A Qualitative Inquiry Into the Challenges of Medical Education for Retention of General Practitioners in Rural and Underserved Areas of Iran

Delavari, Sajad,Arab, Mohammad,Rashidian, Arash,Nedjat, Saharnaz,Souteh, Rahmatollah Gholipour The Korean Society for Preventive Medicine 2016 Journal of Preventive Medicine and Public Health Vol.49 No.6

Objectives: General practitioners (GPs) retention in rural and underserved areas highly effects on accessibility of healthcare facilities across the country. Education seems to be a critical factor that affects GPs retention. Thus, the present study aimed at inquiry into medical education challenges that limit their retention in rural and underserved areas. Methods: A qualitative approach was applied for the aim of this study. Data were gathered via 28 semi-structured interviews with experts at different levels of Iran's health system as well as GPs who retained and refused to retain working in rural settings. Interviews mainly were performed face-to-face and in some cases via telephone during 2015 and then coded and analyzed using content analysis approach. Results: Iran's medical education is faced with several challenges that were categorized in four main themes including student selection, medical students' perception about their field of study, education setting and approach, curriculum of medical education. According to experts this challenges could results in making GP graduates disinterested for practicing in rural and underserved areas. Conclusions: Challenges that were found could have negative effects on retention. Modification in student's perception about rural practice could be done via changing education setting and approach and curriculum. These modifications could improve GPs retention in rural and underserved areas.

A Qualitative Inquiry Into the Challenges of Medical Education for Retention of General Practitioners in Rural and Underserved Areas of Iran

Sajad Delavari,Mohammad Arab,Arash Rashidian,Saharnaz Nedjat,Rahmatollah Gholipour Souteh 대한예방의학회 2016 Journal of Preventive Medicine and Public Health Vol.49 No.6

Objectives: General practitioners (GPs) retention in rural and underserved areas highly effects on accessibility of healthcare facilities across the country. Education seems to be a critical factor that affects GPs retention. Thus, the present study aimed at inquiry into medical education challenges that limit their retention in rural and underserved areas. Methods: A qualitative approach was applied for the aim of this study. Data were gathered via 28 semi-structured interviews with experts at different levels of Iran’s health system as well as GPs who retained and refused to retain working in rural settings. Interviews mainly were performed face-to-face and in some cases via telephone during 2015 and then coded and analyzed using content analysis approach. Results: Iran’s medical education is faced with several challenges that were categorized in four main themes including student selection, medical students’ perception about their field of study, education setting and approach, curriculum of medical education. According to experts this challenges could results in making GP graduates disinterested for practicing in rural and underserved areas. Conclusions: Challenges that were found could have negative effects on retention. Modification in student’s perception about rural practice could be done via changing education setting and approach and curriculum. These modifications could improve GPs retention in rural and underserved areas.

SILICON CARBIDE NANOWIRES FROM POLYVINYL ALCOHOL/SILICA ELECTROSPUN NANOFIBERS

H. DELAVARI H.,M. KOKABI 성균관대학교(자연과학캠퍼스) 성균나노과학기술원 2011 NANO Vol.6 No.1

The catalyst-free synthesis of silicon carbide (SiC) nanowires was carried out from polyvinyl alcohol (PVA)/silica electrospun nanofibers at high temperature. Scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray powder diffraction (XRD), and thermogravimetery analysis (TGA) were employed to study morphology and formation of SiC nanowires. Based on the TGA analysis, the carbon yield was increased when inert gas flow rate and heating rate decreased and polymeric nanofibers has been stabilized. The XRD and TEM results showed that the produced nanowires were crystalline β-SiC and rather homogeneous in thickness with an average diameter around 50 to 70 nm and a length of more than 10 μm. Finally, a possible growth mechanism of β-SiC nanowire based on a vapor–solid (VS) mechanism was proposed.

Predicting the buckling load of smart multilayer columns using soft computing tools

Shahbazi, Yaser,Delavari, Ehsan,Chenaghlou, Mohammad Reza Techno-Press 2014 Smart Structures and Systems, An International Jou Vol.13 No.1

This paper presents the elastic buckling of smart lightweight column structures integrated with a pair of surface piezoelectric layers using artificial intelligence. The finite element modeling of Smart lightweight columns is found using $ANSYS^{(R)}$ software. Then, the first buckling load of the structure is calculated using eigenvalue buckling analysis. To determine the accuracy of the present finite element analysis, a compression study is carried out with literature. Later, parametric studies for length variations, width, and thickness of the elastic core and of the piezoelectric outer layers are performed and the associated buckling load data sets for artificial intelligence are gathered. Finally, the application of soft computing-based methods including artificial neural network (ANN), fuzzy inference system (FIS), and adaptive neuro fuzzy inference system (ANFIS) were carried out. A comparative study is then made between the mentioned soft computing methods and the performance of the models is evaluated using statistic measurements. The comparison of the results reveal that, the ANFIS model with Gaussian membership function provides high accuracy on the prediction of the buckling load in smart lightweight columns, providing better predictions compared to other methods. However, the results obtained from the ANN model using the feed-forward algorithm are also accurate and reliable.

Predicting the buckling load of smart multilayer columns using soft computing tools

Yaser Shahbazi,Ehsan Delavari,Mohammad Reza Chenaghlou 국제구조공학회 2014 Smart Structures and Systems, An International Jou Vol.13 No.1

This paper presents the elastic buckling of smart lightweight column structures integrated with a pair of surface piezoelectric layers using artificial intelligence. The finite element modeling of Smart lightweight columns is found using ANSYS® software. Then, the first buckling load of the structure is calculated using eigenvalue buckling analysis. To determine the accuracy of the present finite element analysis, a compression study is carried out with literature. Later, parametric studies for length variations,width, and thickness of the elastic core and of the piezoelectric outer layers are performed and the associated buckling load data sets for artificial intelligence are gathered. Finally, the application of soft computing-based methods including artificial neural network (ANN), fuzzy inference system (FIS), and adaptive neuro fuzzy inference system (ANFIS) were carried out. A comparative study is then made between the mentioned soft computing methods and the performance of the models is evaluated using statistic measurements. The comparison of the results reveal that, the ANFIS model with Gaussian membership function provides high accuracy on the prediction of the buckling load in smart lightweight columns, providing better predictions compared to other methods. However, the results obtained from the ANN model using the feed-forward algorithm are also accurate and reliable.

Does Economic Instability Affect Healthcare Provision? Evidence Based on the Urban Family Physician Program in Iran

Enayatollah Homaie Rad,Sajad Delavari,Afsoon Aeenparast,Abolhassan Afkar,Faranak Farzadi,Farzaneh Maftoon 대한가정의학회 2017 Korean Journal of Family Medicine Vol.38 No.5

Background: The main aim of this study was to evaluate the achievements of some important goals of Iran’s urban family physician plan. This plan was implemented when the country experienced economic instability. We exam-ine whether an economic crisis affects the efficacy of a healthcare program.Methods: We used the household income and expenditures survey data for 2011 (before program implementa-tion) and 2012 (after program implementation). Changes in out-of-pocket payments and healthcare utilization were investigated using the propensity score matching estimator. Furthermore, changes in inequality in these two dimensions were examined.Results: No changes in out-of-pocket payments and healthcare utilization were found after the implementation of this program; however, inequality in out-of-pocket payments increased during the reform.Conclusion: The urban family physician program was not implemented completely and many of its fundamental settings were not conducted because of lack of necessary healthcare infrastructure and budget limitations. Family physician programs should be implemented under a strong healthcare infrastructure and favorable economic con-ditions.

Tamoxifen Induces Apoptosis of Leishmania major Promastigotes in Vitro

Masoud Doroodgar,Mahdi Delavari,Moein Doroodgar,Ali Abbasi,Ali Akbar Taherian,Abbas Doroodgar 대한기생충학열대의학회 2016 The Korean Journal of Parasitology Vol.54 No.1

Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models

Kamyar Mansori,Masoud Solaymani-Dodaran,Alireza Mosavi-Jarrahi,Ali Ganbary Motlagh,Masoud Salehi,Alireza Delavari,Mohsen Asadi-Lari 대한예방의학회 2018 Journal of Preventive Medicine and Public Health Vol.51 No.1

Objectives: The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models. Methods: This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The Besag-York-Mollié (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis. Results: The Moran index was statistically significant for all the variables studied (p<0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively. Conclusions: Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in atrisk areas.

Development of Gold-Coated Magnetic Nanoparticles as a Potential MRI Contrast Agent

Ali Reza Montazerabadi,Mohammad Ali Oghabian,Rasoul Irajirad,Samad Muhammadnejad,Davoud Ahmadvand,Hamid Delavari H,Seyed Rabie Mahdavi 성균관대학교(자연과학캠퍼스) 성균나노과학기술원 2015 NANO Vol.10 No.4

Gold-coated superparamagnetic iron oxide nanoparticles (SPIONs) coated with methylpolyethylene glycol (mPEG) are synthesized and investigated as a magnetic resonance (MR) imaging contrast agent. The synthesized mPEG-core@shells are characterized by UV-visible spectroscopy, transmission electron microscopy (TEM), dynamic light scattering (DLS), vibrating sample magnetometry (VSM), zeta-potential analysis and X-ray diffraction (XRD). In addition, the transverse relaxivity of the mPEG-core@shells is measured using a 3 T MRI scanner. The cytotoxicity of the mPEG-core@shells is tested in the LNCaP cell line using an 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The results show that the mPEG-core@shell particles are semispherical with hydrodynamic size of ~65 nm and a transverse relaxivity of 162.3 mM-1 S-1. The mPEG-core@shell particles demonstrate good stability in biological media without any significant in vitro cytotoxicity under high cellular uptake conditions. Finally, in vivo imaging shows that mPEG-core@shells are a potential contrast agent for use in early-stage detection.

Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models

Mansori, Kamyar,Solaymani-Dodaran, Masoud,Mosavi-Jarrahi, Alireza,Motlagh, Ali Ganbary,Salehi, Masoud,Delavari, Alireza,Asadi-Lari, Mohsen The Korean Society for Preventive Medicine 2018 Journal of Preventive Medicine and Public Health Vol.51 No.1

Objectives: The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models. Methods: This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The $Besag-York-Molli{\acute{e}}$ (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis. Results: The Moran index was statistically significant for all the variables studied (p<0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively. Conclusions: Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in at-risk areas.