The Outcome of Surgical Versus Conservative Management in Old Patients With Traumatic Brain Injury

Background and Aim: It is still unclear whether the surgical or conservative approach has the best recovery and the least adverse outcomes after the treatment of patients with traumatic brain injury (TBI), especially the elderly. The use of invasive versus conservative therapies in elderly patients with TBI is controversial, and the current brain surgery procedures for the elderly require further evaluation. Methods and Materials/Patients: In this retrospective cohort study, the medical records of 238 patients with TBI (119 surgical patients and 119 patients treated with conservative methods) over the age of 65 were reviewed. The patients were compared for the degree of recovery indicated by the Glasgow outcome score (GOS) and postoperative complications. Results: No difference was found in the primary Glasgow coma scale (GCS) between surgical and conservative approaches, but after two treatment protocols, the assessment of GCS and GOS showed a significant difference between the two groups; however, after adjusting baseline parameters in a multivariable logistic regression model, the difference between the two groups in CGS and recovery state turned to insignificance. There was no difference between surgical and conservative management in the post-treatment sequels, including contusion, hydrocephalus, myocardial infarction, pulmonary infection, and death. However, the recurrence of hematoma was significantly higher in those who were treated by the conservative method even after multivariate regression modeling. Conclusion: In TBI patients aged over 65 years, surgical management can result in more favorable outcomes compared with the conservative approach

Sustainability criteria of apicultural industry: evidence from Iran

This study aimed to determine the sustainability criteria of the beekeeping industry in Iran, which was performed using three-stage classical Delphi technique. The participants were 32 experts in beekeeping industry who were purposefully selected using the snowball sampling method. The criteria identified, after three Delphi stages, consisted of 70 items, which were categorized into 13 general criteria and into four economic, environmental, social, and institutional dimensions. The general criteria were presented in the form of a conceptual model, including: farmers’ environmental behavior quality, beekeepers' environmental behavior quality, the quality of marketing and sales of beekeeping productions, productivity and performance improvement, amount of monetization from pollinations' right, the amount of monetization of byproducts and value added, employment rate and job stability, the level of social development of stakeholders, the quality of the role-playing of non-governmental stakeholders, the quality of extension and education new sciences and technologies to stakeholders, comprehensiveness of laws and programs, quality of role-playing of stakeholder non-governmental organizations, and the quality of the roleplaying of governmental institutions stakeholder. Using them, a comprehensive perception of the necessary criteria for the sustainability of Iran's beekeeping industry can be obtained and a comprehensive program can be designed for its implementation