products to benefit patients and public health, including enhancing internal expertise and developing non-financial resources to assist small businesses as they develop their products and seek private sector investment and partnership.

  15. The NASA 2017 Eclipse Education Program: Through the Eyes of NASA to the Hearts of a Nation

    Science.gov (United States)

    Young, C. Alex; Mayo, Louis; Ng, Carolyn; Cline, Troy D.; Lewis, Elaine; Stephenson, Bryan; Odenwald, Sten; Hill, Steele; Bleacher, Lora; Kirk, Michael S.; jones, andrea

    2016-05-01

    The August 21, 2017, eclipse across America will be seen by an estimated 500 million people from northern Canada to South America as well as parts of western Europe and Africa. Through This "Great American Eclipse" NASA in partnership with Google, the American Parks Network, American Astronomical Society, the Astronomical League, and numerous other science, education, outreach, and public communications groups and organizations will develop the approaches, resources, partnerships, and technology applications necessary to bring the excitement and the science of the August 21st, 2017 total solar eclipse across America to formal and informal audiences in the US and around the world. This effort will be supported by the highly visible and successful Sun Earth Days program and will be the main theme for Sun-Earth Days 2017.This presentation will discuss NASA's education and communication plans for the eclipse and will detail a number of specific programs and partnerships from across the country being leveraged to enhance our reach and impact. We also discuss the observations and science of current and future NASA missions such as SDO, Hinode and Solar Probe Plus along with their relationship to such a unique celestial event as a total solar eclipse.

  16. Pediatric burns in Khuzestan Province, Iran.

    Science.gov (United States)

    Houshyarikhah, Hojjat; Shayestehfard, Marzieh; Javaherizadeh, Hazhir; Cheraghian, Bahman; Latifzadeh, Shila; Madari, Zahra

    2012-04-01

    Burn injuries are the most frequently occurring injuries among pediatric populations worldwide, and they are significant pediatric injuries in Iran. This study was conducted to analyze the pattern of pediatric burns in Khuzestan province in the south-west of Iran from April 2006 to March 2007. The location of the study was Taleghani Hospital, a sole center for burn patients in Khuzestan province. The number of patients with burns admitted to the center in 1 year (from April 2006 to March 2007) was 211. Data were obtained by reviewing the medical records of patients hospitalized at the center. Of the patients, 85 (40.3%) were female and 126 (59.7%) were male. Of the 85 female patients, 50 were from urban areas and 35 were from rural areas. Of the 126 male patients, 68 (54%) were from urban areas and 58 (46%) were from rural areas. The mean ± SE age of the children ranging between 0 and 11 years was 3.20 ± 0.188. Scalding was the predominant cause of burns and caused 86.7% of the burns. The age of the patients with scald injuries (2.95 ± 2.56 years) was significantly lower than that of patients with flame injuries (4.28 ± 3.3 years) (P=0.007). Correlation analysis showed that younger children and urban residents are more vulnerable to scald injuries. The mean body surface area of burns was 20.5 ± 10.26 cm in all patients. Scalding was the most common cause of burns. Age burn accidents in children in Khuzestan. An appropriate burn prevention program, with focus on education, is needed to prevent this injury.

  17. Iran: Illusion, Reality, and Interests

    Science.gov (United States)

    2012-09-01

    government emerged loosely based on the secular Turkish model established by Mustafa Kemal - Ataturk .3 The fractured nature of society and political...Iran 39 Turkey, Mustafa Kemal was making progress toward modernization that appeared almost miraculous. Given Reza Shah’s military background, his...attempted to impose authoritarian top-down modernization on a pre-modern society. Like Mustafa Kemal in Turkey, Reza Shah believed that traditional

  18. Hypoplastic left heart syndrome

    Science.gov (United States)

    HLHS; Congenital heart - hypoplastic left heart; Cyanotic heart disease - hypoplastic left heart ... Hypoplastic left heart is a rare type of congenital heart disease. It is more common in males than in females. As ...

  19. Experience of a Maastrich type II non heart beating donor program in a small city: preliminary results.

    Science.gov (United States)

    Miñambres, E; Suberviola, B; Guerra, C; Lavid, N; Lassalle, M; González-Castro, A; Ballesteros, M A

    2015-10-01

    To study the results of a non-controlled cardiac death (Maastricht type II) donor program in a city of 200,000 inhabitants. The study was initially focused on lung donation and was extended to kidney donation after 9 months. A prospective observational study was conducted between October 2012 and December 2013. The Intensive Care Unit of Marqués de Valdecilla University Hospital in Santander (Spain), and surrounding areas. Patients (< 55 years) who died of out-of-hospital cardiac arrest. All out-of-hospital cardiac arrests were treated with mechanical cardiac compression (LUCAS II). The diagnosis of death and organ preservation were performed in the ICU. A total of 14 calls were received, of which three were discarded. Of the 11 potential donors, 7 were effective donors with a median age of 39.5 years (range: 32-48). A total of 5 single lung transplants and four kidney transplants were performed. In addition, corneas and tissues were harvested. The non-valid donors were rejected mainly due to technical problems. There were no donation refusals on the part of the patient relatives. The lung transplant patient survival rate was 100% after one month and 80% after one year. One month after transplantation, the kidney recipients had a serum creatinine concentration of<2mg/dl. The interval from cardiac arrest to renal preservation was 80minutes (range: 71-89), and the interval from cardiac arrest to lung preservation was 84minutes (range: 77-94). A Maastricht type II donation program in a small city is viable for both abdominal and thoracic organs. The program was initially very cautious, but its potential is easily improvable by increasing donor and by equipping mobile ICU ambulances with mechanical cardiac compression systems. Full management of the donor in the ICU, avoiding the emergency department or operating rooms, reduces the warm ischemia time, thereby improving transplant outcomes. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  20. Exercise and Your Heart.

    Science.gov (United States)

    National Heart and Lung Inst. (DHHS/NIH), Bethesda, MD.

    This pamphlet presents information on the effects of physical activity on the heart and practical guidelines for starting and staying on an exercise program. The following topics are discussed: (1) the benefits of getting sufficient exercise; (2) possible risks in exercising compared to benefits; (3) when to seek doctor's advice and prevention of…

  1. Agenda Setting And Irans Nuclear News In BBC & VOA Persian Websites During 2004-2006 --- برجسته‏سازي اخبار انرژي هسته اي ايران در بخش فارسي سايت‏هاي بي بي سي و صداي آمريكا طي سال هاي1383 تا 1385

    OpenAIRE

    Behnam Rezagholizadeh - بهنام رضاقلي زاده; Abdullah Guivian, - عبدالله گيويان

    2010-01-01

    Islamic Republic of Irans nuclear program is one of the most important topics and issues in Iran and at the international level. Since being introduced, this program has been criticized and somehow rejected by Western countries and maily by the U.S. These countries claim that Iran may want to access nuclear weapons; but the Islamic Republic of Iran believes that all of her nuclear activities are peaceful and within the framework of the International Atomic Energy Agency obligations. Using...

  2. Participation in Heart-Healthy Behaviors: A Secondary Analysis of the American Heart Association Go Red Heart Match Data.

    Science.gov (United States)

    Arslanian-Engoren, Cynthia; Eastwood, Jo-Ann; De Jong, Marla J; Berra, Kathy

    2015-01-01

    The American Heart Association created Go Red Heart Match, a free and secure online program that enables women to connect with each other to fight heart disease either personally or as a caregiver for someone with heart disease. Through these connections, participants have an opportunity to develop a personal, private, and supportive relationship with other women; share common experiences; and motivate and encourage each other to follow a heart-healthy lifestyle. The aims of this study were to describe the demographic characteristics of the Go Red Heart Match responders and to determine whether participation in the program prompted participants to engage in heart-healthy behaviors. A secondary analysis of data collected as part of a needs assessment survey from the American Heart Association Go Red Heart Match was conducted. A total of 117 (35%) of the 334 invited women completed the survey. Most responders were female, married, and college educated. A total of 105 (90%) responders were diagnosed with a type of heart disease or stroke and 77 (73%) responders had undergone treatment. As a result of participating in the program, 75% of the responders reported the following improvements in heart-healthy behaviors: eating a more heart-healthy diet (54%), exercising more frequently (53%), losing weight (47%), and quitting smoking (10%). Responders who had a diagnosis of heart attack (n = 48) were more likely (P = .003) to quit smoking than were those with other diagnoses (n = 69). Notably, 48% of responders reported encouraging someone else in their life to speak to their doctor about their risk for heart disease. Most women who participated in Heart Match reported engaging in new heart-healthy behaviors. The findings support expanding the existing program in a more diverse population as a potentially important way to reach women and encourage cardiovascular disease risk reduction for those with heart disease and stroke.

  3. Chelation for Coronary Heart Disease

    Science.gov (United States)

    ... procedures, and cardiac rehabilitation (a program consisting of education, counseling, and exercise training) are among the mainstays of conventional treatment . Some heart patients also turn to chelation therapy using disodium EDTA ( ...

  4. Iran, the bomb and the pursuit of security. Structured conflict analyses; Iran, die Bombe und das Streben nach Sicherheit. Strukturierte Konfliktanalysen

    Energy Technology Data Exchange (ETDEWEB)

    Bock, Andreas M. [Akkon-Hochschule fuer Humanwissenschaften, Berlin (Germany); Henneberg, Ingo (ed.) [Freiburg Univ. (Germany). Professur fuer Governance in Mehrebenensystemen

    2014-07-01

    This volume introduces readers to the structured conflict analysis as a tool of social science research and uses this instrument exemplarily to analyze systematically and on a broad basis the various conflicts that are associated with Iran both domestically and in foreign policy - beyond popular stereotypes such as the ''bomb''. The 13 contributions draw a complex picture of the conflicts with and in Iran and reflect the various aspects of these conflicts from different perspectives and at a high methodological and theoretical level. The nuclear program is examined, inter alia through the eyes of four major theories of International Relations. In addition, the analyses are concerned with the regional security dimension, the relationship USA-Iran, the role of national preferences, and the effect of national processes to the Iranian foreign policy.

  5. Efficacy of a Community-Based Physical Activity Program KM2H2 for Stroke and Heart Attack Prevention among Senior Hypertensive Patients: A Cluster Randomized Controlled Phase-II Trial.

    Science.gov (United States)

    Gong, Jie; Chen, Xinguang; Li, Sijian

    2015-01-01

    To evaluate the efficacy of the program Keep Moving toward Healthy Heart and Healthy Brain (KM2H2) in encouraging physical activities for the prevention of heart attack and stroke among hypertensive patients enrolled in the Community-Based Hypertension Control Program (CBHCP). Cluster randomized controlled trial with three waves of longitudinal assessments at baseline, 3 and 6 months post intervention. Community-based and patient-centered self-care for behavioral intervention in urban settings of China. A total of 450 participants diagnosed with hypertension from 12 community health centers in Wuhan, China were recruited, and were randomly assigned by center to receive either KM2H2 plus standard CBHCP care (6 centers and 232 patients) or the standard care only (6 centers and 218 patients). KM2H2 is a behavioral intervention guided by the Transtheoretical Model, the Model of Personalized Medicine and Social Capital Theory. It consists of six intervention sessions and two booster sessions engineered in a progressive manner. The purpose is to motivate and maintain physical activities for the prevention of heart attack and stroke. Heart attack and stroke (clinically diagnosed, primary outcome), blood pressure (measured, secondary outcome), and physical activity (self-report, tertiary outcome) were assessed at the individual level during the baseline, 3- and 6-month post-intervention. Relative to the standard care, receiving KM2H2 was associated with significant reductions in the incidence of heart attack (3.60% vs. 7.03%, p heart attack and stroke among senior patients who are on anti-hypertensive medication. Findings of this study provide solid data supporting a formal phase-III trial to establish the effectiveness of KM2H2 for use in community settings for prevention. ISRCTN Register ISRCTN12608966.

  6. The "Happy Heart" educational program for changes in health habits in children and their families: protocol for a randomized clinical trial.

    Science.gov (United States)

    Minossi, Vanessa; Pellanda, Lucia Campos

    2015-03-10

    The prevalence of childhood obesity increased worldwide in recent decades and is associated with risk factors for the development of chronic diseases in adulthood. Strategies for health promotion directed at an early age, with recommendation for healthy habits, can achieve good results. The objective of this study is to evaluate the effectiveness of an innovative, simple and cost effective educational program to improve eating habits, physical activity and the knowledge about healthy habits in children, as well as in their families, as compared to routine outpatient care. The study is designed as a randomized clinical trial. Sample size is estimated to include 37 children, aged between 7 and 11 years, and their guardians, randomized for an intervention or a control group. The intervention will consist of 11-weekly group meetings of nutritional education and distribution of explanatory material, with orientation about healthy food and family habits and physical activity. Recreational, simple and low cost resources, carefully designed for the presentation of contents to the children and parents, will be used in all meetings. The control group will receive standard outpatient care based in individual clinical practice guidelines. The primary outcomes will be changes in dietary habits, knowledge and physical activity of children and adults. The secondary outcomes will be changes of body mass index, waist circumference, systolic and diastolic blood pressure and laboratory tests, in children and adults. The Happy Heart Study offers a playful and low-cost approach for the prevention and control of obesity and cardiovascular disease in children. Although this program is being planned for implementation in Brazil, the method can be adapted to many other countries. Protocol registered on the site ensaiosclinicos.gov.br: RBR-8ttw64.

  7. Heart transplant

    Science.gov (United States)

    ... check for infections Tests of your kidney and liver Tests to evaluate your heart, such as EKG , echocardiogram , and cardiac catheterization Tests to look for cancer Tissue and blood typing , to help make sure your body will not reject the donated heart Ultrasound of your neck and legs You will want ...

  8. Heart Attack

    Science.gov (United States)

    ... This substance travels to your heart. A special camera uses the substance to produce pictures. These show ... guard against certain diseases, including heart disease. New studies have shown ... If you have an acute case of angina (chest pain), your doctor will probably ...

  9. Heart Truth for African American Women

    Science.gov (United States)

    ... Quit, and just one year later, your heart disease risk will drop by more than half. There’s no easy way to quit but making a plan helps. You also can try an organized program or ... of heart disease, stroke, and congestive heart failure. Even levels slightly ...

  10. Modernization and Consanguineous Marriage in Iran.

    Science.gov (United States)

    Givens, Benjamin P.; Hirschman, Charles

    1994-01-01

    Used data on 4,667 women from the Iran Fertility Survey to examine trends and social correlates of consanguineous marriage. Found modest increase in proportion of marriages between cousins in Iran from 1940s to 1970s. Results suggest that modernization may be eroding social bases on consanguinity, whereas increased availability of cousins may lead…

  11. Reflections on Foreign Language Education in Iran

    Science.gov (United States)

    Farhady, Hossein; Hezaveh, Fattaneh Sajadi; Hedayati, Hora

    2010-01-01

    This article reflects upon foreign-language education in Iran. Contrary to its political and historical reputation in the world, Iran has not been well presented regarding its educational system in general and its foreign-language education in particular. Of course, a critical assessment of the strengths and weaknesses of the Iranian education…

  12. Turkey and Iran Transcaucasia Policy: Comparative Analysis

    Directory of Open Access Journals (Sweden)

    А V Suleimanov

    2010-03-01

    Full Text Available Turkey and Iran Transcaucasia modern foreign policy is analyzed. As is known, Turkey and Iran historically were the competing parties for spheres of influence in Transcaucasia, as well as Russia, the USA and the Great Britain. Regional relations between Azerbaijan, Armenia and Georgia are discussed in context of Nagorno-Karabakh and Georgia-South Ossetia conflicts and Caspian problem.

  13. Factors Associated with Incidence of Induced Abortion in Hamedan, Iran.

    Science.gov (United States)

    Hosseini, Hatam; Erfani, Amir; Nojomi, Marzieh

    2017-05-01

    There is limited reliable information on abortion in Iran, where abortion is illegal and many women of reproductive age seek clandestine abortion to end their unintended pregnancy. This study aims to examine the determinants of induced abortion in the city of Hamedan, Iran. The study utilizes recent data from the 2015 Hamedan Survey of Fertility, conducted in a representative sample of 3,000 married women aged 15-49 years in the city of Hamedan, Iran. Binary logistic regression models are used to examine factors associated with the incidence of abortion. Overall, 3.8% of respondents reported having had an induced abortion in their life. Multivariate results showed that the incidence of abortion was strongly associated with women's education, type of contraceptive and family income level, after controlling for confounding factors. Women using long-acting contraceptive methods, those educated under high school diploma or postsecondary education, and those with high level of income were more likely to report having an induced abortion. The high incidence of abortion among less or more educated women and those with high income level signifies unmet family planning needs among these women, which must be addressed by focused reproductive health and family planning programs.

  14. Women's Views About Domestic Violence: A Qualitative Study in Iran.

    Science.gov (United States)

    Shams, Mohsen; Kianfard, Leila; Parhizkar, Saadat; Mousavizadeh, Ali

    2017-05-01

    Violence against women is an urgent health priority in Iran. Designing effective programs for preventing and controlling the problem necessitates a thorough understanding of Iranian women and their perspectives regarding domestic violence. This study was aimed at exploring the domestic violence-related views of married women who were referred to health care facilities in Ahvaz, Iran. In this qualitative research, data were collected through four focus group discussions with 30 married women. All the discussions were recorded and transcribed, after which the data were classified separately. The main themes and subthemes were then manually derived from the data and analyzed. The five main themes identified were domestic violence against women in Ahvaz, behavioral influencing factors, nonbehavioral influencing factors, the necessity to empower women to prevent domestic violence, and recommendations for developing special training programs for Ahvazi women. Most of the participants were aware that domestic violence against women is a common occurrence in Iran. They were well aware of the definition of violence and expressed a belief that behavioral factors exert an important effect on the occurrence of the problem. They recommended the development of appropriate training programs that empower women to prevent the problem, the use of mass media to educate citizens about domestic violence, and the involvement of opinion leaders in eliminating the taboo against considering such violence a crime against Iranian women. Considering the views and ideas of women as consumers of educational services is a principle used to develop effective programs for preventing and controlling domestic violence. As indicated by the findings, the participants believe that empowering women must be treated as a priority in the Iranian health care system. However, they recommended differing approaches and methods of empowerment on the basis of their individual views and concerns.

  15. Simple, heart-smart substitutions

    Science.gov (United States)

    Coronary artery disease - heart smart substitutions; Atherosclerosis - heart smart substitutions; Cholesterol - heart smart substitutions; Coronary heart disease - heart smart substitutions; Healthy diet - heart ...

  16. 31 CFR 560.304 - Government of Iran.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Government of Iran. 560.304 Section... § 560.304 Government of Iran. The term Government of Iran includes: (a) The state and the Government of Iran, as well as any political subdivision, agency, or instrumentality thereof; (b) Any entity owned or...

  17. HIV/AIDS policy agenda setting in Iran.

    Science.gov (United States)

    Khodayari-Zarnaq, Rahim; Ravaghi, Hamid; Mohammad Mosaddeghrad, Ali; Sedaghat, Abbas; Mohraz, Minoo

    2016-01-01

    HIV/AIDS control are one of the most important goals of the health systems. The aim of this study was to determine how HIV/AIDS control was initiated among policy makers' agenda setting in Iran. A qualitative research (semi-structured interview) was conducted using Kingdon's framework (problem, policy and politics streams, and policy windows and policy entrepreneurs) to analysis HIV/AIDS agenda setting in Iran. Thirty-two policy makers, managers, specialists, and researchers were interviewed. Also, 30 policy documents were analyzed. Framework analysis method was used for data analysis. the increase of HIV among Injecting drug users (IDUs) and Female Sex Workers (FSWs), lack of control of their high-risk behaviors, and exceeding the HIV into concentrated phase were examples of problem stream. Policy stream was evidence-based solutions that highlighted the need for changing strategies for dealing with such a problem and finding technically feasible and acceptable solutions. Iran's participation in United Nations General Assembly special sessions on HIV/AIDS (UNGASS), the establishment of National AIDS Committee; highlighting AIDS control in Iran's five years development program and the support of the judiciary system of harm reduction policies were examples of politics stream. Policy entrepreneurs linking these streams put the HIV/AIDS on the national agenda (policy windows) and provide their solutions. There were mutual interactions among these three streams and sometimes, they weakened or reinforced each other. Future studies are recommended to understand the interactions between these streams' parts and perhaps develop further Kingdon's framework, especially in the health sector.

  18. High hepatitis C virus prevalence among drug users in Iran: systematic review and meta-analysis of epidemiological evidence (2001–2012

    Directory of Open Access Journals (Sweden)

    Mohsen Malekinejad

    2015-11-01

    Conclusions: HCV prevalence is high in drug users in Iran, especially among those with a history of injection drug use, needle sharing, and imprisonment. Drug user-focused HCV prevention and treatment programs are urgently needed.

  19. A pharmacist-led follow-up program for patients with established coronary heart disease in North Norway – a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Garcia BH

    2015-06-01

    Full Text Available Objectives: The aim of the study was twofold; 1 to develop a clinical pharmacist-led 12 month lasting follow-up program for patients with established coronary heart disease (CHD discharged from the University Hospital of North Norway, and 2 to explore the impact of the program with regards to adherence to a medication assessment tool for secondary prevention of CHD and change in biomedical risk factors. Methods: A total of 102 patients aged 18-82 years were enrolled in a non-blinded randomized controlled trial with an intervention group and a control group. The intervention comprised medication reconciliation, medication review and patient education during three meetings; at discharge, after three months and after twelve months. The control group received standard care from their general practitioner. Primary outcomes were adherence to clinical guideline recommendations concerning prescription, therapy goal achievement and lifestyle education defined in the medication assessment tool for secondary prevention of CHD (MAT-CHDSP. Secondary outcomes included changes in the biomedical risk factors cholesterol, blood pressure and blood glucose. Results: Ninety-four patients completed the trial, 48 intervention group patients and 46 controls. Appropriate prescribing was high, but therapy goal achievement was low in both groups. Overall adherence to MAT-CHDSP criteria increased in both groups and was significantly higher in the intervention group at study end, 78.4% vs. 62.0%, p<0.001. The difference was statistically significant for the documented lifestyle advices in intervention group patients. No significant improvements in biomedical risk factors were observed in favor of the intervention group. Conclusions: The study showed an increased guideline adherence in both study groups. This indicates that attention to clinical practice guideline recommendations in itself increases adherence – which may be a clinical pharmacist task. A larger adequately

  20. Improving continuing medical education by enhancing interactivity: lessons from Iran.

    Science.gov (United States)

    Faghihi, Seyed Aliakbar; Khankeh, Hamid Reza; Hosseini, Seyed Jalil; Soltani Arabshahi, Seyed Kamran; Faghih, Zahra; Parikh, Sagar V; Shirazi, Mandana

    2016-04-01

    Continuing Medical Education (CME) has been considered as a lifelong commitment for doctors to provide the optimal care for patients. Despite a long history of creating CME programs, outcomes are far from ideal. The present qualitative study aims to clarify the barriers affecting effectiveness of the CME programs in Iran based on the experiences of general practitioners. Sixteen general practitioners were recruited to participate in in-depth interviews and field observations concerning experiences with CME. The study was performed using a qualitative content analysis method. The codes, categories and themes were explored through an inductive process in which the researchers moved from specific to general. The participants' experiences identified a number of barriers, particularly insufficient interaction with the instructors; additional problems included the teachers' use of an undifferentiated approach; unreal and abstract CME; and ignorance of the diverse reasons to participate in CME. Based on the study results, there are multiple barriers to effective implementation of CME in Iran. The key barriers include insufficient interaction between the trainees and providers, which must be considered by other stakeholders and program designers. Such interactions would facilitate improved program design, invite more specific tailoring of the education to the participants, allow for more effective educational methods and set the stage for outcome evaluation from the learners actually applying their new knowledge in practice. Replication of these findings with another sample would improve confidence in these recommendations, but these findings are broadly consistent with findings in the educational literature on improving the efficacy of CME.

  1. The Monetary Burden of Cystic Echinococcosis in Iran

    Science.gov (United States)

    Fasihi Harandi, Majid; Budke, Christine M.; Rostami, Sima

    2012-01-01

    Cystic echinococcosis (CE) is a globally distributed parasitic infection of humans and livestock. The disease is of significant medical and economic importance in many developing countries, including Iran. However, the socioeconomic impact of the disease, in most endemic countries, is not fully understood. The purpose of the present study was to determine the monetary burden of CE in Iran. Epidemiological data, including prevalence and incidence of CE in humans and animals, were obtained from regional hospitals, the scientific literature, and official government reports. Economic data relating to human and animal disease, including cost of treatment, productivity losses, and livestock production losses were obtained from official national and international datasets. Monte Carlo simulation methods were used to represent uncertainty in input parameters. Mean number of surgical CE cases per year for 2000–2009 was estimated at 1,295. The number of asymptomatic individuals living in the country was estimated at 635,232 (95% Credible Interval, CI 149,466–1,120,998). The overall annual cost of CE in Iran was estimated at US$232.3 million (95% CI US$103.1–397.8 million), including both direct and indirect costs. The cost associated with human CE was estimated at US$93.39 million (95% CI US$6.1–222.7 million) and the annual cost associated with CE in livestock was estimated at US$132 million (95% CI US$61.8–246.5 million). The cost per surgical human case was estimated at US$1,539. CE has a considerable economic impact on Iran, with the cost of the disease approximated at 0.03% of the country's gross domestic product. Establishment of a CE surveillance system and implementation of a control program are necessary to reduce the economic burden of CE on the country. Cost-benefit analysis of different control programs is recommended, incorporating present knowledge of the economic losses due to CE in Iran. PMID:23209857

  2. Information report brought in the application of the article 145 of the regulation by the foreign affairs commission in conclusion of the works of an information mission constituted the 30 January 2008 (1), on Iran and the geo-political equilibrium in Middle East; Rapport d'information depose en application de l'article 145 du reglement par la commission des affaires etrangeres en conclusion des travaux d'une mission d'information constituee le 30 janvier 2008 (1), sur Iran et equilibre geopolitique au Moyen-Orient

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    This information report presents the Iran situation concerning the nuclear energy and its military program. It discusses in a first part the certainty concerning the military nuclear program. The second part is devoted to historical aspects of the today situation, the negotiations, the international sanctions and the Iran motivations. The third part presents the objective of the international community for the Iran: play a stabilizing role in the Middle East. (A.L.B.)

  3. 78 FR 21183 - Persons on Whom Sanctions Have Been Imposed Under the Iran Sanctions Act of 1996 and the Iran...

    Science.gov (United States)

    2013-04-09

    ... on Whom Sanctions Have Been Imposed Under the Iran Sanctions Act of 1996 and the Iran Threat... persons have engaged in sanctionable activity described in section 5(a)(8) of the Iran Sanctions Act of...''), that the following persons have engaged in sanctionable activity described in section 212 of the Iran...

  4. Acute Poisoning in Elderly; a Five-Year Study (2008-2013 in Hamadan, Iran

    Directory of Open Access Journals (Sweden)

    Saeed Afzali

    2015-12-01

    Conclusion: Deliberate self-harm and poisoning with opioids especially methadone showed a high prevalence in elderly poisoned patients in Hamadan, Iran.  It seems that drug trafficking control, addiction rehabilitation therapies and suicide prevention programs for elderly can be helpful in poisoning reduction in this age group in this part of the country.

  5. Prevalence of burnout among nurses in Iran: a systematic review and meta-analysis.

    Science.gov (United States)

    Rezaei, S; Karami Matin, B; Hajizadeh, M; Soroush, A; Nouri, B

    2018-01-30

    This study aimed to summarize the available information in the literature to make an accurate estimate of the prevalence of burnout among Iranian nurses. Burnout is a work-related stress syndrome that has negative impact on healthcare providers, patients and healthcare delivery systems. A comprehensive search of literature using international [PubMed, Scopus and the Institute for Scientific Information (ISI)] and Iranian scientific data bases [Scientific Information Database (SID), IranMedex and Magiran] was conducted to identify English and Persian language studies, published between 2000 and 2016, that examined the prevalence of burnout among nurses in Iran. The I-squared test and Chi-squared-based Q-test suggested heterogeneity of reported prevalence among the qualified studies; thus, a random-effects model was applied to estimate the overall prevalence of burnout among nurses in Iran. Based on 21 selected articles with 4180 participants, the overall prevalence of burnout among Iranian nurses was estimated to be 36% [95% confidence interval (CI), 20-53%] in Iran. Meta-regression indicated that sample size and year of data collection, mean age of samples, female to male ratio and geographic regions were not statistically significantly associated with the prevalence of burnout. Also, based on Egger's test and funnel plot, there is no publication bias among studies included in the analysis. Professional burnout affects more than one-third of nursing staff in Iran; thus, effective interventions and strategies are required to reduce and prevent burnout among nurses. Due to the negative consequences of burnout on patients, nurses and organizations, nursing and healthcare managers should intervene to prevent and reduce burnout among nurses in Iran. Policy attention should focus on developing effective interventions to prevent and minimize the burden of burnout among nurses in Iran. Nurses' involvement in the policy-making process is crucial in the implementation of

  6. Histopathological study on parasites in freshwater ornamental fishes in Iran.

    Science.gov (United States)

    Nematollahi, A; Jaberi, S; Helan, J Ashrafi; Sheikhzadeh, N

    2016-09-01

    During March 2012 through February 2013, 100 freshwater ornamental fishes in 22 species from some aquarium fish shops were examined. Specimens were dissected and tissue samples consisted of liver, kidney, spleen, heart, intestine, ovary, brain and eye were fixed in 10 % buffered formalin and sections were provided and stained with hematoxylin and eosin, Periodic Acid-Schiff, Giemsa and acid-fast staining (Ziehl-Neelsen). At present study six species of protozoans consisting of Eimeria spp. Cryptosporidium spp., Tetrahymena corlissi, Thecamoeba spp., Giardia spp., Myxobolus spp. and two metazoan parasite consisting of Nematoda spp. and Benedenia monticelli were identified. Thecamoeba, B. monticelli and Cryptosporidium spp. were not reported in previous Iranian studies and it is the first report of infestation to this parasite in ornamental fish in Iran.

  7. Intake of fish oil, oleic acid, folic acid, and vitamins B-6 and E for 1 year decreases plasma C-reactive protein and reduces coronary heart disease risk factors in male patients in a cardiac rehabilitation program.

    Science.gov (United States)

    Carrero, Juan Jesús; Fonollá, Juristo; Marti, José Luis; Jiménez, Jesús; Boza, Julio J; López-Huertas, Eduardo

    2007-02-01

    Certain nutrients have been shown to be effective in preventing coronary heart disease. We hypothesized that a daily intake of low amounts of a number of these nutrients would exert beneficial effects on risk factors and clinical variables in patients that suffered from myocardial infarction (MI) and were following a cardiac rehabilitation program. Forty male MI patients were randomly allocated into 2 groups. The supplemented group consumed 500 mL/d of a fortified dairy product containing eicosapentaenoic acid, docosahexaenoic acid, oleic acid, folic acid, and vitamins A, B-6, D, and E. The control group consumed 500 mL/d of semi-skimmed milk with added vitamins A and D. The patients received supervised exercise training, lifestyle and dietary recommendations, and they were instructed to consume the products in addition to their regular diet. Blood extractions and clinical examinations were performed after 0, 3, 6, 9, and 12 mo. Plasma concentrations of eicosapentaenoic acid, docosahexaenoic acid, oleic acid, folic acid, vitamin B-6, and vitamin E increased after supplementation (Pprotein concentrations decreased in the supplemented group (P<0.05), and plasma total homocysteine decreased in both groups. There were no changes in heart rate, blood pressure, or cardiac electrocardiographic parameters in either group. Therapeutic lifestyle changes, effected through a CR program comprising regular exercise and the intake of a combination of dietary nutrients, reduced a variety of risk factors in MI patients, which supports the rationale for nutritional programs in the secondary prevention of coronary heart disease.

  8. Cost-effectiveness of rabies post exposure prophylaxis in Iran.

    Science.gov (United States)

    Hatam, Nahid; Esmaelzade, Firooz; Mirahmadizadeh, Alireza; Keshavarz, Khosro; Rajabi, Abdolhalim; Afsar Kazerooni, Parvin; Ataollahi, Marzieh

    2014-01-01

    The rabies is one of the most important officially-known viral zoonotic diseases for its global distribution, outbreak, high human and veterinary costs, and high death rate and causes high economic costs in different countries of the world every year. The rabies is the deadliest disease and if the symptoms break out in a person, one will certainly die. However, the deaths resulting from rabies can be prevented by post-exposure prophylaxis. To do so, in Iran and most of the countries in the world, all the people who are exposed to animal bite receive Post-Exposure Prophylaxis (PEP) treatment. The present survey aimed to investigate the cost-effectiveness of PEP in southern Iran. The present study estimated the PEP costs from the government`s Perspective with step-down method for the people exposed to animal bite, estimated the number of DALYs prevented by PEP in the individuals using decision Tree model, and computed the Incremental cost-effectiveness Ratio. The information collected of all reported animal bite cases (n=7111) in Fars Province, who referred rabies registries in urban and rural health centers to receive active care. Performing the PEP program cost estimated 1,052,756.1 USD for one  year and the estimated cost for the treatment of each animal bite case and each prevented death was 148.04 and 5945.42 USD, respectively. Likewise 4,509.82 DALYs were prevented in southern Iran in 2011 by PEP program. The incremental cost-effectiveness ratio for each DALY was estimated to be 233.43 USD. In addition to its full effectiveness in prophylaxis from rabies, PEP program saves the financial resources of the society, as well. This study showed performing PEP to be more cost-effective.

  9. Wine and heart health

    Science.gov (United States)

    Health and wine; Wine and heart disease; Preventing heart disease - wine; Preventing heart disease - alcohol ... more often just to lower your risk of heart disease. Heavier drinking can harm the heart and ...

  10. What Is Heart Failure?

    Science.gov (United States)

    ... Intramural Research Home / Heart Failure Heart Failure Also known as Congestive heart failure What ... diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays ...

  11. What Causes Heart Failure?

    Science.gov (United States)

    ... Intramural Research Home / Heart Failure Heart Failure Also known as Congestive heart failure What ... diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays ...

  12. Living with Heart Failure

    Science.gov (United States)

    ... Intramural Research Home / Heart Failure Heart Failure Also known as Congestive heart failure What ... diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays ...

  13. About Heart Attacks

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More About Heart Attacks Updated:Jan 27,2017 A heart attack is ... coronary artery damage leads to a heart attack . Heart Attack Questions and Answers What is a heart attack? ...

  14. Men and Heart Disease

    Science.gov (United States)

    ... Pressure Salt Cholesterol Million Hearts® WISEWOMAN Men and Heart Disease Fact Sheet Recommend on Facebook Tweet Share Compartir Source: Interactive Atlas of Heart Disease and Stroke Heart Disease Facts in Men Heart disease is the leading ...

  15. Heart Disease (For Kids)

    Science.gov (United States)

    ... System Taking Care of Your Teeth Bad Breath Heart Disease KidsHealth > For Kids > Heart Disease Print A A ... chest pain, heart attacks, and strokes . What Is Heart Disease? The heart is the center of the cardiovascular ...

  16. Heart Attack

    Science.gov (United States)

    ... pain Fatigue Heart attack Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  17. Heart pacemaker

    Science.gov (United States)

    ... rhythms Bleeding Punctured lung. This is rare. Infection Puncture of the heart, which can lead to bleeding ... Rinse your mouth with water if it feels dry, but be careful not to swallow. Take the ...

  18. Heart block

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007658.htm Heart block To use the sharing features on this page, ... Date 4/16/2017 Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of ...

  19. Heart attack

    Science.gov (United States)

    ... heart attack. A stent is a small, metal mesh tube that opens up (expands) inside a coronary ... e228. PMID: 25260718 www.ncbi.nlm.nih.gov/pubmed/25260718 . Anderson JL. ST segment elevation acute myocardial ...

  20. Selective enrollment in Disease Management Programs for coronary heart disease in Germany - An analysis based on cross-sectional survey and administrative claims data.

    Science.gov (United States)

    Röttger, Julia; Blümel, Miriam; Busse, Reinhard

    2017-04-04

    In 2002, Disease Management Programs (DMPs) were introduced within the German healthcare system with the aim to increase the quality of chronic disease care. Due to the enrollment procedures, it can be assumed a) that only certain patients actively decide to enroll in a DMP and/or b) that only certain patients get the recommendation for DMP enrollment from their physician. How strong this assumed effect of self- and/or professional selection is, is still unclear. We used data from a cross-sectional postal-survey linked on individual level with administrative claims data from a German sickness fund. The sample consisted of individuals suffering from coronary heart disease (CHD) who i) were either enrolled in the respective DMP or ii) fulfilled the disease related criteria for enrollment but were not enrolled. We applied multivariate logistic regression analyses to assess factors on patient level associated with DMP enrollment. We included 7070 individuals in our analyses. Male sex, higher age and receiving old age pension, a higher Charlson Score and a diagnosis of type 2 diabetes increased the odds for DMP-CHD enrollment significantly. Individuals with a diagnosed myocardial infarction (MI) were also more likely to be enrolled in the DMP-CHD. We found a significant interaction effect for MI and sex, indicating that the association between MI and DMP enrollment is stronger for women than for men. DMP-enrollees and non-enrollees differ in various factors. Studies analyzing the effectiveness of DMP-CHD should carefully take into account these group differences. Furthermore, the results suggest that the DMP-CHD assessed reaches men better than women.

  1. Statin treatment patterns and clinical profile of patients with risk factors for coronary heart disease defined by National Cholesterol Education Program Adult Treatment Panel III.

    Science.gov (United States)

    Kern, David M; Balu, Sanjeev; Tunceli, Ozgur; Anzalone, Deborah

    2014-12-01

    To compare clinical characteristics, statin treatment patterns and adherence among patients at different risk for coronary heart disease (CHD) as defined by National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines. Patients ≥ 18 years old with ≥ 1 claim for dyslipidemia, ≥ 1 statin claim, or ≥ 1 LDL-C value ≥ 100 mg/dL were identified from 1 January 2007 to 31 July 2012. Patients were classified as low risk (LR) (0-1 risk factor: hypertension, age ≥ 45 years [men] or ≥ 55 years [women], or low HDL-C), moderate/moderately high risk (MR) (≥ 2 risk factors), high risk (HR) (CHD or CHD risk equivalent), or very high risk (VHR) (acute coronary syndrome, or established cardiovascular disease plus diabetes or metabolic syndrome). Medication use and lipid levels during the 12 months before and statin use during the 6 months after index were compared across risk groups. There were 1,524,351 LR, 242,357 MR, 188,222 HR, and 57,469 VHR patients identified. Statin use was observed in 15% of all patients, but was higher in the VHR group (45%) versus LR (12%), MR (18%), and HR (29%) groups. Simvastatin accounted for 50%-52% of all statin use, and average statin dose was higher among VHR patients compared with all other groups. Adherence was low overall (mean proportion of days covered [PDC]: 0.57), but higher among VHR (0.69) versus others (mean PDC: 0.55, 0.59, and 0.59 in LR, MR, and HR groups, respectively). Statin treatment was low across all risk groups, and VHR patients had higher doses and better adherence compared with other risk groups. However, adherence was not optimal, indicating a potential limited benefit from statin treatment.

  2. Training and Capacity Building in LMIC for Research in Heart and Lung Diseases: The NHLBI-UnitedHealth Global Health Centers of Excellence Program.

    Science.gov (United States)

    Bloomfield, Gerald S; Xavier, Denis; Belis, Deshirée; Alam, Dewan; Davis, Patricia; Dorairaj, Prabhakaran; Ghannem, Hassen; Gilman, Robert H; Kamath, Deepak; Kimaiyo, Sylvester; Levitt, Naomi; Martinez, Homero; Mejicano, Gabriela; Miranda, J Jaime; Koehlmoos, Tracey Perez; Rabadán-Diehl, Cristina; Ramirez-Zea, Manuel; Rubinstein, Adolfo; Sacksteder, Katherine A; Steyn, Krisela; Tandon, Nikhil; Vedanthan, Rajesh; Wolbach, Tracy; Wu, Yangfeng; Yan, Lijing L

    2016-03-01

    Stemming the tide of noncommunicable diseases (NCDs) worldwide requires a multipronged approach. Although much attention has been paid to disease control measures, there is relatively little consideration of the importance of training the next generation of health-related researchers to play their important role in this global epidemic. The lack of support for early stage investigators in low- and middle-income countries interested in the global NCD field has resulted in inadequate funding opportunities for research, insufficient training in advanced research methodology and data analysis, lack of mentorship in manuscript and grant writing, and meager institutional support for developing, submitting, and administering research applications and awards. To address this unmet need, The National Heart, Lung, and Blood Institute-UnitedHealth Collaborating Centers of Excellence initiative created a Training Subcommittee that coordinated and developed an intensive, mentored health-related research experience for a number of early stage investigators from the 11 Centers of Excellence around the world. We describe the challenges faced by early stage investigators in low- and middle-income countries, the organization and scope of the Training Subcommittee, training activities, early outcomes of the early stage investigators (foreign and domestic) and training materials that have been developed by this program that are available to the public. By investing in the careers of individuals in a supportive global NCD network, we demonstrate the impact that an investment in training individuals from low- and middle-income countries can have on the preferred future of or current efforts to combat NCDs. Published by Elsevier B.V.

  3. Patient's rights charter in Iran.

    Directory of Open Access Journals (Sweden)

    Alireza Parsapoor

    2014-01-01

    Full Text Available Given the importance of patient's rights in healthcare, special attention has been given to the concept of patient's rights by the Ministry of Health and Medical Education in Iran. Iranian patient's rights charter has been compiled with a novel and comprehensive approach. This charter aims to elucidate rights of recipients of health services as well as observing ethical standards in medicine. This paper presents the Iranian patient's rights charter. Based on a study done from 2007 to 2009, the charter has been finalized through an extensive consultation involving all stakeholders, patients, physicians, nurses, lawyers, patient associations and health policy makers. The developed charter was adopted by the Ministry of Health in December 2009. Iranian patient's rights charter has been formulated in the framework of 5 chapters and 37 articles including vision and an explanatory note. The five chapters concern right to receiving appropriate services, right to access desired and enough information, right to choose and decide freely about receiving healthcare, right to privacy and confidentiality, and finally right to access an efficient system of dealing with complaints which have been explained in 14, 9, 7, 4 and 3 articles, respectively.  The paper concludes that, adopting the patient's rights charter is a valuable measure to meet patient's rights; however, a serious challenge is how to implement and acculturate observing patient's rights in practice in our healthcare system in Iran.

  4. CMS Virtual Visit from Iran - 28 April 2016

    CERN Multimedia

    Zeinali, Maryam

    2016-01-01

    First introductory workshop about CERN for high school physics teachers School of particles and accelerators at IPM in association with Physics Society of Iran held a national workshop for high school physics teachers in order to introduce CERN to this community. It took place on 27-28 April 2016, in Tehran. The program highly relied on the ability and enthusiasm of teachers to distribute this knowledge to their students who are the main target, even if indirectly, for these kind of activities. By inviting teachers from all over the country, specially from those towns with no strong Internet connections at schools, we had the opportunity to broaden our target.

  5. Research Ethics Education in Post-Graduate Medical Curricula in I.R. Iran.

    Science.gov (United States)

    Nikravanfard, Nazila; Khorasanizadeh, Faezeh; Zendehdel, Kazem

    2017-08-01

    Research ethics training during post-graduate education is necessary to improve ethical standards in the design and conduct of biomedical research. We studied quality and quantity of research ethics training in the curricula of post-graduate programs in the medical science in I.R. Iran. We evaluated curricula of 125 post-graduate programs in medical sciences in I.R. Iran. We qualitatively studied the curricula by education level, including the Master and PhD degrees and analyzed the contents and the amount of teaching allocated for ethics training in each curriculum. We found no research ethics training in 72 (58%) of the programs. Among the 53 (42%) programs that considered research ethics training, only 17 programs had specific courses for research ethics and eight of them had detailed topics on their courses. The research ethics training was optional in 25% and mandatory in 76% of the programs. Post-graduate studies that were approved in the more recent years had more attention to the research ethics training. Research ethics training was neglected in most of the medical post-graduate programs. We suggest including sufficient amount of mandatory research ethics training in Master and PhD programs in I.R. Iran. Further research about quality of research ethics training and implementation of curricula in the biomedical institutions is warranted. © 2016 John Wiley & Sons Ltd.

  6. A heart within a heart.

    Science.gov (United States)

    Carreras, Edward T; Barghash, Maya; Givertz, Michael M; Bhatt, Deepak L

    2017-06-01

    A 44-year-old man with a history of end-stage dilated cardiomyopathy status-post orthotopic cardiac transplant 14 years ago presented for coronary angiography in preparation for re-operative tricuspid valve replacement. Coronary angiography revealed an anomalous origin of the left coronary artery, with a common coronary trunk arising from the right coronary cusp and bifurcating into right and left main coronary arteries. Interestingly, the right and left coronary arteries coursed to form the shape of a heart, hence, a heart within a heart! © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  7. The effectiveness of German disease management programs (DMPs) in patients with type 2 diabetes mellitus and coronary heart disease: results from an observational longitudinal study.

    Science.gov (United States)

    Laxy, Michael; Stark, Renée; Meisinger, Christa; Kirchberger, Inge; Heier, Margit; von Scheidt, Wolfgang; Holle, Rolf

    2015-01-01

    Although the population-based German disease management programs (DMPs) for diabetes mellitus (DM) and coronary heart disease (CHD) are among the biggest worldwide, evidence on the effectiveness of these programs is still inconclusive or missing, particularly for high risk patients with comorbidities. The objective of this study was therefore to analyze the impact of DMPs on process and outcome parameters in patients with both, type 2 DM and CHD. Analyses are based on two postal surveys of patients from the KORA myocardial infarction registry (southern Germany) with type 2 DM and on two postal validation studies with patients' general physicians (2006, n = 312 and 2011, n = 212). The association between DMP enrollment (being enrolled in either DMP-DM or DMP-CHD) and guideline care (defined by several process indicators) at baseline (2006) and its development until follow-up (2011) was analyzed using logistic regression models accounting for the repeated measurements structure. The impact of DMP enrollment/guideline care on cumulated (quality-adjusted) life years ((QA)LYs) over a 4-year time horizon (2006-2010) was assessed using multiple linear regression methods. Logistic regression models were applied to analyze the association between DMP status and patient self-management at follow-up. Being enrolled in a DMP was associated with better guideline care at baseline [OR = 2.3 (95 % CI 1.27-4.03)], but not at follow-up [OR = 0.80 (95 % CI 0.40-1.58); p value for time-interaction management than patients not being enrolled into a DMP. The results of this study concerning the effectiveness of DMPs in patients with DM and CHD are mixed, but are weakly in favor of DMPs. However, we found a clear positive impact of guideline care on quality adjusted survival in this patient group. The development of the association between DMP enrollment and guideline care over the follow-up time indicates some external effects, which should be the subject of further

  8. Blogistan: The Internet and Politics in Iran

    OpenAIRE

    Sreberny, Annabelle; Khiabany, Gholam

    2010-01-01

    The protests unleashed by Iran's disputed presidential election in June 2009 brought the Islamic Republic's vigorous cyber culture to the world's attention. Iran has an estimated 700,000 bloggers, and new media such as Facebook, Twitter and YouTube were thought to have played a key role in spreading news of the protests. The internet is often celebrated as an agent of social change in countries like Iran, but most literature on the subject has struggled to grasp what this new phenomenon actua...

  9. Antimicrobial-resistant Shigella infections from Iran

    DEFF Research Database (Denmark)

    Tajbakhsh, Mercedeh; García Migura, Lourdes; Rahbar, Mohammad

    2012-01-01

    of 44 Shigella isolates were collected from Iranian patients admitted to Milad Hospital, Tehran, Iran, during 2008–10. Of these, 37 were serotyped and characterized by MIC determination. A subset of eight suspected extended-spectrum β-lactamase (ESBL) producers (six Shigella sonnei phase II and two...... or the presence of an endemic clone in Iran. ; Conclusions: This is the first known description of ESBL-producing and AmpC β-lactamase-producing Shigella and of PMQR Shigella in Iran. The emergence of CTX-15, CMY-2 and qnrS1 genes may compromise the treatment of shigellosis. Strategies to minimize the spread...

  10. Report of A Larval Parasitoid of Tuta Absoluta (Meyrick (Lepidoptera: Gelechiidae from Iran

    Directory of Open Access Journals (Sweden)

    Sohrabi Fariba

    2014-07-01

    Full Text Available The tomato leafminer Tuta absoluta (Meyrick is one of the most devastating pests of greenhouse and outdoor tomato crops. Since it is a newly introduced pest in Iran, there is an important need to search for its natural enemies. In the course of a survey on the natural enemies of this pest, samplings were carried out in tomato greenhouses heavily infested with the tomato leafminer, in the Borazjan region of the Bushehr province in Iran. Leaves with mines were reared in the laboratory until emergence of parasitoids. A single parasitoid species of the family Eulophidae was reared and identified as Neochrysocharis formosus (Westwood 1833. This species is reported for the first time on the tomato leafminer in Iran. Such information may help in developing biological control programs to control this serious pest.

  11. Prevalence of iron deficiency anemia among adolescent schoolgirls from Kermanshah, Western Iran.

    Science.gov (United States)

    Akramipour, Reza; Rezaei, Mansour; Rahimi, Zohreh

    2008-12-01

    Iron deficiency anemia is a major health problem in developing countries. Anemia reduces physical work capacity and cognitive function and adversely affects learning and scholastic performance in schoolgirls entering adolescence. A cross-sectional study was conducted to determine the prevalence of iron deficiency, iron deficiency anemia and anemia among adolescent school girls aged 14-20 years from 20 different high schools located in three educational areas of Kermanshah, the capital of Kermanshah province in Western Iran. The prevalence of anemia (HbIran were found to be lower than those reported for females aged 12-18 years. In conclusion, regarding the detrimental long-term effects and high prevalence of iron deficiency, iron deficiency anemia and anemia in Kermanshah, Western Iran its prevention could be a high priority in the programs of health system of the country and supplementation of a weekly iron dose is recommended.

  12. Assisted Reproductive Technology in Iran: The First National Report on Centers, 2011

    Directory of Open Access Journals (Sweden)

    Mehrandokht Abedini

    2016-09-01

    Full Text Available Background: Due to the worldwide increase in infertility, it is both necessary and important to have assisted reproductive technology (ART registries. In Iran, donation and surrogacy programs are approved by decrees from religious scholars. ART has been used since 1984 in Iran and the first Iranian infant conceived by gamete intra-fallopian transfer (GIFT was born in 1989. This report, however, is the first national report on Iranian ART centers. Materials and Methods: This cross-sectional study, conducted under the supervision of the Iranian Ministry of Health, presented a summary of the numbers and percentages of centers that provided infertility services in Iran, as well as the status of ART in Iran during 2011. Results: A total of 52 centers reported treatment cycles and performed approximately 29000 intrauterine insemination (IUI, in addition to 35000 in vitro fertilization (IVF and intra-cytoplasmic sperm injection (ICSI cycles. Conclusion: Iran has considerable potential to provide IVF services for both Iranians as well as other nationalities throughout the region. This proves the need for a national center that will implement a registry system.

  13. Analysis of spatial autocorrelation patterns of heavy and super-heavy rainfall in Iran

    Science.gov (United States)

    Rousta, Iman; Doostkamian, Mehdi; Haghighi, Esmaeil; Ghafarian Malamiri, Hamid Reza; Yarahmadi, Parvane

    2017-09-01

    Rainfall is a highly variable climatic element, and rainfall-related changes occur in spatial and temporal dimensions within a regional climate. The purpose of this study is to investigate the spatial autocorrelation changes of Iran's heavy and super-heavy rainfall over the past 40 years. For this purpose, the daily rainfall data of 664 meteorological stations between 1971 and 2011 are used. To analyze the changes in rainfall within a decade, geostatistical techniques like spatial autocorrelation analysis of hot spots, based on the Getis-Ord G i statistic, are employed. Furthermore, programming features in MATLAB, Surfer, and GIS are used. The results indicate that the Caspian coast, the northwest and west of the western foothills of the Zagros Mountains of Iran, the inner regions of Iran, and southern parts of Southeast and Northeast Iran, have the highest likelihood of heavy and super-heavy rainfall. The spatial pattern of heavy rainfall shows that, despite its oscillation in different periods, the maximum positive spatial autocorrelation pattern of heavy rainfall includes areas of the west, northwest and west coast of the Caspian Sea. On the other hand, a negative spatial autocorrelation pattern of heavy rainfall is observed in central Iran and parts of the east, particularly in Zabul. Finally, it is found that patterns of super-heavy rainfall are similar to those of heavy rainfall.

  14. Outcome Evaluation of Therapeutic Community Model in Iran

    Directory of Open Access Journals (Sweden)

    Nasrindokht Sadir

    2013-01-01

    Full Text Available BackgroundEvaluation of treatment programs in addiction field is a prerequisite to improve the quality of care. This study aimed to investigate the effectiveness of Therapeutic Community (TC program in Iran. MethodsIndividuals who had voluntarily enrolled in the TC center within a period of seven years, from early 2005 to late 2011, entered the study. Those who successfully completed the 14-week residential course were considered as ‘completers’. They were subsequently called in for urine test and interviews using Maudsley Addiction Profile. Urine test was conducted to determine if they were positive for heroin, opium, methadone, methamphetamine, bupronorphine, hashish, and tramadol. ResultsA number of 378 individuals with mean (± SD age of 32.5 ± 7.8 enrolled in the TC program during the study period, 240 individuals of whom completed the 14 weeks course (69.0%. At the end of the sixth year, 22% of the participants were in abstinence. Physical and mental health in abstainers proved to be of better conditions than those of non-abstainers (P<0.05. ConclusionConsidering the TC outcome in other countries, it seems that TC maintains an acceptable effectiveness in Iran. Prospective controlled studies are warranted to investigate the outcomes in more details.

  15. Efficacy of a Community-Based Physical Activity Program KM2H2 for Stroke and Heart Attack Prevention among Senior Hypertensive Patients: A Cluster Randomized Controlled Phase-II Trial

    Science.gov (United States)

    Gong, Jie; Chen, Xinguang; Li, Sijian

    2015-01-01

    Objective To evaluate the efficacy of the program Keep Moving toward Healthy Heart and Healthy Brain (KM2H2) in encouraging physical activities for the prevention of heart attack and stroke among hypertensive patients enrolled in the Community-Based Hypertension Control Program (CBHCP). Design Cluster randomized controlled trial with three waves of longitudinal assessments at baseline, 3 and 6 months post intervention. Setting Community-based and patient-centered self-care for behavioral intervention in urban settings of China. Participants A total of 450 participants diagnosed with hypertension from 12 community health centers in Wuhan, China were recruited, and were randomly assigned by center to receive either KM2H2 plus standard CBHCP care (6 centers and 232 patients) or the standard care only (6 centers and 218 patients). Intervention KM2H2 is a behavioral intervention guided by the Transtheoretical Model, the Model of Personalized Medicine and Social Capital Theory. It consists of six intervention sessions and two booster sessions engineered in a progressive manner. The purpose is to motivate and maintain physical activities for the prevention of heart attack and stroke. Outcome Measures Heart attack and stroke (clinically diagnosed, primary outcome), blood pressure (measured, secondary outcome), and physical activity (self-report, tertiary outcome) were assessed at the individual level during the baseline, 3- and 6-month post-intervention. Results Relative to the standard care, receiving KM2H2 was associated with significant reductions in the incidence of heart attack (3.60% vs. 7.03%, p activity at 3- (d = 0.53, 95% CI: 0.21, 0.85) and 6-month (d = 0.45, 95% CI: 0.04, 0.85) post-intervention, respectively. Conclusion The program KM2H2 is efficacious to reduce the risk of heart attack and stroke among senior patients who are on anti-hypertensive medication. Findings of this study provide solid data supporting a formal phase-III trial to establish the

  16. Efficacy of a Community-Based Physical Activity Program KM2H2 for Stroke and Heart Attack Prevention among Senior Hypertensive Patients: A Cluster Randomized Controlled Phase-II Trial.

    Directory of Open Access Journals (Sweden)

    Jie Gong

    Full Text Available To evaluate the efficacy of the program Keep Moving toward Healthy Heart and Healthy Brain (KM2H2 in encouraging physical activities for the prevention of heart attack and stroke among hypertensive patients enrolled in the Community-Based Hypertension Control Program (CBHCP.Cluster randomized controlled trial with three waves of longitudinal assessments at baseline, 3 and 6 months post intervention.Community-based and patient-centered self-care for behavioral intervention in urban settings of China.A total of 450 participants diagnosed with hypertension from 12 community health centers in Wuhan, China were recruited, and were randomly assigned by center to receive either KM2H2 plus standard CBHCP care (6 centers and 232 patients or the standard care only (6 centers and 218 patients.KM2H2 is a behavioral intervention guided by the Transtheoretical Model, the Model of Personalized Medicine and Social Capital Theory. It consists of six intervention sessions and two booster sessions engineered in a progressive manner. The purpose is to motivate and maintain physical activities for the prevention of heart attack and stroke.Heart attack and stroke (clinically diagnosed, primary outcome, blood pressure (measured, secondary outcome, and physical activity (self-report, tertiary outcome were assessed at the individual level during the baseline, 3- and 6-month post-intervention.Relative to the standard care, receiving KM2H2 was associated with significant reductions in the incidence of heart attack (3.60% vs. 7.03%, p < .05 and stroke (5.11% vs. 9.90%, p<0.05, and moderate reduction in blood pressure (-3.72 mmHg in DBP and -2.92 mmHg in DBP at 6-month post-intervention; and significant increases in physical activity at 3- (d = 0.53, 95% CI: 0.21, 0.85 and 6-month (d = 0.45, 95% CI: 0.04, 0.85 post-intervention, respectively.The program KM2H2 is efficacious to reduce the risk of heart attack and stroke among senior patients who are on anti

  17. A Viewpoint on Medical Education in Iran

    Directory of Open Access Journals (Sweden)

    Mozafar Khazaei

    2013-08-01

    of students, determining appropriate strategies to prevent academic failure can preserve financial and human investment and enhance the academic rank of the universities. Taking the academic failure into account as one of the challenges facing medical education in Iran and doing intervention and meta-analysis studies are recommended.The increasing number of medical sciences students, especially general medicine during the recent years, that has caused congestion in theoretical and practical classes and relative decline in the quality of education, is also another noticeable challenge in the medical education. It seems necessary to have appropriate and prospective plan for this quantitative increase of students before they enter clinical wards in hospitals and to make anticipations for the preparation of physical and educational conditions and facilities needed for clinical and outpatient training. Taking into account of the ability and interest of the new generation of students in electronic facilities like internet and mobile and explicit emphasis of educational authorities and programmers of the country in the recent medical education congress (2013 on the necessity of applying virtual education, designing new educational programs and models based on virtual education can be considered as one of the methods of coping with the given challenge.

  18. Iran's Multiple Indicator Demographic and Health Survey - 2010: Study Protocol.

    Science.gov (United States)

    Rashidian, Arash; Karimi-Shahanjarini, Akram; Khosravi, Ardeshir; Elahi, Elham; Beheshtian, Maryam; Shakibazadeh, Elham; Khabiri, Roghayeh; Arab, Mohammad; Zakeri, Mohammad-Reza

    2014-05-01

    There is an international emphasis on providing timely and high quality data to monitor progress of countries toward Millennium Development Goals. Iran's Multiple Indicator Demographic and Health Survey (IrMIDHS) aimed to provide valid information on population and health outcomes to monitor progress in achieving national priorities and health programs and to assist policy makers to design effective strategies for improving health outcomes and equity in access to care. A cross-sectional multi-stage stratified cluster-random survey is conducted through face-to-face household interviews. The sampling frame is developed using Iran's 2006 population and housing census. Provincial samples ranging are from a minimum of 400 households per province to 6400 households in Tehran province. Cluster size is 10 households. The target sample includes 3096 clusters: 2187 clusters in urban and 909 clusters in rural areas. IrMIDHS instruments include three questionnaires: Household questionnaire, women aged 15-54 questionnaire, children under five questionnaire, supervision and quality assessment checklists and data collection sheets and standard weight and height measurement tools for under-five children. A cascading decentralized training method is used for training data collection and supervision teams. Quality assurance procedures are defined for the five steps of conducting the survey including: Sampling, training data collection and training teams, survey implementation, data entry and analysis. A multi-layer supervision and monitoring procedure is established. All the questionnaires are double entered. IrMIDHS will provide valuable data for policymakers in Iran. Designing and implementation of the study involve contributions from academics as well as program managers and policy makers. The collaborative nature of the study may facilitate better usage of its results.

  19. Rediscovery of Acorus calamus (Acoraceae in Iran

    Directory of Open Access Journals (Sweden)

    Abbas Gholipour

    2013-09-01

    Full Text Available Acorus calamus has already been reported based on a single specimen collected from Guilan province. Yet, this species has not been reported during last 50 years in Iran and thus, its herbarium specimen is not available. A sample of the species was collected from southern area of Sari during a study on aquatic plants of Mazandaran province. According to the new finding, the natural occurrence of the species was confirmed in Iran. Complementary botanical description, photographs of plant habitat and distribution map of the species were presented. Although, according to the Flora Iranica and Flora of Iran Acorus was considered as a genus of Araceae the recent phylogenetic study considered its taxonomic position in Acoraceae as a distinct family. Therefore, Acoraceae is introduced as a new family to the Flora of Iran with a single representative i. e. Acorus calamus.

  20. L'Iran mobilise des scientifiques

    CERN Multimedia

    Brouet, Anne-Muriel

    2005-01-01

    An Open Letter to the General Secretary of UNO circulates in the laboratories of CERN. This letter is to protest against the tension between Iran from one part, and USA and Europe on the other part (½ page)

  1. Major faults in Iran (flt2cg)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The geology data set for this map includes arcs, polygons, and labels that outline and describe the general geologic age and type of bedrock of Iran. The geologic...

  2. Astronomy and Astrology in India and Iran

    National Research Council Canada - National Science Library

    David Pingree

    2014-01-01

    ... scholar to the erroneous conclusion that Sasanian Iran played a crucial role in the introduction of Greek and Babylonian astronomy and astrology to India and in the development of Indian planetary theory...

  3. The spider family Filistatidae (Araneae) in Iran

    National Research Council Canada - National Science Library

    Marusik, Yuri M; Zamani, Alireza

    2015-01-01

    All species of Filistatidae occurring in Iran are surveyed. Zaituniaakhanii sp. n. is described on the basis of female specimens collected in Tehran province, and the previously unknown male of Sahastatasinuspersica Marusik, Zamani...

  4. Earthquake Damage, Northern Iran, June 21, 1990

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — A magnitude 7.7 earthquake occurred in the Gilan Province between the towns of Rudbar and Manjil in northern Iran on Thursday, June 21, 1990. The event, the largest...

  5. Surficial geology of Iran (geo2cg)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The geology data set for this map includes arcs, polygons, and labels that outline and describe the general geologic age and type of bedrock of Iran. The geologic...

  6. Paediatric heart failure research: role of the National Heart, Lung, and Blood Institute.

    Science.gov (United States)

    Burns, Kristin M

    2015-08-01

    The National Heart, Lung, and Blood Institute, of the National Institutes of Health, is committed to supporting research in paediatric heart failure. The Institute's support of paediatric heart failure research includes both investigator-initiated grants and Institute initiatives. There were 107 funded grants in paediatric heart failure over the past 20 years in basic, translational and clinical research, technology development, and support of registries. Such research includes a broad diversity of scientific topics and approaches. The Institute also supports several initiatives for paediatric heart failure, including the Pediatric Circulatory Support Program, the Pumps for Kids, Infants, and Neonates (PumpKIN) Program, PediMACS, and the Pediatric Heart Network. This review article describes the National Heart, Lung, and Blood Institute's past, present, and future efforts to promote a better understanding of paediatric heart failure, with the ultimate goal of improving outcomes.

  7. Comparison of current practices of cardiopulmonary perfusion technology in Iran with American Society of Extracorporeal Technology's standards.

    Science.gov (United States)

    Faravan, Amir; Mohammadi, Nooredin; Alizadeh Ghavidel, Alireza; Toutounchi, Mohammad Zia; Ghanbari, Ameneh; Mazloomi, Mehran

    2016-01-01

    Standards have a significant role in showing the minimum level of optimal optimum and the expected performance. Since the perfusion technology staffs play an the leading role in providing the quality services to the patients undergoing open heart surgery with cardiopulmonary bypass machine, this study aimed to assess the standards on how Iranian perfusion technology staffs evaluate and manage the patients during the cardiopulmonary bypass process and compare their practice with the recommended standards by American Society of Extracorporeal Technology. In this descriptive study, data was collected from 48 Iranian public hospitals and educational health centers through a researcher-created questionnaire. The data collection questionnaire assessed the standards which are recommended by American Society of Extracorporeal Technology. Findings showed that appropriate measurements were carried out by the perfusion technology staffs to prevent the hemodilution and avoid the blood transfusion and unnecessary blood products, determine the initial dose of heparin based on one of the proposed methods, monitor the anticoagulants based on ACT measurement, and determine the additional doses of heparin during the cardiopulmonary bypass based on ACT or protamine titration. It was done only in 4.2% of hospitals and health centers. Current practices of cardiopulmonary perfusion technology in Iran are inappropriate based on the standards of American Society of Cardiovascular Perfusion. This represents the necessity of authorities' attention to the validation programs and development of the caring standards on one hand and continuous assessment of using these standards on the other hand.

  8. Iran’s Foreign and Defense Policies

    Science.gov (United States)

    2017-02-06

    and sustainment infrastructure for air force operations. As noted, the IRGC is also increasingly involved in Iran’s economy, acting through a network...and Bahrain, and the sustained and frequent engagement with Iran exhibited by Oman. Qatar maintains periodic high-level contact with Iran; the...Palestinian peace process through Hamas attacks on buses, restaurants , and other civilian targets inside Israel. However, in 2012, their differing positions

  9. CURCULIONOIDEA FROM GOLESTAN PROVINCE, NORTHERN IRAN (Coleoptera)

    OpenAIRE

    Hassan Ghahari; Enzo Colonnelli

    2012-01-01

    The 195 species of Curculionoidea (Coleoptera) thus far indicated from Golestan province (northern Iran) according to both literature and original records are listed in this paper. New data for 61 species belonging to 18 genera collected during this research are also given. Besides the 42 species newly reported for the Golestan province, the following additional 15 species are newly recorded from Iran: Brachypera lunata, Ceutorhynchus anatolicus, Datonychus urticae, Hypera contaminata, Hypera...

  10. Neuroimaging in Iran: A Review

    Directory of Open Access Journals (Sweden)

    G. Ali Hossein-Zadeh

    2010-11-01

    Full Text Available ABSTRACTNeuroimaging allows noninvasive evaluation of the anatomy, physiology, and function of the brain. It is widely used for diagnosis, treatment planning, and treatment evaluation of neurological disorders as well as understanding functions of the brain in health and disease. Neuroimaging modalities include X-ray computed tomography (CT, magnetic resonance imaging (MRI, single photon emission computed tomography (SPECT, positron emission tomography (PET, electroencephalography (EEG, and magnetoencephalography (MEG. This paper presents an overview of the neuroimaging research in Iran in recent years, partitioned into three categories: anatomical imaging; anatomical image analysis; and functional imaging and analysis. Published papers reflect considerable progress in development of neuroimaging infrastructure, hardware installation and software development. However, group work and research collaborations among engineers, scientists, and clinicians need significant enhancement to optimize utility of the resources and maximize productivity. This is a challenge that cannot be solved without specific plans, policies, and funding.

  11. Education and training of medical physics in Iran: The past, the present and the future.

    Science.gov (United States)

    Mahdavi, Seyed Rabi; Rasuli, Behrouz; Niroomand-Rad, Azam

    2017-04-01

    The aim of this study was to investigate the current status of education and training programs in medical physics in Iran. A questionnaire was designed and sent to 274 IAMP (Iranian Association of Medical Physicists) members focusing on these two topics: the educational situation (course syllabus, number of faculty members, number of PhD and MSc students and sub-fields offered in the department) and the professional situation (work experience, workplaces of medical physicists, postgraduate degrees that were granted and the amount of therapy and imaging equipment). Medical physics education in Iran is provided at 14 universities at master and doctorate levels. All medical physics departments offer an MSc program and 6 of them offer a PhD program. Most medical physics faculty (24%) work in the radiotherapy physics sub-specialty. Also, about 95 medical physics students graduate every year. There are six major peer-reviewed Iranian journals that publish medical physics papers in English. In addition, there are 74 radiotherapy machines including Co-60 and LINACs (LINear ACcelerators) across Iran as of 2013. The curriculum of medical physics programs (MSc and PhD) in Iran must be improved to include long-term clinical courses in the four major sub-specialties of radiotherapy, medical imaging, nuclear medicine and radiation protection. It is hoped that clinical medical physicists will go through nationally-accredited exams before assuming independent clinical responsibilities. Moreover, the work situation of the medical physics profession in Iran should be clear and the government authorities must recognize importance of this interdisciplinary field in medicine. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  12. Silurian stratigraphy of Central Iran - an update

    Science.gov (United States)

    Hairapetian, Vachik; Pour, Mansoureh Ghobadi; Popov, Leonid E.; Männik, Peep; Miller, C. Giles

    2017-06-01

    The Silurian biostratigraphy, lithostratigraphy, and facies of Central Iran including the Kashmar (Boghu Mountains), Tabas (Derenjal Mountains, Ozbak-Kuh), Anarak (Pol-e Khavand) and Kerman regions is reviewed and updated. The current state of knowledge of the Silurian in the Zagros Basin, Alborz, Kopet-Dagh and Talysh regions, as well as in a few areas scattered across the Sabzevar Zone, and the Sanandaj-Sirjan terranes is also reviewed. Silurian volcanism in various parts of Iran is briefly discussed. The end of the Ordovician coincided with a widespread regression across Iran synchronous with the Hirnantian glaciation, and only in the Zagros Basin is there a continuous Ordovician-Silurian transition represented by graptolitic black shales of the Sarchahan Formation. In the Central-East Iranian Platform marine sedimentation re-commenced in the early to mid Aeronian. By the Sheinwoodian, carbonate platform depositional environments were established along its north-eastern margin. In other parts of Iran (e.g., Kopet-Dagh and the Sabzevar Zone), siliciclastic sedimentation continued probably into the late Silurian. The Silurian conodont and brachiopod biostratigraphy of Central Iran is significantly updated facilitating a precise correlation with the Standard Global Chronostratigraphic Scale, as well as with key Silurian sections in other parts of Iran. The Silurian lithostratigraphy is considerably revised and two new lithostratigraphical units, namely the Boghu and Dahaneh-Kalut formations, are introduced.

  13. Heart failure - tests

    Science.gov (United States)

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... the best test to: Identify which type of heart failure (systolic, diastolic, valvular) Monitor your heart failure and ...

  14. Heart attack - discharge

    Science.gov (United States)

    ... attack Heart bypass surgery Heart bypass surgery - minimally invasive Heart pacemaker High blood cholesterol levels High blood pressure Implantable cardioverter-defibrillator Smoking - tips on how to ...

  15. ALOHA to women's heart disease.

    Science.gov (United States)

    Bravo, Kimberly J

    2006-01-01

    This article describes the American Heart Association, ALOHA program. ALOHA is a multidisciplinary approach to helping lay people and clinicians determine the best course of action for managing cardiac risk factors in women. ALOHA, an acronym that stands for designated interventions based on individualized assessment of patients, along with the Framingham risk assessment calculator, allows health care providers with their patients to individualize treatment for heart disease and management of risk factors.

  16. Effect of a 16-week Bikram yoga program on heart rate variability and associated cardiovascular disease risk factors in stressed and sedentary adults: A randomized controlled trial.

    Science.gov (United States)

    Hewett, Zoe L; Pumpa, Kate L; Smith, Caroline A; Fahey, Paul P; Cheema, Birinder S

    2017-04-21

    Chronic activation of the stress-response can contribute to cardiovascular disease risk, particularly in sedentary individuals. This study investigated the effect of a Bikram yoga intervention on the high frequency power component of heart rate variability (HRV) and associated cardiovascular disease (CVD) risk factors (i.e. additional domains of HRV, hemodynamic, hematologic, anthropometric and body composition outcome measures) in stressed and sedentary adults. Eligible adults were randomized to an experimental group (n = 29) or a no treatment control group (n = 34). Experimental group participants were instructed to attend three to five supervised Bikram yoga classes per week for 16 weeks at local studios. Outcome measures were assessed at baseline (week 0) and completion (week 17). Sixty-three adults (37.2 ± 10.8 years, 79% women) were included in the intention-to-treat analysis. The experimental group attended 27 ± 18 classes. Analyses of covariance revealed no significant change in the high-frequency component of HRV (p = 0.912, partial η 2 = 0.000) or in any secondary outcome measure between groups over time. However, regression analyses revealed that higher attendance in the experimental group was associated with significant reductions in diastolic blood pressure (p = 0.039; partial η 2 = 0.154), body fat percentage (p = 0.001, partial η 2 = 0.379), fat mass (p = 0.003, partial η 2 = 0.294) and body mass index (p = 0.05, partial η 2 = 0.139). A 16-week Bikram yoga program did not increase the high frequency power component of HRV or any other CVD risk factors investigated. As revealed by post hoc analyses, low adherence likely contributed to the null effects. Future studies are required to address barriers to adherence to better elucidate the dose-response effects of Bikram yoga practice as a medium to lower stress-related CVD risk. Retrospectively registered with Australia New Zealand Clinical Trials Registry ACTRN

  17. Better lipid target achievement for secondary prevention through disease management programs for diabetes mellitus and coronary heart disease in clinical practice in Germany.

    Science.gov (United States)

    Gitt, Anselm K; Sonntag, Frank; Jannowitz, Christina; Weizel, Achim; Karmann, Barbara; Schaefer, Juergen R; Pittrow, David; Hildemann, Steven K

    2016-01-01

    Disease management programs (DMP) for diabetes mellitus (DM) or coronary heart disease (CHD) address the treatment of lipid disorders. The current registry aimed to compare drug utilization, lipid lowering effects and further outcomes of outpatients at high cardiovascular risk in DMP for DM or CHD compared to patients in routine care (no-DMP). This was a prospective non-interventional registry with a 1 year follow-up which enrolled consecutive patients with known DM and/or any vascular disease on simvastatin 40 mg monotherapy, to document lipid target achievement in clinical practice in Germany according to existing guidelines. Drug use (maintenance, add-on, switch, discontinuation) and other components of care were upon the discretion of the treating physician. Of a total of 12,154 patients (mean age 65.8 years, 61.2% males), 3273 were in DMP CHD, 3265 in DMP DM and 1760 in DMP CHD + DM. In DMP patients compared to no-DMP patients, comorbidities/risk factors were more frequent. More patients in the DMP groups attained the target level of low density lipoprotein (LDL-C) <70 mg/dl (1.8 mmol/l) at baseline (8.5% DMP vs. 5.7% no-DMP), at 6 month (10.3% vs. 7.4%) and 12 month follow-up (10.1% vs. 7.1%). Cholesterol absorption inhibitors were added in 16% of the patients at the end of the baseline or at the follow-up visits, while statin treatment (including mean dose) remained largely unchanged. Target achievement rates were highest for all time points in the DMP CHD + DM group. With respect to limitations, this study was restricted to lipid disorders as qualifying diagnosis and simvastatin as qualifying treatment, which is a potential cause of selection bias. Information on non-pharmacological measures was not collected, and the 12-month follow-up period was relatively short. Patients in DMP compared to those not in DMP achieved better LDL-C lowering and higher control rates, but overall lipid target achievement rates need to be improved. Longer

  18. Sex based levels of C-reactive protein and white blood cell count in subjects with metabolic syndrome: Isfahan Healthy Heart Program

    Directory of Open Access Journals (Sweden)

    Mojgan Gharipour

    2013-01-01

    Full Text Available Background: C-reactive protein (CRP and white blood cell (WBC are proinflammatory markers. They are major pathophysiological for the development of metabolic syndrome (MetS. This study aimed to address the independent associations between MetS and WBC counts and serum CRP levels and evaluation of their magnitude in relation to the MetS, based on the sex in the Iranian adults. Materials and Methods: In this cross-sectional study, subjects who met the MetS criteria, based on the Adult Treatment Panel III were selected from the Isfahan Healthy Heart Program database. A questionnaire containing the demographic data, weight, height, waist, and hip circumference of the respondents was completed for each person. Blood pressure was measured and the anthropometric measurements were done, and fasting blood samples were taken for 2 h postload plasma glucose (2 hpp. Serum [total, high-density lipoprotein (HDL, and low-density lipoprotein] levels of cholesterol, triglyceride, and CRP as well as WBC counts were determined. The univariate analyses were carried out to assess the relation between the CRP levels, WBC counts with the MetS in both sexes the. Results: In men with the abdominal obesity, the higher levels of WBC count, high serum triglyceride and blood glucose levels, a low serum HDL level, and raised systolic and diastolic blood pressure were observed. However, the higher serum CRP levels were only observed in those with the low serum HDL-cholesterol levels. The mean values of the WBC counts were statistically different between the men with and without MetS, but the mean values of the CRP levels were similar between the two groups. In women, the mean values of WBC count and CRP levels were statistically different in the subjects with and without a MetS components (except for the low serum HDL levels and high diastolic blood pressure for the WBC measures and abdominal obesity for the CRP measures and for those with and without MetS. The age and

  19. Soil erosion in Iran: Issues and solutions

    Science.gov (United States)

    Hamidreza Sadeghi, Seyed; Cerdà, Artemi

    2015-04-01

    Iran currently faces many soil erosion-related problems (see citations below). These issues are resulted from some inherent characteristic and anthropogenic triggering forces. Nowadays, the latter plays more important rule to accelerate the erosion with further emphasis on soil erosion-prone arid and semi arid regions of the country. This contribution attempts to identify and describe the existing main reasons behind accelerated soil erosion in Iran. Appropriate solutions viz. structural and non-structural approaches will be then advised to combat or minimise the problems. Iran can be used as a pilot research site to understand the soil erosion processes in semiarid, arid and mountainous terrain and our research will review the scientific literature and will give an insight of the soil erosion rates in the main factors of the soil erosion in Iran. Key words: Anthropogenic Erosion, Land Degradation; Sediment Management; Sediment Problems Acknowledgements The research projects GL2008-02879/BTE, LEDDRA 243857 and PREVENTING AND REMEDIATING DEGRADATION OF SOILS IN EUROPE THROUGH LAND CARE (RECARE)FP7-ENV-2013- supported this research. References Aghili Nategh, N., Hemmat, A., & Sadeghi, M. (2014). Assessing confined and semi-confined compression curves of highly calcareous remolded soil amended with farmyard manure. Journal of Terramechanics, 53, 75-82. Arekhi, S., Bolourani, A. D., Shabani, A., Fathizad, H., Ahamdy-Asbchin, S. 2012. Mapping Soil Erosion and Sediment Yield Susceptibility using RUSLE, Remote Sensing and GIS (Case study: Cham Gardalan Watershed, Iran). Advances in Environmental Biology, 6(1), 109-124. Arekhi, S., Shabani, A., Rostamizad, G. 2012. Application of the modified universal soil loss equation (MUSLE) in prediction of sediment yield (Case study: Kengir Watershed, Iran). Arabian Journal of Geosciences, 5(6), 1259-1267.Sadeghi, S. H., Moosavi, V., Karami, A., Behnia, N. 2012. Soil erosion assessment and prioritization of affecting factors at plot

  20. Predictors of Prolonged Mechanical Ventilation in Pediatric Patients After Cardiac Surgery for Congenital Heart Disease.

    Science.gov (United States)

    Tabib, Avisa; Abrishami, Seyed Ehsan; Mahdavi, Mohammad; Mortezaeian, Hojjat; Totonchi, Ziae

    2016-08-01

    The duration of mechanical ventilation (MV) is one of the most important clinical factors which predict outcomes in pediatric cardiac surgery. The prolonged mechanical ventilation (PMV) following cardiac surgery is a multifactorial phenomenon and there are conflicts regarding its predictors in pediatric population between different centers. The current study aimed to describe PMV predictors in patients undergoing cardiac surgery for congenital heart disease in a tertiary center for pediatric cardiovascular diseases in Iran. From May to December 2014, all pediatric patients (less than a month - 15 years old) admitted to pediatric Intensive Care Unit (PICU) after congenital heart surgeries were consecutively included. The PMV was defined as mechanical ventilation duration more than 72 hours as medium PMV and more than seven days as extended PMV. The demographic data and variables probably related to PMV were recorded during the PICU stay. A total of 300 patients, 56.7% male, were enrolled in this study. Their mean age was 32 ± 40 months .The median duration (IQR) of MV was 18 hours (8.6 - 48 hours). The incidence of PMV more than 72 hours and seven days was 20% and 10.7%, respectively. Younger age, lower weight, heart failure, higher doses of inotropes, pulmonary hypertension, respiratory infections and delayed sternal closure were independent predictors of PMV in multivariate analyses. The results of this study indicated that PMV predictors could be specific for each center and a good administration program is needed for each pediatric cardiac surgery center for the preoperative management of patients undergoing congenital heart surgeries.

  1. Heart failure in children - overview

    Science.gov (United States)

    Congestive heart failure - children; Cor pulmonale - children; Cardiomyopathy - children; CHF - children; Congenital heart defect - heart failure in children; Cyanotic heart disease - heart failure in children; Birth defect of the heart - heart ...

  2. Heart Health: The Heart Truth Campaign 2009

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table ... one of the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) ...

  3. Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

  4. Women's Heart Disease: Heart Attack Symptoms

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter 2014 Table ... NHLBI has uncovered some of the causes of heart diseases and conditions, as well as ways to prevent ...

  5. Using Clinical Decision Support and Dashboard Technology to Improve Heart Team Efficiency and Accuracy in a Transcatheter Aortic Valve Implantation (TAVI) Program.

    Science.gov (United States)

    Clarke, Sarah; Wilson, Marisa L; Terhaar, Mary

    2016-01-01

    Heart Team meetings are becoming the model of care for patients undergoing transcatheter aortic valve implantations (TAVI) worldwide. While Heart Teams have potential to improve the quality of patient care, the volume of patient data processed during the meeting is large, variable, and comes from different sources. Thus, consolidation is difficult. Also, meetings impose substantial time constraints on the members and financial pressure on the institution. We describe a clinical decision support system (CDSS) designed to assist the experts in treatment selection decisions in the Heart Team. Development of the algorithms and visualization strategy required a multifaceted approach and end-user involvement. An innovative feature is its ability to utilize algorithms to consolidate data and provide clinically useful information to inform the treatment decision. The data are integrated using algorithms and rule-based alert systems to improve efficiency, accuracy, and usability. Future research should focus on determining if this CDSS improves patient selection and patient outcomes.

  6. Revealing Hearts

    DEFF Research Database (Denmark)

    Saghaug, Kristin Falck; Pattison, George; Lindgren, Peter

    2014-01-01

    Some small business owners want to balance personal values as well as economic values. “I have to follow my heart” or “it must be meaningful” some of them say. But how might they be able to know what gives meaning to the heart? The philosophical theologian Paul Tillich finds that the problem...

  7. Rationale and design of a randomised controlled trial evaluating the effectiveness of an exercise program to improve the quality of life of patients with heart failure in primary care: The EFICAR study protocol

    Directory of Open Access Journals (Sweden)

    de la Torre Maria M

    2010-01-01

    Full Text Available Abstract Background Quality of life (QoL decreases as heart failure worsens, which is one of the greatest worries of these patients. Physical exercise has been shown to be safe for people with heart failure. Previous studies have tested heterogeneous exercise programs using different QoL instruments and reported inconsistent effects on QoL. The aim of this study is to evaluate the effectiveness of a new exercise program for people with heart failure (EFICAR, additional to the recommended optimal treatment in primary care, to improve QoL, functional capacity and control of cardiovascular risk factors. Methods/Design Multicenter clinical trial in which 600 patients with heart failure in NYHA class II-IV will be randomized to two parallel groups: EFICAR and control. After being recruited, through the reference cardiology services, in six health centres from the Spanish Primary Care Prevention and Health Promotion Research Network (redIAPP, patients are followed for 1 year after the beginning of the intervention. Both groups receive the optimized treatment according to the European Society of Cardiology guidelines. In addition, the EFICAR group performs a 3 month supervised progressive exercise program with an aerobic (high-intensity intervals and a strength component; and the programme continues linked with community resources for 9 months. The main outcome measure is the change in health-related QoL measured by the SF-36 and the Minnesota Living with Heart Failure Questionnaires at baseline, 3, 6 and 12 months. Secondary outcomes considered are changes in functional capacity measured by the 6-Minute Walking Test, cardiac structure (B-type natriuretic peptides, muscle strength and body composition. Both groups will be compared on an intention to treat basis, using multi-level longitudinal mixed models. Sex, age, social class, co-morbidity and cardiovascular risk factors will be considered as potential confounding and predictor variables. Discussion

  8. Central nervous system infections in heart transplant recipients

    NARCIS (Netherlands)

    van de Beek, Diederik; Patel, Robin; Daly, Richard C.; McGregor, Christopher G. A.; Wijdicks, Eelco F. M.

    2007-01-01

    OBJECTIVE: To study central nervous system infections after heart transplantations. DESIGN: Retrospective cohort study. SETTING: Cardiac Transplant Program at Mayo Clinic, Rochester, Minnesota. Patients Three hundred fifteen consecutive patients who underwent heart transplantation from January 1988

  9. Women's Heart Disease: Cindy Parsons and Follow the Fifty

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Cindy Parsons and Follow the Fifty Past Issues / ... Program, knowing that her personal risk factors for heart disease, including family history, were high. She watched her ...

  10. Heart Disease and Stroke

    Science.gov (United States)

    ... email updates Enter email Submit Heart Disease and Stroke Heart disease and stroke are important health issues ... Stroke risk factors View more Heart Disease and Stroke resources Related information Heart-healthy eating Stress and ...

  11. Heart failure - overview

    Science.gov (United States)

    ... heart failure; Right-sided heart failure - cor pulmonale; Cardiomyopathy - heart failure; HF ... Disease Section. Heart Failure as a newly approved diagnosis for cardiac rehabilitation: challenges and opportunities. J Am ...

  12. Pericarditis - after heart attack

    Science.gov (United States)

    ... include: A previous heart attack Open heart surgery Chest trauma A heart attack that has affected the thickness of your heart muscle Symptoms Symptoms include: Anxiety Chest pain from the swollen pericardium rubbing on the ...

  13. Heart attack first aid

    Science.gov (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle ...

  14. Heart disease - risk factors

    Science.gov (United States)

    ... disease Heart bypass surgery Heart bypass surgery - minimally invasive Heart failure - overview Heart pacemaker High blood cholesterol levels High blood pressure Implantable cardioverter-defibrillator Smoking - tips on how to ...

  15. Heart Diseases and Disorders

    Science.gov (United States)

    ... Resources Heart Diseases & Disorders Back to Patient Resources Heart Diseases & Disorders Millions of people experience irregular or abnormal ... harmless and happen in healthy people free of heart disease. However, some abnormal heart rhythms can be serious ...

  16. Getting a New Heart

    Science.gov (United States)

    ... a procedure that opens clogged arteries. Repair the heart valve . This procedure can often make your heart function ... heart muscle. Ventricular assist devices (VAD) . These are mechanical pumps that surgeons insert to help the heart ...

  17. [Heart arrest].

    Science.gov (United States)

    Chiarella, F; Giovannini, E; Bozzano, A; Caristo, G; Delise, P; Fedele, F; Fera, M S; Lavalle, C; Roghi, A; Valagussa, F

    2001-03-01

    Cardiac arrest is one of the leading causes of mortality in industrialized countries and is mainly due to ischemic heart disease. According to ISTAT estimates, approximately 45,000 sudden deaths occur annually in Italy whereas according to the World Health Organization, its incidence is 1 per 1000 persons. The most common cause of cardiac arrest is ventricular fibrillation due to an acute ischemic episode. During acute ischemia the onset of a ventricular tachyarrhythmia is sudden, unpredictable and often irreversible and lethal. Each minute that passes, the probability that the patient survives decreases by 10%. For this reason, the first 10 min are considered to be priceless for an efficacious first aid. The possibility of survival depends on the presence of witnesses, on the heart rhythm and on the resolution of the arrhythmia. In the majority of cases, the latter is possible by means of electrical defibrillation followed by the reestablishment of systolic function. An increase in equipment alone does not suffice for efficacious handling of cardiac arrest occurring outside the hospital premises. Above all, an adequate intervention strategy is required. Ambulance personnel must be well trained and capable of intervening rapidly, possibly within the first 5 min. The key to success lies in the diffusion and proper use of defibrillators. The availability of new generation instruments, the external automatic defibrillators, encourages their widespread use. On the territory, these emergencies are the responsibility of the 118 organization based, according to the characteristics specific to each country, on the regulated coordination between the operative command, the crews and the first-aid means. Strategies for the handling of these emergencies within hospitals have been proposed by the Conference of Bethesda and tend to guarantee an efficacious resuscitation with a maximum latency of 2 min between cardiac arrest and the first electric shock. The diffusion of external

  18. Ten years of snakebites in Iran.

    Science.gov (United States)

    Dehghani, Rouhullah; Fathi, Behrooz; Shahi, Morteza Panjeh; Jazayeri, Mehrdad

    2014-11-01

    Many species of venomous snakes are found in Iran. The most medically important species which are responsible for the most snakebite incidents in Iran belong to the Viperidae family, including Vipera lebetina, Echis carinatus, Pseudocerastes persicus, Vipera albicornuta and the Elapidae family, especially Naja naja oxiana. At least one kind of venomous snake is found in each of the 31 provinces, and many provinces have more than one venomous species. As a result, snakebite is a considerable health hazard in Iran, especially in the rural area of south and south-west of Iran. A retrospective, descriptive study of snakebite in Iran during 2002-2011 was carried out in order based on data collected from medical records of bite victims admitted to hospitals and health centers. From 2002 to 2011, 53,787 cases of snake bites were reported by medical centers in Iran. The annual incidence of snake bites in 100,000 of population varied from 4.5 to 9.1 during this decade and the number of recorded deaths were about 67 cases. The highest rate of snakebite was found in provinces of south and southwest of Iran. We suggest that people, especially in the rural areas, need to be trained and educated about venomous snakes, their hazards, prevention of bite and the importance of early hospital referral and treatment of victims. Also adequate antivenins as the main life saving medicine should be made available based on the recorded numbers of victims in each area of the country. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Prevalence of Preeclampsia and Eclampsia in Iran.

    Science.gov (United States)

    Kharaghani, Roghieh; Cheraghi, Zahra; Okhovat Esfahani, Batool; Mohammadian, Zahra; Nooreldinc, Reyhaneh Sadat

    2016-01-01

    Several studies have been conducted to investigate the prevalence of preeclampsia and eclampsia in Iran. These studies have yielded different results. This meta-analysis was aimed to estimate the prevalence of preeclampsia and eclampsia in Iran. International and national electronic databases were searched up to August 2014 including PubMed, Science Direct, Scopus, Science Information Database, MagIran, and IranMedex as well as conference databases. All studies, in which the prevalence or cumulative incidence of preeclampsia in Iran was reported, were included in this meta-analysis. Thirty-six separate studies were assessed involving overall 132,737 participants, of which 4360 had preeclampsia and 49 had eclampsia. Overall prevalence of preeclampsia and eclampsia was 0.05 (95% CI: 0.05, 0.06) and 0.23% (95% CI: 0.12%, 0.33%) respectively. The prevalence of preeclampsia, increased from 0.04 (95% CI: 0.03, 0.05) during 1996 to 2005 to 0.07 (95% CI: 0.04, 0.09) during 2010 to 2013, while the prevalence of eclampsia decreased from 0.30% (95% CI: 0.15%, 0.45%) to 0.01% (95% CI: 0.01%, 0.01%), during the same period. The preeclampsia prevalence had an increasing growth and the eclampsia prevalence had declining growth in recent years. In addition, despite many studies aimed the prevalence of preeclampsia and eclampsia in Iran, there is a significant variation between the results. So, it is difficult to give an exact estimation of the preeclampsia and eclampsia prevalence in Iran.

  20. Review of the Freshwater Sharks of Iran (Family Carcharhinidae)

    OpenAIRE

    Brian W. Coad

    2015-01-01

    The systematics, morphology, distribution, biology, economic importance and conservation of the bull shark (Carcharhinus leucas) in Iran are described, the species is illustrated, and a bibliography on this fish in Iran is provided.