Journal of Knowledge & Health in Basic Medical Sciences
Year:2017 | Volume:12 | Issue:1 |Papers Count:14

Introduction: Induced demand is one of the health challenges of our country. Paid costs by insurance lead to waste of health system resource.Methods: This descriptive- analytical study has been conducted to evaluate induced demand using information of first level services to the insured individuals in 2013. logit model was run by EViews version 7 for analyzing results. In logit mode, two dependent variables including total cost and total time were studied. The final effect of independent variables on these dependent variables was evaluated as a final impact on induced demand.Results: In stipulated model of total cost, type of physicians’ contract (P=0.0195), physicians’ age (P=0.0474) and visit of female patients (P<0.001) were statistically significant. In stipulated model of total time, type of physicians’ contract (P=0.008), visiting patient aged more than 60 years (P=0.0144), visiting patients aged less than 5 years (P=0.0001) and number of referring (P=0.019) were statistically significant. Ultimate effect on total cost of type of physicians’ contract was 11%; considering total time, the type of physicians’ contract with highest effect was 19%.Conclusion: Results of this research showed that health policy authorities should imped delivery of unnecessary services and optimize allocation of health resources through adopting a scientific method based on purchasing services by the insurer, approval of standards and rules, and determining logical treatment framework.

Introduction: The rapid increase in the number of elderly in the country is a concerning subject for supplying the needs of this group in the fields of health, hygiene and well-being. Nursing homes residency is a phenomenon that has been increasing and its effects on the physical and mental health of the elderly are undeniable. The aim of this study was to determine the relationship between depression and quality of life among nursing home residents and non- residents.Methods: In the present cross-sectional study, 315 elderly ones including 80 (25.39%) nursing home residents and 235 (74.61%) non-residents were selected by convenience sampling method from Shahroud City. Data collection tools including the demographic information questionnaire, short form of the geriatric depression scale and quality of life questionnaire SF-36 (Short form) questionnaires were completed through face to face interviews. After completing the questionnaire, the data analysis was performed using the SPSS Version16 software.Results: According to the results of this study, the majority of the elderly in both groups of nursing homes residents (73.8%) and non-nursing home residents (80.9%) were 60-70 years old. The depression scores of both groups were in the middle range.Among nursing home residents, a significant positive correlation between physical- mental aspects and total quality of life scores with depression scores was seen, but there was not a significant relationship between the variables in non-resident elderly as well as all the elderly.Conclusion: The results showed the negative impact of residency at nursing homes on many aspects of elderly lives and it is suggested to encourage families to keep supporting the elderly as the best way to prevent many of the problems.

Introduction: Worry is a common psychological construct in multiple sclerosis (MS). In previous studies, there is little data about the psychometric properties of the measurement tools in population of MS patients. Thus, the present study was performed to validate Penn State Worry Questionnaire (PSWQ) as a common tool for measuring worry.Methods: The research design was cross-sectional for a validation study. It included two groups of MS patients (n=80) and their healthy counterparts (n=80) which were sampled by purposive method and matched by demographic factors. The study population consisted of all patients member of the MS Society of Guilan province in 2011-2012. The internal consistency reliability, construct, concurrent, predictive and differential validity of PSWQ was assessed Also the subjects were evaluated in terms of symptoms of depression, anxiety, obsessive compulsive and General Severity Index (GSI) in Symptom Checklist 90 Revised (SCL-90-R) and neuroticism in NEO Five Factor inventory (NEO-FFI).Results: The internal consistency of PSWQ was appropriate (a=0.74). The item-total correlation coefficient was better for general worry factor and was in range of 0.21 to 0.60. Results of concurrent validity indicated that PSWQ has a significant relationship with all constructs associated with research tools (P£0.001). Moreover, PSWQ predicted a significant proportion of the psychopathological symptoms scores and neuroticism variance, even after controlling for confounders. Finally, discriminant analysis model showed that PSWQ can differentiate the two groups of patients and healthy counterparts according to worry level and its overall classification accuracy is 63.1%.Conclusion: PSWQ have good psychometric properties in the studied MS patients and can be used in clinical settings and related research.

Introduction: Salmonella enteritidis (SE) is reported to be among the leading agents of food-borne human illnesses which are often transferred via consumption of contaminated poultry products. Probiotics are live microbial feed supplements which could decrease the intestinal infection of salmonellae by competitive-exclusion phenomenon. The objective of the present study was to evaluate the effect of a probiotic based on Lactobacillus, Bifidiobacter and Enterococcus spp. on gut colonization and tissue invasion of SE in broiler chickens.Methods: One hundred and twenty-eight day-old chicks were divided by a completely randomization into four treatments (T1-T4) each with four replicates of eight birds. The chicks in T1 and T2 received water contained 120 mg/l probiotic during the experiment, but those in T3 and T4 were given pure water. At the second day, the chicks in T1 and T3 were challenged by introducing seeder chicks inoculated with 1.5×105 cfu SE one day before. At the 3rd, 5th, 7th and 21st days, samples were obtained from cecum and liver, and examined for SE isolation.Results: The chicks did not experience any clinical signs or mortality. The seeder chicks were infected over the experiment. Cecal colonization of SE was not influenced by probiotic significantlyc, but SE isolation from liver samples showed nearly 55% decrease.Conclusion: Addition of probiotic to the water of newly-hatched chicks could be useful from a clinical viewpoint, but sanitation considerations in parent flocks and their offspring is more important.

Introduction: Defining the metastasis processes and what are the most effecting factors on improve the survival of patients and hopefully treating them. We aim to investigate and defining the factors predict breast cancer metastasis using data mining techniques. Data mining is the technique and tool of knowledge discovery from the big data. Nowadays data mining is spreading rapidly in several areas of research and business. In medicine, diagnosis of diseases is one of the fruitful and highly spreading filed of data mining.Methods: There were 2025 usable records in ACECR Breast Disease Center’s data base after data preparation. We try to uncover the patterns that would help the prediction of metastasis factors using CHAID and Artificial Neural Network.Results: After implementing mentioned algorithms, the tumor stage, surgery type and pathology results, the most important variables in metastasis prediction.Conclusion: Comparing the algorithms execution revealed that, Artificial Neural Network, CHAID are convenient prediction models for breast cancer metastasis.

Introduction: Among the various treatment methods, the use of technologies related to biological processes such as biofilm systems is very important. The aim of this study was to optimization of MBSBR bioreactor for control of F/M Ratio and system' s organic shock with an emphasis on LAS removal from detergent industries wastewater.Methods: A plexy glass made reactor with totally 35 L volume (useful volume of 30 L) has been used and operated in three media filling rate (40, 50 and 60%). System organic loading rate and LAS were 1000 mg/L for COD and 100, 200 and 250 mg/L for LAS.Results: The results indicated that MBSBR has high ability in treatment of detergent industries wastewater. So that the maximum removal efficiency of organic load and LAS in the hydraulic retention time of 2.5 hours with organic loading rate of 1000 mg/L and LAS rate of 100 mg/L (for COD) and 200 mg/L (for LAS) in the media filling rate of fifty percent were 90.3 and 99.71%, respectively. In optimal conditions, F/M ratio obtained in media filling rate of 50% was in the range of 0.03-0.1 day-1. Also LAS removal efficiency obtained at organic shocks of 1500 and 2000 mg/L were 98.12 and 96.42, respectively which means MBSBR have high ability to control it.Conclusion: The results showed the high ability of MBSBR biofilm reactor for LAS removal at different F/M ratio and system organic shocks so it can be used as effective biological treatment system.

Introduction: Education is a fundamental and important issue to achieve optimal quality of life in diabetes. One of the most effective factors in the quality of education is the choice of appropriate methods of educational. This study with purpose assessing the effect of self- management education on quality of life of patients with diabetes mellitus type 2 was carried out.Methods: This study was a clinical trial on 98 patients with type 2 diabetes that conducted through Random allocation assigned to two intervention and control groups. Data collection tool contain diabetes quality of life brief clinical inventory (DQOL-BCI) in Farsi, demographic and patient information questionnaire. Before intervention, questionnaires were completed by patients and then self-management educational intervention for the intervention group was implemented and quality of life questionnaire was completed after two months. To analyze the data, SPSS statistical software version 21 and chi-square test, Fisher exact test, independent t-test and significance level (P<0.05) was used.Results: No significant differences in demographic factors between the two groups before the intervention. Quality of life score before intervention was not significantly different between the two groups (P=0.82). But after the intervention quality of life score was significantly different between the two groups (P=0.002).Conclusion: The results suggest improved quality of life after the self-management education. According to important role of education in the management and control of chronic diseases such as diabetes, use of this type of training to achieve the desired quality of life is recommended.

Introduction: Despite antioxidant properties of whey protein, its effect on liver enzymes after resistance exercise in un-trained individuals has remained unknown. The aim of this study was to determine the effect of whey protein supplementation on Aspartate aminotransferase (AST) and Alkaline phosphates (ALP) as liver enzymes during muscle soreness induced by resistance exercise in un-trained individuals.Methods: In this double-blind randomized controlled trial study, twenty eight un-trained student boys (78±12 kg) were divided in glutamine (3 times/ 0.4 g per kg of body weight) and placebo groups. Blood samples were taken before, immediately after and 24, 48 and 72 h after an intense resistance exercise session consist of leg eccentric contraction and analyzed for AST and ALP activity. Analysis of Variance (repeated measure) was used for compare the data between 2 groups.Results: Compared to pre-test, a significant increase occurred in AST and ALP immediately after exercise in 2 groups (P<0.05). Based on ANOVA results, whey protein supplementation did not resulted in significant changes in AST and ALP in recovery period (24, 48 and 72 h recovery) compared with placebo group (P>0.05).Conclusion: Based on results, it was concluded that whey protein supplementation after resistance exercise can not affect the determinative enzymes for liver damage in un-trained subjects.

Introduction: Accurate, safe and simple measurement of the cardio-respiratory fitness is important in clinical and research settings. Therefore, the assessing the validity of exercise testsoutside the laboratory environment is important. The aim of this study was to assess the validity and reliability of the Francis steps protocol based on respiratory gases analysis method and design a native equation to estimate aerobic capacity in Iranian boys.Methods: Maximum oxygen consumption was measured in two ways of maximal standard test on treadmill with direct measurement of respiratory gases and Francis steps tests by Ergostep electromechanical bench with adjustable height from 138 students ranging from 8 to 13 years old. To assess the validity and reliability of the Francis steps protocol, Pearson’s correlation coefficient and intra-class correlation coefficient (ICC) was used.Results: Significant correlation between maximal oxygen uptake measured by the direct method and the results obtained through the steps protocol of Francis was observed (P<0.001, r=0.85). Francis steps test reliability was observed in excellent level (ICC=0.96). Iranian boys predictive equation for maximum oxygen consumption using age, BMI, ending heart rate, of the Francis steps test was designed (P<0.001, SEE=2.61, r=0.88).Conclusion: Due to the high validity of adjustable height Francis step test, it can be used for estimating the performance of the cardio respiratory system of the boys. Thus application of native equation of Francis step test in Iranian boys, in clinical and exercise setting and in health sciences studies, can be used.

Full Text [PDF 915KB] Introduction: The aim of study was to examine the effect of aerobic exercise with melatonin consumption on the expression of HSP60 and HSP70 markers in rat myocard after ischemic-reperfusion by isoprenaline.Methods: 30 male Wistar rats were used weighing approximately 200-250 g with two to three months old. Then the rats divided into five groups: pilot (n=4), control (n=4), melatonin (n=4), aerobic (n=4) and melatonin aerobic (n=4). Rats in melatonin group were gavaged every day for one month using a dose of 10 mg/kg BW. Meanwhile, rats in aerobic group and melatonin aerobic group were familiar with running on treadmill for one week, and then they were exposed training course with frequency of three times weekly for one month. After one month, all rats were injected isoprenaline with dose of 150 and 125 mg/kg BW with 24 hours in two consecutive days. Finally, rats were sacrificed after confirmation of infarct and expression of HSP60 and HSP70 gene were studied by real-time method. Data were analyzed with 2-DDct formula, one-way ANNOVA and Kruskal Wallis methods.Results: The results showed that there are significant differences in HSP70 gene expression between different groups (P£0.05) but there aren’t significant differences in HSP70 gene expression between melatonin and melatonin aerobic groups (P³0.669). Also there aren’t significant differences in HSP60 gene expression between different groups (P³0.05).Conclusion: Melatonin treatment and aerobic training have negligible effect on HSP60 and HSP70 gene expression. In the other hand, aerobic exercise with consuming melatonin can decrease and increase HSP60 and HSP70 gene expression respectively.