Quality of Life and Related Factors Among People With Spinal Cord Injuries in Tehran, Iran

Background: Spinal Cord Injury (SCI) is one of the biggest health problems. Disabilities resulting from injuries such as spinal disability requires special attention because of their potential reduced to cause adverse effects in different systems of the body. Today, improving the Quality of Life (QOL) in patients with SCIs is an important goal of treatment. Objectives: The purpose of this study was to determine the QOL and related factors among people with SCIs. Patients and Methods: In this cross-sectional descriptive study, 106 patients with SCI were selected through sampling based on census. Data were collected using a demographic questionnaire and a Short-Form 36 (SF-36) health survey questionnaire for measuring the QOL among patients. Data were analyzed using SPSS 14 software and descriptive and inferential statistics. P < 0.05 was considered statistically significant. Results: The mean QOL in these patients was 37.1 ± 1.7 years (21 - 65 years) and mean disease duration was 7.3±6 years. The most common injury was paraplegia. Most of the patients have moderate QOL (54.7 %). The results showed a significant relationship between QOL and marital status and employment status (P < 0.05). Also, results showed a significant relationship between QOL and education levels (P = 0.002), age (P = 0.001), and duration of illness (P = 0.001).The highest and lowest scores were 64 ± 7.1 and 36 ± 5.3 for understanding General Health (GH) and role physical, respectively. Conclusions: The results show that patients with SCI have a moderate health-related QOL Determining the QOL is needed to focus on the strengths and weaknesses of patients with spinal cord injuries. Planning principles is recommended in order to reform the disability

Effects of iranian healthcare transformation plan on discharge against medical advice

Background: The Health care transformation plan (HCTP) is expected to improve the regulations and quality of the provided services in hospitals. The aim of this study was to evaluate the Effects of Iranian healthcare transformation plan on discharge against medical advice (DAMA) of Mazandaran University of Medical Sciences. Method: This descriptive-retrospective study was performed 2630 patients discharged during the two half-yearly time intervals before (2013-2014) and after (2015-2016), respectively. Data collection was by standard form of DAMA issued by the Ministry of Health and Medical Education. Data analyses were performed by descriptive statistics and inferential statistics. SPSS-16 software was used in this study and P values less than 0.05 were considered significant. Results: The level DAMA before and after introduction of the Healthcare Reform was 4.5 and 4.11 percent, respectively, which did not differ significantly (p = 0.889). In addition, there was no significant difference in the discharge level by age groups, hospital departments (p = 1), gender (p = 0.57), or holydays (p = 0.73). Conclusion: Our study did not find any evidence for the impact of the HCTP on frequency of the DAMA and the factors associated to it. However, the overall results implied necessity of a more comprehensive and integrated planning regarding supply of the required facilities, equipment, and human resources, as well as enlargement of physical space of treatment centers within the framework of this large-scale, nationwide program. © 2020, Hampstead Psychological Associates. All rights reserved

The role of rock joint frictional strength in the containment of fracture propagation

The fracturing phenomenon within the reservoir environment is a complex process that is controlled by several factors and may occur either naturally or by artificial drivers. Even when deliberately induced, the fracturing behaviour is greatly influenced by the subsurface architecture and existing features. The presence of discontinuities such as joints, artificial and naturally occurring faults and interfaces between rock layers and microfractures plays an important role in the fracturing process and has been known to significantly alter the course of fracture growth. In this paper, an important property (joint friction) that governs the shear behaviour of discontinuities is considered. The applied numerical procedure entails the implementation of the discrete element method to enable a more dynamic monitoring of the fracturing process, where the joint frictional property is considered in isolation. Whereas fracture propagation is constrained by joints of low frictional resistance, in non-frictional joints, the unrestricted sliding of the joint plane increases the tendency for reinitiation and proliferation of fractures at other locations. The ability of a frictional joint to suppress fracture growth decreases as the frictional resistance increases; however, this phenomenon exacerbates the influence of other factors including in situ stresses and overburden conditions. The effect of the joint frictional property is not limited to the strength of rock formations; it also impacts on fracturing processes, which could be particularly evident in jointed rock masses or formations with prominent faults and/or discontinuities

Numerical modeling of hydraulic fracture propagation, closure and reopening using XFEM with application to in-situ stress estimation

In this paper, a fully coupled model is developed for numerical modeling of hydraulic fracturing in partially saturated weak porous formations using the extended finite element method, which provides an effective means to simulate the coupled hydro-mechanical processes occurring during hydraulic fracturing. The developed model is for short fractures where plane strain assumptions are valid. The propagation of the hydraulic fracture is governed by the cohesive crack model, which accounts for crack closure and reopening. The developed model allows for fluid flow within the open part of the crack and crack face contact resulting from fracture closure. To prevent the unphysical crack face interpenetration during the closing mode, the crack face contact or self-contact condition is enforced using the penalty method. Along the open part of the crack, the leakage flux through the crack faces is obtained directly as a part of the solution without introducing any simplifying assumption. If the crack undergoes the closing mode, zero leakage flux condition is imposed along the contact zone. An application of the developed model is shown in numerical modeling of pump-in/shut-in test. It is illustrated that the developed model is able to capture the salient features bottomhole pressure/time records exhibit and can extract the confining stress perpendicular to the direction of the hydraulic fracture propagation from the fracture closure pressure

Numerical modeling of hydraulic fracture propagation, closure and reopening using XFEM with application to in-situ stress estimation

In this paper, a fully coupled model is developed for numerical modeling of hydraulic fracturing in partially saturated weak porous formations using the extended finite element method, which provides an effective means to simulate the coupled hydro-mechanical processes occurring during hydraulic fracturing. The developed model is for short fractures where plane strain assumptions are valid. The propagation of the hydraulic fracture is governed by the cohesive crack model, which accounts for crack closure and reopening. The developed model allows for fluid flow within the open part of the crack and crack face contact resulting from fracture closure. To prevent the unphysical crack face interpenetration during the closing mode, the crack face contact or self-contact condition is enforced using the penalty method. Along the open part of the crack, the leakage flux through the crack faces is obtained directly as a part of the solution without introducing any simplifying assumption. If the crack undergoes the closing mode, zero leakage flux condition is imposed along the contact zone. An application of the developed model is shown in numerical modeling of pump-in/shut-in test. It is illustrated that the developed model is able to capture the salient features bottomhole pressure/time records exhibit and can extract the confining stress perpendicular to the direction of the hydraulic fracture propagation from the fracture closure pressure

Flow Liquefaction Instability as a Mechanism for Lower End of Liquefaction Charts

The state-of-the-practice uses the “simplified procedure” for evaluating liquefaction susceptibility of soils. Based on this procedure, liquefaction charts have been developed that correlate soil resistance to earthquake-induced stresses. These charts are based on case histories of past earthquakes and have proven to be useful while evaluating liquefaction susceptibility at a new site. However, these charts are inherently empirical, which makes extrapolation into regimes with insufficient data difficult. In addition, they do not inform an engineer about the effects of liquefaction. This work hypothesizes that the lower end of liquefaction charts corresponds to soils that are susceptible to unstable flow liquefaction. A numerical investigation is undertaken, the results of which support this hypothesis. This implies that if test data at a new site correspond to the lower end of liquefaction charts, then the site may be susceptible to flow liquefaction. This in turn could provide an engineer with some predictive power regarding the effects of liquefaction

Does vitamin D supplementation for COVID-19 increase the chances of fertility in women with polycystic ovary syndrome?

COVID-19 has been associated with factors such as inflammation, obesity, low vitamin D levels, and hyperandrogenism. These factors are also directly related to Polycystic ovary syndrome (PCOS). We hypothesize that concurrent COVID-19 and high dose vitamin D supplement will decrease the inflammation, and can increase the chances of fertility in these women

Prevalence of iron deficiency anemia in Iranian children under 6 years of age: a systematic review and meta-analysis

Mahboubeh Nazari,1 Esmaeil Mohammadnejad,2 Sahar Dalvand,3 Reza Ghanei Gheshlagh4,51Department of Nursing, Garmsar Branch, Islamic Azad University, Garmsar, Iran; 2Department of Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; 3Biostatistics Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; 4Department of Nursing, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran; 5Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, IranBackground: Iron deficiency anemia is a prevalent condition among children in developing and developed countries that leads to impaired development, activity intolerance, behavioral changes, irritability, and reduced learning ability. The studies conducted in Iran have reported different prevalence rates for this condition. This systematic review and meta-analysis were aimed at estimating the prevalence of iron deficiency anemia in Iranian children under 6 years of age.Methodology: Persian and English articles published from 2001 to 2018 were collected. The search process was conducted in national and international databases, including SID, MagIran, PubMed, Scopus, and Web of Science, using the following keywords and their combinations: Iron, Iron deficiency, Iron deficiency anemia, Ferritin, Child, Children, and Iran. The data were analyzed using the meta-analysis and random effects model. Heterogeneity was assessed using the I2, statistic. All analyses were performed using the STATA software, version 12.Results: Analysis of six selected articles with a total sample size of 1,700 showed that the prevalence rates of iron deficiency and iron deficiency anemia in the Iranian children under 6 years of age were 27.7% (95% CI: 11.9&ndash;43.5) and 18.2% (95% CI: 14.3&ndash;22), respectively. In addition, the prevalence of iron deficiency anemia was higher in boys (17.7% with 95% CI: 5.9&ndash;29.5) than in girls (14.4% with 95% CI: 4.5&ndash;24.2).Conclusion: About one-fifth of Iranian children under the age of 6 years suffer from iron deficiency anemia. Identification of those at risk of developing this condition with the goal of prevention, diagnosis, and treatment seems to be an important and necessary task.Keywords: anemia, iron deficiency anemia, iron, meta-analysis, Iran, prevalenc

The intention to turnover and its relationship with healthy work environment among nursing staff

Background & Aim: Nurses play an important role in the health system and their turnover disrupts its performance. The aim of this study was to investigate intention to turnover and its relationship with healthy work environment among nursing staff. Methods & Materials: This cross-sectional study was conducted on 295 nursing staff from Imam Khomeini hospital complex in Tehran in 2016. Nurses were selected by the stratified random sampling with a proportional allocation, and completed a demographic data form, the Healthy Work Environment questionnaire and the Anticipated Turnover Scale (ATS). Data were analyzed by descriptive statistics, independent t-test, one-way ANOVA, Pearson/Spearman correlation coefficient and multiple linear regression tests using the SPSS software version 20. Results: The mean score for the intention to turnover was 36.21 (SD=4.38) ranged from 12 to 60. �Authentic leadership� and �skilled communication� domains obtained the highest (9.60±3) and lowest (8.97±2.74) scores respectively. There was poor correlation between the meaningful recognition domain and the anticipated turnover score (r=-0.135, P=0.024). In addition, the anticipated turnover score was significantly higher in male nurses than in female nurses (P=0.023). Conclusion: Although there was no relationship between anticipated turnover and healthy work environment in this study, considering the importance of nurses� recruitment and retention, there is a need to investigate the reasons for turnover, including characteristics of work environment, and take necessary measures. © 2017, Tehran University of Medical Sciences (TUMS). All rights reserved