Fairness of health financing before and after introduction of iranian health sector evolution plan: A case study

Introduction: Since out-of-pocket payments of household are a serious obstacle to the equitable utilization of health services, paying attention to the direct payment of households and, consequently, incidence of catastrophic health expenditures should always be considered in the planning and policy-making of health services. Iranian Health Sector Evolution Plan (HSEP) has been implemented since 2014, aiming at achieving universal coverage of health services and reducing the amount of out-of-pocket payments as a percentage of total health expenditures. Aim: To measure the fairness of health care financing and to identify incidence rate of catastrophic health expenditures and it�s most important determinants before and after implementing the HSEP among households in one province of Iran (Lorestan). Materials and Methods: The study population of present cross-sectional research was Lorestan households whose information was collected by a three-stage randomized cluster sampling method by the Statistics Center of Iran during 4/2012-3/2015. For data analysis, Logit�s regression model using Stata14 software was performed. Results: Based on the findings between 4/2012 and 3/2015, the incidence rate of Catastrophic Health Expenditure (CHE) reduced from 6.7 to 4.34 and Fairness Financial Contribution Index (FFCI) varied from 0.66 to 0.74 and percentage of poverty due to health expenditure varied from 1.96 to 0.28. The most important determinants of facing catastrophic health expenditure are economic status of households, location of households (urban or rural), and number of people over the age of 65 and under the age of 5 in the household, age and sex of household head and insurance status of households. The use of health care also showed a significant relationship with the incidence of catastrophic health expenditure. Conclusion: After implementing Iranian HSEP, the incidence of CHE and the percentage of poverty caused by health expenditure at the level of households were reduced to some degree, and fairness financial contribution index improved. The finding of this study will help health policymakers to identify factors increasing the likelihood of household exposure to catastrophic health expenditure, and based on these factors, to review and revise the programs implemented within the framework of Iranian HSEP and adopt appropriate policies to promote the protection of households against catastrophic health expenditure. © 2018, Journal of Clinical and Diagnostic Research. All rights reserved

Fairness of health financing before and after introduction of iranian health sector evolution plan: A case study

Introduction: Since out-of-pocket payments of household are a serious obstacle to the equitable utilization of health services, paying attention to the direct payment of households and, consequently, incidence of catastrophic health expenditures should always be considered in the planning and policy-making of health services. Iranian Health Sector Evolution Plan (HSEP) has been implemented since 2014, aiming at achieving universal coverage of health services and reducing the amount of out-of-pocket payments as a percentage of total health expenditures. Aim: To measure the fairness of health care financing and to identify incidence rate of catastrophic health expenditures and it�s most important determinants before and after implementing the HSEP among households in one province of Iran (Lorestan). Materials and Methods: The study population of present cross-sectional research was Lorestan households whose information was collected by a three-stage randomized cluster sampling method by the Statistics Center of Iran during 4/2012-3/2015. For data analysis, Logit�s regression model using Stata14 software was performed. Results: Based on the findings between 4/2012 and 3/2015, the incidence rate of Catastrophic Health Expenditure (CHE) reduced from 6.7 to 4.34 and Fairness Financial Contribution Index (FFCI) varied from 0.66 to 0.74 and percentage of poverty due to health expenditure varied from 1.96 to 0.28. The most important determinants of facing catastrophic health expenditure are economic status of households, location of households (urban or rural), and number of people over the age of 65 and under the age of 5 in the household, age and sex of household head and insurance status of households. The use of health care also showed a significant relationship with the incidence of catastrophic health expenditure. Conclusion: After implementing Iranian HSEP, the incidence of CHE and the percentage of poverty caused by health expenditure at the level of households were reduced to some degree, and fairness financial contribution index improved. The finding of this study will help health policymakers to identify factors increasing the likelihood of household exposure to catastrophic health expenditure, and based on these factors, to review and revise the programs implemented within the framework of Iranian HSEP and adopt appropriate policies to promote the protection of households against catastrophic health expenditure. © 2018, Journal of Clinical and Diagnostic Research. All rights reserved

Increasing the order of convergence of iterative schemes for solving nonlinear systems

[EN] A set of multistep iterative methods with increasing order of convergence is presented, for solving systems of nonlinear equations. One of the main advantages of these schemes is to achieve high order of convergence with few Jacobian and functional evaluations, joint with the use of the same matrix of coefficients in the most of the linear systems involved in the process. Indeed, the application of the pseudocomposition technique on these proposed schemes allows us to increase their order of convergence, obtaining new high-order, efficient methods. Finally, some numerical tests are performed in order to check their practical behavior. (C) 2012 Elsevier B.V. All rights reserved.This research was supported by Ministerio de Ciencia y Tecnología MTM2011-28636-C02-02 and FONDOCYT 2011-1-B1-33 República DominicanaCordero Barbero, A.; Torregrosa Sánchez, JR.; Penkova Vassileva, M. (2013). Increasing the order of convergence of iterative schemes for solving nonlinear systems. Journal of Computational and Applied Mathematics. 252:86-94. https://doi.org/10.1016/j.cam.2012.11.024S869425

QUEST-DMC:Background Modelling and Resulting Heat Deposit for a Superfluid Helium-3 Bolometer

We report the results of radioactivity assays and heat leak calculations for a range of common cryogenic materials, considered for use in the QUEST-DMC superfluid 3He dark matter detector. The bolometer, instrumented with nanomechanical resonators, will be sensitive to energy deposits from dark matter interactions. Events from radioactive decays and cosmic rays constitute a significant background and must be precisely modelled, using a combination of material screening and Monte Carlo simulations. However, the results presented here are of wider interest for experiments and quantum devices sensitive to minute heat leaks and spurious events, thus we present heat leak per unit mass or surface area for every material studied. This can inform material choices for other experiments, especially if underground operation is considered – where the radiogenic backgrounds will dominate even at shallow depths

QUEST-DMC superfluid ³He detector for sub-GeV dark matter

The focus of dark matter searches to date has been on Weakly Interacting Massive Particles (WIMPs) in the GeV/c2-TeV/c2 mass range. The direct, indirect and collider searches in this mass range have been extensive but ultimately unsuccessful, providing a strong motivation for widening the search outside this range. Here we describe a new concept for a dark matter experiment, employing superfluid 3He as a detector for dark matter that is close to the mass of the proton, of order 1 GeV/c2. The QUEST-DMC detector concept is based on quasiparticle detection in a bolometer cell by a nanomechanical resonator. In this paper we develop the energy measurement methodology and detector response model, simulate candidate dark matter signals and expected background interactions, and calculate the sensitivity of such a detector. We project that such a detector can reach sub-eV nuclear recoil energy threshold, opening up new windows on the parameter space of both spin-dependent and spin-independent interactions of light dark matter candidates

Homozygous microdeletion of exon 5 in ZNF277 in a girl with specific language impairment

Peer reviewedPublisher PD

Feasibility study on development of artificial reefs in the Persian Gulf (Hormuzgan province)

Persian Gulf waters (areas of Hormuzgan province) in order to determine the best location for installation of Artificial reefs were studied seasonally from December 2006 to March 2007. Distribution of fauna and flora and estimation of deposit depth by SCUBA diving method, density and frequency of macrobenthose communities, frequency of ichthyoplankton communities, determination of organic carbon (OC) and Grain size and measurement of water physical factors including salinity, saturation oxygen, dissolved oxygen, temperature, chlorophyll a, in transect and subtransect was studied for recognizing the best placement to installation of artificial reefs. All areas of Shipping, military areas, around of Islands, natural habitats and entrance to jetty were introduced for excluding areas. South of Qeshm Island (transects of Bahman jetty, Bandar Masen and Bandar Salakh) are catching area for small pelagic (sardine and anchovy fishes), therefore in these areas installation of artificial reefs have confined with this restriction. Also entrance to Bahman jetty, sea plant habitats (sea grass and algae) in transects of Bahman jetty and Bandar Masen were considered as restricted areas. In this area, suitable areas for installation of artificial reefs was determined based on distribution of Ichthyoplankton societies for every transect, for macrobenthose enrichment Bahman jetty transect was calculated middle, but transects of Bandar Masen, Hengam island and Bandar Salakh was done good indicator. The deposition depth in transects of Bandar Masen and Hengam island was determined as good factor but this index was known as average factor for transects of Bahman jetty and Bandar Masen. Also, two another indicators, primary production and bottom sturdiness, were calculated as middle factor for Bahman jetty transect, but these indicators were known as good factors for other transects in this area (Bandar Masen, Hengam island and Bandar Salakh). The results of these indicators in transects of Bandar Kong and Bandar Bostaneh in Bandar Lengeh area was indicated that T. O. C and bottom sturdiness indices had no significant difference (p>0. 05) and the whole of these transects had average priority. Bottom sturdiness, primary productions and macrobenthose communities indices had difference in Bandar Lengeh area (p<0. 05) and these indices had average priority in Bandar Kong transect and had good priority in transects of Bandar Bostaneh and Bandar Hasineh. Ichthyoplankton community had average priority for Bandar Bostaneh transect, and had good priority for transects of Bandar Kong and Bandar Hasineh. The good priority has obtained for transects of Bandar Charak, Bandar Gorzeh and Bandar Chiroeyah. Also Macrobenthose community, primary production, water physical factors and bottom sturdiness were known as good, good, average and weakness priority respectively for transects of Bandar Charak, Bandar Gorzeh, but primary production, bottom sturdiness, water physical factors and macrobenthose community were resulted as average, good, good and average priority respectively for Bandar Chiroeyah transect . T.O.C index was determined as average priority for transects of Bandar Gorzeh and Bandar Chiroeyah and good priority for Bandar Charak transect. Finally, excluded areas maps, suitability areas maps and feasibility areas maps were drawn by Arc GIS software. In this survey, layers between 10 to 20 meters depth were recognized as the best position for installation of artificial reefs

Does high-dose metformin cause lactic acidosis in type 2 diabetic patients after CABG surgery? A double blind randomized clinical trial

Metformin is a dimethyl biguanide oral anti-hyperglycemic agent. Lactic acidosis due to metformin is a fatal metabolic condition that limits its use in patients in poor clinical condition, consequently reducing the number of patients who benefit from this medication. In a double blind randomized clinical trial, we investigated 200 type 2 diabetic patients after coronary artery bypass surgery in the open heart ICU of the Mazandaran Heart Center, and randomly assigned them to equal intervention and control groups. The intervention group received regular insulin infusion along with 2 metformin 500 mg tablets every twelve hours, while the control group received only intravenous insulin with 2 placebo tablets every twelve hours. Lactate level, pH, base excess, blood glucose and serum creatinine were measured over five 12 h periods, with data averaged for each period. The primary outcome in this study was high lactate levels. Comparison between the 2 groups was made by independent Student’s t-test. To compare changes in multiple measures in each group and analysis of group interaction, a repeated measurement ANOVA test was used