Factors affecting the process of obtaining informed consent to surgery among patients and relatives in a developing country: results from Pakistan

Efforts have been made in Pakistan to create ethical guidelines for research and medical practice. This study explored the perceptions of and factors affecting the process of obtaining informed consent to surgery among inpatients and families at a tertiary-care hospital in Karachi. A random sample of 400 post-surgery adult patients answered a pre-tested, structured questionnaire. Overall, 233 patients [58.3%] had signed the surgery consent form themselves, while 167 relatives [41.7%] had signed on behalf of the patient. Perceived factors significantly associated with patients not signing the consent form themselves were: language used [adjusted OR = 4.6], medical terminology used [aOR = 2.7], insufficient time allocation [aOR = 3.8], cultural/traditional reasons [aOR = 1.5] and low education [aOR = 2.4]. Inappropriate timing for taking consent and not being informed/asked about consent were not statistically significant factors. Health-care practitioners should encourage patients to sign the consent form themselves

Statistical modeling of future lake level under climatic conditions, case study of Urmia lake [Iran]

The present research focuses on the changes of Urmia Lake level. For this purpose, two time scales have been considered. The trend changes of temperature, precipitation rate and quantitative values of climate type for the observational period from 1968 to 2011 [past scale] and from 2011 to 2100 [future scale] have been analyzed. General Circulation Model [GCM] is considered for simulating the values of the future meteorological components, and statistical models have been used for modeling the lake's level in future decades. One of the most significant results achieved for the future decades is the increase of the lake's temperature for around 1.5 degrees centigrade till 2100 in comparison with the long-term average of 1961 to 1990. Furthermore, the values extracted from precipitation rate and climate type of the zone also indicate a remarkable decrease of quantitative values in the future decades. Accordingly, the climate type extracted for the year 2100 with numeric value of around 17.75 will be entered a new phase called arid climate for the first time in recent decades. The Lake surface area is diminished from 5650 square kilometers in 1998 to about 2005 square kilometers in 2010. According to the results achieved by statistical models and time series, if this trend continues, the Lake level will be reduced around 3 more meters in 2100

[Comparing dysfunctional attitude and coping response between patients with peptic ulcer disease and healthy control]

Background: In addition to effects of biological factors and physical risks on incidence and exacerbation of gastrointestinal ulcers, the coping strategies and attitudes are also considered as psychologically important factors affecting the creation and exacerbation of this disease as well as the disease-associated stress

Objective: The aim of this study was to compare the dysfunctional attitudes and types of coping styles of patients with peptic ulcers with those of healthy control group

Methods: This was a case control study carried out on all patients with gastrointestinal ulcers who were referred to three hospitals [Mostafa Khomeini, Imam Khomeini, and Dr Shariati] in Tehran during February-June 2010. Study population was consisted case [100 patients] and control [100 healthy relatives of patients and hospital staff] groups. Two groups were matched regarding the age, sex, educational level, and marital status. The research tools were three questionnaires on demographic characteristics, dysfunctional attitudes scale, and a list of coping styles questions. Data were analyzed by independent T and chi-square tests and logistic regression analysis

Findings: There were significant differences in dysfunctional attitude variables, problem- and emotion-oriented coping styles between two groups [P<0.05]. Moreover, patients in case group showed higher levels of dysfunctional attitudes and emotion-oriented coping styles whereas in control group the coping styles were mostly problem-oriented. Dysfunctional attitude had the highest share in explaining the peptic ulcer disease followed by problem- and emotion-oriented coping styles, respectively

Conclusion: According to the findings obtained in the present study, it seems that the people's attitude towards themselves and the environment affects the creation and perception of stress. Thus, providing the patients with psychological interventions could lead to more favorable results when treating gastrointestinal ulcers

Simulation of temperature changes in Iran under the atmosphere carbon dioxide duplication condition

The present research intends to show the effect of global warming on the trend and patterns of temperature in Iran. The study has been divided into two primary parts, the first of which is an analysis of the country's temperature trend using the following data measures: the minimum, maximum, and mean seasonal night temperature [the minimum temperature] components, the day temperature [the maximum temperature] component and the mean daily temperature component. This data is specific to the time frame 1951 to 2005 and it was obtained from 92 synoptic and climatology stations around the country. The second part of this research involved simulating and forecasting the effects of global warming on temperature values under conditions in which greenhouse gases have increased. For analyzing these simulations and forecasts the MAGICC SCENGEN model was used and different climate change scenarios were taken into consideration. The results are quite interesting. In the analysis of the country's current temperature trend and in the forecasting's, specifically related to time, a significant temperature increase was observed during the summer months. Also, with regard to altitudinal levels, it was evident that stations at higher altitudes show a more significant increase in daily and mean daily temperatures. Taking into account the output mean of the different climate change scenarios, the temperature simulations show a 4.41 Degree C increase in Iran's mean temperature by 2100. Most of these temperature increases would occur in the southern and eastern parts of Bushehr, certain coastal regions of the Persian Gulf, eastern and western parts of Fars, Kohgilooye, Boyerahmad, southern parts of Yazd, as well as southern and southeastern parts of Esfahan

Simulation of global warming effect on outdoor thermal comfort conditions

In the coming decades, global warming and increase in temperature, in different regions of the world, may change indoor and outdoor thermal comfort conditions and human health. The aim of this research was to study the effects of global warming on thermal comfort conditions in indoor ambiences in Iran. To study the increase in temperature, model for assessment of greenhouse-gas induced climate change scenario generator compound model has been used together with four scenarios and to estimate thermal comfort conditions, adaptive model of the American Society of Heating, Refrigerating and Air-conditioning Engineers has been used. In this study, Iran was divided into 30 zones, outdoor conditions were obtained using meteorological data of 80 climatological stations and changes in neutral comfort conditions in 2025, 2050, 2075 and 2100 were predicted. In accordance with each scenario, findings from this study showed that temperature in the 30 zones will increase by 2100 to between 3.4°C and 5.6°C. In the coming decades and in the 30 studied zones, neutral comfort temperature will increase and be higher and more intense in the central and desert zones of Iran. The low increase in this temperature will be connected to the coastal areas of the Caspian and Oman Sea in southeast Iran. This increase in temperature will be followed by a change in thermal comfort and indoor energy consumption from 8.6% to 13.1% in air conditioning systems. As a result, passive methods as thermal inertia are proposed as a possible solution

Urban sprawl and climatic changes in Tehran

Urban sprawl beginning in the developed countries around 1950 is currently experienced in almost all countries. Many studies on the effects of urban sprawl indicate the emergence of harmful effects of this phenomenon. One of the most important environmental effects is the changes in climate. The purpose of this research was to identify the relation between urban sprawl components of Tehran with changes in climate variables. To this end, two data sets have been used to study the relation between these elements and components. The first data set included climatic elements such as rainfall, temperature, the percent of relative humidity and the percent of calm wind, as well as its mean speed for a period of 54 years [1953-2006]. The second set of data was formed by components relevant to urban sprawl such as city area, private cars per capita, population density and number of urban population. Pearson correlation and multiple regression methods have been applied to compare and identify the relation between climatic components with urban sprawl indices. Results of correlation indicate that among the 5 aforementioned climatic components, annual rainfall and the mean of wind speed do not appear to have significant relation with sprawl, but the oscillations in percent of relative humidity and percent of calm wind seem to have a significant relation with Tehran sprawl. Consequently and using multivariate regression, it was concluded that the most important factor in the increasing temperature of Tehran, is the number of cars; the most important factor in increasing the percent of relative humidity is the area of Tehran, whereas the increase of the percent of calm wind may be attributed to the increase of population

effectiveness of cognitive-behavioral stress management training on glycemic control and depression in patients with type 2 diabetes

Diabetes is a chronic disease with undesirable complications. In addition to physical complications, some psychological problems, especially stress and depression are prevalent among people with diabetes. The aim of present study was to determine the effectiveness of cognitive-behavioral stress management training on glycemic control and depression in patients with type 2 diabetes mellitus. In a randomized clinical trial, 40 members of the Isfahan Diabetes charity, with type 2 diabetes mellitus were selected through voluntary accessible sampling. Participants were randomized to the cognitive-behavioral [n=20] and the control groups [n=20]. The case group participated in two-hour sessions of cognitive-behavior stress management training for 12 weeks. To evaluate the effects of intervention, the glycosylated hemoglobin [HbAlc] test was administered before and 3 months after interventions and the depression subscale of the DASS scale was administered before, after, and again 3 months following intervention. Data were analyzed using repeated measures analysis of variance and analysis of covariance. After intervention, the mean of HbA1c in the experimental group was significantly lower than the control group [p< 0/001]. Also the mean for depression in the experimental group was significantly lower than in controls [p< 0/001], a finding that remained as such at the 3 month follow-up assessment. Stress management training can improve glycemic control and depression in patients with type 2 diabetes mellitus. It is recommended that such trainings programs be intergrated into comprehensive treatment of diabetes mellitus

Effects of climate change process on comfort climate in Shiraz station

Dwelling in cities and city development together with quick increase of population and development of industrial activities with unplanned consumption of fossil fuel have intensively increased pollutions with consequences which will cause different diseases in short period, will lead to some climatic oscillations and its environmental effects such as the change of desirable periods in view of comfort climate in long period. The objective point of view of this research was to study the climate in Shiraz and its effect on comfort conditions for human physiology. In this research, using 55-year climatic data [1952-2006], the relative humidity and temperature through the application Guni comfort climatic model, the desirable months for the comfort of human physiology have been determined in the five 11-year periods and the linear process of these changes have been estimated for the next 11 years. The results of this research show that the temperature trend in Shiraz station is increasing and most months have heating process in a way that it is expected that in the coming future, the cold months will have more favoring conditions for physiological comfort of residents and correspondingly in the warm months, heating tension will have remarkable increase

Cyanide removal by combined adsorption and biodegradation process

Investigation of the effectiveness of simultaneous adsorption and biodegradation [SAB] process over individual processes by using microbes Rhizopus oryzae and Stemphylium loti with granular activated carbon [GAC] as adsorbent was carried out. The maximum removal efficiency of cyanide had been achieved by biodegradation alone was 83% by R. oryzae, while it was 90% by S. loti at initial pH of 5.6 and 7.2 respectively and at initial CN[-] concentration of 150 mg/L. In the combined process efficiency of R. oryzae closer to S. loti [95.3% and 98.6% respectively]