Payesh
Year:2015 | Volume:14 | Issue:2|Papers Count:14

Objective (s): The aim of the present study was to investigate the relationship between human development and mortality of under five children in Iran during 1981 to 2011.Methods: The ordinary least square regression analysis was used to identify the causal relationship between human development index and mortality rate of under-five years children during the study period. The required data for analysis were collected from the Iranian Statistical Center, the World Bank and the United Nations Human Development Reports.Results: The results showed that there was a negative and meaningful relationship between human development index and mortality rate of under-five years children during the study period. Moreover, the analysis showed that there was a positive and meaningful relationship between mortality of under-five years children and inflation rate, unemployment level and Gini coefficient for income distribution.Conclusion: Socio-economic programs conducted by the government should basically focus on education, income distribution, employment and health status aiming to improve the human development index and thereby decrease mortality rate among under five years children in Iran.

Objective (s): Healthcare system can have direct and indirect effects on a country’s income and output. This paper examines the impact of per capita public and private health expenditures on per capita GDP for Iran during 1379-1384.Methods: For the model selection and estimation the panel data econometrics were used and for the estimation of coefficients the EViews software was applied. The data were explored using regression analysis and statistical inference.Results: The results obtained from panel model with fixed effects estimation showed that government per capita health expenditures had positive (0.85) and significant effect on GDP per capita. The results indicated that per capita private health expenditures had also positive (0.08) effect on GDP, though this effect was not statistically significant.Conclusion: The positive and significant effect of public sector expenditures on healthcare emphasizes the prominent and leading role of the government in improving healthcare and per capita income in the country. In addition, the positive effect of private sector spending on healthcare indicated that government should pave the way for private and NGOs activities.

Objective (s): One of the indicators used in evaluating the emergency department is patient’s waiting time for receiving diagnostic services and treatment. This study aimed to determine trauma patients' waiting time referred to an emergency department.Methods: In this cross-sectional study, a sample of trauma patients referred to an emergency department affiliated to Hamedan University of Medical Sciences in Hamadan, Iran were studied using the convenience sampling method. Data were collected using a designed questionnaire and explored by performing descriptive statistics.Results: In all 391trauma patients were studied. 79.5% of trauma patients referred in evening and more than half of participants attended themselves to the emergency department. The mean waiting time to be visited by a general physician was 3.9 minutes. The mean waiting time to be visited by a resident and intern was 77.1 minutes and 88.9 minutes respectively. Delay time for performing the first consultation was 35 minutes.35% of delay was related to lack of guide boards, and 47.3% and 33% of factors were related to lack of personnel for per forming services and that patients were agitated, respectively.Conclusion: Waiting time for trauma patients was more than the standard. Indeed reducing waiting time in emergency departments is essential.

Objective (s): Mothers and infants are considered as vulnerable groups. Maintaining and improving their health are very much dependent on quality and accuracy of health information. Thus providing timely information is essential for monitoring and evaluating maternal and neonatal health condition. Since this information is organized in perinatal health information systems in developed countries, this study was conducted to present a model of perinatal information management system in Iran.Methods: This was an applied and mixed method study (qualitative-comparative and Delphi) conducted in 2013. Perinatal information management systems in Australia, Canada, New Zealand, America, England and Iran were studied and compared via library sources, the Internet, available documents, and correspondence with authors. Comparative tables were provided to analyze the data. Then, the initial model for perinatal information management system was suggested and a questionnaire was developed. The questionnaire was tested by Delphi technique in two rounds. Finally, items by more than 75 percent were added to the model.Results: The final model was presented in three major topics: goals, structures and mechanism of data collection. In this model, 32 goals were confirmed. Responsible organizations, monitoring organizations, committees and centers of data production in the axis of structure were determined. In data collection mechanism, data sources, media types, long range data transmission, data collection processes, privacy and data security procedures were also examined.Conclusion: The proposed model is expected to serve as a basis for improving the quality of perinatal health information, exchanging health data and achieving an integrated information management system.

Objective (s): Breast cancer screening is an important approach for early detection of the disease. Different factors such as demographic variables, awareness, literacy, social and economic conditions are effective in breast cancer screening behaviors. However, there is no formal screening program for breast cancer in Iran. This study was conducted to investigate the factors affecting breast cancer preventive behaviors among Iranian women.Methods: A systematic review of the Persian literature that published in Iranian biomedical journals was conducted using two search engines (SID and IranMedx). A combination of several key words including breast cancer, screening awareness was used to retrieve papers.Results: In all 30 papers were included in the review. The reported awareness level had fluctuation between 14 to 73 percent. The breast self-examination by best estimate was between 1.8 to 19.3 percent. Annual clinical breast examination was reported to be 3 to 26 percent. The commonest factors affecting breast cancer unpreventive behaviors included: the fear of detecting the disease, unawareness of the screening plans, being too busy, lack of breast problems, forgetfulness, indifference, and lack of necessity for screening.Conclusion: The findings confirm that awareness of the Iranian women on breast cancer preventive behaviors is low. In addition, the use of screening methods (self-examination, clinical examination, and mammography) was also low. It seems that women awareness should become the central part of any effort in breast cancer prevention in Iran.

Objective (s): Maintaining independence and attending to the bio-psychosocial needs of elderly always have been one of the main goals of caregivers and policy-makers. This study was carried out to investigate the psychometric properties of the Persian version of Care Dependency Scale (CDS) in older people nursing home residents.Methods: This study was carried out during 2011 and 2012 among a sample of 100 older people 65 years and older residing in nursing homes in Ahvaz, Iran. First, the English version of the CDS was translated into Persian language. Then, psychometric properties of the questionnaire were assessed by several tests. To examine reliability, the Cronbach’s alpha coefficient and test-retest reliability analyses were performed. Construct validity was determined using exploratory and confirmatory factor analyses and concurrent validity was carried out using the Modified Barthel Index.Results: The Exploratory and confirmatory factor analyses indicated that CDS has 2 factors including psycho-social (65.73% of the variance) and somatic (8.71% of the variance) factors. Internal consistency as assessed by the Cronbach’s alpha coefficient was 0.95, test-retest reliability was 0.99 and it showed excellent correlation with the Modified Barthel Index (r=0.90).Conclusion: The results study indicated that the Persian version of the CDS is reliable and valid measure for assessment of care dependency and to determine care needs among older persons.

Objective (s): Childhood obesity and sedentary lifestyle are one of the most serious public health challenges. Physical activity and exercise are an important way to prevent obesity and its consequences. The purpose of this study was to evaluate factors affecting physical activity in female high school students.Methods: The Pender’s health promotion model served as the framework for this cross-sectional study, which included a total of 500 female high school students in Kashan, Iran. The data were collected through interviews. The interviewers were conducted based on health promotion model (self efficacy, perceived affect, perceived barriers, perceived social support, self esteem). The data were explored using path analysis.Results: All constructs of the health promotion model except perceived barriers were significantly related to the girls’ physical activity. Self-esteem (b=0.46, p<0.001) had the highest correlation with the girls’ physical activity. All constructs of the health promotion model accounted for 52% of variance for physical activity.Conclusion: The results of this study demonstrated that the health promotion model predicted variance in physical activity among students. Theory-based interventions focusing on self-esteem and self-efficacy should be implemented to improve physical activity among female students.

Objective (s): Human papilloma virus (HPV) is a leading cause of cervical cancer and sexually transmitted infections are common health problems among young females. This study aimed to assess knowledge, attitude and acceptance of the HPV vaccine in female students of a medical university.Methods: The present cross sectional study was conducted on 202 female students. Data were collected using a questionnaire containing items on demographic, items related to knowledge, attitudes, and acceptance of the HPV vaccine.Results: The findings showed that the majority of students (66.8%) had poor knowledge and in 5% of cases the level of knowledge level was found to be good. About 25 percent of students had a positive attitude and 2.5 percent had negative attitudes toward the HPV vaccine. Over 70% of students reported if vaccine were available, they are willing to receive it. The regression model showed that age was related to the level of knowledge (b=0.36, p<0.0001). Knowledge of nursing and midwifery students was higher than others (p<0.0001). Married students were more aware than singles (p=0.05). Linear regression analysis showed that there was no significant relationship between the level of knowledge of cervical cancer and attitudes towards cervical cancer vaccine. Logistic regression model, had showed a significant relationship between knowledge of cervical cancer and acceptance of the HPV vaccine (OR=1.8, and p<0.01). Attitudes toward vaccines (OR=1.6, P<0.000), and marital status (OR=5.1, P=0.02) were predictors of vaccine acceptance.Conclusion: Due to lack of programs related to prevention of human papilloma virus and vaccination in the country, implementing community awareness and prevention programs seem essential.

Objective (s): Infertility affects 9% to 15% of the childbearing women population Infertility is a major life crisis and can lead to depression, anxiety, social isolation and sexual dysfunction. This study aimed to investigate about the effect of an educational package on self-efficacy of infertile women.Methods: This experimental study carried out in a reproductive health center affiliated to Tehran University of Medical Sciences in Iran in 2012. A sample of 104 infertile women attending the center was randomly allocated to intervention and control groups. The intervention group received an educational program in four sessions on four consecutive weeks. Each session lasted for 60-90 minutes. In addition, a booklet was given to the intervention group. The control group only received usual care. Both groups completed the questionnaires at two points in time: at baseline and six weeks after the last educational session. Data were collected by a questionnaire including items on demographic and infertility self-efficacy scale (ISE). Data were analyzed using chi-square, paired t-test and independent sample t test.Results: There was no significant difference between the two groups at baseline. However, there was a significant difference between self-efficacy scores in two groups after intervention (P<0.0001).Conclusion: The findings showed that the educational package was effective in increasing self-efficacy of infertile women. Indeed, implementation of programs to improve self-efficacy in women is recommended.

Objective (s): The aim of this study was to compare empathy components and cognitive emotion regulation strategies in students with and without vulnerable and grandiose narcissistic traits.Methods: In this cross sectional study, a sample of 90 students was selected using the Pathological Narcissistic Inventory. The Baron-Cohen Empathy Quotient Scale and the Cognitive Emotion Regulation Questionnaire were used to collect data. The data were analyzed using MANOVA.Results: The results showed that both students with grandiose and vulnerable narcissistic traits were significantly different in using 'self-blame and catastrophizing' emotion regulation strategies, compared to non-narcissistic students. Non-narcissistic students significantly used ' positive appraisal' strategies more than vulnerable students. There was a significant difference in cognitive empathy and emotional reactivity, between grandiose and non-narcissistic students. Vulnerable and grandiose students were significantly different only in cognitive empathy.Conclusion: The findings provide support for the idea that grandiose and vulnerable narcissism are different expressions of the same pathology, and their expression depends on the individual defensive structure.