ABSTRACT
Objectives@#Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran. @*Methods@#First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties. @*Results@#It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider. @*Conclusions@#This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.
ABSTRACT
Background: ADHD [attention-deficit hyperactivity disorder] is a developmental disorder that has been attracting the attention of psychologists and psychiatrists for a long time. The purpose of this research was to study the effectiveness of training in improving attention and working memory on continuous performance in ADHD children
Materials and methods: This was a semi-expremental study performed on 44 ADHD children referred to psychiatric clinics in Babol city. They were equally divided into the experimental and the control groups. The performance of the members belonging to both groups was assessed using the continuous performance test in the pretest stage. Each member of the experimental group was then individually trained for 20 half-hour sessions [three half-hour sessions per week for a period of seven weeks] using attention and working memory improvement software. After the training period, post-test was conducted on members of both groups using the mentioned software
Results: Results of ANCOVA indicated that despite increased continuous performance in both the experimental and the control groups in the post-test stage, the increased continuous performance in the experimental group was greater compared to the control group. Therefore, training in improving attention and working memory was effective in increasing continuous performance in ADHA children
Conclusion: Training in improving attention and working memory, and similar trainings, can be considered as complementary treatment method, or a substitute method for medicines
ABSTRACT
Background: Chronic hepatitis B virus [HBV] infection is one of the most important health problems worldwide with a high rate of morbidity and mortality. It is a major risk factor for cirrhosis and liver cancer. Currently, Iran is located in the intermediate HBV zone; however, recent studies have provided some evidence indicating an epidemiological change in the country. The aim of this study was to estimate the prevalence of HBV in Iran
Methods: A systematic review was conducted to evaluate the studies performed in the past 25 years that have reported the prevalence of HBV infection and its associated factors in the Iranian general population [1990-2014]. Any study assessing and reporting serum Hbs Ag levels was included in this review
Results: After excluding all impertinent studies, 19 eligible studies were included in the analysis. The overall prevalence of HBV was 3% [95% CI 2% to 3%]. Its distribution showed that the prevalence of HBV varies in different provinces from 0.87% to 8.86%. The HBV rate was highest in the Golestan [8.86%] and lowest in the Kurdistan [0.87%] provinces
Conclusion: This study provides some evidence about the prevalence of HBV in Iran. However, the collected data was very heterogenic, even within a single province, which made it hard to estimate a single-point prevalence. High quality studies are needed to find reliable information about HBV prevalence and to decrease the heterogeneity of results in the country
Subject(s)
Prevalence , Mortality , PopulationABSTRACT
Hbs-Ag positivity rates in dialysis patients correlate with endemicity in the general population. There is a subset of patients with occult HBV infection that defined as the presence of detectable HBV-DNA by PCR in patients who are negative for Hbs-Ag. We decided to detect the occult HBV cases in our hemodialysis patients. With support of charity society of renal patients of Qazvin, a cross sectional study was scheduled. We tested all the 134 hemodialysis patients in Buali Hospital of Qazvin university of medical sciences for viral hepatitis B in 1 year period. All the patients were chronic hemodialysis patients. Then Hbc-Ab and Hbs-Ag were detected by ELISA tests. Duplication is considered to have true test results. After completion of this stage, the aliquoted samples were tested for qualitative HBV-DNA [PCR]. The positive cases for HBV-DNA were tested again in a referral center to ensure of test results. 43% were female and 57% were male cases. We had 5 positive cases for hepatitis B by ELISA tests [3.7%] that 4 of them were Hbc-Ab and HBV-DNA positive also as expected, although 1 of them had negative test result by PCR test unusually. We detected 4 [3%] another positive PCR test results for HBV that had negative tests for Hbs-Ag, called occult HBV cases. 3 [75%] of these occult cases were Hbc-Ab negative and known as seronegative occult cases. No significant association was found with the duration of hemodialysis, age or sex and HCV positivity in these cases. Age of occult HBV cases was significantly more [p=0.02]. As mentioned most of our occult HBV cases were seronegative. It seems that Hbc-Ab detection is not sensitive test in these cases. Segregation of positive HBV cases in hemodialysis units is mandatory and new protocols may be considered to detect the cases for segregation in the future