Determination of birth indices in healthy neonates

Determination of birth indices is essential for primary supportive care, evaluation of perinatal anomalies, determination amount of difference from standard values and for further follow up. In this study using a multicentre sampling, a number of 2832 healthy neonates selected. Mean and percentile values of four main birth indices; weight, height, head and chest circumference are presented. In this study, males outnumbered the females (50.8 vs. 49.2). Mean (± SD) weight, height, head and chest circumferences were 3231.70 gr (±3.92), 49.77 cm (±1.76), 35.03 cm (± 1.27) and 33.34 cm (±1.56), respectively. Weight, height and head circumference had significant statistical differences in male and female. Chest circumference had difference in gender groups, but it seemed to be clinically not significant (mean difference= 0.416). Birth weight in both genders plus height and chest circumference in girls were significantly lower than NCHS standard values. But, head circumference was more. Height and chest circumference of males had no statistically difference. © 2007 Tehran University of Medical Sciences. All rights reserved

Spirituality as a sociocultural determinant of health in the context of medical curriculum: A call for action

Background: This study aimed to investigate the state of spirituality in the general medicine curricula in Iran. Methods: Reference books for general medicine were reviewed and data were analyzed according to the qualitative content analysis method. Results: After reviewing references, it was found that only 35 paragraphs of the educational reference pages dealt with this subject. Related topics to spirituality had 2 major themes: (a) spirituality and care (assessment, treatment, palliative care, and bereavement); (b) spirituality and professionalism (considering culture and medical ethics). Conclusion: This study showed that despite the importance of the subject and much evidence on spirituality and medicine, medical references have limitations. The authors suggested some strategies to develop a specific course and integrate all educational references with the objectives of the general medical education course in Iran. © Iran University of Medical Sciences

The person-centred approach to an ageing society

Modern care is often based on investigations such as laboratory markers and imaging - for example, X-ray or ultrasound. The results contribute to a diagnosis and, if judged necessary, treatment is initiated. This diseased-oriented approach is the prevailing mode of management in modern medicine. In contrast, person-centered care (PCC) takes the point of departure from each person\ub4s subjective experience of illness and its impact on daily life. A patient is considered as a person with emotions and feelings. PCC is considered present within clinical care according to a definition articulated by the Centre for Person Centred Care at the University of Gothenburg (GPCC) when three core components are present: elicitation of a detailed patient narrative; formulated partnership between caregiver and patient and documentation of the partnership in the patient record. Accordingly, when there is an illness requiring care and the person is attended using these components, PCC is being applied. In most situations today, PCC is not applied in terms of the narrative and is not fully elicited or the partnership and/or the documentation are not included. It is proposed that the challenge to Society arising from changing demographics can be addressed by implementing PCC and creating an alternative to existing healthcare. The importance and benefits of such an approach on a wider scale is not yet clear as research has been limited to date. Studies in selected patient populations (heart failure and hip fractures), however, have shown promising results. As the population ages, there will be a dramatic increase in healthcare consumption. Even with technological developments, there will be a need for tremendous resources to be dedicated to care. A new organization and attitude from healthcare policymakers and providers above and beyond the present model appears required in order to respond to this demand. As part of such change, person-centred care, with the interaction between healthcare providers and the person of the patient, can facilitate, compensate and develop more effective healthcare services for the future

Intelligent Traffic Conditioners for Assured Forwarding Based Differentiated Services Networks

Abstract. Issues related to bandwidth assurance in Assured Forwarding based Differentiated Services (Diffserv) networks have been discussed in recent research papers [7][8][11]. Some of the factors that can bias bandwidth assurance are Round Trip Time (RTT), UDP/TCP interaction and different target rates. The bias due to these factors needs to be mitigated before bandwidth assurance for a paying customer can be articulated in Service Level Agreements (SLAs). This paper proposes intelligent traffic conditioning approaches at the edge of the network to mitigate the effect of Round Trip Time, UDP/TCP interactions, and different target rates. The simulation results show a significant improvement in bandwidth assurance with intelligent traffic conditioning. The limitation of the proposed solutions is that they require communication between edge devices. In addition, these solutions are not applicable for a one-to-any network topology.

Submitted to IFIP Conference on High Performance Networking (HPN’98) A Connectionless Approach to Providing QoS in IP Networks

Abstract: The attempt to provide QoS in IP networks has raised some interesting questions on how a service can be provided to meet the application requirements while obeying the network resource constraints. Previous efforts focussed on a flow-based, connection oriented approach to deliver QoS for IP Networks- Intserv. This approach was quite comprehensive but it has not been widely deployed because of complexity and scalability issues. A recent packet marking based scheme called Differentiated Services (Diffserv) Architecture provides a relatively simple and coarse approach. It is too early to predict the usefulness of this approach. This paper outlines a framework to deliver IP QoS which is based on Intserv. It addresses scalability concerns by removing the need for a connection-oriented reservation setup mechanism and replaces it with a Diffserv-like mechanism to consistently allocate bandwidth end-to-end in a network. A prototype device is discussed that manages bandwidth on a node. An algorithm is presented that allows the device to automatically detect application QoS requirements without the need for applicationlevel signalling. A priority-based scheduling mechanism with a variant of weighted round-robin is described

Using TCP models to understand bandwidth assurance in a differentiated services network, Nortel

Abstract—In this paper, a comprehensive analytical model to predict the bandwidth achieved by aggregates of TCP flows in a Diffserv network is presented. The model predicts achieved bandwidth in three different cases: an over-provisioned network, an under-provisioned network, and a nearprovisioned network. In developing the model, we ensure that all parameters are measurable using standard tools and information available from routers and network management tools in today’s networks. Simulation was used to establish the validity of the model and understand its scope of applicability and limitations. Using the model, we explain why achieved excess bandwidth is based on factors such as RTT, packet size, and CIR. Finally, we present a novel extension of the model to predict the bandwidth of TCP flows in a Diffserv network with multiple congested nodes. Index terms—Assured Forwarding PHB, Diffserv, multipl