OBJECTIVES:The survival rate of thalassemia patients has not been conclusively established, and the factors associated with survival remain unclear. This study aimed to determine the survival rate of thalassemia among patients in southern Iran and to identify the factors associated with mortality from thalassemia.METHODS:This retrospective cohort study was conducted based on a retrospective review of the medical records of 911 beta-thalassemia patients in 2014. Data analysis was conducted using the Kaplan-Meier method and Cox regression analysis.RESULTS:Overall, 212 patients (23.3%) died, and 26.8% had thalassemia intermedia. The 20-year, 40-year, and 60-year survival rates were 85%, 63%, and 54%, respectively. Both crude and adjusted analyses found that education, marital status, ferritin levels, and comorbidities were related to mortality.CONCLUSIONS:Sociodemographic and hematological factors were found to be significantly associated with the survival rate of thalassemia. Addressing these factors may help healthcare providers and physicians to provide the best possible care and to improve the survival rate.

<p>Medical professionals involved at intraoperative fluoroscopy are exposed to low doses of the occupational radiation exposures. The biological effects of chronic low-dose radiation on human health are complex and have not been well established. The aim of the present study is to follow up hematological parameter changes during 2 years in medical professionals exposed to ionization radiation in operating rooms.<strong></strong></p><p>22 medical professionals (medical specialists and technicians), chronically exposed to ionizing radiation of mobile C-Arm X ray machine, were selected. The seven hematological parameters were examined each time. The statistical analyses were done by Student’s t test and one way ONOVA test.</p><p>The data analysis led to the following observations: (1) the present study incorporated that the basic hematological parameters including the mean value of red blood cells (P=0.90), white blood cells (P=0.68), and platelets count (P=0.45) did not show a significant difference between two years. (2) The mean values corpuscular hemoglobin concentration, corpuscular hemoglobin, and hematocrit parameters were found disturbed low or high in some of medical professionals but their means were not significantly different between two measurements. (3)A statistically significant relation in mean value of RBCs with the duration of exposure and sex were observed.</p><p>It seems that, hematological parameters survey could not be a reliable test as the biological indicator of long term exposure to very low dose of radiation exposure in medical professionals which their physical dosimetry values are lower than dose limits. </p>

This study aims to use integrated Shannon's Entropy-TOPSIS methodology for environmental risk assessment of the Helleh protected area in Iran. In this research, first, with regard to field visits, interview with natives of the area, and investigation of the environment of the study area, the risks existing in the region were identified. Then, for final identification of the risks, the Delphi method was applied. Analysis and prioritization of risks of the area of Helleh were performed by multi-criteria decision-making methods of Shannon's Entropy and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). In this research, risks were assessed by three criteria of severity, probability of occurrence, and vulnerability. Twenty six of the risks were identified which were specified in two groups, natural events and environmental risks. The environmental ones were classified into four groups: physicochemical, biological, social-economic, and cultural. Results of the research showed that the construction of the Rayis-Ali-Delvari Dam at the upper part of the study area threatens the wetland. Water supply for the dam 75 km away from the area with concession of 0.9999 holds the first priority of risk-generating factors. Of the managerial workable solutions suggested controlling the risks, the stopping of the pumping of water from the wetland and observation of hunting season length and permissible type and number of hunting in the area can be mentioned.

Background Nursing documentation is a critical aspect of the nursing care workflow. There is a varying degree in how detailed nursing reports are described in scientific literature and care practice, and no uniform structured documentation is provided. This study aimed to describe the process of designing and evaluating the content of an electronic clinical nursing documentation system (ECNDS) to provide consistent and unified reporting in this context. Methods A four-step sequential methodological approach was utilized. The Minimum Data Set (MDS) development process consisted of two phases, as follows: First, a literature review was performed to attain an exhaustive overview of the relevant elements of nursing and map the available evidence underpinning the development of the MDS. Then, the data included from the literature review were analyzed using a two-round Delphi study with content validation by an expert panel. Afterward, the ECNDS was developed according to the finalized MDS, and eventually, its performance was evaluated by involving the end-users. Results The proposed MDS was divided into administrative and clinical sections; including nursing assessment and the nursing diagnosis process. Then, a web-based system with modular and layered architecture was developed based on the derived MDS. Finally, to evaluate the developed system, a survey of 150 registered nurses (RNs) was conducted to identify the positive and negative impacts of the system. Conclusions The developed system is suitable for the documentation of patient care in nursing care plans within a legal, ethical, and professional framework. However, nurses need further training in documenting patient care according to the nursing process, and in using the standard reporting templates to increase patient safety and improve documentation.