The Economic Contribution of Tourism in Iran: An Input-Output Approach

Historically, Iran has been heavily dependent on crude oil revenues. However, Iran is richly endowed with many natural and cultural attractions. Possibly due to the image of being an unsafe destination, international tourism has not been developed as quickly as in other parts of the world. However, the tourism industry can play an important role in the economic growth of many countries. The economic tourism potential for Iran has been an underresearched area. An input–output model has been used to calculate income multipliers and employment multipliers to assess the economic contribution of tourism activities. Compared to other sectors in the economy, we find there is economic potential for tourism. The tourism industry can play an important role to stimulate economic growth and employment

Postoperative Acute Kidney Injury is Associated with Persistent Renal Dysfunction: A Multicenter Propensity Matched Cohort Study

BackgroundThe risk of developing a persistent reduction in renal function after postoperative acute kidney injury (pAKI) is not well-established.ObjectivePerform a multi-center retrospective propensity matched study evaluating whether patients that develop pAKI have a greater decline in long-term renal function than patients that did not develop postoperative AKI.DesignMulti-center retrospective propensity matched study.SettingAnesthesia data warehouses at three tertiary care hospitals were queried.PatientsAdult patients undergoing surgery with available preoperative and postoperative creatinine results and without baseline hemodialysis requirements.MeasurementsThe primary outcome was a decline in follow-up glomerular filtration rate (GFR) of 40% relative to baseline, based on follow-up outpatient visits from 0-36 months after hospital discharge. A propensity score matched sample was used in Kaplan-Meier analysis and in a piecewise Cox model to compare time to first 40% decline in GFR for patients with and without pAKI.ResultsA total of 95,208 patients were included. The rate of pAKI ranged from 9.9% to 13.7%. In the piecewise Cox model, pAKI significantly increased the hazard of a 40% decline in GFR. The common effect hazard ratio was 13.35 (95% CI: 10.79 to 16.51, p<0.001) for 0-6 months, 7.07 (5.52 to 9.05, p<0.001) for 6-12 months, 6.02 (4.69 to 7.74, p<0.001) for 12-24 months, and 4.32 (2.65 to 7.05, p<0.001) for 24-36 months.LimitationsRetrospective; Patients undergoing ambulatory surgery without postoperative lab tests drawn before discharge were not captured; certain variables like postoperative urine output were not reliably available.ConclusionPostoperative AKI significantly increases the risk of a 40% decline in GFR up to 36 months after the index surgery across three institutions

Systematic Review on Internet Support Groups (ISGs) and Depression (1): Do ISGs Reduce Depressive Symptoms?

BACKGROUND: Internet support groups (ISGs) enable individuals with specific health problems to readily communicate online. Peer support has been postulated to improve mental health, including depression, through the provision of social support. Given th