Evaluación de los efectos de la fisuración inducida por ASR en la resistencia a cortante directa del hormigón reciclado

Recycled concrete aggregates (RCA) have been adopted as one of the most efficient methods to reduce the carbon footprint of the concrete industry. However, the performance of recycled concrete mixtures made of Alkali-silica reaction (ASR)-affected RCA is primarily unknown. In this work, two types of RCA were produced from ASR-affected concrete with distinct levels of deterioration (i.e., slight and severe). Three levels of secondary damage (i.e., expansion levels of 0.05%, 0.12%, and 0.20%) were selected and evaluated through the direct shear test. Results revealed that RCA concrete’s shear strength depends on the severity of the RCA’s past deterioration. Moreover, the performance of the concrete specimens subjected to direct shear are in accordance with the cracks features formed in the microstructure of the recycled concrete as a function of ASR-induced secondary expansion observed through the damage rating index (DRI).Los áridos reciclados de hormigón (RCA) están siendo utilizados como uno de los métodos más eficientes para reducir la huella de carbono de la industria del hormigón. Sin embargo, el desempeño de las mezclas de hormigón reciclado hechas de RCA afectado por la reacción álcali-sílice (ASR) es en su mayoría desconocido. En el presente trabajo se produjeron dos tipos de RCA a partir del hormigón afectado por ASR con distintos niveles de daño (leve y severo). Se seleccionaron tres niveles de daño secundario (niveles de expansión de 0,05 %, 0,12 % y 0,20 %) y se evaluaron mediante el ensayo a cortante directo. Los resultados revelaron que la resistencia a la cizalladura del hormigón con RCA depende de la severidad de su daño anterior. Además, el comportamiento del hormigón sometido a cortante directo está en acuconcordancia con las características de las fisuras formadas en la microestructura del hormigón reciclado en función de la expansión secundaria inducida por ASR por el índice de clasificación de daños (DRI)

A study of the lower gastrointestinal tract cancer with emphasis on gender and age of the patients in western Iran (Kermanshah) over 2006-2011

Given that the incidence of cancers in the coming years will have a growing trend due to the increased average age of the world's population, the partial control of communicable diseases, and the rapid growth of the environmental risk factors. The present work was a descriptive, comparative and analytical study. The statistical population consisted of all patients residing in Kermanshah who had been suffering from the lower gastrointestinal tract cancer for five years. The results of the present study revealed that 46.10% were male, and 53.90% were female. Further, the results indicated that the age of patients and the intensity of cancer differentiation were significantly correlated.It seemed that the lack of early diagnosis would ensue from a lack of periodic screening programs at early ages and lack of forums in which specialists could get together due to the unavailability of comparative statistics.Keywords: Cancer, Lower Gastrointestinal Tract Cancer, Western Iran, Kermanshah Cit

Global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017

Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980–2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package—a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87–2·04) and has since decreased to 0·95 million deaths (0·91–1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79–3·67) and since then have gradually decreased to 1·94 million (1·63–2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8–39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact

Challenges Facing Women Survivors of Self-Immolation in the Kurdish Regions of Iran: A Qualitative Study

Objectives: Women confront many problems after self-immolation, so the purpose of this study was to explore the challenges facing women survivors of self-immolation in the Kurdish Regions of Iran. Method: This study used a qualitative approach and conventional content analysis. Data were collected through semi-structured interviews with 19 Kurdish women who attempted self-immolation in Iran. They were sampled through purposeful sampling and snowball sampling. The Lincoln and Guba criteria were used to strengthen the research. Results: The results of data analysis were categorized into five main categories: 1�psychological problems, 2�lack of social and legal supportive structures, 3�incomplete treatment, 4�poor self-care, and 5�social problems. These categories consist of 19 subcategories. Conclusion: Having been rescued from self-immolation, the women confront many challenges returning to normal life. Reducing these women�s problems and paving the way for their return to life requires multi-dimensional and community-based interventions. Therefore, all social organizations and institutes can cooperate and each of them paves part of the way. © Copyright © 2020 Yoosefi Lebni, Abbas, Khorami, Khosravi, Jalali and Ziapour

The effect of education based on health belief model on promoting preventive behaviors of hypertensive disease in staff of the Iran University of Medical Sciences

Background: Hypertension is one of the major causes of many diseases, such as heart attack, strokes, kidney failure, and many internal disorders. This presentresearch study aimed to investigate the impact of educational programs based on the health belief model to promote hypertension prevention behavior of Iran University of Medical Sciences staff. Methods: This study has incorporated pretest-posttest quasi-experimental based on 128 staff members and randomly assigned the recruited and involved participants to an intervention (n = 64) and a control group (n = 64). The data collection tool was based on a questionnaire related to health belief model constructs based on 42 questions. The study interpreted the results using ANCOVA and robust ANCOVA as suitable approaches. Results: ANCOVA showed improvement in the cues to participants� action following educational interventional (p = 0.011). the robust ANCOVA specified that the intervention was successful for participants with low to moderate initial levels of knowledge, perceived susceptibility, perceived severity, perceived barriers, and self-efficacy scores. The levels of these components did not change in participants with very high baseline scores. Compared to a control group, regardless of baseline score, the perceived benefits and practice (behavior) of participants at the intervention group were improved significantly (P < 0.05). Conclusion: This current study specified that the education-based health belief model effectively promotes hypertension preventive behaviors among Iran University of Medical Sciences staff. © 2021, The Author(s)

Challenges and opportunities confronting female-headed households in Iran: a qualitative study

BACKGROUND: Female-headed households are one of the most vulnerable groups of society that confront many problems and challenges. Therefore, the present study aimed to explore the challenges and opportunities confronting female-headed households in Iran. METHODS: This qualitative study was conducted among female-headed households in Kermanshah, West of Iran, in 2019. The data were collected through Semi-structured interviews with 26 female-headed households who were selected by purposeful and theoretical sampling. Data analysis was done through conventional qualitative content analysis, and the software MAXQDA-12 was used for the management of data. The four criteria of Goba and Lincon, including credibility, confirmability, dependability, and transferability, were observed to evaluate the quality of research results. RESULTS: After analyzing the data, 4 main categories and 13 subcategories were obtained as follows: individual problems (role overload, role conflict, end of love, psychological problems), intra-family problems (declined independence, intra-family tension, poverty reproduction and family disability), social problems (stigma of being unattended, social insecurity, social isolation, social exclusion), positive outcomes (positive self-concept, social maturity). CONCLUSION: Female-headed households face many challenges that can become a big threat or an opportunity. Therefore, their health improvement can be achieved through training and helping them to adapt to new and multifaceted roles, providing more economic support and helping them raise their social status

Hospital managers' skills required and onward challenges: A qualitative study

Introduction: The qualification of managers in terms of management skills is one of the most important factors in the continuous success of each organization, and utilizing such skills can have a positive contribution in the effectiveness of the organization while improving the performance of the employees in line with the objectives and goals of the organization. The study's primary objective was to examine the necessary skills of the hospital managers and their capabilities to manage the challenges in providing health care facilities to their patients and employees. Materials and Methods: This study is a qualitative that deep interviews were performed with 22 managers (senior and middle managers) of educational hospitals of Kermanshah city, and the sample size was 22 individuals. The interviews were analyzed by a MAXQDA software application after transcription. Results: This study includes 8 themes and 23 subthemes. The strategic skill, the perceptive skill, the human relations skill, work experience, and personal characteristics were among the skills necessary for hospital managers. Some of the challenges facing the hospital managers included rapid changes in the policies, the limitations of financial resources, and lack of proportion between the educational and occupational spheres. Conclusion: Because of their existential philosophy and differences with other service sectors, managing hospitals poses a particular sensitivity. In this regard, the role of the hospital manager is very important. Therefore, in order to meet the satisfaction of those receiving services, decision.makers and policy.makers must think twice when selecting and appointing hospital managers and evaluate and appraise this group in terms of abilities and skills necessary for managing such an important service section. © 2020 Journal of Education and Health Promotion

The consequences of regular methamphetamine use in Tehran: Qualitative content analysis

Background: In recent years, methamphetamine use has increased noticeably in Iran, and this can make harmful consequences for the health of individuals and society. Therefore, the study aimed to investigate the consequences of regular methamphetamine use in Tehran. Methods: This study was conducted based on a conventional content analysis approach. Data were collected through observation and in-depth interviews with 20 regular adult users of methamphetamine in Tehran (including 15 males and 5 females). Participants were selected using snowball sampling and purposeful sampling, which continued until data saturation. Guba and Lincoln's criteria were used to assess the strength of the study. Results: The extraction of the codes resulted in three main categories: (1)the short-term consequences, consisting of the sub-categories of individual and social consequences, (2) the long-term consequences, consisting of the sub-categories of psychological and physical consequences, high-risk behaviors, severely decayed memory and changes in the eating pattern, and (3) hallucinations and delusions including the sub-categories of visual and auditory hallucinations, persecutory delusions and delusion of having supernatural power. Conclusion: Regular methamphetamine use may have serious adverse effects on the overall health of individuals. It is therefore highly recommended that educational programs must implement with the use of methamphetamine in the high-risk groups in order to raise awareness and change attitudes about the short and long term consequences. is highly recommended. © 2020 The Author(s)

Experiences of rural women with damages resulting from an earthquake in Iran: A qualitative study

Background: Women, with more vulnerabilities and less access to resources, are often seen as victims of natural disasters. Therefore, the present study aimed to investigate the experiences of rural women with damages resulting from an earthquake in Iran. Methods: In this research, a qualitative approach, as well as the conventional content analysis was employed. The study population consisted of rural women residing in the earthquake-stricken areas of Sarpol-e Zahab and Salas-e Babajani counties in Kermanshah Province, Iran. Semi-structured interviews were used for data collection. Moreover, sampling was purposeful, theoretical saturation was achieved by conducting 22 interviews, and the data analysis process was performed according to the steps proposed by Graneheim and Lundman. For the strength and transferability of the research, Lincoln and Guba's Evaluative Criteria were used. Results: There were seven categories regarding the experiences of rural women after the earthquakes including neglecting the health needs; tension in the family and marital relations; gender inequality in the provision of assistance; feeling insecure; ignoring the ruling culture of the region; concealing needs for fear of stigmatization, and incoherent mourning as well as two categories regarding their reactions to and interaction with the earthquake consequences including positive and negative interactions. Conclusions: Paying more attention to the needs of rural women, taking the culture governing the village into account at the time of service delivery, and helping them with positive adaptations are some indispensable measures that should be taken. © 2020 The Author(s)

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations