Journal of Health System Research
Year:2013 | Volume:9 | Issue:4|Papers Count:15

A growing number of observational and epidemiological studies have suggested that mental illness, in particular mood disorders, is associated with decreased dietary intake and/or cellular abundance of omega- 3 polyunsaturated fatty acids (PUFA). This has prompted researchers to test the efficacy of omega-3 PUFA in a range of different psychiatric disorders. We have critically reviewed the double-blinded placebo controlled clinical trials published prior to April 2009 to determine whether omega-3 PUFA are likely to be efficacious in these disorders. Most trials involved a small number of participants but were largely well designed. Omega-3 PUFAs were well tolerated by both children and adults with mild gastrointestinal effects being the only consistently reported adverse event. There was little evidence of a robust clinically relevant effect for schizophrenia. In the case of attention deficit hyperactivity disorder (ADHD) and related disorders, most trials showed at most small benefits over placebo. A limited metaanalysis of these trials suggested that benefits of omega-3 PUFA supplementation may be greater in a classroom setting than at home. A meta-analysis of trials involving patients with major depressive disorder and bipolar disorder provided evidence that omega-3 PUFA supplementation reduces symptoms of depression. Furthermore, meta-regression analysis suggested that supplementation with eicosapentaenoic acid may be more beneficial in mood disorders than with docosahexaenoic acid (DHA); although several confounding factors prevented a definitive conclusion being made regarding which species of omega-3 PUFA is most beneficial. The mechanisms underlying the apparent efficacy of omega-3 PUFA in mood disorders compared to schizophrenia were discussed as is a rational for the possibly greater efficacy of eicosapentaenoic acid compared to docosahexaenoic acid. While it is not currently possible to recommend omega-3 PUFA as either a mono or adjunctive-therapy in any mental illnesses, the available evidence is strong enough to justify continued study, especially with regard to attention, anxiety and mood disorders.

Background: Nurses are always faced with workload and lack of human resources and on the other hand they must play their family roles as well. According to needs of coordination between work and family tasks, this may have some effects on quality of life. This study aimed to assess work and family conflicts and its association with quality of life (QoL) among clinical nurses.Methods: This was a cross-sectional study with simple randomization which was conducted on 60 nurses who worked in three university hospitals of Tehran. The study tools included demographic information, Carlson’s Work-Family Conflict Scale and 36-Item Short Form Health Survey (SF-36). The significant level was set at 0.05.Findings: Result of the study revealed that work conflict with family was more than family conflict with work which time and role conflicts were more significant domains. Furthermore, these two variables had significant, linear and direct association to each other (r=0.388; P<0.001).Quality of life of many nurses was moderate. QoL had a significant and indirect association with work conflict with family (r=-0.469; P<0.001) and family conflict with work (r=-0.282; P<0.005).Conclusion: It seems that some strategies must be performed to decrease the work-family conflicts in workplace among clinical nurses.

Background: Smoking in adolescent is an important health issue. It is a serious high-risk factor for other risk behaviors in later adulthood. Regarding the start of smoking in lower ages and also the relative risks, giving attention to the level of knowledge and preventive behaviors of smoking is important in adolescents. Therefore, the present study aimed to determine the effectiveness of educational program on promotion of smoking preventive behaviors in adolescences.Methods: A quasi-experimental study was carried out in the secondary school male students (2nd grade) of Shiraz, Iran in academic years 2009-2010. Before starting the study, a baseline study was carried out and two schools were selected; then a total number of 240 students were randomly selected for the intervention (n=120) and the control (n=120) groups. A questionnaire was designed for the prevention group, and then the data were collected after two months in both groups. Data were analyzed using independent ttests, paired t-test, McNemar’s test and chi-square test.Findings: The results showed that educational intervention had a significant effect on intervention group’s average response for knowledge of smoking side-effects (P<0.0001) in addition to average response for the preventive behaviors (P<0.0001).Conclusion: Given these findings, educational programs must be applied for promotion of smoking preventive behaviors for controlling and prevention of tobacco use among adolescents.

Background: Silicosis is a lung disease with irreversible and slow evolution which is one of the occupational diseases, and has no symptoms in the early stages, and the main symptoms are exclusively radiological signs. Symptoms are depending upon age, individual susceptibility, working history, smoking and exposure time. The aim of this study was to review the prevalence of silicosis and its related factors among the stone carving workers in Khomeinishahr, Iran.Methods: This cross-sectional study was conducted using census method on 70 stone carving workers.Required data were obtained by workers’ form No.1 for check-ups and form S-5 for workers exposure to silica. Chest X-Ray was obtained from all the subjects and was examined by an occupational medicine physician. Data were analyzed through chi-square, Mann-Whitney and independent t-test.Findings: The mean age of patients with silicosis was 46.4±18.4 years.28.57% of the patients had less than 20 years of experience. Besides 3 out of the 7 patients with this disease were smokers. Chi-square test showed a statistically significant association between smoking and risk of silicosis (P=0.05). Independent t-test showed no statistically significant association between experience and age in silicosis patients.Conclusion: Due to the risk of 15.6% among the workers, occupational health authorities have to provide more accurate plans for improving workplace conditions, timely medical examination and control of harmful agents in the workplace to protect and maintain the health of such individuals.

Background: There are high numbers of human pathogenic microorganisms existing in municipal sewage sludge including bacteria, viruses, and protozoan parasites. Therefore, biosolids could be considered as the environmental contaminants and a major carrier of disease causing diseases. As the etiological agents of acute gastroenteritis and hepatitis, enteroviruses are one of the most significant enteric pathogens affecting human health. The aim of this research was to detect the enteroviruses in the sludge of two wastewater treatment plants (WWTP) in Isfahan, Iran.Methods: In this study, 30 biosolid samples were taken from two WWTPs. After measuring the temperature, the samples were transported to the laboratory and analyzed for total solids (TS), volatile solids (VS) and enteroviruses according to the test methods of Standard Methods (part 9510F) and manual of Control of Pathogens and Vector Attraction in Sewage Sludge from Environmental Protection Agency (EPA) appendix F.Findings: Average temperature of the samples was about 23o C. The average number of enteroviruses was 4.5×106 and 7.7×105 plaque-forming unit (PFU) in 4 grams sludge for two WWTPs, respectively. The statistical analysis revealed a significant association between the enteroviruses and volatile solids. The number of enteroviruses was higher in summer in comparison to autumn.Conclusion: The results showed that all the biosolid samples could not meet the Class A pathogen requirements for enteroviruses and poses a potential health risk for people exposed to. Therefore, restrictions in land application of biosolids are required in order to protect public health and the environment. Moreover, special biosolid treatment procedures must be used to reduce pathogens and to meet land-application standards.

Background: The present study aimed to determine the association between constructs of the health belief model (HBM) (i.e. perceived susceptibility to smoking health-related problems, perceived barriers to nonsmoking, perceived benefits of non-smoking, and perceived self-efficacy to non-smoking and cues to action of non-smoking) and cigarette smoking among male pre-university students.Methods: A cross-sectional survey of 382 pre-university students was conducted in Isfahan, Iran in 2011. The sampling method was systematic randomized and students were selected from eight schools. The instrument was developed by the researchers based on the HBM. Statistical analysis was carried out using chi square and independent t-tests.Findings: The mean age of students was 17.72±0.62 years. In total, 7.2% of the subjects reported smoking in the past 30 days and 32.7% of them also reported ever having smoked in their lifetime. Results of ttest showed that there were significant differences in knowledge, perceived susceptibility (P=0.03), benefits (P= 0.01), self-efficacy (P<0.01) and cues to action (P=0.07) between smokers and non-smokers.Conclusion: The results suggested that constructs of HBM can be incorporated when examining the predictors of cigarette smoking and developing smoking preventive programs among pre-university students. In addition, with a better understanding of factors affecting this complex behavior (cigarette smoking), it can be a useful step to reduce rate of mortality, costs, and improve community health outcomes.

Background: Breast cancer is the most frequently occurring cancer among women worldwide so that, if detected in early stages, it would be controllable. Mammography is considered as the most exact means of detecting breast cancer in the earlier stages. This study evaluated and compared the effectiveness of three educational interventions on knowledge and health beliefs regarding breast cancer screening behaviors in women above 40 years in Isfahan, Iran.Methods: This population-based, experimental study was conducted on 96 women above 40 years in Isfahan, Iran. These women were randomly divided into three interventional groups (group education along with book, group education, and mailing the book by post). Data collection tool was a three-part questionnaire which covered demographic data, knowledge questions and questions about constructs of the health belief model (HBM) (based on Champion’s health belief model questionnaire). The obtained data were analyzed using descriptive and analytical statistics such as chi-square, paired t-test and one-way analysis of variance (one-way ANOVA) at the set significance level a=0.05.Findings: There was no statistical significant difference in mean scores of the knowledge and the HBM constructs between the three groups before the intervention. Whereas three months after the intervention, there was a statistical significant difference observed in mean scores of the knowledge and model structures between the three groups. The statistical tests showed a statistical significant difference between the mean scores of the knowledge and most of the HBM’s constructs before and after three months of intervention in each of the study groups (P£0.001).Conclusion: Among the methods examined in this study, group education along with books has been increasingly awarded. As a result, their perceived sensitivity, severity, and perceived benefits increased and perceived barriers to mammography decreased. This issue demands to the design of combined educational programs.

Background: The aim of this study was to determine the effects of educational program on fruit and vegetable consumption among the fourth grade elementary school students.Methods: This experimental study randomly divided 138 students into intervention group (n=68) and control group (n=70). Data collection tool was a self-administered questionnaire and food recording and food frequency questionnaire. The validity and reliability of the questionnaire was provided using content validity, face validity and internal reliability (a=0.86). The six 60-minute educational sessions were conducted during one month. Data of the two groups were collected before and three months after the educational intervention. Finally, the data were analyzed using chi-square, t-test and paired t-test.Findings: Findings of this study showed that mean scores of the knowledge (P<0.001), attitude to action (P<0.001) and social support (P=0.030) were significantly increased in the intervention group compared to the controls after the intervention. Moreover, the number of serving intakes regarding the fruit and vegetable has been increased significantly in the intervention group (P<0.001).Conclusion: Our findings suggested that nutritional education is an accessible effective tool in health promotion programs with a focus on development of healthy nutritional practices.

Background: One of the diseases in the present century, which unfortunately affects the youths particularly the young girls and women, is the multiple sclerosis (MS). The cause of this disease is still unclear in the view of medical specialists in the whole world. Given numerous number of MS patients and importance of identifying effective acts to promote their quality of life (QoL), this study accomplished to review the association between social support and the QoL of MS patients.Methods: This descriptive study selected 230 MS patients with simple random sampling method (164 females and 66 males). MS in Isfahan, Iran was measured with a questionnaire. The variables included socioeconomic, socio-cultural, services, patient relative recovery, life satisfaction, enhanced social status, sense of security, confidence, devotion and depression supports in a Likert scale measure. After determining the reliability and validity of the primary study, the final data were analyzed using descriptive statistics and Pearson’s correlation coefficient.Findings: Results of this study showed that there were 71.3% females, 35.7% married, and 30.9% employed subjects. Results showed that there was a statistical significant association between the social support and life satisfaction, enhanced social status, and life expectancy, motivation for accepting the disease and symptoms, increased confidence in MS patients (r=0.28; P<0.0001).Conclusion: The results suggested that the importance of social support can lead to a sense of satisfaction with life and hope in MS patients. However, the social supports financially, educationally, in terms of training and serviced may have an impression on MS patients’ welfare, but due to lack of a definite treatment for this disease, all the social support cannot have a statistical significant association with the relative improvement of the said sufferers.

Background: Nutritional education is a necessity in diabetic patients to better control of the disease. The aim of this study was to determine the effectiveness of educational programs to promote nutritional knowledge in type II diabetes patients using the health belief model (HBM).Methods: This was a quasi-experimental study which was performed among type II diabetic patients referred to rural health centers in Gachsaran, Iran. Thus, after obtaining permission from officials of the health center in Gachsaran city and coordination with rural health centers, two centers as the intervention group and two centers as the control group were randomly selected, and then for study enrollment, 140 of the patients (70 patients in control group and 70 patients in intervention group) were selected in simple random sampling method among the patients; intervention group received the intended educations and were taken final assessment after 3 months of educational intervention in both groups.Findings: The results showed a statistical significant difference after the implementation of educational programs in the intervention group in the mean knowledge scores, perceived severity, perceived susceptibility, perceived benefits and perceived self-efficacy and decreased perceived barriers (P<0.05).Conclusion: The results demonstrated usefulness of implementing educational programs among intervention group concerning the promotion of nutritional knowledge.

Background: Current studies show high increase of obesity worldwide. Regarding the increment of prevalence of obesity, overweight and central obesity in Iranian community and its association with lifestyle and social and professional structures, anthropometrics indices and the prevalence of mentioned problems need to be assessed in future studies. The present study aimed to determine the prevalence of overweight, obesity and central obesity among students of School of Medicine in Isfahan University of Medical Sciences, Isfahan, Iran.Methods: In this cross-sectional study, 215 students of different courses and degrees in School of Medicine were selected by cluster randomized stratified sampling method. The questionnaires were completed and their anthropometrics were determined by a standard protocol.Findings: None of the females and 5.88% of the males afflicted with overweight (Body Mass Index or BMI>25); none of the females and 3.92% of the males with obesity (BMI>30), 5.31% of the females and 4.95% of the males with central obesity. There was a slight difference between the subjects with or without these disorders. The prevalence were directly associated with the age increase and family history.Conclusion: There were no statistical significant differences regarding the prevalence of obesity, overweight and central adiposity in different age, sex and family history groups.

Background: After conducting a study on shift work and its related health problems in a petrochemical company and recommending a new shift system, the company changed its shift schedule from 12-hour to 8-hour pattern. After a year of implementing this new system, the present study was carried out to evaluate the effects of this change on health problems of shifting workers.Methods: In this cross-sectional study, the subjects consisted of 79 shifting workers of the present study and 74 shift workers from the previous study. Data were collected by an anonymous questionnaire, similar to the one used in the previous study, in which questions on demographic characteristics, health problems and workers’ views about shift pattern change were included.Findings: Mean working experience in shift work workers of the present and the previous study were 5.91±2.40 and 5.18±3.79 years, respectively (P>0.05). The results showed that the prevalence of some gastrointestinal and musculoskeletal problems in the present study were statistically and significantly higher than those of the previous study (P<0.05); however, the prevalence of some psychological disorders were lower in the present study subjects as compared to the individuals of the previous study (P<0.05). The results revealed that from the viewpoint of shift workers, new shift pattern improved quality and quantity of sleep. Furthermore, the findings showed that 97.5% of the subjects evaluated the new shift schedule to be better than the previous one.Conclusion: Based on the findings, changing the shift pattern from 12-hour to 8-hour system resulted in decreased prevalence of psychological problems, improvement of sleeping quality and improvement of their lives. It is, therefore, concluded that the change implemented in the shift pattern was useful, and most subjects evaluated it to be effective and positive.