The National Health Assembly, a way to increase community participation in health decision making

Health is the result of dynamic and complicated relationships and deals with non-linear and non-predictable procedures. Nowadays, the health section cannot solely solve its challenges. Changing the load of diseases toward noncommunicable diseases all over the world including developing countries, and the fact that development of such diseases has complicated mechanisms and is dependent on several factors made us consider the importance of doing some health based interferences in other sections more than before (1,2)

Challenges of Memorandum of Understanding as a tool for strengthening intersectoral collaboration in health system

Background: For sustainable development and resolve complex public health problems, intersectoral collaboration is a necessity. A Memorandum of Understanding (MOU) is one of the tools used to develop intersectoral interactions. In this study, the challenges in the development and implementation of MOUs and propose strategies to overcome these challenges were studied by collecting the views of some stakeholders from other organizations.   Methods: For identifying challenges and solutions to improve the situation, group discussions were conducted with the presence of representatives from four ministries of Agriculture, Roads and Urban Development, Sports and Youth, and Education and the representatives of the Ministry of Health and Medical Education, who were responsible for preparing MOUs. All sessions were transcript and analyzed by using content analysis method.   Results: Some challenges were defined according to the development and implementation of MOUs. For better implementation, suggested strategies were: Strengthening the stewardship of intersectoral collaboration, effective and powerful management in monitoring the implementation of MOUs, Determining the appropriate financing path, strengthening individual and organizational capabilities in developing and implementing of MOUs, improving the terms and conditions of the implementing the MOUs.   Conclusion: Collaboration with other sectors has now become one of the main issues in health systems. For better achievement, strengthening the stewardship of intersectoral collaboration to effective coordination for drafting MOU, and facilitates and monitors the effective implementation of MOUs by identifying key people in each organization and empowering them is necessary

Monte Carlo study on the impact of spinal fixation rods on dose distribution in photon beams

BackgroundMetal spinal rods are used as fixation devices in spinal surgery. The attenuation effect of these rods has not been completely studied for patients with spinal rods and requiring spinal radiotherapy.AimThe purpose of the current study was to investigate the dosimetric perturbation effect of metallic spinal rods in different photon beams.Materials/MethodsThree photon beams of 6, 9 and 15MV were modelled using MCNP4C Monte Carlo (MC) code. The geometry consisted of two spinal rods at a depth of 4cm and a water phantom was used for MC calculations. The beam profiles at depths of 5.5, 6.5 and 7.5cm were calculated.ResultsDose reductions of 10.2–11.2% and 5–6.2% were observed for steel and titanium rods respectively. The insertion of metallic rods into the photon beams did not change the spinal cord received dose but the effect of both types of rods on the target region behind the rods cannot be ignored, especially for steel rods.ConclusionsOur results suggest that for reliable spinal radiotherapy the dose attenuation effect of spinal rods must be taken into account in treatment planning calculations

Small-disturbance voltage stability of distribution systems with wind turbine implemented with WRIG

The small-disturbance voltage stability of a grid-connected wound-rotor induction-generator (WRIG) wind-turbine system is analyzed under different operating conditions. This theoretical study shows the effect of the wound-rotor induction generator and its parameters on load-bus voltage collapse phenomena. Results show that the rotor resistance of the induction generators may decrease the system voltage stability margin and that the transmission line length has an important effect on the maximum loading point and critical point of loading

Transient stability evaluation of wind farms implemented with induction generators

The progress of wind-energy generation around the world in recent years has been consistently impressive. As more and more attention is paid to the increase of wind-turbine farms, a number of problems should be investigated in more detail. Among these problems, the transient stability of wind farms implemented with induction generators becomes necessary, especially when operating into a weak connection. The transient behavior and stability of wind farms with induction generators have been studied in this paper and some important operating conditions are analyzed. The impact of some important parameters such as strength of main grid, of X/R ratio of the transmission line on the transient stability of wind farm, and operation during severe faults are all investigated. The results of simulation show that these parameters have a great impact on the transient stability of wind farm. Power-system oscillation caused by a transient fault in the vicinity of a wind turbine is the worst case scenario, as the wind turbine has to ride through the fault and keep its stability

Occupational Health Services Integrated in Primary Health Care in Iran

Introduction: A healthy workforce is vital for maintaining social and economic development on a global, national and local level. Around half of the world's people are economically active and spend at least one third of their time in their place of work while only 15% of workers have access to basic occupational health services. According to WHO report, since the early 1980s, health indicators in Iran have consistently improved, to the extent that it is comparable with those in developed countries. In this paper it was tried to briefly describe about Health care system and occupational Health Services as part of Primary Health care in Iran. Methods: To describe the health care system in the country and the status of occupational health services to the workers and employers, its integration into Primary Health Care (PHC) and outlining the challenges in provision of occupational health services to the all working population. Findings: Iran has fairly good health indicators. More than 85 percent of the population in rural and deprived regions, for instance, have access to primary healthcare services. The PHC centers provide essential healthcare and public-health services for the community. Providing, maintaining and improving of the workers' health are the main goals of occupational health services in Iran that are presented by different approaches and mostly through Workers' Houses in the PHC system. Conclusions: Iran has developed an extensive network of PHC facilities with good coverage in most rural areas, but there are still few remote areas that might suffer from inadequate services. It seems that there is still no transparent policy to collaborate with the private sector, train managers or provide a sustainable mechanism for improving the quality of services. Finally, strengthening national policies for health at work, promotion of healthy work and work environment, sharing healthy work practices, developing updated training curricula to improve human resource knowledge including occupational health professionals are recommended

A Novel Approach Based on DEMATEL Method for Causal Modeling an Effective Factors in Falling from Height Accidents in Construction Projects

Falling from height known as one of the most important factors that leads to fatal accidents in the construction industry. The purpose of this study was to investigate and identify the effective factors in the occurrence of falling from height accidents in the construction projects and determine the causal relationships between organizational, individual and environmental factors. In this research, the surveyed population was the workers of five construction projects of a gas refinery in south of Iran from 2011 to 2015. Using the Integrated Management System (IMS) information, factors and sub-factors affecting the occurrence of falling from height accidents in the construction projects were determined. Then, a semi-comparative questionnaire based on the DEMATEL technique was designed and distributed among 10 experts at two different periods. Based on the expert's opinions, the identified factors and sub-factors were classified into three main factors and fourteen sub-factors, respectively. Then, the causal relationships between each the effective factor were identified, using DEMATEL technique. The results of DEMATEL technique revealed that the individual factors were considered to be the most important criteria, as it has acquired the maximum (D+R) value, i.e., 36.689 whereas, organizational factors had scored the least, i.e., 35.180. Accordingly, organizational factors and their sub-factors had a substantial effect on the falling from height accidents and were considered as causal variables (D-R>0), while, the indices of individual and environmental factors were the effect variables (D-

Listening to the voice of people: first Iran National Health Assembly

Background: People's participation in health affairs has been given more importance, recently. Establishment of the first National Health Assembly (NHA) in Iran was to shape dialogue among stakeholders and advocacy for health among all non-health sectors; decentralizing health decision making process, involving community and societies in health policy and planning, identification, appreciation, and development of health policies and measures in all economic, social, and cultural institutions of the country. This report summarized the Iranian context, process, and procedures of the establishment of the first NHA in Iran.   Presentation of case: To ensure participation of all people around the country, provincial health assemblies, district health assemblies, and neighborhood health assemblies were formed throughout the country. The main theme selected for the 1st NHA was “Health for All, All for Health”.   Conclusion: The final statement mentioned that health is a citizens’ right and all people and organizations are responsible for it; therefore, cultural activities and legal support are needed for the institutionalization of social accountability for health

A qualitative study on physical health threatening factors of Iranian seafarers working on ocean going tankers

Background: Seafaring is a highly physically demanding profession in a risky environment due to exposure to unique job health related risk factors. The purpose of the study is to describe physical health threatening factors of Iranian seafarers working on tankers. Materials and methods: A qualitative content analysis with inductive approach was performed on 17 Iranian male seafarers in 2016. Subjects were selected by purposive sampling, which continued until data saturation. Data were gathered using semi-structural questionnaire via in-depth-interviews. All interviews were transformed into computer files. Analysis was done based on conventional content analysis approach. Results: Mean job history and age of the participants was 11.9 ± 7.2 and 35.8 ± 9.3 years, respectively. Two main themes emerged during analysis of data and categories were created. The themes are (1) physical health threatening factors at the ship; (2) high risk ranks at the ship. Conclusions: The need for addressing nutrition at sea was acknowledged by seafarers. Also, it seems that revision of some regulations regarding seafarers’ medical examination, oral health and heart diseases is necessary

Transient stability evaluation of wind farms implemented with induction generators

The progress of wind-energy generation around the world in recent years has been consistently impressive. As more and more attention is paid to the increase of wind-turbine farms, a number of problems should be investigated in more detail. Among these problems, the transient stability of wind farms implemented with induction generators becomes necessary, especially when operating into a weak connection. The transient behavior and stability of wind farms with induction generators have been studied in this paper and some important operating conditions are analyzed. The impact of some important parameters such as strength of main grid, of X/R ratio of the transmission line on the transient stability of wind farm, and operation during severe faults are all investigated. The results of simulation show that these parameters have a great impact on the transient stability of wind farm. Power-system oscillation caused by a transient fault in the vicinity of a wind turbine is the worst case scenario, as the wind turbine has to ride through the fault and keep its stability