Purpose. This study aimed to examine the effect of chronic exposure to flour dust on the pulmonary symptoms and pulmonary indices of mill workers. Methods. The cohort study was conducted on 67 mill workers and 53 controls from 2014 to 2016. Demographic information was collected through interviews and pulmonary indices; flour dust exposure was measured by spirometry, and NIOSH 0500 and NIOSH 0600 methods. Results. The incidences of pulmonary symptoms, including cough, sputum, dyspnea, wheezing and bronchitis, were significantly more in the case group than the control group. At the beginning of the study, there was no significant difference between the case and control groups regarding the pulmonary indices of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow and FEV1/FVC; however, after 2 years of exposure to flour dust, the pulmonary indices significantly decreased in the case group and showed a restrictive pattern. Based on the linear regression model, the most important predictor variables of FVC and FEV1 were age, body mass index, smoking and level of exposure to respirable flour dust. Conclusions: There is a strong correlation between chronic exposure to flour dust and the incidence of pulmonary complications and reduced pulmonary functions.
The mechanical behavior of the transosseous elements is a defining factor in the overall stiffness, stability, and reliability of an external fixation system. Mechanics involving the application of thin Kirschner wires in Ilizarov apparatus is yet to be fully explained. To address this problem, load-deflection behavior of the pretensioned thin wires laterally loaded by the bone is necessary to be studied. In this paper, the lateral deflections of thin Kirschner wires are studied both theoretically and computationally. Fully three dimensional finite element (FE) modeling and analyses were performed in which the bone was modeled as a hollow cylinder, and the wire-bone interaction was assumed to be frictionless. The mathematical solution resulted in new exact solutions for the deflection as well as final tension in the wires subjected to the lateral loading under a cylinder representing the bone. Results from the FE analyses turned out to be very close to those from the mathematical solution. The results obtained from theory and FE method are comparable to published experimental findings. Some aspects of the pretensioned thin wire behavior in ring fixation systems, e.g., stiffness-tension proportionality, were revealed in the results. The current study adds to the existing knowledge on the general behavior of tensile elements.
Abstract The experience of the spousal bereavement of widows who are single parents has been largely neglected in the literature. This qualitative study provides insight into how such women grieved over their spouse's death in Iran. In‐depth interviews with 24 participants were held and field notes were written. The generated data were analyzed by using the constant comparative method. The results indicated four main categories: “intense grief”, “becoming hopeless”, “internalizing bereavement and continuing bonds”, and “the contexts of experience of spousal death”. The fourth category consisted of two subcategories: “the unexpected nature of death” and “full dependence”. The findings suggested that hopelessness related to spousal death changed the lifestyles of the participants, which led to health risks in these women. We conclude that it is the duty of health‐care professionals, especially nurses, to first identify widows at risk, with the help of the contexts of experience of spousal death and the symptoms presented in this study, and then to provide hope therapy, which can facilitate positive bereavement outcomes for healthier living after spousal death.
Mental training considers sharing of mental health care information as the primary objective. The secondary objectives include facilitating dialogue about feelings such as isolation, sadness, labeling, loneliness and possible strategies for confronting with these feelings. Group therapy trainings have supportive functioning in accepting the environment so that the members are able to be part of the indigenous groups. However, no study has been ever done on the impact of this educational method on the communication problems of this group. This study aimed to determine the impact of group therapy training on the communication problems of Afghan immigrants.This was a clinical trial study. Eighty-eight Afghan men were investigated. Sampling method was simple sampling method. Thereafter, the study subjects were divided randomly into two groups of test and control based on the inclusion criteria. Data collection tool was a self-made questionnaire about the social problems. For analyzing the data, software SPSS, independent t-test and paired t-test were used.Reviewing the data indicated lower mean score of the social problems after implementing the group therapy training in social communication compared with before implementing the group therapy training. Paired t-test showed a significant difference between mean scores of the social communication problems before and after the implementation of group therapy training.Given the effectiveness of the intervention, group therapy training on social problems in social communication of Afghan immigrants is recommended. This program should be part of continuous education and training of the Afghan immigrants.
Background: Organizing the health system around family medicine (FM) has been a productive approach for developed countries. The aim of this study, which was concurrent with the Iran Health Transform Plan (HTP) and the establishment of the family physician in Iran, was to discuss the sufficiency of a family physician training program for their roles and increase their competency.Methods: This descriptive study was conducted in the Psychosomatic Research Center affiliated to Isfahan University of Medical Science, Iran, with the assistance of the Iranian Institute of Higher Health (2015). An expert panel consisting of 6 individuals including specialists, trainers, and researchers in FM and psychosomatic medicine was held for this purpose. Using the World Organization of Family Doctors‎ (WONCA) website for the definition of a family physician, the curriculum developed by the Ministry of Health and Medical Education was studied. Data were summarized in one table.Results: The current FM curriculum, with this content and method, does not seem to be capable of enabling physicians to perform their multidisciplinary roles. it still has a reductionist approach and disease orientation instead of a clinical reasoning method and systematic viewpoint. The psychosomatic approach is applicable at all prevention levels and in all diseases‎, since it is basically designed for this longitudinal (between all preventive levels) and horizontal (bio-physical–social-spiritual intervention) integration.Conclusion: Psychosomatic medicine, not as a biomedical specialty, but rather as a systems thinking model in health, had a rapid rise during previous decades. Now, its services have been integrated into all medical fields. This means that it should be adopted in the core of health care services (i.e., the family physician position) before other sections. This would help the implementation of this approach in the health system, and the reduction of patients' pain and uncertainty and improvement of their health. Thus, psychosomatic approaches for family physicians only emphasize on some of their fundamental acts.
Assessment of national children growth has shown that a high percent of Country's children are afflicted to growth failure. Community participation is one of the principles of PHC emphasized by WHO that is necessary for develop- ment of health services. The objective of this study was to develop a model for mother's participation in order to improving growth and nutrition of children. Methods: This community-based field trial was rendered on 74 pairs of mothers and children less than three years of age. A model was designed for increasing mother's participation, so that, a group of mother's volunteered and were instructed in the subjects of growth monitoring and child nutrition. The program was evaluated by CIPP Model (Context, Input, Product, Process). Results: Difference between the mean grade of mothers' knowledge and practice, before and after intervention were mean- ingful (P< 0.001).This plan had considerable effects on the increase of individual and social capabilities of the participants, including their self-confidence. Other findings were related to the evaluation of impact, effectiveness, sustainability and transportability of the program. Conclusion: By enhancement of mother's participation, considerable improvement of their knowledge and practice concerning growth and nutrition of children were achieved. Also individual and social capabilities of the mothers' increased.
INTRODUCTION: Many factors affect academic success of students among which are learning strategies and factors associated with them. This study aims to evaluate the effect of teaching mindfulness on learning strategies and learning of students in Isfahan University of Medical Sciences in the first semester of 2012.METHODS: In this study, 62 bachelor degree students were randomly selected and placed in case and control groups. Mindfulness training was carried out in 8 sessions. Before and after training, all students were asked to fill Weinstein learning strategy and 80-item mindfulness questionnaires.RESULTS: Analysis of the results showed that mindfulness training caused statistically significant improvement in components of information processing in the area of skill, attitude in the area of enthusiasm, and self-examination in the area of self-regulation (P ≤ 0.05).CONCLUSION: These results show that mindfulness training is successful in improving some components of learning strategy and academic performance.
Mechanical characteristics of orthopaedic fixators, such as the stiffness and stability, directly influence the mechanobiological environment in which the bone is healed. In circular external fixators, the transfixing Kirschner wires are the major contributors to the biomechanics involved. A comprehensive understanding of the mechanical behaviour of the wires is therefore the key to biomechanical analysis of the Ilizarov fixator. In this study, to model the behaviour of the wires, a purely theoretical approach has been adopted to obtain explicit equations for a solely tension-based model formulation. Mathematical modelling leads to new algebraic polynomials whose solutions are the exact maximum deflection, angle of deflection, and total (final) tension in the wire. The predictions are compared with published experimental and computational findings on the deflection and stiffness of the wires, and analytical explanations are provided for the previously observed behaviours. Parametric (practical) implications of this type of abstraction include the fact that the angle of deflection as well as the tension in the wire are independent of its length. The inverse proportionality of wire stiffness to its length is also deduced. The findings are applicable to tensile elements (ropes, chains, etc.), provided that the tensile deformation (elongation) can be deemed to be the dominant mode of deformation.
The Barcelona Clinic Liver Cancer (BCLC) Staging and Treatment Algorithm recommends transarterial chemoembolization (TACE) and radio/microwave ablation (MWA) for non-resectable, early- to intermediate-stage (BCLC A-B) hepatocellular carcinoma (HCC). 90Yittrium (90Y) radioembolization is recommended as a secondary treatment pathway. As clinical data has become available, some centers have begun utilizing 90Y as a primary treatment option for BCLC A-B. This study uses retrospective data from multiple centers within a single health system to compare liver-directed therapy (LDT) outcomes among TACE, MWA, and 90Y after subgrouping based on primary target tumor diameter ≤ or > 3 cm. Retrospective, single system, multi-center study included treatment naïve, non-resectable HCC with BCLC A-B and ECOG 0-1 with underlying cirrhosis Child-Pugh (CP) A5–B9 that received liver-directed therapy (LDT) as a definitive treatment approach (n = 445, 2016-2023). LDT approaches included MWA, doxorubicin-eluting embolic TACE (DEE-TACE), and 90Y. Objective response (OR) was calculated after the first treatment cycle. Target time to retreatment (tTTR) and time to BCLC-C progression (TTP) were compared among treatment approaches. Subgrouping based on target tumor diameter yielded the cohorts: ≤ 3 cm–TACE (n = 94), MWA (n = 78), 90Y (n = 87) and > 3-cm–TACE (n = 54), 90Y (n = 132). In the ≤ 3-cm cohort, the OR was similar among treatment modalities (P = 0.053)–TACE (58/91), MWA (58/72), 90Y (65/82). Median tTTR (P < 0.001) was shorter for TACE (4 months) compared to MWA (43 months) or 90Y (31 months) and resulted in a higher 1 year retreatment frequency [TACE (68%), MWA (24%), 90Y (34%)]. However, TTP were similar (P = 0.194) with 2 year progression rates of–TACE (33%), MWA (19%), and 90Y (22%). In the > 3-cm cohort, there was a similar OR between treatments (P = 0.720) - TACE (33/51), 90Y (85/122). However, there was a significance difference in tTTR (P < 0.001) with TACE having a shorter median tTTR–TACE (2 months), 90Y (8 months). At 1 year after treatment, nearly all patients receiving TACE required retreatment to the target tumor–TACE (92%), 90Y (60%); however, TTP were similar (P = 0.633) with 2 year progression rates–TACE (48%), 90Y (54%). In this single system retrospective analysis, MWA and 90Y provided a more durable treatment response compared to TACE for HCC ≤ 3 cm. For HCC > 3 cm, 90Y also yielded a more durable treatment response compared to TACE.
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