Journal of Health System Research
Year:2015 | Volume:11 | Issue:2|Papers Count:28

Background: The use of costly high-tech diagnostic services has increased in the past decade. Researches that have been done, indicate several contributing factors according to the health care system in each country. These factors include the aging population, advances in detection technologies, increasing numbers of radiologists etc. So, considering health economics science before setting up high-tech diagnostic services has increasingly grown day to day.Methods: This review article extracted required information from ISI, Pubmed, Science Direct, Journal of Health Economics science and other related journals by considering key words like induced demand, magnetic resonance imaging, health care utilization etc during recent years.Findings: Increased use of MRI services is for several reasons. This study classified causes for increased cost of diagnostic services in five categories included: technological factors, factors related to the physician, patient and community factors, factors related to radiologists and health system factors related to market performance. Details of these classes and sub-classes must be in accordance with each country' s circumstances to defined policy.Conclusion: Correct applications of diagnostic services must institutionalize both in medical community culture, patients and politicians viewpoint. Wrong policies in under developing countries deduct a significant share of their income deductions resulting from the lack of detailed expertise on the effectiveness and efficiency of services. Improved culture of society along with emphasizing on different aspects of legal, educational and cultural needs for medical community required necessary measurement.

Background: Cancer is uncomfortable and unbelievable experience for everyone which has many sings such as pain and physical and psychological disturbance. Social support is a trusty source that help patients with cancer to cope with illness and its symptom that increase quality of life.This study has done for investigationof perceived social supports in cancer patients and its relation with demographic characteristics in patients with cancer.Methods: This descriptive analytic study has done in 117 patients with cancer treated withchemotherapyin Seied Al-shohada hospital selectedthrough continuumsamplingin 1392.. The data, collected by a questionnaire including two sections of demographic characteristics and, perceived social supportandanalyzed by descriptive and analytical statistical tests.Findings: Social supportwith mean 59.21, was at two low (57.3%) and moderate levels (42.7%). And ithadinverse association with age (p=0.02), and right association with graduation (p=0.134). mean of social support was higher insingle patients thanmarried and widow or divorced patients (p=0.02) and in females was higher than males (p=0.01).Conclusion: based on resultSocial support was low in patients. also males, older, divorced and widow patients and who werein low graduated levels receivedlowSocial support, it decreased with old age. its necessary to more attention to social support specify in groups with lowSocial support.

Background: The studies indicate that the majority of healthy and unhealthy behaviors formed during adolescence and t hey are considered educable. Therefore, investing in the health and education of young people toward prevention of cardiovascular disease is considered as the underlying action. This study’s aim was to investigate the effect of educational intervention on knowledge and attitude of students regarding cardiovascular diseases using constructs of Health Belief Model.Methods: In this pre-post quasi experimental study that conducted throughout high schools in Izeh City, the subjects were196students (79 girls and 117 boys) who were selected through the multistage random sampling method; A self-designed questionnaire was prepared on the basis of the specified goals of study, and its validity and reliability were confirmed. The questionnaire was filled out in two stages, before and after the intervention. The obtained data were analyzed by SPSS 20 software, descriptive statistics & T-test, Pearson and Spearman correlation statistical tests at the significant level of a=0.05.Findings: The mean of the total score of the students’ knowledge about risk factors of Cardiovascular Diseases was 12.95±4.18 before the intervention and 23.85±4.48 after the intervention (p<0.001). The mean of the student’ attitude also increased from 68.10±9.21 to 82.44±8.27 (p<0.001). The mean of all model constructs (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy and cues to action) before and after the intervention showed significant difference (p<0.001).Conclusion: The results of this study, verifies the effectiveness of educational interventions based on health belief model to promote level of knowledge and the effect on students' perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy and cues to action in relation to heart disease and their prevention methods. Therefore, to improve the cardiovascular protective behaviors and ultimately, prevention of being infected with these diseases at older ages, applying educational program based on this model should be considered as an educational priority in schools by authorities and managers of education and health.

Background: Ventilation systems in buildings are one of the most important sources of noise, which are spread into the surrounding environment through fans and channels or distributors. Since axial fans are used in industry very much and silencers are among ways to voice control. The purpose of this study is investigation on use of Absorptive silencer in reduction Low-frequency noise Iranian axial fan.Methods: In this study, we used galvanized channel 0.6 mm with 30*30 cm2 dimension and axial fan. Absorptive silencer as channel was designed to cross section of channel and silencers after embedded the absorber be identical together. Length of absorptive silencer was 50cm and there used mineral wool absorbent (density 80, 100 Kg/m3 and thickness 5, 10 cm). To determine the sound pressure level in a channel, two microphones are embedded that be accomplished by using MATLAB software in the one third of octave broadband and variable speeds 600-2500 rpm. we investigate amount of the reduction in absorption silencer sound filled with Iranian absorbing materials and influence of thickness and density of adsorbent material in silence.Findings: The maximum 2 dB reduction is in pressure sound at low frequencies of designed absorptive silencer that design in the channel surface. In this study, an increase in the thickness of the absorbent material of absorption silencer, there was a little change in the volume decreasing but with increasing density from 80 to 100 Kg/m3 better results were seen to reduce noise levels and it caused to increase NR rate.Conclusion: According to data from the present study we can used silencer with 5cm thick and 100 Kg/ m3 density in the reduction of sound pressure level at frequencies lower than 250 Hz in the ventilation system as an effective device.

Background: According to the importance and the role of efficient and powerful workforce in the country and the important aim of universities for developing student's talents and this fact that motivating achievement of inner factors including emotional intelligence and self-efficiency has a significant role, the present paper aims to study the relation between self-efficiency andemotional intelligence with achievement motivation among Payam-e-Noor University students Methods: In this descriptive study with respect to coherency, 341 students atBirjandPayam-e-Noor University, collected by stratified random sampling, were observed. Research instruments are three questionnaires: Shring's Emotional Intelligence questionnaire, Sherer's General Self-efficiency Scale questionnaire, and Herman's Academic Achievement Motivation questionnaire. The data were analyzed by 15 SPSS software and statistical tests, Independent-T, one-way analysis of variance, Pearson' s Coherence Coefficient and multi-variable regression at 0.5 level.Findings: Among the students, 174 were male (%51) and 262 were female (%76.7).Pearson's Coherence Coefficient showed that a positive and meaningful relation is between self-efficiency and also selfawareness and social skill components with academic achievement motivation. The average score of academic achievement motivation among female students is more than academic achievement motivation among male and the average score of self-efficiencyamong male students is more than the average score of self-efficiency among female students; but in the case of emotional intelligence, there is no difference in both groups. Furthermore, for all of these variables, there is no meaningful distinctionin different age classifications and different fields of study.Conclusion: Because it has been shown that there is meaningful and positive coherence between selfefficiency and social skill with academic achievement motivation, we suggest that by increasing selfefficiency and emotional intelligence by means of using suitable methods and enriching the training environment, we can improve academic achievement motivation among university students.

Background: A wealth of study shows that increasing RBMI accompanies with physical inactivity, consequently. The aims of this study were determining the distribution of daily physical activity amount by gender in obese and overweight students Methods: This is a cross-sectional descriptive study carried out to determine the distribution of daily physical activity level by genders and relative body mass index in overweight and obese children. We selected 300 students grade 5th and 6th randomly and studied their health profiles. So we selected those who were in the range of overweight and obesity based on National Centre for Health Statistics (NCHS). Physical activities of the subjects were measured with a qualified questionnaire.Findings: there was a significant difference between the prevalence of obesity and overweight between genders (P=0.000). Overweight children, regardless to the gender they are, have higher daily physical activity than obese ones and statistical analyses shows significant differences between means of MPA, VPA and MET by genders and relative body mass index (P=0.000).Conclusion: As Increasing RBMI is concomitant with increasing students' physical inactivity in both genders, it is important to prepare more qualified plan increasing physical activities in obese children rather than overweight ones.

Background: AIDS is a public health problem throughout the world, especially in the developing countries. Injecting drug users are heavily affected and account for nearly 68.15% of all cases in Iran. The purpose of this study is to determine the relationship between the health belief model constructs and AIDS preventive behaviors among addicts in Khorramabad, Iran.Methods: A cross-sectional study was conducted in 2012-2013. The study population was a random selection of 88 men admitted to a rehabilitation center in Khorramabad. The data collection tool was a questionnaire designed to assess the health belief model (HBM), knowledge, and behavior. The data was analyzed using multiple linear regression analysis and Pearson correlation coefficients.Findings: Health belief model constructs together with by knowledge explained 46% of the variance in HIV preventive behaviors. Among these variables, the level of the variable predictive efficacy (b =0.39) was higher than the other variables and the variable knowledge (b=0.21) was next in order.Conclusion: The findings of the present study confirmed the relationship between self-efficacy, perceived severity and perceived barriers toward the adoption of preventive behaviors against AIDS.The results of this study can be used in theory-based interventional strategies to establish and change health behaviors.

Background: According to the consequences of job stress on drivers and traffic accidents that will cause deaths and damage, therefore, this study was conducted to investigate the relationship between job stress and accident history of agency drivers of urban Yazd city.Methods: This research is a case - control study that was done on the drivers of the 10 agencies within the city of Yazd in 1392. For this purpose, 142 shiftwork drivers and 125 non-shiftwork were selected with random-quota sampling method. In order to collect of research data was used a two-part questionnaire.The first part is demographic and the second part is measuring job stress with Philip L. Rice questionnaire.Finally, the results were analyzed by spss software.Findings: Analysis of the data showed that percent of shift workers with accident history (75.4%) is higher than non-shift workers (56%) and this difference was statistically significant. The mean score of stress in terms of accident history in shift workers (169.74 ± 26.61) was higher than non-shift workers (160.47 ± 28.05) and this difference is significant (P=0.03).Conclusion: The results indicate that Shift work has significant effects on job stress drivers and provides accidents and decrease performance. Therefore, it is necessary to perform a comprehensive examine of stress on drivers and must be considered necessary actions to reduce the consequences.

Background: Identifying and understanding risk factors affecting stress among primary school teachers and cope strategies can cause major changes in educational system and design educational interventions in order to promote people and communities health. This study aimed at undrestanding stress experiences and coping strategies among primary school teachers.Methods: This qualitative study was conducted with participation of46 female primary teachers working in urban and rural schools of Lorestan province, Iran, using semi- structured focous groups in 2013. After reciving the informed consent, semi- structures interviews were conducted, transcripted, control for accuracy and data generated using content analysis. Acceptability and verifiability were utilized to support the data validity.Findings: Five major themes were extracted from content analysis including nature of job stress, re organizational engineering, cultural, social and personal factors and role conflicts.Conclusion: Understanding isuues about stress and coping strategies can be effective in educational interventions to solve problems and provide a way to implement more comprehensive researchs. It seems that using such models like social ones are able to be effective in designing proceduressuch as monitoring and control, teachers educational system, valuing and modification in job promotion.

Background: Some cross sectional studies have showed association of vitamin D deficiency with components of metabolic syndrome. But findings are inconsistent. With regarding to high prevalence of vitamin D deficiency in Iran this study was designed.Methods: In this cross sectional study, 156 women aged ≥30 with at least three of five criteria metabolic syndrome were recruited by consecutive random sampling. Serum 25 (OH) D levels and components of the metabolic syndrome were measured. Metabolic syndrome was defined according to NCEP/ATP III criteria. Subjects were three groups according to their serum concentration of 25 (OH) D.Findings: Mean of serum concentration of 25-hydroxyvitamin D was 20.5 ± 10.8 ng/ml, and %54.5 of subjects were vitamin D deficient, 23.1% and 22.4% were insufficient and sufficient, respectively. After adjustment for age, BMI, physical activity, ANCOVA showed fasting blood sugar concentration was inversely associated with serum 25 (OH) D (P=0.004), at the other hand HDL-C had significant correlation across different groups of vitamin D status (P=0.014). Waist Circumference had favorable changes, although there was no statistically significant correlation. No significant association was observed between other metabolic syndromes of components across 25 (OH) D groups.Conclusion: In study, association serum 25 (OH) D with fasting blood sugar and HDL-C concentrations can predictive it relation with chronic disease. But, determining role of vitamin D with metabolic syndrome and related disease, large prospective studies and clinical trial is necessary to be conducted.

Background: In the steel industry, a wide range of machinery and equipment is used in the manufacturing process, are considered as sources of annoying noise. This study aimed to assess the environmental sound level and the noise exposure in the steel industry.Methods: After identifying the sources and characteristics of sound equipment in the production process Measurement of noise level and dosimetry was performed using sound level meter model of Cell.450 and dosimeter model TES-1345. Distribution of noise level in the investigated workshop in form of noise map was provided using AutoCAD software.The rate of hearing loss workers was extracted during three consecutive years. Hearing loss workers were analyzed to the equivalent sound level of exposure and the dose received.Findings: 18.5% of measurement stations were in the danger zone. The sound pressure level in the furnace, energy, costing and material workroom was 97.6, 95, 89.7 and 83 dB (A) respectively. Sound pressure level was more than 90dB (A) in the blast furnace, blower and cooling tower units. The average of noise dose in blast furnace, costing, blower, bag filter and cooling tower was 282.8%, 295.1%, 239.9%, 234% and 180.5% respectively. Average NIHL workers in three consecutive years were 12.4, 14.5 and 15.4 dBA, respectively.Conclusion: Noise pollution in blast furnace, costing and blower units is high So that the mean hearing loss of workers has increased to 1.5dB per year. Therefore, appropriate control measures should be taken in these units.

Background: Job stress can affected negative effects on organizational commitment, loyalty to organization, and job performance. The aim of this study was to survey of job stress and its relationship with organizational commitment and job performance in prison staff of Ilam province.Methods: The study was conduced on 177 employees of the Organization of prisons and security measures of Ilam (include central prison of Ilam, vocational training and occupational integration of Dalab, prison of Darehshahr and juvenile institution). Data was collected with HSE job stress scale, Allen and Meyer's Organizational Commitment Questionnaire, and Paterson job performance questionnaire.Data was analyzed by using SPSS version 20 and general linear model, ANOVA and Pearson correlation coefficient.Findings: The results showed that the mean stress score (± SD) was in the central prison of Ilam, vocational training and occupational integration of Dalab, prison of Darehshahr and juvenile institution 74.98 (81.14 ±), 60 . 95 (08.15 ±), 12.99 (12.19 ±) and 71.85 (71.15 ±), respectively. It also was found that there was no significant relationship between job stress and organizational commitment, but there was a statistically significant relationship between job stress and job performance.Conclusion: Job stress had no significant effect on organizational commitment prison, but had a significant effect on job performance. Implementing appropriate measures is essential to manage, reduce or eliminate occupational stress and its stressors for increase of personal health and the quality and quantity of their job performance.

Background: Discriminant analysis and classification is one of the most practical statistical parts in various scientific scopes. Classical statistics methods have such prior hypothesizes that they should be considered; otherwise using these methods can cause some noticeable errors. For this reason, researchers tend to choose the methods with less limitation, such as nervation, so they don' t need to a specific kind of prior hypothesis.Methods: For conducting this research, is used logistic regression method, quadratic discriminant and artificial neural network method for comparison. In this study the participants are 1000 case-control data, who suffered from Myocardial Infarction. Neural network analysis was done with error least squares criterion, and is used Error Back-Propagation algoritm. Then is compared the function of three different BFGS Conjugate, gradient and Gradient descent algorithm of neural network for diagnosis of the stated illness. For analyzing data, is used SPSS, STATISTICA and R-SAS softwares.Findings: Based on quadratic discriminant method, prediction error percent, prediction correct percent, sensitivity, specificity and area under the roc curve are 10.15, 89.85, 0.8888, 0.9083 and 0.922, based on logistic regression method these measurements are 10.88, 89.12, 0.8743, 0.9110 and 0.941. And for artificial neural network method these measurements are 3.97, 96.03, 0.9561, 0.9644 and 0.966. There was a meaningful difference between are a under the Rroc curve for these three methods. Also, between three different algorithms, nervation algorithm BFGS has had the best function.Conclusion: The present findings show that the artificial nervation is more accurate for diagnosising Myocardial Infarction illness compared with logistic regression and quadratic discriminant methods.

Background: Although the relationship between number of teeth and gastric disturbances has been recognized, limited data are available linking tooth loss and irritable bowel syndrome (IBS). This study aimed to investigate the relation between dental status and IBS among Iranian adults.Methods: In a cross-sectional study on 4012 Iranian adults, dental status was evaluated using a self-administered questionnaire. Participants were categorized into three main groups: those with full dentition, individual who had lost 1-5 teeth and those who had lost more than 5 teeth. IBS and its subtypes were defined using Rome III criteria.Findings: After adjusting for different confounding variables, those who had lost 1-5 teeth had 1.33 times greater odds for IBS than fully dentate subjects. After controlling for different confounders, individuals who had lost 1-5 teeth had 37% greater chance to have constipation-predominant IBS than those with full dentition (Odds ratio: 1.37, 95% confidence interval: 1.01-1.86). Neither in crude nor in adjusted models was any significant association between dental status and other subtypes of IBS. In addition, we did not find any association between losing more than 5 teeth and IBS.Conclusion: We found that losing 1-5 teeth was significantly associated with increased risk of IBS, particularly the constipation-predominant subtype. This association was seen in men, but not in women. There should be further studies to confirm these findings.

Background: Effluents containing synthetic dyes are hazardous to ecological systems and public health. Adsorption process is one of the treatment methods that has been attracted much attention in recent years. Therefore, the purpose of this study was to survey the feasibility of using zinc oxide (ZnO) nanoparticles stabilized on activated carbon to the methylene blue dye adsorption from synthetic wastewater.Methods: The study was conducted in the batch system. The stabilization of the nano particles on the adsorbent, in order to increase the sorption properties, was carried out by thermal procedure. The effect of various parameters including the nano particles loading, pH, contact time, dye concentration and adsorbent dose was studied on the adsorption. The reaction kinetics and adsorption isotherm was also studied.Findings: The sorption capacity of the dye by the modified activated carbon (with dye concentration=50 mg/l, adsorbent content=0.3 g/l and contact time=120 min) at the various loadings of nano particles (0.01, 0.1 and 0.5 g per gram of the adsorbent) was 16.6, 16.45 and 14.52 mg/g, respectively. The sorption capacity of the modified activated carbon (16.6 mg/g) was higher that of the raw sorbent (6.47 mg/g).Conclusion: The study showed that activated carbon modified with ZnO nanoparticles can be used as an effective method to remove Methylene blue dye in the aqueous solutions.

Background: Chromium is one of heavy metal that is found in industrial effluents. Due to its negative effects on living organisms and environment the concentration in waters that discharge to receving ecosystem must be decreased. The aim of this study was to find out the efficiency of NH4Cl-induced activated carbon (NAC) for the removal of Chromium (VI) from aqueous solutions and comparison with commercial activated carbon.Methods: In this Study, the effects of pH, initial concentration of Chromium (VI), adsorbent dose, contact time, also adsorption isotherm and kinetic of NAC and SAC for removal Of Cr (VI) was determined.Findings: The result showed that NH4Cl-induced activated carbon (NAC) can be removed more than 90% Cr (VI) in the concentration 50 mg/l with optimum dose 1 gr/l NAC and pH 2, 30 minute in contact time.The adsorption kinetics fitted well using the pseudo second-order kinetic model; however, the adsorption isotherm could be described by the Langmuir model. The maximum adsorption capacity for NAC and SAC was obtained 142.85 and 63.69 mg/g, respectively.Conclusion: The result showed NAC compared with SAC was an effective and inexpensive adsorbent, for removing chromium (VI) from contaminated waters.

Background: Exposure to metals is discussed as a risk to human health and environment. Determination of elements in different solutions, is an introduction to the prevention and control of exposure to metals. The sample preparation procedures are used to facilitate the analysis methods. In this study, nanozeolit Y based solid phase extraction for concentration of trace amounts of Cd2+and Cr6+from aqueous solutions have been proposed.Methods: Solid phase was evaluated with encapsulation of ligand in the micelles of Triton X-100 where these setting were loaded on the pore of nano-Zeolite Y. The prepared solid phase was investigated in various PH, ligand concentrations and shaking time. Metal extraction at the trace concentration from optimized solid phase was measured and validated by flameless-atomic absorption spectroscopy.Findings: Standard curves for both metals after extraction in the range of 5 to 80 micrograms per liter, with a correlation coefficient of 99% was obtained. CV (Coefficient variance) of the within- and between-day for the chromium (VI) and cadmium (II) extraction from the optimized solid phase at different concentrations were less than 10%.Conclusion: Results indicate that inhibition of the chelator such as APDC in the micelles of Triton X-100 can trap the metals in very small quantities. Investigation of various factors such as reproducibility and accuracy of extraction showed that functionalized nanozeolit Y has operated successfully in Cd2+and Cr6+extraction.

Background: In this paper, we study the Regression clustering using Dirichlet processes to achieve a comprehensive insight about the status of children and adolescence’s healthbased on Iranian national studies. This clustering approach, as well as removing the effects of troublous factors in clustering and obtaining more accurate analysis, estimates the number of clusters and their patterns In the present study, subjects of the sample are clustered according to the cholesterol index and Food blood sugar (Fbs) which are known as risk factors of cardiovascular disease and diabetes. Furthermore, the effects of the anthropometric index, category of age and sex on clustering are evaluated.Methods: To estimate unknown parameters of model, in a Bayesian approach, we adopt Markov chain Monte Carlo simulation methods using OpenBUGs software. In addition, to get a correct view of the number of patterns on the risk of cardiovascular disease and diabetes based on Fbs and the cholesterol index, the Dirichlet Process is applied.Findings: The anthropometric index, category of age and sex as explanatory variables were entered in the model and effects of them were removed. Then, three clusters were obtained. Percentages of allocated subjects to clusters one to three are 47% (1310 persons), 4% (112 persons) and 49% (1366 persons), respectively. By analyzing the first and the third quantiles of the Fbs and the cholesterol index in each cluster, it is revealed that the allocated subjects to the third cluster, who consist a significant part of the sample, are assumed to be at the risk of both cardiovascular disease and diabetes. Moreover, people in the first cluster have normal levels of Fbs and the cholesterol index and the subjects allocated to the second cluster have dangerous level of Fbs and normal level of the cholesterol index.Conclusion: In clustering of children and adolescence based on Fbs and the cholesterol index, category of age, sex and the anthropometric index were known as influential factors on estimating the number of clusters and creating their structures. Also, three clusters are obtained based on this study: subjects with the safe status, subjects at the risk of diabetes and subjects at the risk of both cardiovascular disease and diabetes.

Background: During the past few years, social marketing has been used frequently to affect the health behavior. Advertisement has a key role in the preservation of organizations as a factor in marketing by introducing different products. In other words, advertisement is one of the popular marketing tools which improves the market and increases the use of the products. The aim of this study is to investigate the effect of giving promotional-educational programs including brochures, commercial videos, and consulting on the consumption of fast foods on Sama Elementary School students.Methods: This half-experimental study was done on 56 girls and boys from Sama Elementary School in two experiment and control groups. The tool of gathering the data was a questionnaire which had two parts including basic questions and questions about fast food usage based on previous studies. This questionnaire was completed in pre-test. Later, based on the results, the promotional-educational program including brochures, commercial videos, and consulting was shown to the under-study group. After three weeks, the second test was given to both groups and the results were analyzed by testing different hypotheses including the Variance Analysis Hypothesis.Findings: The results showed that there is a positive relationship between the promotional-educational programs brochures, commercial videos, and consulting and the decrease in the consumption of fast foods.Conclusion: Promotional - training program to reduce Fast food consumption in the nutritional behavior of the students in this study had a positive effect. Considering to the low level of awareness of elementary school students and to improve their nutritional behavior to reduce Fast food consumption, Using the promotional-training program is necessary.