Epidemiology of Accidents and Traumas in Qom Province in 2010

Background: Accidents are the most important public health challenges in our society. To prevent\n the accidents, the identification of their epidemiological features seems necessary. Objectives: This study was conducted to reveal the epidemiological features of accidents and their\n casualties in Qom province in 2010. Patients and Methods: A cross–sectional study was conducted on 29426 injured people referred to Qom\n province hospitals in 2010. Information about place, time, type of accidents and traumas\n and demographic variables had been collected in a veteran hospital. Data were analyzed\n by SPSS (version 16) software, using chi-square test and logistic regression. Results: The incidence of accidents was about 27/1000 per year. The incidences of traffic\n accidents, motorcycle accidents, violence, burns, poisoning and suicides were 3, 1.6,\n 1.2, 0.3, 0.8, 0.37 cases per 1000 people respectively. Strikes (65%) and falls (12%)\n were the main causes of traumas. Forty-six percent of all injuries had occurred in 16 -\n 30 years groups. Most frequent accidents were as follows: fall (97%) and strike (50%) in\n < 12, violence (46%) in 20 - 29, suicide (71%) in 15 - 29, poisoning (34%) and burns\n (20%) among < 5 years old. Pedestrian and motorcycle accidents among +60 years old\n people were significantly higher than other (P = 0.000). Odds ratio for suicide among\n female was about 3.36 and in 16 - 30 age-group was 15.7 more than +60 years old group (P\n = 0.000). Conclusions: Most traumas in Qom province occurred among younger age-groups and strikes and falls\n are the main causes of such traumas. Therefore, safeties to prevent falls and traffic\n regulations to reduce strikes can be effective strategies

Impact of rural Family Physician programme on maternal and child health indicators in Iran: an interrupted time series analysis.

OBJECTIVES: The establishment of the Family Physician (FP) programme in the rural areas of Iran in 2005 has made health services accessible and affordable. This paper aims to assess the overall trends of maternal and child health (MCH) indicators in a 20-year period and possible effects of the FP programme (intervention) on these indicators in Iran. DESIGN AND SETTING: An interrupted time series analysis was conducted on 20 annual MCH-related data points from 1994 to 2013. The intervention time was at the 12th data point in 2005. OUTCOMES: MCH indicators were grouped into three categories: structure (mother's age, education, occupation and gravidity), process (number of antenatal care visits (ACVs), laboratory tests, ultrasounds and natural vaginal deliveries (NVDs)) and outcomes (maternal mortality ratio (MMR), neonatal mortality rate (NMR), birth weight (BW), history of abortion and/or stillbirth, and haemoglobin level (Hb)). RESULTS: The adjusted slope of the ACV trend decreased sharply after the intervention (b=-0.36, p<0.01), whereas it increased for the frequency of ultrasounds (b=0.2, p<0.01) and did not change for number of laboratory tests (b=-0.09, p=0.95). The intensification of the descending slope observed for NVD (b=-1.91, p=0.03) disappeared after the adjustment for structural confounders (b=1.33, p=0.26). There was no significant slope change for MMR (b=1.12, p=0.28) and NMR (b=0.67, p=0.07) after the intervention. The slope for the history of abortion trend was constant before and after the intervention, but it considerably intensified for the history of stillbirths after the intervention (b=1.72, p<0.01). The decreasing trend of BW turned into a constant mode after the intervention (b=33.2, p<0.01), but no change was observed for Hb (b=-0.02, p=0.78). CONCLUSION: Although the FP programme had a positive effect on the process and proximal outcome indicators (BW), no dramatic effect on mortality outcome indicators was distinguished. It shows that there should be determinants or mediators of mortality outcomes in this setting, other than accessibility and affordability of MCH services.Esmaeil Khedmati Morasae is part-funded by the National Institute for Health Research Collaboration for Leadership in AppliedHealth Research and Care, North West Coast (NIHR CLAHRC NWC)

Evaluations of employer-focused policies designed to improve employment opportunities and outcomes for people with disabilities: A systematic review protocol

This is the final version.A protocol for a systematic review focusing on interventions designed to target employer behaviour relating to the employment of people with disabilities.European Regional Development Fund (ERDF

Assessment of women's empowerment: An exploratory study to develop a valid and reliable Persian-version tool

Lack of a valid and reliable women's empowerment tool was reported by previous studies in Iran. The authors of this paper, accordingly, intended to fill this gap by developing a valid questionnaire. 600 women in Dezful city, southeast of Iran, took part in the study in 2014�2015. Multistage sampling method was used to recruit the participants. Our exploratory factor analysis revealed that 18 items of the model loaded on 4 factors. Internal consistency of the questionnaire was suitable as Cronbach's alpha coefficient was 0.77. Considering high validity and shortness of the questionnaire, it can be used as a trustful and comprehensive tool to measure women's empowerment in future studies. © 2018 Taylor & Francis Group, LL

Assessment of women's empowerment: An exploratory study to develop a valid and reliable Persian-version tool

Lack of a valid and reliable women's empowerment tool was reported by previous studies in Iran. The authors of this paper, accordingly, intended to fill this gap by developing a valid questionnaire. 600 women in Dezful city, southeast of Iran, took part in the study in 2014�2015. Multistage sampling method was used to recruit the participants. Our exploratory factor analysis revealed that 18 items of the model loaded on 4 factors. Internal consistency of the questionnaire was suitable as Cronbach's alpha coefficient was 0.77. Considering high validity and shortness of the questionnaire, it can be used as a trustful and comprehensive tool to measure women's empowerment in future studies. © 2018 Taylor & Francis Group, LL

Advancing the discourse: a next-generation value chain-based taxonomy for circular economy key performance indicators

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordThe growth of interest in circular economy (CE) has been accompanied by different approaches to measurement of CE outcomes and impacts, leading to a wide portfolio of indicators with varying degrees of overlap, inconsistency, and convergence. The aim of this paper is to propose a unifying framework for CE indicators, as the next generation of CE taxonomies. We first undertake a scoping review of 59 review papers on CE indicators using manual and computational methods (i.e., topic modelling) to inform the taxonomy structure and content. As a result, we report on 11 clusters of approaches that have been attentive to different dimensions of CE (e.g. horizontal value chain, vertical scale of operation (macro, meso, micro), impact category (economic, biophysical, social), material vs product focus, etc.). Highlighting the strengths and weakness of these approaches, we identify gaps in dimensions related to horizontal and vertical scales of measurement, and propose an agnostic, integrative framework that builds on the scientific foundations of previous research, within a more systemic and comprehensive taxonomy. This taxonomy could be used as a guiding framework or heuristic for regulators, both nationally and internationally, and for practitioners to undertake a comprehensive measurement and assessment of CE related interventions and initiatives at scale.UKR

Why caesarean is more unequally concentrated among better-off people in Tehran? A concentration index decomposition approach

Background Iran, as one of the low-income and middle-income countries, has experienced a remarkable increase in the caesarean section (CS) rate during the past three decades. Although several studies have been conducted on the prevalence and risk factors affecting CS, but few studies were done regarding socioeconomic factors influencing the CS rate. The aim of this study was to identify socioeconomic inequalities and its determinants in CS in Tehran, capital of Iran. Methods A population-based cross-sectional study was conducted on 5170 pregnancies in Tehran, since 2015. Principal component analysis was applied to measure the asset-based economic status. Concentration index was used to measure socioeconomic inequality in CS and then decomposed in to its determinants. Results The concentration index and its 95 CI for CS history was 0.102 (0.091 to 0.112). Decomposition of the concentration index showed that economic status had the largest contribution (49.2) to socioeconomic inequality in CS. Mother's education (14.9), father's occupation (13.3) and father's nationality (9.7) had the next high positive contribution to measured inequality in CS, respectively. Conclusions CS is mostly concentrated among women with high economic status. The identified contributing factors should be addressed to decrease the socioeconomic inequalities as possible. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ