Determinant criteria for designing Health benefit package in selected countries

Health benefit package described as primary health interventions that provided with government using general funds for all regardless their financial ability. This study was aimed at determine appropriate pattern for Iran using comparative survey of Health benefit package in various countries. A review exploration was done, scholars was selected population of both developed and developing countries, required information was also extracted by articles, searches and reports of reliable sources and date were analyzed by SPSS, in brief. The vast majority frequencies was respectively allocated to accessibility (40.7%), cost- effectiveness (29.6%), prioritize, efficacy and cost (22.2%). most countries located in WHO African region were selected cost-effectiveness and accessibility, WHO southeast Asia region were selected, coverage, prioritize, efficacy and quality and finally most WHO Europeans region were elected effectiveness and services costs for including services in Health benefit package. According to most Health benefit package designer emphasis on criteria including accessibility and costeffectiveness, to design Health benefit package for Iran, these criteria must be noticed

Spatial changes of beach profiles for a small tidal inlet (Currumbin Creek, Australia)

Many tidal inlets are actively monitored to investigate the change in flood or ebb shoals, as these sand deposits can have a major influence on the sediment budget of the adjacent coast. However, here it is hypothesized that the shores of the back barrier area can also act as a source of sediment to be considered in the sediment budget. Therefore, profile changes around Currumbin Creek tidal inlet were considered to identify the extent of such a contribution on the surrounding beach and the overall evolution of the inlet system. The results of 16 weeks survey showed that in general, the shores of the back barrier lagoon had a very marginal effect in the provision of material to the sand budget, although the gorge area is highly vulnerable and dynamic. Even an intense storm event and heavy rainfall during the data collection period, resulting in erosion of the surrounding beaches, showed no significant influence on the shore face of the lagoon

Modelling of flow around hexagonal and textured cylinders

The flow regime around a hexagonal polygon with low Reynolds numbers Re<200 is numerically investigated in two different orientations namely face-oriented and corner-oriented. The basic flow characteristics, including drag coefficient, lift coefficient, Strouhal number and critical Reynolds number of the hexagonal cylinders, are calculated using 2D transient numerical analysis. Within the studied range of Re, the predicted lift coefficient and Strouhal number of the face-oriented hexagon were higher than those of the corner-oriented hexagon. In contrast, the predicted drag coefficient and critical Reynolds number of the corner-oriented hexagon were greater than those of the face-oriented. Flow characteristics of a novel textured geometry are also studied using 3D transient analysis. The Strouhal number St of the textured geometry was found to be in between the St of both the hexagonal cylinders, and its lift coefficient is lower than that of the hexagonal cylinders

Wave height forecasting in Dayyer, the Persian Gulf

Forecasting of wave parameters is necessary for many marine and coastal operations. Different forecasting methodologies have been developed using the wind and wave characteristics. In this paper, artificial neural network (ANN) as a robust data learning method is used to forecast the wave height for the next 3, 6, 12 and 24 h in the Persian Gulf. To determine the effective parameters, different models with various combinations of input parameters were considered. Parameters such as wind speed, direction and wave height of the previous 3 h, were found to be the best inputs. Furthermore, using the difference between wave and wind directions showed better performance. The results also indicated that if only the wind parameters are used as model inputs the accuracy of the forecasting increases as the time horizon increases up to 6 h. This can be due to the lower influence of previous wave heights on larger lead time forecasting and the existing lag between the wind and wave growth. It was also found that in short lead times, the forecasted wave heights primarily depend on the previous wave heights, while in larger lead times there is a greater dependence on previous wind speeds

A suggested prototype for assessing bone health

Background- Osteoporosis is becoming a health concern worldwide. Considering the fact that prevention plays an important role in reducing the burden of this silent disease and in view of the limited resources available, many countries have adopted certain programs to fight osteoporosis through shifting their attention towards at-risk individuals. The Iranian Multicenter Osteoporosis Study (IMOS) is one of these programs. The program aims to assess bone health and the prevalence of vitamin D deficiency in different parts of Iran with various altitudes, latitudes and lifestyle habits in a way that the results could be generalized to the country. Method- The present article presents the protocol used in the third phase of the study. It was designed based on the experiences gathered in the previous phases to overcome the shortcomings particularly subject loss. The questionnaire applied in this study was developed based on a thorough literature review of the risk factors and secondary causes of osteoporosis and was approved by an expert panel. It should be added that while the majority of the existing studies aim to study a certain aspect of osteoporosis, the present protocol provides the information needed for policy makers and researchers to study different osteoporosis-related issues. Conclusion- The authors believe the protocol, to be implemented with small modifications, can help policymakers in different parts of the world, particularly developing countries, gather accurate information on different aspects of bone health at the national level. © 2015, Academy of Medical Sciences of I.R. Iran. All rights reserved

The epidemiology of tuberculosis in the Iranians' population in 2016

Background: Tuberculosis (TB) is the 10thmost common infectious disease in the world, and it is one of the major health problems in Iran despite the implementation of the National Tuberculosis Control Program. Methods: Tuberculosis data in Iran were used in 2016 by the Ministry of Health and Treatment. The data on mortality and incidence of disease were determined by age groups, sex, and the provinces of country. Data were analyzed using Excel (2010) and SPSS software. Findings: The overall incidence rate of tuberculosis in the country was 9.7 per 100000 population (10.7 in men and 8.7 in women). The highest incidence rate of TB and mortality in both sexes were over 80 years. The death rate was 1 person per 100,000 populations, 57.7 of whom were men. Most of the deaths were from pulmonary tuberculosis. The highest incidence and mortality rates were reported in Golestan and Sistan and Baluchestan provinces. Conclusion: The incidence and mortality rate of TB has decreased in recent decades in Iran. Nevertheless, considering the raising trend of human immunodeficiency virus (HIV) among the patients with TB, and the neighborhood with endemic countries, TB should be noticed as one of the most important health priorities in the health system of the country. © 2020 Isfahan University of Medical Sciences(IUMS). All rights reserved

The national rate of intensive care units-acquired infections, one-year retrospective study in Iran

Background: Hospital-acquired infections (HAIs) in intensive care units (ICUs) are among the avoidable morbidity and mortality causes. This study aimed at investigating the rate of ICU-acquired infections (ICU-AIs) in Iran. Methods: For the purpose of this multi-center study, the rate of ICU-AIs calculated based on the data collected through Iranian nosocomial infections surveillance system and hospital information system. The data expanded based on 12 months of the year (13,632 records in terms of �hospital-ward-month�), and then, the last observation carried forward method was used to replace the missing data. Results: The mean (standard deviation) age of 52,276 patients with HAIs in the ICUs was 47.37 (30.78) years. The overall rate of ICU-AIs was 96.61 per 1000 patients and 16.82 per 1000 patient-days in Iran�s hospitals. The three main HAIs in the general ICUs were ventilator-associated events (VAE), urinary tract infection (UTI), and pneumonia events & lower respiratory tract infection (PNEU & LRI) infections. The three main HAIs in the internal and surgical ICUs were VAE, UTI, and bloodstream infections/surgical site infections (BSI/SSI). The most prevalent HAIs were BSI, PNEU & LRI and eye, ear, nose, throat, or mouth (EENT) infections in the neonatal ICU and PNEU & LRI, VAE, and BSI in the PICU. Device, catheter, and ventilator-associated infections accounted for 60.96, 18.56, and 39.83 of ICU-AIs, respectively. The ventilator-associated infection rate was 26.29 per 1000 ventilator-days. Based on the Pabon Lasso model, the lowest rates of ICU-AIs (66.95 per 1000 patients and 15.19 patient-days) observed in zone III, the efficient area. Conclusions: HAIs are common in the internal ICU wards. In fact, VAE and ventilator-related infections are more prevalent in Iran. HAIs in the ICUs leads to an increased risk of ICU-related mortality. Therefore, to reduce ICU-AIs, the specific and trained personnel must be responsible for the use of the devices (catheter use and ventilators), avoid over use of catheterization when possible, and remove catheters earlier. © 2021, The Author(s)

Rate of the incidence of hospital-acquired infections in Iran based on the data of the national nosocomial infections surveillance

Hospital-acquired infections (HAIs) lead to increased length of hospital stay, inappropriate use of broad-spectrum antibiotics and multiple antibiotic resistance. This study aimed to investigate the rate of HAIs in Iran. In this multi-centre study, the rate of HAIs was calculated based on the data collected through Iranian nosocomial infections surveillance for patients with HAIs, as well as through hospital statistics and information systems on hospital-related variables. Data were analysed using STATA software; in addition, ArcGIS was used for plotting the geographical distribution of HAIs by different provinces. The mean age of the 107 669 patients affected by HAIs was 52 ± 26.71 years. Just over half (51.55) of the patients were male. The overall rate of HAIs was 26.57 per 1000 patients and 7.41 per 1000 patient-days. The most common HAIs were urinary tract infections (26.83; 1.99 per 1000 patient-days), ventilator-associated events (20.28; 1.5 per 1000 patient-days), surgical-site infections (19.73; 1.45 per 1000 patient-days) and bloodstream infections (13.51; 1 per 1000 patient-days), respectively. The highest rate of HAIs was observed in intensive care units. Device, catheter and ventilator-associated infections accounted for 38.72, 18.79 and 16 of all HAIs, respectively. Based on the results, HAIs are common in intensive care units, and urinary tract infections and device-related infections are more prevalent in Iran. To reduce HAIs it is recommended to implement appropriate policies and interventions, train staff about the use of devices, and prepare and update protocols and guidelines for improving the quality of care. © 2020 The Author(s

Multiple light scattering in anisotropic random media

In the last decade Diffusing Wave Spectroscopy (DWS) has emerged as a powerful tool to study turbid media. In this article we develop the formalism to describe light diffusion in general anisotropic turbid media. We give explicit formulas to calculate the diffusion tensor and the dynamic absorption coefficient, measured in DWS experiments. We apply our theory to uniaxial systems, namely nematic liquid crystals, where light is scattered from thermal fluctuations of the local optical axis, called director. We perform a detailed analysis of the two essential diffusion constants, parallel and perpendicular to the director, in terms of Frank elastic constants, dielectric anisotropy, and applied magnetic field. We also point out the relevance of our results to different liquid crystalline systems, such as discotic nematics, smectic-A phases, and polymer liquid crystals. Finally, we show that the dynamic absorption coefficient is the angular average over the inverse viscosity, which governs the dynamics of director fluctuations.Comment: 23 pages, 12 ps figures, to be published in Phys. Rev.

The role of intratidal oscillations in sediment resuspension in a diurnal, partially mixed estuary

Using detailed observations of the mean and turbulent properties of flow, salinity and turbidity that spanned 2001/02, we examined the physical mechanisms underpinning sediment resuspension in the low-energy Swan River estuary, Western Australia. In this diurnal tidally-dominated estuary, the presence of intratidal oscillations, a tidal inequality lasting 2 to 3 hours on the flood tide, generated by interactions of the four main diurnal and semidiurnal astronomical constituents, K₁, O₁, M₂, and S₂, played a major role in modifying vertical stratification and mixing. These intratidal oscillations are controlled by phase differences between the tropic and synodic months rather than being temporally-fixed by bed friction, as occurs in semidiurnal estuaries. Intratidal oscillations are largest, at around 0.1 m, near to the Austral solstice when the lunar and solar declination are in-phase. Despite the seemingly small change in water level, shear-induced interfacial mixing caused destratification of the water column with the top-to-bottom salinity (ΔS) difference of 3.5 present early in the flood tide eroded to less than 0.3 by the end of the intratidal oscillation. High turbidity peaks, of 250 nephelometric turbidity units, coincided with these intratidal oscillations and could not be explained by bed friction since shear stress from mean flow did not exceed threshold criteria. High Reynolds stresses of ∼1 Nm⁻² did, however, exceed τcr and together with negative Reynolds fluxes indicate a net downward transport of material. Destratification of the water column induced by shear instabilities resulted in large overturns capable of moving in situ material towards the bed during intratidal oscillations and these turbidities were ∼10 times greater than those from bed-generated resuspension observed later during the flood tide