Determining the Frequency of Defensive Medicine Among General Practitioners in Southeast Iran

Background: Defensive medicine prompts physicians not to admit high-risk patients who need intensive care. This phenomenon not only decreases the quality of healthcare services, but also wastes scarce health resources. Defensive medicine occurs in negative and positive forms. Hence, the present study aimed to determine frequency of positive and negative defensive medicine behaviors and their underlying factors among general practitioners in Southeast Iran. Methods: The present cross-sectional study was performed among general practitioners in Southeast Iran. 423 subjects participated in the study on a census basis and a questionnaire was used for data collection. Data analysis was carried out using descriptive and analytical statistics through SPSS 20. Results: The majority of participants were male (58.2%). The mean age of physicians was 40 ± 8.5. The frequency of positive and negative defensive medicine among general practitioners in Southeast Iran was 99.8% and 79.2% respectively. A significant relationship was observed between working experience, being informed of law suits against their colleagues, and committing defensive medicine behavior (P< 0.001). Conclusion: The present study indicated high frequency of defensive medicine behavior in the Southeast Iran. So, it calls policy-makers special attention to improve the status quo

Planning for PV plant performance monitoring by means of unmanned aerial systems (UAS)

The sustainable use of renewables will represent a key challenge in the near future, and relative energy management operations will play a crucial role in energy efficiency and savings for future generations. The operation and maintenance of energy systems are a very high valuable activity to prevent energy losses, and a correct monitoring can detect in advance equipment degradation guaranteeing good performance over time. Present research strives to find out possibility of unmanned aerial vehicle (UAV) use in monitoring applications for energy production sites and to investigate effects of this novel method on energy management procedures. Furthermore, investigation about novel approaches in cooperative inspection of real photovoltaic (PV) plants was carried out by light UAVs and utilize the global positioning system to find out the optimum route mapping during the solar PV modules monitoring. The purpose of this work is to propose a reliable, fast and cost effective method for PV plant planning and monitoring by means of UAS technolog

Enhancing climate resilience in buildings using Collective Intelligence: A pilot study on a Norwegian elderly care center

The combined challenge of climate change and population aging requires novel solutions that enhance the resilience of building energy systems and secure indoor comfort for vulnerable occupants in extreme weather conditions. This research investigates the performance of a newly developed Energy Management (EM) system based on Collective Intelligence (CI) and Reinforcement Learning (RL), called CIRLEM, managing the energy performance of an urban complex in Ålesund, Norway, including an elderly care center with decentralized PV generation, EV charging and storage, while connected to a main electricity grid. CIRLEM controls multiple flexibility assets including independent thermal zones (the demand-side agents) and Electric Vehicle (EV) charging stations (the local storage). In a novel approach, CIRLEM coordinates the distributed storage and generation together with the demand side to control energy systems and react collaboratively to environmental variations. Under extreme weather conditions, without applying CIRLEM, the demand can be more than double that of typical weather conditions. The implementation of the double-layer CIRLEM can reduce the total demand by 35 % over a month. Furthermore, the inclusion of photovoltaic (PV) systems allows the system to be independent from the grid for almost 40 % of its operational hours, while adding EV storage can increase it to around 70 %. Finally, the application of CIRLEM reduced overheating hours from 17 h ∙°C to 2 h ∙°C under extreme conditions, while maintaining comfortable conditions even during temperature ramps

Determining the frequency of defensive medicine among general practitioners in Southeast Iran

Abstract Background: Defensive medicine prompts physicians not to admit high-risk patients who need intensive care. This phenomenon not only decreases the quality of healthcare services, but also wastes scarce health resources. Defensive medicine occurs in negative and positive forms. Hence, the present study aimed to determine frequency of positive and negative defensive medicine behaviors and their underlying factors among general practitioners in Southeast Iran. Methods: The present cross-sectional study was performed among general practitioners in Southeast Iran. 423 subjects participated in the study on a census basis and a questionnaire was used for data collection. Data analysis was carried out using descriptive and analytical statistics through SPSS 20. Results: The majority of participants were male (58.2%). The mean age of physicians was 40 ± 8.5. The frequency of positive and negative defensive medicine among general practitioners in Southeast Iran was 99.8% and 79.2% respectively. A significant relationship was observed between working experience, being informed of law suits against their colleagues, and committing defensive medicine behavior (P&lt; 0.001). Conclusion: The present study indicated high frequency of defensive medicine behavior in the Southeast Iran. So, it calls policy-makers special attention to improve the status quo

A novel framework for assessing the smartness and the smart readiness level in highly electrified non-residential buildings: A Norwegian case study

This work presents a new operational framework to measure the smartness and smart readiness of highly electrified buildings. The framework seeks to enhance legacy systems and controls of existing buildings and establish minimum criteria for future constructions to ensure they interact effectively with users and the grid, aiming for a clean energy transition. To this end, we develop two modified complementary assessments, one based on the method indicated by the Smart Readiness Indicator (SRI), proposed by the European Union (EU), and the other following the Smart by Powerhouse scheme, introduced by a Norwegian consortium of stakeholders focused on developing future proof climate buildings. The proposed structure is implemented in ten non-residential buildings in Norway with different energy systems, typologies, and construction dates. The results of this study demonstrate that energy flexibility quantification plays a crucial role in correctly implementing the framework in highly electrified buildings. Therefore, the dynamic impact of having Electric Vehicle Charging (EVC) and other electrical-dependent loads must be considered in the assessment. With the proposed modifications, the EVC weight in the flexibility score now varies from 24.0 to 43.6%, up from the original 5%. Overall, the pilot buildings have a smart readiness level between 21.6% and 31.7%, with mostly automated smartness levels. Nevertheless, the study also emphasizes the need to differentiate current HVAC (Heating, Ventilation, and Air Conditioning) technologies and their efficiencies

Caregiving consequences in cancer family caregivers: a narrative review of qualitative studies

BackgroundCancer is a significant public health issue, causing various challenges for individuals affected by it. As cancer progresses, patients often become dependent on others for support. Family caregivers and members play a crucial role in the recovery and rehabilitation of these patients. However, caregivers themselves face numerous challenges throughout the course of their family member’s illness. Exploring the experiences of family caregivers can inform long-term planning and supportive interventions to address their caregiving difficulties. This study reviews previous literature on caregiving outcomes.MethodThis study presents a narrative review of qualitative studies, analyzing a total of 23 articles. The results were extracted and organized into subcategories. After revision by the research team, main categories were identified. These categories encompass both positive and negative outcomes of caregiving.ResultsThe findings of this review demonstrate that caring for a family member with cancer has significant implications for caregivers. These implications include: (A) Positive outcomes of caregiving (such as achieving self-management and balance, promoting kinship intimacy, finding meaning and purpose, and experiencing spiritual growth) and (B) Negative outcomes of caregiving (including care-related physical exhaustion, disruption of personal life plans, psycho-emotional consequences, and socio-economic burden).ConclusionThe results of this study highlight the challenges faced by family caregivers and emphasize the importance of addressing their needs within the healthcare system. By providing support and attention to their well-being, caregivers can enhance their resilience and adaptability in managing caregiving difficulties

Bushehr Elderly Health (BEH) Programme, phase I (cardiovascular system)

Purpose: The main objective of the Bushehr Elderly Health Programme, in its first phase, is to investigate the prevalence of cardiovascular risk factors and their association with major adverse cardiovascular events. Participants: Between March 2013 and October 2014, a total of 3000 men and women aged ≥60 years, residing in Bushehr, Iran, participated in this prospective cohort study ( participation rate=90.2%). Findings to date: Baseline data on risk factors, including demographic and socioeconomic status, smoking and medical history, were collected through a modified WHO MONICA questionnaire. Vital signs and anthropometric measures, including systolic and diastolic blood pressure, weight, height, and waist and hip circumference, were also measured. 12-lead electrocardiography and echocardiography were conducted on all participants, and total of 10 cc venous blood was taken, and sera was separated and stored at –80°C for possible future use. Preliminary data analyses showed a noticeably higher prevalence of risk factors among older women compared to that in men. Future plans: Risk factor assessments will be repeated every 5 years, and the participantswill be followed during the study to measure the occurrence of major adverse cardiac events. Moreover, the second phase, which includes investigation of bone health and cognition in the elderly, was started in September 2015. Data are available at the Persian Gulf Biomedical Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran, for any collaboratio