Payesh
Year:2012 | Volume:11 | Issue:6|Papers Count:24

Objective (s): Events occurring during life can affect people's physical, mental, social, and even spiritual health.Considering the stage of growth they are in, school age children when facing life events may be more vulnerable than adults and so require more attention in the assessment, treatment received and appropriate actions done by parents, physicians, school administrators, appropriate authority, and policy makers.Methods: A mini review using the words "school", "children", "pupils", "events", "disasters", "accident", and "fire" carried out in official newspapers and news agencies websites in the absence of an office to register the events occurring inside and outside the schools in Iran to access a preliminary image of the subject and what is needed to be done in Iran.Results: The findings of the study showed that similar events occur repeatedly in different provinces in Iran, some with victims more than the number expected. It seems factors such as lack of correct or inadequate training of school personnel, choosing non-standard recreation places for students, non-standard schools, lack of necessary facilities, possible problems in some roads, and … might be involved in occurrence of the events. Despite the high frequency of crises there is not a professionally developed program to reduce the disasters and help events victims to cope with the effects of them.Conclusion: Considering the nature of the crises it seems at least some of these disasters could be prevented and there is a need for developing a practical program as well as using a contingency plan to cope with crises in schools of Iran.

Objective (s): One of the recent reforms in the health system, rural insurance with a focus on family physician and is the referral system. This study was carried out in order to investigate the quality of the referra system in the national family physician plan in Shahroud.Methods: This applied study was carried out in a cross-sectional procedure in 2010. In this study, all the health care centers where the family physician plan was implemented were studied and 800 referred patients were investigated and the checklists and questionnaires were completed by observing the documents and interviewing the patients. The data were analyzed using SPSS, and the results were displayed in frequency distribution tables.Results: In 56.2% of the patients, the necessity of the reference was recognized by the physician, and in 43.8% of the cases, the patients had asked to be referred. In 66% of the cases, the level two physicians had been selected by the patients, and in 34% of the cases, they had been selected by the physician. 53% of the patients had been referred to private surgeries and clinics in level two. One-third of the patients had been referred by health houses and about one fifth of the references had led to patients’ admission to hospitals. Only in 12.5% of the cases were there copies of the references from the family physicians to the health houses. Internists had received the largest number of the referred patients (16%) from level one. The quality of the feedback was desirable only in 8.4% of the patients. There was a significant relationship between the place of reference in level two and the feedback (P=0.002).Conclusion: Although one of the aims of the national family physician plan has been and sill is the improvement of the reference system, the results show that there are serious problems in levels one and two and the removal of these problems will lead to the improvement of the services and consequently to patient satisfaction.

Objective (s): Food insecurity implies a limited ability to secure adequate and safe food or limited or uncertain ability to acquire acceptable foods in socially acceptable ways.This study aimed to identify the food insecurity prevalence and effected causes in urban families in Dezful.Methods: A total of 400 household were randomly selected by two stage sampling from different areas in Dezful. Mothers provided detailed demographic and food insecurity information via a face- to- face interview. Information on food insrcurity was collected using the instrument originally developed by USDA.Results: The prevalence of food insecurity was %37.6. Results showed that, paternal age, education and occupation, race and family size, household with children<18yrs and BMI of mother significantly effective on food insecurity status.Conclusion: Prevalence of food insecurity was high in Dezful urban families and preventive actions must be taken.

Objective (s): To measure inequality in health human resource and hospital beds distribution for Ardebil province and then analyze the relationship between the mentioned resources distribution with maternal mortality rate, under one year children mortality rate and under five mortality rate.Methods: This is a retrospective and applicable research, that all health human resources and hospital beds have made the society of it. The required data has collected from Iranian Statistical Centre and Ministry of Health and Medical Education. The data has been analyzed by using Lorenz curve plotting and then Gini coefficient calculated.Results: Gini coefficient proportion for medicines in head of term was 0.54 and in end of term was 0.44. This proportion for nurse in head of term was 0.51 and in end of term was 0.40 and for specialist medico in head of term was 0.58 and end of term was 0.52. Gini coefficient proportion for psychiatrists in head of term was 0.60 and in end of term was 0.65 and finally this proportion for pharmacist was 0.62 and 0.65 and for hospital sickbed in head of term was 0.60 and in end of term was 0.59.Conclusion: The distribution of health resources is uneven and unbalanced at the Ardebil province. In period of study we observed a little change for decreasing of inequality. In based on this study results, there is a significant relationship between the health resources distribution and maternal, under one age children and under five age children mortality rates.

Objective (s): To assess the obesity among 15-65 years old, some related factors and its comparison among the 11 districts during five years leading to 2010 in Golestan province.Methods: This is a descriptive-analytical study that established on the 6489 cases that were chosen by cluster and random sampling. Sample size estimated based on 0.05 accuracy and 95% confidential interval. Data collected by questionnaire and anthropometric measurements were made for all samples. Obesity defined based on BMI classification. Spss.16 soft-war was used for statistical analysis.Results: Prevalence of overweight and obesity in Golestan province were in men 32.4% and 14.1% and in women 30.5% and 31.8%, respectively. Statistical differences were significant between gender (P=0.001). The prevalence of overweight and obesity in urban areas were 33.7% and 25.5% and in rural area were 29.9% and 21.2%, respectively. Statistical differences were significant between location area (P=0.001). Totally, 54.5% of adult people in Golestan province suffer from overweight or obesity and they were prevalent in Ramian (45.2%) and in Bandar Gaz (61.3%) as the lowest and highest among Golestan districts, respectively. The odds ratio for obesity estimate was 1.28 [95% CI: 1.14-1.44] for urban area compared to rural area; 2.83 [95% CI: 2.50-3.20] for women compared to men; 1.45 [95% CI: 1.21-1.74] in good economic group compared to poor economic group and 2.23 [95% CI: 1.53-3.25] in illiterate people compared to college educated people. P=0.001 obtained for all of groups.Conclusion: In Golestan province, 31 and 23 cases from every hundred people suffer from overweight and obesity, respectively. Bandar Gaz and Rummian districts were suffering from obesity more than and less than other regions, respectively. Illiteracy and improving economic are the risk factors for the obesity and overweight in this area.

Objective (s): To explore adolescents and key informants' perception and experiences regarding to RHS needs of adolescents to plan support services.Methods: This qualitative study was conducted in Sari in the North of Iran. Sixty-seven urban and rural female adolescents between 12-18 years of old participated in 8 focus group discussions. In addition, semi structured interviews were done with 11 key informants. Participants were selected based on purposeful sampling and with maximum variety. All tape-recorded data was fully transcribed and thematic analysis was done to identify key themes.Results: Findings of this research around the adolescents' reproductive health services needs emphasized on 5 overarching themes including: general services, exclusive services, reinforcement of facilitators, reduce barriers and appropriate management of services.Conclusion: Provision of comprehensive services for adolescents and appropriate youth-friendly services at all level are needed to promote female adolescents' health and to prevent high risk behaviors.

Objective (s): The rising of risky injections has caused HIV infections epidemics among Intravenous Drug Users (IDUs). So, high costs of HIV/AIDS care and low financial resources necessitate economic evaluation to choose the best decision to control HIV/AIDS. This study was conducted to determine cost-effectiveness of Methadone Maintenance Treatment (MMT) centers to prevent HIV infections among IDUs.Methods: In this study, we selected all seven MMT centers and their IDUs (n=259). We calculated all costs from government perspective. Mathematical models were used to estimate number of HIV cases averted from risky injecting behaviors changes.Results: Total cost of MMT centers was $204297.7 and cost of HIV/AIDS care in no intervention scenario, was estimated $13942756.8. ICER was $109035.3 per HIV case averted based on an estimated 126 HIV case averted. The results of the sensitivity analysis indicated that MMT intervention is cost-effective even in worst scenario and ICER varies from $39149.42 to $290004.1 per HIV case averted.Conclusion: Considering to high effectiveness and cost-effectiveness of MMT centers, it is necessary to develop these centers in regional and national levels to cover the high risk people more.

Objective (s): There is evidence that a significant proportion of People Living with HIV (PLWH) still practice unsafe sex and this remains a challenge for HIV prevention. To effectively promote their consistent use, it was necessary to understand their sexual practices and experience of barriers to condom use. This qualitative study explored perceptions of PLWH regarding condom use barriers in the Islamic Republic of Iran.Methods: In-depth, semi-structured interviews were held with a purposively selected group of 26 PLHIV (22 male and 4 female) recruited from three HIV care clinics in Tehran. Data were analyzed using the content analysis approach.Results: Nearly all participants reported that their major barriers experienced were that condoms reduced their sexual satisfaction and caused hindered their sexual interest. Less than half of people noted to: embarrassed to buy condoms and unavailability of condoms during sexual contact. Nine percent of male patients practiced unprotected sex in the last sex.Conclusion: Risk-taking sexual behavior has been shown to decrease among HIV-infected individuals when intervention strategies are implemented in HV health care settings. Prevention efforts targeting HIV-positive to assist them in adopting and maintaining safer sexual behaviors need to be intensified.

Objective(s): Valid and reliable data collection requires valid and reliable tools (questionnaires). In using questionnaires in other languages, translation and psychometrics to make them compatible with target culture gain the first priority. The aim of this study was to translate KINDL questionnaire (for measuring quality of life in school-age children) to Farsi and to perform its psychometric evaluation.Methods: In this methodology study, after permission from developers of KINDL questionnaire, it was translated in 7 stages. Its English version was first translated to Farsi. Different early translations were then unified into one Farsi version. The final product was then translated back into English with revision, correction and finalization. For measuring psychometric, content validly, criterion validity and reliability by test-retest methods were used. First the KINDL questionnaire was translated and then psychometric was measured. Content validity index (CVI) of the questionnaire was measured based on the "relevance", "clarity", and "simplicity" on a four point scale.Results: The results showed that content validity index was more than %75 for all questions. In addition, the results of criterion validity of KINDL questionnaire and "Quality of Life Questionnaire for Children with Asthma" showed a significant, linear and positive relationship between the scores of the two questionnaires by Spearman statistical test. In addition, test-retest results showed a high correlation between the different domains of the questionnaire.Conclusion: Foreign questionnaires should be translated by expert people and made compatible with the target culture of each country. Researchers should be aware of this important point when they apply questionnaires from other countries. In this research, content validity index, criterion validity and reliability of KINDL questionnaire were measured and approved. Thus, it can be concluded that the questionnaire is suitable to measure quality of life in children.

Objective: To assess the intake of food groups and the related factors in lactating women.Methods: In this descriptive study, 1112 lactating women were selected from health centers in Qom. Data were gathered using the 24 hour dietary recall questionnaire. Efficiency of food groups was calculated by the formula: [(reported dietary intake ÷ predicted dietary requirement) ×100]. Food consumpsion was compared with food guide pyramid.Results: The dietary intakes of lactating women in food groups except fruit and vegetables were less than the recommended levels. There was significant relationship between occupation and consumpsion of bread and cereal (P<0.05) and milk and dairy products (P<0.05). There was also a significant relationship between consumpsion of meat and nuts (P<0.05) and milk and dairy products (P<0.05) and level of education.Conclusion: Based on finding educational planning is recommended to housewives, illiterate mothers and women with children younger than 3 years old.

Objective (s): Polycystic ovary syndrome (PCOS) is a disorder of hyperandrogenemia and chronic anovulation which affects 5-10% of all women. The PCOS symptoms such as hirsutism, irregular menses, obesity and infertility are a major source of psychological morbidity and can negatively affect quality of life. In this study, we examined the health-related quality of life among Iranian women who suffering from PCOS.Study design: Quality of life was assessed in five domain separatively (menstrual disorders, hirsutism, infertility problems, emotions, and obesity) in 152 women who referred to Tehran selected infertility centers in Tehran, Iran in 2010-2011.Results: The findings showed that patients scored lower on menstrual disorders, hirsutism, infertility problems, emotions, and obesity.Conclusion: This study showed that menstural disorder is the most important domain that affects Iranian women’s HR-QoL.

Objective (s): Diabetes is the third leading cause of death due to illness. During illness, periods of hospitalization, medical expenses, social status and psychological damage, stress that impairs a person's life are Can affect the quality of sleep, the study compared the sleep patterns of patients with type 1 diabetes and no diabetic subjects was designed.Methods: In this study - a comparison, 180 patients were enrolled. Group of 90 patients referred to the Diabetes Association Shahrecord that was randomly enrolled. The control group of 90 no diabetic subjects and were matched with cases. Data from the Pittsburgh Sleep Quality Inventory and the Beck depression questionnaire were collected. Results of statistical software for analysis and statistical tests SPSS15 Man Whitney, Chi-square and T student was used.Results: The results showed that most (70%) patient's relatively good quality sleeps and greater percentage (79%) In the healthy group had a good sleep quality, sleep quality, the Mann-Whitney test for two groups showed a statistically significant (P>0.001).Conclusion: According to the results, sleep problems more common in diabetic patients is necessary to create appropriate solutions to improve patient treatment and education affecting their quality of sleep is recommended.

Objective (s): To determine the prevalence of sexual dysfunction and its effective factors in a community based study among reproductive aged women.Methods: In the present study, 784 married women, lived in urban area of Ghazvin, Golestan, Kermanshah and Hormozgan provinces, were recruited using stratified, multistage probability cluster sampling method. The sexual dysfunction was assessed using a standard questionnaire.Results: The study results demonstrated that 27.3% of women had various degrees of sexual dysfunction; 0.8%, % 20.3% and 6.3% of women had sever, moderate and mild dysfunction, respectively. Sexual desire, sexual arousal and lubrication were disturbed in 35.6%, 39.9% and 18.9% of women, respectively. Furthermore 27.3% of women had orgasm’s problem and 15.2% of participants were unsatisfied with sexual activity, dyspareunia was reported by 56.1% of women. There is a statistical significant relationship between sexual dysfunction with duration of the marriage, the level of attractiveness in the perspective of the husband, the overall satisfaction of common life and the ability for sexual expression.Conclusion: Sexual dysfunction is prevalent among Iranian women, as a result providing its educational facilities and counseling center is a priority for women’s health.

Objective (s): To identify the relationship between constructs of Health Belief Model (HBM) with unwanted pregnancy and intention to continuation or termination of pregnancy among women in health centers of Behbahan city.Methods: Methods: In a descriptive-analytic study 320 married women aged 15-49 years attending 8 health centers of Behbahan city that experienced at least one pregnancy participated in this study in 2010. Variables including: situation of pregnancy (wanted or unwanted), intention to continuation or termination of pregnancy and constructs of HBM were studies. A self-administered used for data collection after evaluation for face and content validity and internal consistency. Filling the questionnaires by trained investigator was used for data collection. Data analysis carried out through SPSS and Chi square, logistic regression and correlation and T tests were done.Results: The mean age of women was 31.06±7.5 years. About one third of women had history of at least one unwanted pregnancy. A significant association was found between unwanted pregnancy and perceived benefits, perceived barriers and self efficacy (P<0.05). A significant relationship was between intend to induced abortion with women literacy, age of women’s husband, duration of marriage, dimension of household, gravida, number of alive children, number of sons, perceived benefits, perceived barriers and self-efficacy (P<0.05).Conclusion: Due to high proportion of unwanted pregnancies, families who have no intention to more pregnancy should be identified. Providing family planning services and education about proper use of contraceptive methods gave priority. In unwanted pregnancy, couple should be aware about actual benefits and barriers of pregnancy continuation. Providing appropriate methods for improving of their self-efficacy is very important.

Objective (s): To investigate whether the use of fetal monitoring had an effect on cesarean section rate at Mahdieh hospital.Methods: This retrospective, analytical cross sectional study involved patients' data from deliveries occurring at Mahdieh teaching hospital, Tehran, in 1385 and 1387. During 1387 fetal monitoring was available and use for all mothers in the labor, whereas during 1385 it was unavailable. Data on cause of cesarean were collected in 1385 and 1387.Results: 4346 deliveries used fetal monitoring and 4656 deliveries did not. 2133 Cesarean occurred in 1387 and 1739 cesarean occurred in 1385. Causes of cesarean were: Labor Dystocia, Meconium, Fetal Distress, CPD, Placenta Previa, Placenta Abruptio, Cord prolase, Preeclampsia, Multiple Pregnancy, Malpresentation, Abnormal Fetus, and Previous Cesarean. There was Statistical significance difference in Meconium (13.4 %, v/s 17.1%, P<0.05), Fetal Distress (11.78% v/s 13.92%, P<0.05), Abruptio placenta (2.1% v/s 6.14% P<0.05), Labor Dystocia (11.09% v/s 9.1%, P<0.05) and Malpresentation (13.6% v/s 10%, P<0.05). There was no significance difference in Previous Cesarean, Multiple pregnancies, CPD, Preeclampsia, Placenta Previa, and Cord Prolapse.Conclusion: The Study shows 12% rising on cesarean rate from 1385 till 1387.Statistical difference was demonstrated in the rate of fetal distress that Cause cesarean section. Use of fetal monitoring detected any fetal distress in labor and cesarean performed for avoiding cerebral palsy and Low APGAR infant. There is no evidence that use of fetal monitoring improved newborn outcome.

Objective (s): To examine the relationship between maternal weight and breastfeeding initiation and duration.Methods: This research is an analytical and cross-sectional study which has been done during 2007-2008. Data were collected through questionnaire and interview. Sample consisted of mothers of children 6-12 month attending to west Ahvaz health centers and 150 mothers were selected randomly.Results: mean prepregnancy weight and mean maternal prepregnancy BMI were 65.46±13.1kg, and 25.625.1 kg respectively. Most common (%72.7) method of infant nutrition was exclusively breast feeding. There was no association between maternal BMI and feeding patterns. BMI showed a significant relationship with duration of each BF and number of feedings per 24 hours. (P<0.01) although after using multivariate regression just daily number of breastfeeding was related to duration of breast feeding. (P<0.05) There was found a significant relationship between delivery mode and postpartum initiation of breast feeding (P<0.01).Conclusion: Mother's weight has adverse effect on daily number of breast feedingIn this study Mother's weight has no effect on pattern of breast feeding, so it seems to clear these issue further studies should carry out.

Objective (s): To investigate the effects of Quran reading during third trimester on severity of labor pain in primiparas women.Methods: This was a randomized clinical trial. A sample of primiparas women attending a prenatal care centre in hospital, entered into the study. They were randomly allocated into two groups: the experimental group (n=41) included women who they were reading Quran from third trimester of pregnancy to normal spontaneous delivery (at least 30 times) whereas the control group (n=46) received routine care only. Severity of pain were determined by visual analogue scale in three cervical dilatation of 3-5, 5-8, 8-10 centimeter and second stage.Results: In all 87 women took part in this study. There were not differing between two groups in baseline characteristics. There were significant differences in severity of pain score between two groups in cervical dilatation of 3-5, 5-8, 8-10 centimeter (P=0.001, P=0.003, P=0.023 respectively) but there was no significance difference in severity of pain score in second stage (P=0.368).Conclusion: This study provides evidence for the use of Quran reading is an acceptable and non- medical strategy for reducing the pain during labor at the first stage of delivery.

Objective (s): To comparison of Health Belief Model- based methods of video and face to face training about risk factors on knowledge and attitude of Myocardial Infarction patients during discharge.Methods: This was a Clinical trial study. Eighty patients randomly assigned to either video or face to face group. Data was collected by a researcher-made questionnaire. Educational contents were designed in health belief model frame based on the collected data and educational needs; then it was turned into a movie. The movie was shown to each patient in the video group individually and face to face group received face to face training. Finally, data were analyzed using SPSS (version 16).Results: Analysis of baseline data showed that there were no significant differences between the two groups regarding any of dimensions of model (P>0.05). Study results showed that the mean score of knowledge and attitudes in the video group was 32 (±0.98), 112.62 (±3.12) and in face to face group was 31.02 (±1.4), 105.9 (±5.96), Comparing these means using t-test showed a significant difference between the means of two groups (P<0.05) in any of dimensions of model exception knowledge of diet.Conclusion: Using videos for educating myocardial infarction patients about risk factors of the disease is a useful method for preventing recurrence of the disease.

Objective (s): To explore various effective factors relevant to the decision for organ donation of Brain-Death patient’s family.Method: This study is a qualitative research with its focus on the content analysis approach. Data collection process included 38unstructured in- depth interviews with 14 Brain-Death patient's families (totaling 34 participants) who announced their consent to donate their patient’s organ and so with 12 families who refused from organ donation and field notes. Sampling method begun as purposive in transplantation management center in Mashhad University of medical science - October 2009 -and continued until data saturation occurred in December 2010.Results: Qualitative content analyses of interviews and filed notes resulted to six main themes were extracted from the current dataset that showed the most important factors which influenced family’s decision making process These were included: brain death acceptance, cognitive preparation, confrontation's quality and time, decision makeing mediators', familial interactions, bleives and motivators.Conclusion: The results showed a number of factors are influential in organ donation that Discovering and explaining these factors help policy makers and administrators to planing and interventions in relation to culture-building and facilitate organ donation. Also recommended medical team team ensure families understand the concept of brain death and its irreversibility and give thems clear and complete information.