Factors influencing the geographic distribution of physicians in Iran: A qualitative study

Introduction: The uneven geographic distribution of physicians has been a longstanding important issue worldwide. Different policies have been recently employed in Iran, with the aim of bridging the gap. This study aimed to explore factors influencing the distribution of specialist physicians in Iran and investigate the effects of newly established policies on attracting and retaining physicians in rural and remote areas. Methods: This qualitative study was conducted in 2012. Qualitative data were obtained through an open-ended questionnaire and by reviewing relevant documents. Participants were 82 key officials from medical universities, who were directly involved in the distribution of physicians across the country, including vice chancellors for treatment affairs, managers for treatment affairs, and human resources experts. Thematic analysis was used to analyse qualitative data. Results: Four main factors influencing the distribution of physicians were explored, namely external, contextual, individual, and organizational factors. The decision to practice in rural areas was mainly influenced by socioeconomic characteristics of the designated areas and personal attributes of physicians, including sex, income expectations, and rural background. Participants also asserted that the implemented policies had a major positive influence on the distribution of physicians. In addition, participants believed that the improvement in the distribution of physicians had both positive economic and health impacts in underdeveloped areas. Conclusions: It seems that the regional distribution and supply of physicians have been improved in the light of the implemented policies in recent years. The study also revealed that a number of factors influence physician choices to stay and practice in rural and underdeveloped areas. Policies such as providing more financial and non-financial incentives, reducing disparities between physicians' income in rural and metropolitan areas, selection of students with rural background, and supportive measures for physicians working in underserved areas were recommended. © H Ravaghi, E Taati, Z Abdi, A Meshkini, S Sarvarizadeh, 2015

A step too far? Making health equity interventions in Namibia more sufficient

BACKGROUND: Equality of health status is the health equity goal being pursued in developed countries and advocated by development agencies such as WHO and The Rockefeller Foundation for developing countries also. Other concepts of fair distribution of health such as equity of access to medical care may not be sufficient to equalise health outcomes but, nevertheless, they may be more practical and effective in advancing health equity in developing countries. METHODS: A framework for relating health equity goals to development strategies allowing progressive redistribution of primary health care resources towards the more deprived communities is formulated. The framework is applied to the development of primary health care in post-independence Namibia. RESULTS: In Namibia health equity has been advanced through the progressive application of health equity goals of equal distribution of primary care resources per head, equality of access for equal met need and equality of utilisation for equal need. For practical and efficiency reasons it is unlikely that health equity would have been advanced further or more effectively by attempting to implement the goal of equality of health status. CONCLUSION: The goal of equality of health status may not be appropriate in many developing country situations. A stepwise approach based on progressive redistribution of medical services and resources may be more appropriate. This conclusion challenges the views of health economists who emphasise the need to select a single health equality goal and of development agencies which stress that equality of health status is the most important dimension of health equity

Women's right to health in Iran

In Iran, discrimination based on gender in enjoyment of the right to health is prohibited. Making health services physically and financially accessible to the entire population and removing social and cultural barriers of women's access to health services are main considerations of the health law sand policies of Iran. The health of Iranian women has improved considerably in recent years. But there are disparities in health status and access of women to health services around the country. Some groups of women, including the poor, the elderly, the disabled, the illegal immigrant, and those without an appropriate male guardian, and rural women have limited access to health services in Iran. To realize women's right to health, this country should immediately remove the disparities and use all the necessary means including legislative, administrative, budgetary, promotional,and judicial measures. National plans on women's empowerment and support should be interpreted in provincial pro-grams and action plans. Moreover, a monitoring system and certain benchmarks for tracing the progress of the plans should be established. Realizing other economic, social,and cultural rights including the rights to food, shelter, education, work, social security, and participation in society will improve the Iranian women's enjoyment of their right

Cavity soliton inhibition of extreme events in lasers with injection

Vortex mediated turbulence can be the key element in the generation of extreme events in spatially extended lasers with optical injection. Here, we study the interplay of vortex mediated turbulence and cavity solitons on the onset of extreme events in semiconductor lasers with injection. We first analyze and characterize these two features separately, spatiotemporal chaotic optical vortices for low values of the injection intensity and cavity solitons above the locking regime. In regimes where vortex mediated turbulence and cavity solitons coexist, localized peaks of light inhibit instead of enhancing the generation of rogue waves by locally regularizing the otherwise chaotic phase of the optical field. Cavity solitons can then be used to manipulate and control extreme events in systems displaying vortex mediated turbulence

Chasing feet in the wild: A proposed egocentric motion-aware gait assessment tool

Despite advances in gait analysis tools, including optical motion capture and wireless electrophysiology, our understanding of human mobility is largely limited to controlled conditions in a clinic and/or laboratory. In order to examine human mobility under natural conditions, or the 'wild', this paper presents a novel markerless model to obtain gait patterns by localizing feet in the egocentric video data. Based on a belt-mounted camera feed, the proposed hybrid FootChaser model consists of: 1) the FootRegionProposer, a ConvNet that proposes regions with high probability of containing feet in RGB frames (global appearance of feet), and 2) LocomoNet, which is sensitive to the periodic gait patterns, and further examines the temporal content in the stacks of optical low corresponding to the proposed region. The LocomoNet signicantly boosted the overall model's result by ltering out the false positives proposed by the FootRegionProposer. This work advances our long-term objective to develop novel markerless models to extract spatiotemporal gait parameters, particularly step width, to complement existing inertial measurement unit (IMU) based methods

Use of Accelerometer-Based Feedback of Walking Activity for Appraising Progress With Walking-Related Goals in Inpatient Stroke Rehabilitation: A Randomized Controlled Trial

Trial registration: ClinicalTrials.gov NCT01521234Background: Regaining independent ambulation is important to those with stroke. Increased walking practice during ‘down time’ in rehabilitation could improve walking function for individuals with stroke. Objective: To determine the effect of providing physiotherapists with accelerometer-based feedback on patient activity and walking-related goals during in-patient stroke rehabilitation. Methods: Participants with stroke wore accelerometers around both ankles every weekday during in-patient rehabilitation. Participants were randomly assigned to receive daily feedback about walking activity via their physiotherapists (n=29) or to receive no feedback (n=28). Changes in measures of daily walking (walking time, number of steps, average cadence, longest bout duration, and number of ‘long’ walking bouts) and changes in gait control and function assessed in-laboratory were compared between groups. Results: There was no significant increase in walking time, number of steps, longest bout duration, or number of long walking bouts for the feedback group compared to the control group (p-values>0.20). However, individuals who received feedback significantly increased cadence of daily walking than the control group (p=0.013). From the in-laboratory gait assessment, individuals who received feedback had a greater increase in walking speed and decrease in step time variability than the control group (p-values<0.030). Conclusion: Feedback did not increase the amount of walking completed by individuals with stroke. However, there was a significant increase in cadence, indicating that intensity of daily walking was greater for those who received feedback than the control group. Additionally, more intense daily walking activity appeared to translate to greater improvements in walking speed.This project was generously funded by a grant from the Ontario Ministry of Health and Long-Term Care, administered and supported by the Ontario Stroke Network (OSN1101-000149). Equipment and space have been funded with grants from the Canada Foundation for Innovation, Ontario Innovation Trust, and the Ministry of Research and Innovation. At the time of this study, Elizabeth Inness was supported by a Canadian Institutes of Health Research fellowship. The views expressed do not necessarily reflect those of the funders

Brilliantia kiribatiensis, a new genus and species of Cladophorales (Chlorophyta) from the remote coral reefs of the Southern Line Islands, Pacific Ocean

Author Posting. © The Author(s), 2022. This is the author's version of the work. It is posted here by permission of John Wiley & Sons for personal use, not for redistribution. The definitive version was published in . Journal of Phycology (2022), https://doi.org/10.1111/jpy.13230.The marine green alga Brilliantia kiribatiensis gen. et sp. nov. is described from samples collected from the coral reefs of the Southern Line Islands, Republic of Kiribati, Pacific Ocean. Phylogenetic analysis of sequences of the large- and small-subunit rDNA and the rDNA internal transcribed spacer region revealed that Brilliantia is a member of the Boodleaceae (Cladophorales), containing the genera Apjohnia, Boodlea, Cladophoropsis, Chamaedoris, Phyllodictyon, and Struvea. Within this clade it formed a distinct lineage, sister to Struvea elegans, but more distantly related to the bona fide Struvea species (including the type S. plumosa). Brilliantia differs from the other genera by having a very simple architecture forming upright, unbranched, single-celled filaments attached to the substratum by a rhizoidal mat. Cell division occurs by segregative cell division only at the onset of reproduction. Based on current sample collection, B. kiribatiensis seems to be largely restricted to the Southern Line Islands, although it was also observed on neighboring islands, including Orona Atoll in the Phoenix Islands of Kiribati, and the Rangiroa and Takapoto Atolls in the Tuamotus of French Polynesia. This discovery highlights the likeliness that there is still much biodiversity yet to be discovered from these remote and pristine reefs of the central Pacific.National Geographic Society2022-12-1