Safety Evaluation of the Lighting at the Entrance of a Very Long Road Tunnel: A Case Study in Ilam

BACKGROUND: At the entrance of a tunnel, reflection of sunlight from the surrounding environment and a lack of adequate lighting usually cause some vision problems. The purpose of this study was to perform a safety evaluation of lighting on a very long road in Ilam, Iran. METHODS: The average luminance was measured using a luminance meter (model S3; Hagner, Solna, Sweden). A camera (model 108, 35-mm single-lens reflex; Yashica, Nagano, Japan) was used to take photographs of the safe stopping distance from the tunnel entrance. Equivalent luminance was determined according to the Holliday polar diagram. RESULTS: Considering the average luminance at the tunnel entrance (116.7 cd/m²) and using Adrian's equation, the safe level of lighting at the entrance of the tunnel was determined to be 0.7. CONCLUSION: A comparison between the results of the safe levels of lighting at the entrance of the tunnel and the De Boer scale showed that the phenomenon of black holes is created at the tunnel entrance. This may lead to a misadaptation of the drivers’ eyes to the change in luminance level at the entrance of the tunnel, thereby increasing the risk of road accidents in this zone.

Validating the heat stress indices for using in heavy work activities in hot and dry climates

Background: Necessity of evaluating heat stress in the workplace, require validation of indices and selection optimal index

The present study aimed to assess the precision and validity of some heat stress indices and select the optimum index for using in heavy work activities in hot and dry climates

Methods: It carried out on 184 workers from 40 brick kilns workshops in the city of Qom, central Iran [as representative hot and dry climates]

After reviewing the working process and evaluation the activity of workers and the type of work, environmental and physiological parameters according to standards recommended by International Organization for Standardization [ISO] including ISO 7243 and ISO 9886 were measured and indices were calculated

Results: Workers engaged in indoor kiln experienced the highest values of natural wet temperature, dry temperature, globe temperature and relative humidity among studied sections [P<0.05]

Indoor workplaces had the higher levels of all environmental parameters than outdoors [P=0.0001], except for air velocity

The wet-bulb globe temperature [WBGT], predicted heat strain [PHS] and heat stress index [HSI] indices had the highest correlation with the physiological parameters. Relationship between WBGT index and carotid artery temperature [r=0.49], skin temperature [r=0.319], and oral temperature [r=0.203] was statistically significant [P=0.006]

Conclusions: Since WBGT index, as the most applicable index for evaluating heat stress in workplaces is approved by ISO, and due to the positive features of WBGT such as ease of measurement and calculation, and with respect to some limitation in application of HSI; WBGT can be introduced as the most valid empirical index of heat stress in the brick workshops

Which technique is better for reduction of anterior shoulder dislocation? external rotation or Milch method. a review of literature

Anterior shoulder dislocation is the most common joint dislocation in human body. Many methods are traditionally described for reduction of shoulder dislocation. Most of these techniques are painful to patients and may be associated with further injury. An ideal method should be easy, effective, and less painful, not associated with iatrogenic complications and should be easy to teach and learn. Among different methods of reduction, external rotation and Milch methods are more popular. Both methods are found to be atraumatic, relatively painless and can be performed without anesthesia. In this article, we aimed to review the literatures regarding these two methods of reduction and comparing their success rate and outcome. We reviewed the literature to find articles related to reduction of anterior shoulder dislocations applying one of two techniques described above. We searched PubMed and Google Scholar. In total, 46 articles were found, of them 17 articles -which mainly focused on anterior shoulder dislocation reduction by means of two above methods-were included in this review. The results showed that both techniques were effective, safe, relatively painless, and were well tolerated with no complications, but the external rotation method was superior

[Effective factors in hospitalization costs of the public hospitals: a qualitative study]

Introduction: Hospitals are the most expensive health care organizations. In this study, identifying factors influencing hospitalization costs based on the three aspects of the health system including patients, health care providers, and insurance organizations were considered

Methods: This was a qualitative and phenomenological study. In this study, 12 experts in the field of management and controlling hospital's costs were selected through purposive and snowball sampling method. Data were collected using focused group discussion. Framework analysis was used for data analysis

Results: The factors affecting hospitalization costs were classified into three codes including patients, health care providers, and insurance organizations. Lack of knowledge and awareness and neglecting self-care were the main patient-related factors, and weak management and supervision, lack of medical guidelines, long-term recovery period, lack of implementation of family physician and weak commitments and structural problems of insurance organizations were the main factors related to the health care providers and insurance organizations

Conclusion: The results showed that by increasing and improving self- care programs, providing health-oriented services, implementation of family physician program, specializing the hospital management, improving the quantity and quality of supervisions and reforming expert structure of insurance organizations, the hospitalization costs can be managed

Examination of the managers' attitudes towards the quality of the presented financial reports: a case study

Introduction: The main goal of accounting systems and financial reporting of public sector is to provide the qualified information that can assist managers in performing their responsibility effectively. It can also assist them in making appropriate political, economic, and social decisions

Method: this study evaluated the managers' attitudes towards the quality of financial reports. Forty nine financial managers of some of Iranian medical universities took part in this study in 1391 [Iranian calendar]. To gather the data, a 12-item questionnaire was used. The data obtained through the application of the questionnaire were subjected to descriptive and inferential statistics and the following analyses were run on the data: t-test and QP [Middle]

Results: The findings indicated that the presented information in financial reports should qualitatively be relevant, honest, understandable, timely, verifiable, and comparable

Conclusion: The results of the study indicated that, from the perspectives of manager, the presented information in financial reports in Fars Province University of Medical Sciences has qualitative characteristics

Analysis of cost price and net profit of paraclinic services in private and public sectors: a case study of Kerman city 2014

Introduction: Cost is becoming a growing concern for the managers of health and treatment institutes both in private and public sectors. Based on the opinions of pathology and radiology specialists and experts, one private and one public center for radiology and laboratory were selected to study in Kerman City

Method: This is a cross-sectional and applied study. The two centers were similar in frequency of their services, different tests they were conducting, and their number of personnel. Afterwards, the costs of services in both fields were determined using the activity-based costing method. This study was carried out from March 21 to September 22, 2014. The costs of services in both private and public sectors were compared to the tariffs of the Ministry of Health in 2014

Results: Laboratory results indicated that the costs in all the selected tests were higher than the tariffs and the largest difference [app. 84,930 Rls] was observed in the TSH test while the smallest difference was observed in the ferritin test [11,940 Rls]. However in the private sector, vitamin D and FBS tests were not profitable with differences of about 5500 and 6500 Rls, respectively. In other tests, the costs in the private sector were lower than the tariffs for the private sector. In the private sector radiology center, only the MRI services were not profitable but the other services were. The cost of MRI services in the private sector studied in this research was 190,000 Rls higher than the private sector tariffs

Conclusion: In this study, the results showed that CT scan services were the most profitable services and the price difference was about 203,000 Rls per service. However, all of the radiology services were unprofitable in the public sector and the largest price difference was seen in MRI services which was about 590,000 Rls per service

Fetal gender screening based on placental location by 2-dimentional ultrasonography

Early detection of fetal gender can provide an alarm for parents who complicated by genetic disorders. Moreover, the invasive tests are used for detecting any sex-specific genetic syndromes before 12 weeks of gestation. This study was de-signed to discover any association between placental location and fetal gender between 11 to 13+6 weeks of gestation. A cross-sectional study was conducted on 200 singleton pregnant women. They were referred for Down syndrome screening sonography to prenatal clinic, Imam Khomeini Hospital a tertiary referral university affiliated hospital, Ahvaz, Iran, in 2013. Women were included if they are singleton and at 11 to 13[+6] weeks gestational age. Exclusion criteria were multifetal, ectopic pregnancies, or dead fetus. Information about placental location [upper, middle, below, anterior, posterior], gravidity, and fetal gender were recorded. All participants of our study were evaluated by one trained gynecologist in ultrasound examinations during nuchal translucency [NT] examinations. Ultrasonography was performed using the Accuvix V10 OB/GYN ultrasound. All patients were followed-up till delivery for confirming the predicted gender. Information regarding gender of newborn were collected using medical chart review or by phone contact. Among 200 placenta which had been assessed, 103 [51.5%] were anterior and 97 [48.5%] were posterior. Our results showed that 75 [72.8%] from girl cases had an anterior placenta, while just 28 [27.2%] from boy cases had an anterior placenta [P< 0.001]. In addition, there was significant association between placental location regarding below, middle, and upper and fetal gender. According to our results, an anterior and posterior positions of the placenta had significant relation with fetal gender. Our findings are consistent with previous studies regarding prediction of fetal gender using placental location. We suggest that more research with large sample size is required as well as investigations with more details about placental locations

Study on the serum titer of anti-HBs antibody of the vaccinated staffs of a hospital in three consecutive years

Hepatitis B virus is one of the main factors causing acute and chronic hepatitis and hepatocellular carcinoma. Among others, healthcare workers are at the highest risk for exposure to hepatitis B virus. Vaccination against hepatitis B virus is one of the protective strategies but anti-HBs titer will be reduced in the sera of vaccinated people after some time. The aim of this study was to determine the titer of anti-HBs in the sera of vaccinated medical staffs in three consecutive years since administration of the last dose of hepatitis B vaccine. This study was carried out on 90 Omidvar Hospital [Lar, Iran] medical staffs that had passed 3-4 months since the administration of the last dose of hepatitis B vaccine. All sera samples were tested for anti-HBs in an ELISA method. Finally, statistical analysis was performed using SPSS-16 software. This study was conducted in duration of 3 consecutive years on 90 medical staffs including 14.44% lab technicians, 10% obstetricians, 43.35% nurses, 6.665% specialists, 5.55% general practitioners and 20% maid staffs. While HBs Ab titer was measured as 87.7% [>100 mIU/ml] in the first year elapsed since the last dose of hepatitis B vaccination, it had been decreased to 55.4% after 3 years. The results showed that re-vaccination of the medical staffs is quite necessary as anti-HBs titer had been decreased after 3 years and the desired immune response was seen only in 55.4% of the medical staffs

Increasing antibiotic resistance among uropathogens isolated during years 2006-2009: impact on the empirical management

Urinary tract infections (UTI) are one of the most common infections with an increasing resistance to antimicrobial agents. PURPOSE: Empirical initial antibiotic treatment of UTI must rely on susceptible data from local studies. MATERIALS AND METHODS: Retrospective analysis of isolated bacteria from children with UTIs was performed at the university hospital during years 2006-2009. The findings were compared with data collected in a similar study carried out in 2002- 2003. RESULTS: A total of 1439 uropathogens were isolated. Escherichia coli (E.coli) was the leading cause, followed by Enterobacter, and other gram negative bacilli. It was observed resistance of E.coli to ceftriaxone, cefexime, amikacin, gentamycin, and nalidixic acid; Enterobacter to cefexime; and the resistance of gram negative bacilli to gentamicin and cefexime increased significantly. The highest effective antibiotic was Imipenem, ciprofloxacin, and amikacin with 96.7%, 95% and 91% sensitivity rates , respectively, followed by ceftriaxone 77.2%, gentamicin 77%, nitrofurantoin 76.4%, nalidixic acid 74.3% and cefexime with 70%. CONCLUSION: The use of nitrofurantoin or nalidixic acid as initial empirical antibacterial therapy for cystitis seems appropriate. For cases of simple febrile UTI, the use of initial parenteral therapies with amikacin or ceftriaxone followed by an oral third generation cephalosporin also seemed appropriated, and in cases of severely ill patients or complicated UTI, imipenem as monotherapy or, a combination of Ceftriaxone with an aminoglycoside, are recommended.

[Psychometric properties of iranian version of female sexual function index]

Sexual problems in women are highly prevalent and frequently are associated with personal distress and impaired quality of life. The aim of the study was the validation of a translated and culturally adapted Iranian version of the FSFI-the IV-FSFI [Iranian Version of the Female Sexual Function Index]. In this cross-sectional study, 448 women [19 to 54 yr], after applying inclusion and exclusion criteria were eligible for this study. The instrument was translated into Persian, back-translated, and pilot tested to ascertain cultural sensitivity. Construct validity was evaluated by explanatory and confirmatory factor analysis and internal consistency was estimated with Cronbach's alpha and the average inter-item correlation. In addition, the test-retest reliability of the measure was determined at a 4-week interval [n=362]. Discriminant validity was assessed with betweengroups analysis of variance The overall test-retest reliability coefficients were high for each domain of the IV-FSFI [r ranging from 0.73 to 0.86] and the internal consistencies within the acceptable range [from 0.72 to 0.90]. Principal component analysis with varimax rotation revealed a best fitting five-factor structure similar to the original FSFI. CFA confirmed the underlying domain structure, supporting the factorial validity of the IV-FSFI. In conclusion, the newly developed IV-FSFI has demonstrated to be a reliable and valid instrument with good psychometric properties that allows a quick and accurate preliminary screening of women with unknown sexual health status in clinics and others medical settings