Payesh
Year:2006 | Volume:5 | Issue:3|Papers Count:10

Objective(s): The aim of this study was to determine the opinions of gynecologists and general physicians working in Kerman city about legal abortion.Methods: This cross-sectional study carried out in Kerman. A random sample of 30 gynecologists and 110 general physicians participated in the study. Data collection was carried out by an investigator using a valid questionnaire.Results: The majority of respondents were female (62.1%) and 49% working in a university. Fifty-nine percent of sample believed that there were frequent criminal abortion and all agreed that one way to reduce the mortality of pregnant women is need for a proper legislation. Among the 9 indications for legal abortion, the highest degree of agreement was related to major thalassemia (99.3%) and an HIV-positive mother (96.4%). The lowest agreement rate was seen for severe heart disease- stage II (40%) and mother’s major depression with suicidal thoughts (65.5%).Conclusion: In spite of the existing indications for therapeutic abortion, many participants either had no opinion or disagreed. In order to have newborns and prevent mortality of pregnant mothers there is need forContinuing Medical Education (CME) on legal abortion.

Objective (s): The purpose of this paper is to determine the prevalence and psychological factors of smoking among 1785 students at 30 high schools in Tabriz.Methods: Each student completed a self-administered questionnaire. The intention was to obtain information on smoking, self-esteem, and attitude toward smoking as well as demographic information. Respondents were classified into three categories of never smoker, occasional smoker and regular smoker. Multivariate logistic regression analysis was used to determine the association between smoking status and the independent variables.Results: The prevalence of ever smoking was 22.6% but only 4.4% of the students were regular smokers. Prevalence was higher among students who had experienced alcohol (OR=1.53) and illicit drugs (OR=9.99). Prevalence was also higher among students who had a positive attitude toward smoking (OR=1.26).Conclusion: Smoking prevention programs for adolescents should be adapted at each stages of smoking. The finding has important public health implications, but further research is required to determine if the association was causal.

Objective (s): To determine the relationship between cervical length at 16 and 24 weeks of gestation and the occurrence of preterm labor.Methods: A prospective cohort study was performed on 153 pregnant women in two groups (75 and 78 person) after measuring cervical length with vaginal sonography. We calculated the incidence preterm labor in both groups, plus the sensitivity, specificity, positive and negative predictive values for cervical length.Results: The incidence of preterm labor was 17.3% (13/75) in the group with cervix length of less than 35 mm and 6/4% (5/78) in the group with cervical length ≥35 mm. The relative Risk was 2.7 (95% CI=1.3-4.5). Sensitivity, specificity, positive and negative predictive value of cervical length on preterm delivery with a cut-off point of 35 mm were 72%, 54%, 17% and 93% respectively. In the multivariate analysis of job, education, parity, gravidity and cervical length only cervical length was significantly related to preterm delivery (P<0.01). The cervical length also had a significant correlation with preterm delivery (P<0.001, r=0.61).Conclusion: Cervical length between 16 and 24 weeks of gestation is a strong predictor of preterm labor.

Objective(s): To develop a statistical model to differentiate between patients who need CT Scan and those who did not.Methods: 320 consecutive minor head trauma victims admitted in two teaching hospitals were entered into the study. After completion of medical care, clinical information was collected by physicians. Brain CT Scan was taken from all patients and after clinical use, was filed to be reported by a single radiologist for this research purpose. Logistic Regression method was utilized to analyze results and develop the prediction model.Results: Using logistic regression, a model was developed which showed 100% sensitivity and 74% specificity to detect a positive finding on brain CT Scan Using this model negative finding prevalence in minor head trauma brain scans decreased by 66% while no cases were missed.Conclusion: The proposed statistical model reveals the need for brain CT scan in 70% of minor head trauma victims while preventing any positive findings being missed. This model would be considered as a Clinical Practice Guideline (CPG) in rural areas to refer minor head trauma victims for Brain CT Scan. However, more investigation of this model with more sample size is recommended.

Objective(s): This study seeks to determine the direct cost of wife abuse in the 5 Legal Medicine Centers (LMCs) in Tehran.Methods: This was a descriptive cross sectional study. Given the 18% prevalence of violence against women; with a precision of 5%, a sample size of 225 was estimated. A questionnaire was developed to collect data. The costs were calculated by adding marginal and principal costs. Principal costs included all monetary expenditures related to the medical care services, legal-judiciary follow up, commuting and sundry charges.Results: On average, each woman has spent 132234 Rls for healthcare services. This figure included on average 25156 Rls for visits, 23595 Rls for prescribed drugs, 33483 Rls for radiological studies and 50000 for laboratory tests. Given the total number of 9050 of female victims of the domestic violence attending LMCs in the year 2002, the total medical services was estimated at 280/133/407/Rls. Total legal services charged by the Police Force in 2002 was 1/465/736/910 Rls. In the same period, sundry charges was 320/071/350 Rls. The estimated total costs therefore reached as high as 2/056/941/667 Rls.Conclusion: The study findings indicate that in Iran high expenses of domestic violence is imposed and this needs an urgent attention. Public health inventions might help to reduce the cost of domestic violence against women.

Objective(s): To evaluate the direct and indirect effects of different factors on fertility using the path analysis.Methods: Data were obtained from the research project ''Evaluating the effective elements on the tempo and quantum of fertility in Mazandaran Province in year 2000'', and by a questionnaire containing three sections (demographics, fertility data and family planning). This was a descriptive-analytic study and sampling was performed by a two-stage random procedure. A total of 1343 families were initially included in the study. The research targeted married women aged 10-54 years. We used path analysis to calculate the effect size and 95% confidence intervals for the following set of factors: mothers' age, mothers' education, duration of marriage, age at marriage, and mothers' age at her first pregnancy.Results: In total 1137 women participated in the study. The duration of marriage showed the strongest positive direct effect on fertility (r=0.428); the second strongest positive effect belonged to mothers' age (r=0.203). Mothers' education had the most powerful negative direct effect (r=-0.182). Mothers' age also had the strongest indirect effect (r=0.437), while mothers' education showed the greatest negative indirect effect (r=-0.153). All of the calculated effects were statistically significant (P-Value <0.001).Conclusion: This research illustrated the powerful effect of mothers' education on fertility. There is a potential for effective birth control through modification of factors that have a strong influence on fertility. It is difficult to change all of the factors at once, thus as a first step it might be better to concentrate on duration of marriage and mothers' education.

Objective (s): The aim of this study was to determine the level of knowledge and attitude toward child abuse among general practitioners working in Kerman.Methods: A semi-structured questionnaire was developed based on child abuse literature. 200 physicians participated in this study. 3 questionnaires were filled incorrectly, thus deleted and 197 questionnaires were analyzed. The validity and reliability of the questionnaire were assessed.Results: Most participants did not have adequate knowledge especially in the sexual and psychological aspects. There was a significant relation between knowledge and gender with attitudes toward child abuse.Conclusion: The findings indicated that physicians do not have adequate knowledge and proper attitude regarding child abuse. Implementation of educational programs on child abuse seems necessary for medical students.

Objective (s): To examine nutrition education as perceived by school children and their mothers.Methods: This was a qualitative study using focus group discussion (FGD). The research team consisted of a coordinator, one or two observers and two note takers. Each FGD was held with 6 to 8 person and each session lasted about 60 minutes. The fieldwork activities of the study included 20 FGD sessions, 16 for children grades 1st to 4th and 4 for mothers. The study was held in 2 districts of Tehran. At the end of each group discussion all notes were completed, coded, analyzed and classified by team members.Results: The findings showed that children were eager to learn on effects of healthy foods. Children indicated that TV was the most important and effective teaching medium. In addition to TV, food advertisements, school staff especially teachers were among the most common named on children's nutritional behaviors. Most of children preferred to learn nutritional subjects from father, mother and other family members. The mothers preferred teachers, health instructors’ parents and classmates as the source of knowledge and schools as the most effective place for teaching/or educating nutritional subjects.Conclusion: The study results suggest that children need to learn more about nutrition and foods. Designing longitudinal nutrition education projects aiming at children through TV or other effective media are essential.