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This research was Expertise-Oriented and is conducted with aim of foresight sustainable branding of coastal tourism destinations via an illustrative-analyzing method. This research makes an effort to response this question that what is the best scenario for the sustainable branding of coastal tourism destination? To do so, after extracting and customizing required indexes and propulsions, variables and the relationships among them were checked, key variables were detected and adoption degree of influential and impressive items was extracted. Then deterministic or effective and two-sided variables, risks, objectives, results, exceptions and sustainable branding adjustment variables were extracted and main scenarios authored according to them and architectured in three local, national and international levels. Also, 3 scenarios are presented with topics of “A transition with a reconstruction and improvement approach”, “Medium with a minimalistic retrieval approach” and “Optimal with a maximum retrieval approach”.

Background: The Multi state Markov models have extensively application with categorization of laboratory marker of CD4 cells for evaluation of HIV disease progression. These models with different states result in different effects of covariates and prediction of HIV disease trend. The main purpose of this study was comparison of four and five states models with the three- state in order to select the model with better prediction ability of occurrence of HIV and finally death in HIV positive people. Methods: A total of 305 HIV positive people were included in this cohort study in the Iran AIDS center in Imam Khomeini Hospital in Tehran that entered during March 1995 to January 2005 and then fallowed up to October 2014. The three continuous- time Markov models of three-, four- and five- state models were fitted to data to describe the evolution of a HIV disease Trend over different states. For comparison of models, two criteria of modification of Akaike’s criterion (DRAIC) and likelihood cross-validation criterion (DRLCV) along with their 95% tracking interval was used. For fitting of these models and estimation of transition matrix and the hazard ratio of gender and treatment independent variables, the msm package of R project for statistical computing, version R 3.2.4 (www.r-project.org) was used. Results: The results showed that the four- state model has more prediction ability than five-state model for evaluation of HIV disease Trend. In the four-state model, the progression hazard ratio to death for people who received highly active antiretroviral therapy (HAART) was 0.64 lower than who didn’t get this therapy. Moreover, the progression hazard ratio for men was 2.33 fold in comparison to women. The disease progression hazard ratio to death was 4.9 fold for men in comparison to women. Conclusion: The (DRAIC) and (DRLCV) criterions showed that the four-state model has more predictive ability of the progression trend of HIV disease in comparison of five-state model.

This research was Expertise-Oriented and is conducted with aim of foresight sustainable branding of coastal tourism destinations via an illustrative-analyzing method. This research makes an effort to response this question that what is the best scenario for the sustainable branding of coastal tourism destination? To do so, after extracting and customizing required indexes and propulsions, variables and the relationships among them were checked, key variables were detected and adoption degree of influential and impressive items was extracted. Then deterministic or effective and two-sided variables, risks, objectives, results, exceptions and sustainable branding adjustment variables were extracted and main scenarios authored according to them and architectured in three local, national and international levels. Also, 3 scenarios are presented with topics of “A transition with a reconstruction and improvement approach”, “Medium with a minimalistic retrieval approach” and “Optimal with a maximum retrieval approach”.

Background and aims: More than 40 percent of deaths of pedestrians in traffic accidents happen in Tehran. The aim of this study was to determine the impact of human factors was associated with an increased intensity of pedestrian traffic. Methods: In this cross-sectional study, 6323 traffic injuries and 99 traffic deaths resulted from traffic accidents in pedestrian during 2013 in Tehran were investigated. Data was extracted from traffic police databases and in Tehran. In analytical analysis, logistic regression model was used to control for possible confounders Results: In studied accidents, 4070 (63.5%) and 2335 (36.5%) of injured or died pedestrians were male and female, respectively. The mean age of injured pedestrians was 39.15 ± 19.47 years and the mean age of guilty drivers was 34.75 ± 12.38 years. The final model showed that gender, age, pedestrian position and fault, and type of driverchr('39')s license are correlated to the dependent variable. The events leading to the death was significantly higher in men, pedestrians standing next to the roadway, pedestrians fault and drivers with grade 1 of driver license. Conclusion: Human factors had much role in the severity of traffic accidents related to pedestrians in Tehran. These factors have a high correlation with environmental factors, and vehicles. More researches is needed to specifying mechanisms of effect of these factors in traffic accidents related to the pedestrians and designing strategies for promotion of traffic culture and safe behaviors in drivers and pedestrians.

Background: After primary infection, the number of CD4 T-cells decreases with disease progress. The patient’s immunological status could inform by The CD4 T-cell counts over the time. The main purpose of this study is to assess the trend of CD4 cell count in HIV+ patient that received Antiretroviral Therapy (ART) by using a multistate Markov model to estimate transition intensities and transition probabilities among various states. Methods: A total of 122 HIV+ patients were included in this cohort study who are undergoing Antiretroviral Therapy treatment in the Iran AIDS center in Imam Khomeini Hospital in Tehran that inter during March 1995 to January 2005 and then fallow up to October 2014. All adults with at least two follow-up visits in addition to their pre-ART treatment were considered to be eligible for inclusion in the study. Continuous-time Markov processes are used to describe the evolution of a disease over different states. The mean sojourn time for each state was estimated by multi state Markov model. Results: Sample included 22 (18%) female with a mean age of 43.32 (standard deviation 8.33) years and 100 (82%) male with a mean age of 45.28 (standard deviation 8.34) year. Age was divided in to two categories, 40 years old and lower than that 66 (54.1) patents and persons older than 40 years old 56 (45.9) patents. A total of 122 patients were included. 29 patients died during follow-up. One year transition probability for staying in state 1 of CD4 cell count was 51%. This probability for six year was 33%. The mean sojourn time for sate 4 was 21 month. The hazard ratio of transition from state 3 to state 4 was 4.4 in men related to women. Conclusion: The use of antiretroviral therapy in the treatment of HIV infected persons reduce viral replication and increase in CD4 T lymphocyte count, and delay the progression of disease. This paper is shown the progression of this trend.

Objectives: Mortality rate in traffic accident is high for Iranian elderly. Twenty percent of elderly people are involved in traffic accident in Iran `s cities every year. Methods & Materials: This study is a descriptive cross sectional study. All data in this field from 2006 to 2008 collected from forensic medicine centers across the country and were analyzed with SPSS software. Results: In general, 12029 deaths due to traffic accident occurred in people over 60 years old in Iran from 2006 to 2008. On average 65% of deaths were occurred in young-old: 34.5% in old group and 0.5% in the old-old group. In these years 19.2% of death in elderly people was occurred in drivers, 56.9% in pedestrians and 23.2% in occupants. On average, each year 46% of deaths in traffic accidents were happened in cities 46.3% on suburban roads, and 6.8% were occurred on rural roads. Conclusion: The rate of traffic accident in Iran is about 20 folds in compare to those of other countries. In years of study mortality rate in old and old-old age groups were increased and in young-old group was decreased. The frequency of deaths in elderly people due to traffic accidents was decreased in suburban roads and increased in urban roads.

Background and purpose: Colorectal cancer (CRC) is one of the most prevalent health problems in the world and Iran. This study aimed at determining the survival rate of patients with CRC and the factors influencing it in Iranian patients. Material and Methods: A prospective cohort study was carried out in patients attending 10 state and private hospitals in Tehran during 2006-2011. In this study 1127 patients (totally 2570 individuals-year) were followed up every six months and the follow-up duration was from the definite time of CRC diagnosis until death (or censoring). Only 2% of the patients were censored. Data was analyzed using stata software, bivariate and multivariate analyses, and also Cox regression. Results: The mean age of the patients was 53.5 ± 14 years old at the time of diagnosis. Most of the patients were older than 45 years of age (69.7%). The age at diagnosis was significantly different between men and women (P<0.03). The patients were 61.2% male and the rest were female. The rates of mortality in male and female were 96.9 and 83 in 100,000. After the diagnosis has been made 75%, 50%, and 25% had a survival rate of less than 2.72 years, 5.84 years, and longer than 13 years, respectively. In Cox model some variables including ethnicity, marital status, cancer grade, family history of caner, and smoking were the main determinants of survival. Conclusion: The mean survival time was 5.8 years after diagnosis has been made which shows more improvements compared to previous studies. This study provides some information on CRC survival rate so that action plans could be designed to prevent and control this disease. [ABSTRACT FROM AUTHOR]