RESUMO
Background: Multiple sclerosis (MS) is a debilitating, non-traumatic, neurological disorder in young adults and can reduce quality of life (QoL) by interfering with the ability to work, leisure activities, and routine living tasks. Various studies have shown the dissatisfaction of people with MS in different areas of care services. Regarding the patients' weakness with care and services, we sought to identify the challenges for patients with MS in receiving care and services in Iran. Methods: This cross-sectional study was conducted in 2016-2018 using a researcher-made questionnaire (designed by MS Specialists in an MS research center). The questionnaire examined the care challenges in four areas: 1) costs of medication, hospitalization, and rehabilitation services, 2) family support, insurance system, and job protection, 3) access to transportation system and treatment team, 4) quality of the provided care and services. Results: Completed questionnaires were received from 945 respondents. The mean age of responders was 35.92 years. In total, 731 (77.8) participants were women and 208 (22.2) were men. Academic education was reported among 615 (65.3) participants and 367 (40.2) were employed during the study, while 99 (10.5) of the subjects were not able to walk a minimum of 20 meters. The prioritization of care services challenges was as follows: the cost of pharmaceutical services (49.1), lack of telephone counseling (47.4), uninsured home rehabilitation (44.7), lack of qualified care centers (41.2), and rehabilitation costs (40.2). Conclusion: We found that patients who could not walk at least 20 meters and unemployed individuals had more problems and lower QoL. The patients who had non-academic education had more challenges with the cost of medication, transportation, and lack of familial support. This study shows the challenges of MS patients in receiving health care in Iran that vary in age, education, employment, and ability to walk. As the abovementioned challenges are of great importance in determining the QoL of people with MS, an appropriate solution is provided in this study to overcome these challenges.
RESUMO
The replacement of metals in catalytic processes is highly demanded to improve sustainability and economic growth. Poor stability and metal leaching are the main drawbacks of metal-based catalytic reactions. This work represented the use of nitrogen and sulfur-co-doped mesoporous carbon material ((N, S)-MPC) as a metal-free catalyst for the degradation of 4-nitrophenol (4-NP) as a priority pollutant announced by the Environmental Protection Agency through the persulfate-based advanced oxidation process. A low amount of (N, S)-MPC catalyst (0.3 g/L) exhibited superior performance for the degradation of 4-NP within 3 h at room temperature and unadjusted pH. The COD removal was calculated to be 76% using (N, S)-MPC catalyst. Interestingly, the degradations kinetics of 4-NP followed the zero-order kinetics with the rate constant of 0.505 min-1. The radical quenching experiment was accomplished to investigate the activation pathway of degradation. A real sample from an oil and gas company was treated with the (N, S)-MPC catalyst, which showed excellent total decontamination of 61%. The recyclability and stability of the catalyst have been evaluated for three runs. Owing to the obvious benefits such as high efficiency, metal-free nature, and recyclability, the presented catalyst can improve pollutant removal from aqueous media and practical environmental remediation.
