Effectiveness of naltrexone in the prevention of delayed respiratory arrest in opioid-naive methadone-intoxicated patients

Acute methadone toxicity is a major public health concern in Iran. Methadone-intoxicated patients are in a great risk of recurrent or delayed respiratory arrest despite the prescription of initial doses of naloxone. This study aimed to evaluate the effectiveness of oral naltrexone in the management of acute methadone overdose in opioid-naive patients and check if it could be a substitute of continuous infusion of naloxone in maintaining adequate ventilation. In a randomized, double-blind, placebo-controlled study, a total of 54 opioid-naive patients with acute methadone toxicity were enrolled. The patients received either oral naltrexone or placebo capsules after awakening by naloxone. All patients underwent close monitoring of respiration. Frequency of respiratory depression or arrest, need for another dose of naloxone, duration of hospital stay, and adverse outcomes compared between the two groups. The incidence of respiratory depression was significantly less in those who had received naltrexone. Our results show that single oral dose of naltrexone is quite efficient in the prevention of recurrent or delayed respiratory arrest in opioid-naive methadone-intoxicated patients. It can shorten the duration of hospitalization and, as a consequence, decreased the risk of complications. Further studies are warranted before the generalization of this approach to other patient populations. © 2013 Abbas Aghabiklooei et al

Effectiveness of naltrexone in the prevention of delayed respiratory arrest in opioid-naive methadone-intoxicated patients

Acute methadone toxicity is a major public health concern in Iran. Methadone-intoxicated patients are in a great risk of recurrent or delayed respiratory arrest despite the prescription of initial doses of naloxone. This study aimed to evaluate the effectiveness of oral naltrexone in the management of acute methadone overdose in opioid-naive patients and check if it could be a substitute of continuous infusion of naloxone in maintaining adequate ventilation. In a randomized, double-blind, placebo-controlled study, a total of 54 opioid-naive patients with acute methadone toxicity were enrolled. The patients received either oral naltrexone or placebo capsules after awakening by naloxone. All patients underwent close monitoring of respiration. Frequency of respiratory depression or arrest, need for another dose of naloxone, duration of hospital stay, and adverse outcomes compared between the two groups. The incidence of respiratory depression was significantly less in those who had received naltrexone. Our results show that single oral dose of naltrexone is quite efficient in the prevention of recurrent or delayed respiratory arrest in opioid-naive methadone-intoxicated patients. It can shorten the duration of hospitalization and, as a consequence, decreased the risk of complications. Further studies are warranted before the generalization of this approach to other patient populations. © 2013 Abbas Aghabiklooei et al

An application of European Performance Satisfaction Index toward rural tourism: The case of western Iran. Tourism Management Perspectives

Iran is endowed with numerous historic and cultural attractions spanning more than 7000 years of continuous civilization, affording it much tourism potential. However, the country currently ranks 70th worldwide in tourists' arrivals and 77th in revenues generated by tourism. Though tourism potential does not always lead to its development, an assessment of resident attitudes towards tourism as an economic development strategy is a needed precursor to an integrated management approach so that once the impediments are lifted, the industry can develop in an appropriate and sustainable way. To achieve this end, this study operationalized the European Performance Satisfaction Index to assess resident attitudes and commitment towards tourism in Oraman County in Iran's Kurdistan province. Yielded from the survey data was a causal chain of factors influencing commitment towards tourism among those known in the community to have experience in current tourism offerings and upon whom future tourism development would likely depend

Examining the Attitude and Tendency of Farmers toward Participation in the Establishment of WUAs in Dehloran Township

One of the reasons for the failure of established WUAs is the lack of attention the social context and the set of actions that must be taken before the start of the establishment of WUAs. Regarding this issue, the purpose of this study was to explain the attitude and intention of farmers to participate in the establishment of WUAs. The statistical population of this study included all farmers in the central district of Dehloran Township, which any WUAs has not been established in this region until now and a sample selected using completely random sampling method and Cochran formula among them. A researcher-made questionnaire, which its validity and reliability confirmed, used to collect data.  The data were analyzed using SPSS V20 software. The results of the study showed that there was a positive attitude among the beneficiaries of the region. The findings also showed that large farmers with integrated lands, tend to be less inclined to participate in establishing WUAs. In addition, the results showed a positive and significant relationship between attitude and willingness to participate of the beneficiaries. Finally, some suggestions provided for facilitating the decision-making process towards the establishment of sustainable and successful cooperatives in the future

Genetically modified crops : towards agricultural growth, agricultural development or agricultural sustainability ?

This paper presents the main potentials and challenges of the GM crops in approaching agricultural growth, development, and sustainability. Accordingly, the paper will first discuss briefly the differences between agricultural growth, development, and sustainability. Then, the main potentials and challenges of these crops in approaching agricultural growth, development, and sustainability will be discussed. Finally, a conclusion will be drawn to let policy makers understand, based on which circumstances, GM crops may lead to sustainable agriculture