COVID-19 and disabled people: perspectives from Iran

This is a Current Issue because, at the time of writing, COVID-19 has affected many countries and territories worldwide and Iran ranked early on as one of the most seriously affected countries. As a result, this pandemic crisis poses a considerable challenge to people with disabilities in Iran. In this short article we show the different challenges people with disabilities are facing during the COVID emergency in Iran. In addition, we provide several recommendations, based on our perspective and experience in Rehabilitation and Health Policy Centres, to improve the situation in the content of the COVID-19 breakout. © 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group

Endoscopic mucosal resection: still a reliable therapeutic option for gastrointestinal neuroendocrine tumors

Background: Neuroendocrine tumors (NETs), as a rare and heterogeneous category of solid tumors, feature various morphologies and behaviors. In recent years, the incidence of NETs has continued to increase. Endoscopic mucosal resection (EMR) is one of the therapeutic modalities for the treatment of gastric and rectal NETs. Methods: We evaluated patients with well-differentiated NETs of the stomach, duodenum, or rectum between 2011 and 2018. In this study, all cases with tumors confined to the mucosal or submucosal layers and smaller than 20 mm were resected using the EMR technique. We used EUS, CT scan, or MRI to exclude patients with advanced disease. All patients were actively monitored for recurrence according to the recommended protocols. Results: A total of 36 patients with NETs entered the study; 17 (47.2) were female and the remaining 19 (52.8) were male, with a total age range of 20�74 years (mean: 52.47 ± 13.47 years). Among the tumors, 31 cases (86.1) were G1 and the remaining 5 (13.9) were G2. Based on the pathology reports, 22 tumors (61.1) were smaller than 1 cm, while the remaining 14 (38.9) were between 1�2 cm. Twenty-two patients (61.1) had a margin of specimen involved with the tumor. No recurrence was observed during the mean follow-up time of 63.5 ± 19.8 months (range: 39�103 months). All 36 cases survived during the study period. Conclusion: Conventional EMR procedure provides low chance of R0 (complete resection) achievement in gastrointestinal NETs smaller than 20 mm and limited to the mucosa or sub mucosa. However, it could be an option if patients are closely followed. Postoperative marginal involvement is not a reliable predictor of disease recurrence, which may be explained by the deleterious effect of heat coagulation and cauterization applied during tumor removal. © 2021, The Author(s)

A model for Vision Zero implementation in Iran: a grounded theory study

BACKGROUND: Road Traffic injuries (RTIs) are major global health issues, but they have been neglected. RTIs are multi-faceted in nature and, like many injuries, are costly but preventable. Iran has one of the highest rates of deaths due to traffic accidents among middle-income countries. Hence, there is a need for effective and preventive approaches in road safety management. One of the new approaches to road safety is the Vision Zero. The aim of this study was to design a Vision Zero implementation model in Iran. METHODS: This present study was conducted using the qualitative grounded theory approach. Purposive, snowball and maximum variety sampling were used to select participants. In-depth interviews were used to collect data. Grounded theory method was used to analyze the data using Corbin and Strauss method. RESULTS: In this study, 19 interviews were conducted with 17 participants. Based on data analysis, a total of 4 main categories and 13 subcategories were obtained. According to the participants, the lead agency was recognized as the core category. Other concepts were categorized as causal conditions, intervening conditions, contextual conditions, action/interaction strategies, and consequences. CONCLUSIONS: Establishing a lead agency with inter-organizational coordination through political support and legislation and changing the approach of road safety can be effective in implementing a Vision Zero. Also, improving the safety attitude of the stakeholders and changing their approach through training and advocacy from various organizations related to road safety is effective in creating a lead agency and implementing a vision zero. In addition, in order to implementation of the model, it is very important to pay attention to the economic, political and ethical underlying factors towards human beings

The Challenges of Vision Zero Implementation in Iran: A Qualitative Study

Background: Road traffic crashes' (RTCs) multidimensional nature has piqued the interest of officials all around the world for many years. Vision Zero is one of the most innovative approaches to road safety. Vision Zero is a government initiative aimed at reducing RTC-related deaths and serious injuries. To effectively apply this approach in Iran, it is required to first identify the obstacles to execution. Therefore, the purpose of this study was to examine the obstacles to Vision Zero implementation in Iran.Methods: The qualitative content analysis method was used in this investigation. The participants were chosen using purposive, snowball, and maximum variety sampling methods. Data were collected through face-to-face interviews. Graneheim and Lundman's method was used to analyze data using the content analysis method.Results: There were 16 interviews with 14 participants in this study. The data were organized into four main categories and 13 sub-categories to determine the obstacles to implementing Vision Zero. Managerial and administrative obstacles, as well as supportive, cultural, and social, and transportation design and development challenges, were the main categories.Conclusion: In Iran, implementing Vision Zero necessitates the establishment of a lead agency that considers administrative and managerial, supportive and logistic, socio-cultural, transportation design and development, and infrastructure components. In addition, Vision Zero implementation and road safety improvement would require political commitment and support from the government and society. Vision Zero implementation and road safety management must take into account the ethics and value of human life

The effects of counterforce brace on pain in subjects with lateral elbow tendinopathy: A systematic review and meta-analysis of randomized controlled trials

Background: Lateral elbow tendinopathy, also known as �tennis elbow� or �lateral epicondylitis,� is a common disease leading to pain in the lateral side of the elbow and disability during hand gripping. A counterforce brace is one of the most conventional treatments. However, its effects on outcomes remain inconclusive. Objectives: To investigate the effects of counterforce braces on pain in subjects with lateral elbow tendinopathy. Grip strength was reviewed as a secondary outcome. Study design: Systematic review and meta-analysis of randomized controlled trials. Methods: PubMed, Embase, Scopus, Web of Science, CENTRAL, PEDro, ProQuest, RECAL, and RehabData were searched from January 1, 1995, through June 15, 2019. Results: Seventeen studies were included with a total of 1145 participants. A small improvement in pain over the short term (standardized mean difference �0.02; 95 confidence interval: �0.85 to 0.80) and a moderate-to-large improvement in pain in subjects 45 years or younger (standardized mean difference �0.86; 95 confidence interval: �2.45 to 0.72) in favor of the brace versus physiotherapy interventions were found. In contrast, over the long-term physiotherapy interventions (standardized mean difference 1.17; 95 confidence interval: �0.00 to 2.34), wrist splint (standardized mean difference 0.35; 95 confidence interval: �0.07 to 0.76), and laser therapy (standardized mean difference 0.58; 95 confidence interval: �0.44 to 1.59) had better effects on pain improvement versus the brace. Conclusion: The results indicated that physiotherapy interventions compared to counterforce braces have better effects, especially over the long-term. However, counterforce braces may have better effects on pain in younger people (<45 years old) over the short term (<6 weeks). Clinical relevance: The results suggest that counterforce bracing is a reasonable strategy to alleviate pain over the short term. However, the subgroup analysis suggests that factors such as age may have a role in their effectiveness. © The International Society for Prosthetics and Orthotics 2020