Explanatory Model of the Relationship between Regional Governance, Institutional Capacity and Sustainable Development

Institutional capacity has been recognized as one of the new policies and instruments for the regional development. While, the way in which the institutional capacity affects the regional development has been discussed as a basic problem in the academic and policymaking communities concerning the regional development, and there is no specific model for explaining the problem. On the other hand, many regions of Iran, as a developing country, face the great social, economic and ecological challenges which make it necessary to consider the institutional capacity at the regional level and its effects on the sustainable development. Therefore, this research aims at responding the basic question of: what is the proper model in the framework of the regional governance for explaining the relations between the institutional capacity and the sustainable regional development, emphasizing on Iran conditions?In this research, we have used a combination of survey-quantitative and quantitative methods to study the relationships among the regional governance, institutional capacity and sustainable development based on mainstreaming it in decision-making and activities of the region's institutions. To determine the amount of the institutional capacity effect on the sustainable development through the regional governance, and with regard to the concentrated structure of the country's administrative system and to determine the effect of such concentrated system, we studied the existence of such relations at the regional level, in from of case studies in Boukan and Orumiyeh counties. The results show that there is a direct relationship between the institutional capacity and mainstreaming sustainable regional development. According to the regression analysis results, mainstreaming sustainable regional development has correlation of 0.725 with the constituent factors of the institutional capacity. In addition, the results of the path analysis reveal that the constituent factors of the institutional capacity have different share in the mainstreaming sustainable regional development; so that appropriate legal arrangements, integrated institutions, abilities of institutions, learning and knowledge are effective on the mainstreaming sustainable regional development with 0.604, 0.356, 0.354, 0.248 and 0.074, respectively. Keywords: Explanation, Institutionalism, Institutional Capacity, Sustainable Regional Development, Iran

Explanatory Model of the Relationship between Regional Governance, Institutional Capacity and Sustainable Development in Iran

Institutional capacity has been recognized as one of the new policies and instruments for the regional development. While, the way in which the institutional capacity affects the regional development has been discussed as a basic problem in the academic and policymaking communities concerning the regional development, and there is no specific model for explaining the problem. On the other hand, many regions of Iran, as a developing country, face the great social, economic and ecological challenges which make it necessary to consider the institutional capacity at the regional level and its effects on the sustainable development. Therefore, this research aims at responding the basic question of: what is the proper model in the framework of the regional governance for explaining the relations between the institutional capacity and the sustainable regional development, emphasizing on Iran conditions?In this research, we have used a combination of survey-quantitative and quantitative methods to study the relationships among the regional governance, institutional capacity and sustainable development based on mainstreaming it in decision-making and activities of the region's institutions. To determine the amount of the institutional capacity effect on the sustainable development through the regional governance, and with regard to the concentrated structure of the country's administrative system and to determine the effect of such concentrated system, we studied the existence of such relations at the regional level, in from of case studies in Boukan and Orumiyeh counties. The results show that there is a direct relationship between the institutional capacity and mainstreaming sustainable regional development. According to the regression analysis results, mainstreaming sustainable regional development has correlation of 0.725 with the constituent factors of the institutional capacity. In addition, the results of the path analysis reveal that the constituent factors of the institutional capacity have different share in the mainstreaming sustainable regional development; so that appropriate legal arrangements, integrated institutions, abilities of institutions, learning and knowledge are effective on the mainstreaming sustainable regional development with 0.604, 0.356, 0.354, 0.248 and 0.074, respectively. Keywords: Explanation, Institutionalism, Institutional Capacity, Sustainable Regional Development, Iran

First report of coexistence of AmpC beta-lactamase genes in Klebsiella pneumoniae strains isolated from burn patients

Klebsiella spp. are among the most frequently isolated bacteria from burn wounds. These organisms are among the most important opportunistic pathogens, causing hospital-acquired and healthcare-associated infections worldwide. Limited information is available about prevalence of AmpC-producing Klebsiella pneumoniae from burn patients. Therefore, the aim of this study was to determine the characterization of AmpC beta-lactamase among K. pneumoniae isolated from burn patients. Samples were collected from wound specimens of patients with burn injury from a burn hospital in Tehran during 18 months (March 2015 to August 2016). For phenotypic detection of AmpC beta-lactamase, disk diffusion method with cefoxitin was used for screening, AmpC disk test and boronic acid inhibitor-based method were used as confirmatory tests. Polymerase chain reaction (PCR) was performed to screen all isolates with AmpC genes including ACCM, DHAM, EBCM, FOXM, MOXM, and CITM. Finally, PCR products were validated using sequencing. During this study, 102 isolates of K. pneumoniae were collected. Among these isolates, 52.9% suspected as AmpC producer by disk agar diffusion cefoxitin screening method. By confirmatory phenotypic methods, 19.6% of isolates considered as AmpC producer. Molecular analysis revealed 43.1% of cefoxitin-resistant isolates harbored at least one of the AmpC genes including CITM (22.5%), EBCM (21.5%), DHAM (7.8%), and FOXM (0.98%). In addition, 5.8% of isolates harbored two AmpC genes and 2.9% harbored three AmpC genes. In conclusion, K. pneumoniae is becoming a serious problem in burn patients. Accurate and precise methods and guidelines should be designed for detection of antibiotic-resistant mechanisms. Our data showed the high rate of AmpC beta-lactamase among K. pneumoniae isolated from burn patients, which limit the treatment options. Therefore, the results of this study can provide evidence to help for appropriate treatment of burn patients

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Spatial Analysis of Social and Cultural Factors as Driving Forces and Obstacles in Regional Spatial Planning and Development in Khorasane-Shomali Province

Introduction Development paradigms and approaches have changed at the macro level since 1970s from hard to soft and the traditional development models have been marginalized. At the same time, the local and regional development theories are also changing continuously. By these changes and transformation in theories, there has been a lot of attention to the role of Social and cultural factors in regional spatial planning and development in two recent decades and concepts such as social capital are considered attractive in this arena. Formulating and explaining of the role of social and cultural factors in local and regional development has begun from 1990s, and there has been a lot of studies in recent years which demonstrated that social and cultural factors can act as driving forces and obstacles in local and regional development. The role of social and cultural factors in local and regional development is so important that regional competitiveness models, consider them essential for regional development. Investigating and analysis the role of social and cultural factors, therefore, can be considered as a basic step in development planning for a region. According to the above discussion, this article is trying to answer the question: how the situation is in terms of social and cultural factors as driving forces or obstacles in regional development in Khorasane-Shomali Province? It is necessary to note that although there have been a lot of studies that have theoretically and empirically paid special attention to the role of social and cultural factors in the development, the role of social and cultural factors in regional planning and development is still unknown.   Materials & Methods In this article, we have used a survey and qualitative method to explain the subject and answer the main research question. The empirical data was provided by the plan of spatial planning of Khorasane-Shomali Province. Data gathering tool was questionnaire and the article has used the formal data delivered and reported by local organizations. It should be noted that the Khorasane-Shomali Province is located in the north east of Iran and is one of the new formally shaped provinces that was formed in 2004. Cultural components such as culture of working, willingness to learning and progress, and conflict and opposition between groups (ethnic, social classes, and generic) were examined. The social components such as literacy rate, social problems, identity and sense of locality, and social capital were also investigated.   3- Discussion of Results & Conclusions The results demonstrate that although it is not possible to draw an exact spatial area according to the social and cultural factors in Khorasane-Shomali Province, the counties of the province show different conditions according to the social and cultural factors. So we can draw some approximate boundaries separating social and cultural conditions in that province. The results also demonstrate that there are some social and cultural factors such as working as a value, the important of working, and social capital that act as driving forces in the process of spatial planning and development of Khorasane-Shomali. On the other hand, it can be argued that factors such as declining social status of working, various conflicts and opponents, social problems and unemployment are acting as obstacles in the process of spatial planning and development of Khorasane-Shomali Province. Therefore, according to the results, there are many differences between counties of Khorasane-Shomali Province. These differences stem from historical roots and various cultural, social, geographical, and physical conditions of the counties. For example, the counties located in the south of province such as Esfarayein, Jajarm and Gemeh show more different social and cultural conditions as they are separated from northern parts of province by a mountains chain. The ethnic diversity is also an important factor in the province

The model of urban tourism development in central district of Tehran with Urban management approach

This article is about the capability of urban tourism development in central district of Tehran with the urban management approach, dealing with a primary question about evaluation of urban tourism development capabilities of city-central districts and secondary questions about traits and capabilities of central district of Tehran. This research is a qualitative study, using “grounded theory” method as a tool for gathering and analysis of the data. Data has been collected through deep interviews and field observations. Our sample study is comprised of 31 urban actives that were selected by means of aimed sampling in four groups: state section, private section, public section, and citizens. Results drawn from the paradigm model show that urban tourism in central district of Tehran has not been developed enough to fulfill its capabilities. The Solution proposed is changing the economic central district to cultural central district. In this paper the present position of central district of Tehran and its probable ideal position have been shown in a three-dimensional model; and a pattern composed of both culture-based and economics-based tourism development has been recognized as a suitable pattern for actualizing tourism development potentials in central district of Tehran

Meta-Analysis of Methods and Findings of Urban Quality of Life in Iran

Introduction There is no agreement on what city and urban lifestyle are. It is not just about minimum factors that each city must have, but also about social interactions, social needs and individual perceptions which are dependent on cultural characteristics and geographical details. Generally speaking, cities have complex systems of transportation, sanitation, utilities, land usage, social connections and economic actions. These systems are always in the process of changing and developing. So, development of cities leads to new lifestyles and create what we may call urban life. Development of urban life causes concentration of equipments and resources in cities. Also, it is clear that a mere focus on quantitative facts of urban development is not enough to get to the efficient way of life. Hence researchers and managers have decided to pay more attention to factors which are more related to quality of urban life. In other words, after an initial attention to quantitative development of cities, the concept of quality of life is now getting attention in terms of qualitative factors. Due to this shift, a great deal of scientific and practical studies have been conducted and many new things have been revealed. Medical, sociological, psychological, environmental and economic points of views led to create new indexes and multidimensional frameworks. More than that, each city arrives at special findings which are linked to its local specifications. Because of diversity of results in different cases and cities, reaching to a shared and unique conclusion for urban quality of life is not easy. So the purpose of this study is to centralize and summarize the results of various studies on this topic in Iran. Meta-analysis is a research method for arriving at a specific knowledge from different studies. This research method was introduced in the late 1970s and soon became famous because of its abilities to get clear conclusions. Material & Methods This paper has analyzed Iranian scientific studies on quality of life, which were published until 2012. Meta-analysis is a tool for integrating scattered results and achieving to a new understanding in order to develop boundaries of knowledge. Identifying patterns among study results, contrasting and combining different studies, identifying a common measure of size effects, overcoming bias and doing systematic reviews are different benefits and applications of this method. Some steps are taken in order to get a reliable meta-analysis. First of all, it was decided to find keywords which are related to urban quality of life. Based on ideas of experts and those keywords, all Persian scientific databases which could have articles related to quality of urban life were searched. Initially, 45 articles were included in the sample. Later on, however, some of these articles which were not scientifically acceptable or belonged to medical fields were excluded. After this process, 27 articles were selected, of which 17 articles are published in scientific peer-reviewed journals and the remaining 10 article in other journals. Based on these categories, it was decided to separate results into two different types: "results of studies published in peer-reviewed journals" and "result of studies published in non-peer-reviewed journals". After that, specific findings of articles were written and summarized. For doing this, 9 important dimensions were chosen which were used for filtering the articles. Table 1 provides a view of these indicators. Table 1- View of Filtering Indicators Dimensions Indicators Research method type of research, data collection method, Sampling method Samples, specified samples, quality of samples Research framework Assumptions and Questions and framework selecting Validity and reliability The amount of validity and reliability and declaration of it Theoretical Approach The main approach to quality of urban life and clarity of expression Subjective and objective indicators Type of indicators (objective and subjective) and their separation in final results Main dimensions Environmental/services /social /economic Variables and analysis tools Independent and dependent variables, type of dependent variables and analytical tools Final results Results based on cities Based on the summaries, which were taken through dimensions, making and writing final drafts have done. Discussion of Results & Conclusions Diversity of studies shows that Central, Northeast and Eastern provinces of Iran have more researchers who are interested in studying urban quality of life. Results showed that there are positive and significant relationships between social capital, higher income, being employed and urban quality of life. However, the relationship between gender and urban quality of life is not significant. Educational levels, gender, age, marital status and employment status are the common indicators which most of the researchers have used in their research. Social capital is one of the most important concepts which is used in correlation tests and results proved that there are significant and controversial relationships between social capital and urban quality of life in different cities. Unfortunately more than 60% of studies have not mentioned their research method. In addition, the issue of validity and reliability of these studies was not talked about either. Hence generating numerical facts, which is essential to measure size effects of these variables, is not possible. So, one of the most important findings of our meta-analysis is missed. This research shows that paying more attention to important parts of research articles, which directly effects quality of meta-analysis, is essentially important. Thus, enacting strict rules in journals about data gathering and article writing could be recommended to protect quality of future articles. Table 2 shows reliability and validity of the two different article types. Table 2- Validity and Reliability of Articles Measurement tools Peer-reviewed journals Non-peer-reviewed journals Did reliability exist? Yes 66% 0% No 34% 100% Did validity exist? Yes 27% 0% No 73% 100% Taking a multi-dimensional view and using combinatorial indexes are strength points of analyzed studies and neglecting sociological dimensions is weakness point of these studies. This research shows that Iranian researchers of quality of life focus on quantitative methods more than qualitative ones .But it is believed that using different and complex methods could be the way to create frameworks which are closer to real life. Table 3 shows situation of the two different groups of articles regarding different dimensions. Table 3- Situation of Articles About Different Dimensions Dimensions scientific researches other researches journals Environmental - utility 25% 0% Social/economic/ environmental 63% 87% Economic/ social 12% 13% Urban quality of life is a complex variable whose precise measurement is very difficult. Considering and rebuilding international frameworks for evaluating of this concept is a valuable way to do research. Some of the analyzed studies did in fact try to make specific and creative frameworks for evaluation of urban quality of life, paying more attention to specifications and characteristics of Iranian cities. So, for future research, we recommend designing native and practical models which could be adapted to Iranian culture

The Impact of City Image on Time Choosing and Seasonality of Tourism Travels to Mashhad and How to Encounter

The image of the city, which is one of the basic prerequisites of urban brand building, is composed of various aspects. These aspects can include architecture and urbanism, traffic and transport infrastructure, monuments, environmental features, range of services, culture, economic and science and technology characteristics of the city. Together, these factors create an overall image of the city in the minds of residents and tourists, affecting their attitudes and behavior in different contexts. Among these behaviors is the choice of travel time for tourists. In this research, this impact has been examined and investigated, to see whether is it possible to make the time travel of the city closer to the desired distribution of time by means of the modifications made to the image of the city, in other words, to counteract the seasonal phenomenon of tourism? Based on the results of a questionnaire analysis distributed among 392 tourists in Mashhad city, it was found that among the dimensions of the image of the city, the promotion of the two dimensions of "economy and commerce" and "environment" can have the greatest impact on balancing the time distribution of travel throughout the year and tackling the seasonality phenomenon

Design and Development of Three-Dimensional Model of Tehran Tourism Management (TDMTTM)

The purpose of this research is to provide the “Three-Dimensional Model of Tehran Tourism Management (TDMTTM)” using a two-stages exploratory mixed method design (qualitative-quantitative). At the first and second stages, content analysis and structural equation modeling have been used, respectively. The validity of questionnaire is as content and face validity. Content validity ratio (CVR) and content validity index (CVI) was estimated to be 0.69 and 0.79, respectively. The obtained reliability in Cronbach's Alpha coefficient method is 0.933 and in split of method is 0.0806, respectively. The sample comprises of 400 persons of tourism managers, experts, and professors, from whom the total of 387 valid questionnaires. Were obtaind the The results show that it is necessary to consider structural, environmental, and content factors in designing Tehran Tourism Management Model, and accordingly. “ The Three-Dimensional Model of Tehran Tourism Management (TDMTTM) was developed.”