New secure and low-cost design for defense in depth implementation using open source software

In this paper, we propose a new design with high-level security and low-cost implementation for different network topologies. Achieving both factors at the same time is a challenging work for network experts, especially when they want to apply defense in depth strategy in various components of their networks. Offered scenario has been done for one of the most visited web sites in an Iranian organization with more than 15,000 concurrent web users that all of them reliably and smoothly were served. Also, defense in depth strategy has been used to provide sufficient level of security in diverse components of the project. All applied security solutions in this project were based on open source [1] tools that results in saving a tangible cost by the prevention of purchasing commercial options. We will describe project big map, acquired results and all main components with their functions in this paper

To what extent has the Iranian Health Transformation Plan addressed inequality in healthcare financing in Iran?

Abstract Background One of the major goals of health systems is providing a financing strategy without inequality; this has a significant impact on people’s access to healthcare. The present study aimed to investigate the inequality in households’ financial contribution (HFC) to health expenditure both before and after the implementation of the Iranian Health Transformation Plan (HTP) in 2014. Methods This study is a secondary analysis of two waves of a national survey conducted in Iran. The data were collected from the Households Income and Expenditure Survey in 2013 and 2015. The research sample included 76,195 Iranian households. The inequality in households’ financial contributions to the health system was assessed using the Gini coefficient, and the concentration index (CI). In addition, by using econometric modeling, the relationship between the implementation of the HTP and inequality in HFC was studied. The households’ financial contribution included healthcare and health insurance prepayments. Results The Gini coefficient values were 0.67 and 0.65 in 2013 and 2015, respectively, indicating a medium degree of inequality in HFC in both years. The CI values were 0.54 and 0.56 in 2013 and 2015, respectively, suggesting that inequalities in HFC were in favor of higher income quintiles in the years before and after the implementation of the HTP. Regression analysis showed that households with a female head, with an unemployed head, or with a head having income without a job were contributing more to financing health expenditure. The presence of a household member over the age of 65 was associated with a higher level of HFC. The implementation of the HTP had a negative relationship with the HFC. Conclusion The HTP, aiming to address inequality in the financing system, did not achieve the intended goal as expected. The implementation of the HTP neglected certain factors at the household level, such as the presence of family members older than the age of 65, a female household head, and unemployment. This resulted in a failure to reduce the inequality of the HFC. We suggest that, in the future, policymakers take into account factors at the household level to reduce inequality in the HFC. </jats:sec

Effect of Vitamin D on Insulin Resistance in Overweight and Obese Children and Adolescents With Vitamin D Deficiency

Obesity is one of the major health issues in developed and developing countries, which has been increasing in recent decades. Obesity is one of the important risk factors for type 2 diabetes by developing insulin resistance. The purpose of this study was to investigate the effect of vitamin D on insulin resistance in overweight and obese children and adolescents with vitamin D deficiency. In this interventional study, 53 overweight and obese children and adolescents with vitamin D deficiency referred to the Endocrinology Clinic of Shahrekord University of Medical Sciences were included. The height and weight of participants were measured, and their Body Mass Index (BMI) calculated. To participants, 50,000 units of vitamin D were administered weekly for 8 weeks, and then 1000 units were orally administered daily for 3 months. Before and after the intervention, levels of vitamin D, insulin, and fasting blood sugar were measured. The HOMA-IR was also calculated as an indicator of insulin resistance. After the intervention, serum vitamin D significantly increased, and BMI and fasting blood sugar significantly decreased (P0.05). After the intervention, HOMA-IR had a significant direct correlation with body mass index, insulin, and fasting blood sugar and a significant inverse correlation with vitamin D (P<0.05). Vitamin D had a significant inverse correlation with BMI, insulin, and fasting blood sugar after the intervention (P<0.05). Oral treatment with vitamin D significantly increased serum vitamin D levels and significantly decreased BMI and fasting blood sugar in obese and overweight children

The Impact of Socioeconomic Factors on the Tendency to Cesarean in Pregnant Women Referred to Imam Khomeini Hospital Complex in Tehran in 2016

Background: In recent years, Cesarean has attracted the attention of many pregnant women, although there is not enough awareness of how cesarean is performed and its consequences. The present study aimed to assess the socio-economic factors affecting the tendency of women referred to Imam Khomeini hospital to elective caesarean. Materials and methods: Questionnaire of this sectional study, with the participation of 300 pregnant women referred to Emam Khomeini hospital complex in the last trimester of year 2016 were conducted. For the purpose of data collection,a questionnaire was used. To examine the relationship between variables, software SPSS and X2 test and correlation test is used. Results: Among the studied cases, 55 percent tended to have vaginal delivery 45 percent, inclined to have Cesarean. Some of the signifiant reasons for having cesarean tend are doctors’ persuasion, people’s recommendation, fear and beauty of the mother. The results showed that by increasing the socio – economic level, the tendency toward cesarean increases. A signifiant statistical relationship between the socio-economic class and chosen type of delivery was achieved through Chi-square test (P <0.0001). Conclusion: Study indicated The promotion of socio-economic class has been connected linearly with the increasing trend towards caesarean, however tendency towards cesarean in lower levels of society is still higher than the world standard and it imposes a great cost to the health system

Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia-Results from a Randomized Interventional Study

Insomnia is a common problem in the general population. To treat insomnia, medication therapies and insomnia-related cognitive-behavioral interventions are often applied. The aim of the present study was to investigate the influence of acceptance and commitment therapy (ACT) on sleep quality, dysfunctional sleep beliefs and attitudes, experiential avoidance, and acceptance of sleep problems in individuals with insomnia, compared to a control condition. A total of 35 participants with diagnosed insomnia (mean age: 41.46 years old; 62.9% females) were randomly assigned to the ACT intervention (weekly group therapy for 60-70 min) or to the active control condition (weekly group meetings for 60-70 min without interventional and psychotherapeutic character). At baseline and after eight weeks (end of the study), and again 12 weeks later at follow-up, participants completed self-rating questionnaires on sleep quality, dysfunctional beliefs and attitudes about sleep, emotion regulation, and experiential avoidance. Furthermore, participants in the intervention condition kept a weekly sleep log for eight consecutive weeks (micro-analysis). Every morning, participants completed the daily sleep log, which consisted of items regarding subjective sleep duration, sleep quality, and the feeling of being restored. Sleep quality, dysfunctional beliefs and attitudes towards sleep, emotion regulation, and experiential avoidance improved over time, but only in the ACT condition compared to the control condition. Improvements remained stable until follow-up. Improvements in experiential avoidance were related to a favorable change in sleep and cognitive-emotional processing. Micro-analyses showed that improvements occurred within the first three weeks of treatment. The pattern of results suggests that ACT appeared to have improved experiential avoidance, which in turn improved both sleep quality and sleep-related cognitive-emotional processes at longer-term in adults with insomnia. Keywords: acceptance and commitment therapy; dysfunctional beliefs; experiential avoidance; insomnia; sleep logs; sleep quality

Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia-Results from a Randomized Interventional Study

Zakiei A, Khazaie H, Rostampour M, et al. Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia-Results from a Randomized Interventional Study. Life. 2021;11(2): 133.Insomnia is a common problem in the general population. To treat insomnia, medication therapies and insomnia-related cognitive-behavioral interventions are often applied. The aim of the present study was to investigate the influence of acceptance and commitment therapy (ACT) on sleep quality, dysfunctional sleep beliefs and attitudes, experiential avoidance, and acceptance of sleep problems in individuals with insomnia, compared to a control condition. A total of 35 participants with diagnosed insomnia (mean age: 41.46 years old; 62.9% females) were randomly assigned to the ACT intervention (weekly group therapy for 60-70 min) or to the active control condition (weekly group meetings for 60-70 min without interventional and psychotherapeutic character). At baseline and after eight weeks (end of the study), and again 12 weeks later at follow-up, participants completed self-rating questionnaires on sleep quality, dysfunctional beliefs and attitudes about sleep, emotion regulation, and experiential avoidance. Furthermore, participants in the intervention condition kept a weekly sleep log for eight consecutive weeks (micro-analysis). Every morning, participants completed the daily sleep log, which consisted of items regarding subjective sleep duration, sleep quality, and the feeling of being restored. Sleep quality, dysfunctional beliefs and attitudes towards sleep, emotion regulation, and experiential avoidance improved over time, but only in the ACT condition compared to the control condition. Improvements remained stable until follow-up. Improvements in experiential avoidance were related to a favorable change in sleep and cognitive-emotional processing. Micro-analyses showed that improvements occurred within the first three weeks of treatment. The pattern of results suggests that ACT appeared to have improved experiential avoidance, which in turn improved both sleep quality and sleep-related cognitive-emotional processes at longer-term in adults with insomnia

Device-associated infection rates and bacterial resistance in six academic teaching hospitals of Iran: Findings from the International Nocosomial Infection Control Consortium (INICC)

Summary: Device-associated health care-acquired infections (DA-HAIs) pose a threat to patient safety, particularly in the intensive care unit (ICU). However, few data regarding DA-HAI rates and their associated bacterial resistance in ICUs from Iran are available. A DA-HAI surveillance study was conducted in six adult and pediatric ICUs in academic teaching hospitals in Tehran using CDC/NHSN definitions. We collected prospective data regarding device use, DA-HAI rates, and lengths of stay from 2584 patients, 16,796 bed-days from one adult ICU, and bacterial profiles and bacterial resistance from six ICUs. Among the DA-HAIs, there were 5.84 central line-associated bloodstream infections (CLABs) per 1000 central line-days, 7.88 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator-days and 8.99 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. The device utilization ratios were 0.44 for central lines, 0.42 for mechanical ventilators and 1.0 for urinary catheters. The device utilization ratios of mechanical ventilators and urinary catheters were higher than those reported in the ICUs of the INICC and the CDC's NHSN reports, but central line use was lower. The DA-HAI rates in this study were higher than the CDC's NHSN report. However, compared with the INICC report, the VAP rate in our study was lower, while the CLAB rate was similar and the CAUTI rate was higher. Nearly 83% of the samples showed a mixed-type infection. The most frequent pathogens were Acinetobacter baumannii, Staphylococcus aureus and Pseudomonas aeruginosa, followed by Klebsiella pneumoniae and Enterococcus spp. In the S. aureus isolates, 100% were resistant to oxacillin. Overall resistances of A. baumannii and K. pneumonia to imipenem were 70.5% and 76.7%, respectively. A multiple drug resistance phenotype was detected in 68.15% of the isolates. The DA-HAI rates in Iran were shown to be higher than the CDC-NHSN rates and similar to the INICC rates. Resistance to oxacillin and imipenem was higher as well. Comparing device use, DA-HAI rates, and bacterial resistance for the primary isolated bacteria indicated a direct association between urinary catheter use and the rates of CAUTI. Keywords: Hospital infection, Iran, INICC, International Nosocomial Infection Consortium, Device-associated infection, Bacterial resistanc

The Iranian blood pressure measurement campaign, 2019: study protocol and preliminary results

Purpose Hypertension is one of the most important risk factors for premature mortality and morbidity in Iran. The objective of the Iranian blood pressure (BP) measurement campaign was to identify individuals with raised blood pressure and providing appropriate care and increase the awareness among the public and policymakers of the importance of tackling hypertension. Methods The campaign was conducted in two phases. The first (communication) phase started on May 17th (International Hypertension Day). The second phase started on June 8th, 2019, and lasted up to July 7th during which, blood pressures were measured. The target population was Iranians aged >= 30 years. Participants voluntarily referred to health houses in rural and health posts and comprehensive health centers in urban areas in the setting of the Primary Health Care network. Additionally, over 13,700 temporary stations were set up in highly visited places in urban areas. Volunteer healthcare staff interviewed the participants, measured their BP, and provided them with lifestyle advice and knowledge of the risks and consequences of high blood pressure. They referred participants to physicians in case their BP was high. Participants immediately received a text message containing the relevant advice based on their measured BP and their past history. Results Blood pressure was measured for a total of 26,678,394 participants in the campaign. A total of 13,722,148 participants (51.4%) were female. The mean age was 46 +/- 14.1 years. Among total participants, 15,012,693 adults (56.3%) with no past history of hypertension had normal BP, 7,959,288 participants had BP in the prehypertension range (29.8%), and finally, 3,706,413 participants (13.9%) had either past medical history of hypertension, used medications, or had high BP measured in the campaign. Conclusion The campaign was feasible with the objective to increase the awareness among the public and policymakers of the importance of tackling hypertension in Iran