Payesh
Year:2013 | Volume:12 | Issue:1|Papers Count:17

Objective (s): This study aimed to do institutional mapping of the health innovation system in Iran.Methods: This was a qualitative study. The study was carried out in four stages including determining the main organizations in the national health innovation system, identifying how they work, assessing communication among different organizations, and ultimately determining failure of health innovation system.Results: The results indicated that the financial relationship in higher layers was stronger but it was decreased in lower layers. In the field of administrative communication, there was more vertical relationship in the upper layers. There were btter relationships among middle layers.Conclusion: In general we can conclude that there were some defects in different functions of the national system of innovation in health sector in Iran. These defects were present in the number and type of activity and relationship existing among institutions involved in different layers. To promote innovation in the health sector these defects must be dealth with.

Objective (s): Shortage in human resources is an important challenge for health sector. It is the main cause of demand rationing and queues to receive services. Proper information about the present situation helps to manage queues and waiting time. This study aimed to estimate waiting time to visit an endocrinologist and provide practical solution for its management.Method: This was a cross - sectional study. Samples were selected from participants of the annual Iranian endocrinologist conference, 2008 in Tehran. Twenty four endocrinologists completed the questionnaires. The research tool was a self - administered questionnaire.Results: The study findings showed that the median and mean waiting time of endocrinologists was 15 and 30 days for first visit respectively (0 -135 days). Number of endocrinologists' activity was the only variable that had positive correlation with waiting time (P=0.027). About % 41.7 of endocrinologists had the possibility of increasing their clinical working hours by 10.8 hours per week.Conclusion: Waiting time to visit an endocrinologist seems occurred due to inappropriate distribution of patients and not the shortage of workforce.

Objective (s): Technological developments; economic trends and certain aesthetic perspective have caused less attention to the urban landscape; public open space and social relationships between citizens and their health. This study aimed to investigate about relationship between public open space and neighborhood environments and its impact on citizens’ health.Methods: This study has basically planned on focusing on the elements of urban open public spaces and its impact on the quality of relationships between citizens. Data were obtained from documents, studies, field observations, descriptions, photos and detailed maps of a given region in Tehran, Iran. After analysis and comparing health promotion measures and social interactions with mentioned issues the reasons were established.Results: Elements of the urban landscape that influence social norms and health of the citizens were identified.Conclusion: In designing the residential complexes, creation appropriate communication between green spaces and units can help to improve health and quality of life.

Objective (s): The effect of Ramadan fasting on diabetes control is not clear yet. Some lifestyle changes like changes in drug dose and time, sleep wake cycle, physical activity and diet occur in Ramadan and can lead to metabolic imbalances. As such some studies have shown increased risk of hyperglycemia and hypoglycemia. So, it is necessary to make decision based on scientific evidences about safety and allowing fasting in a wide variety of patients on different stages of metabolic control. Moreover, appropriate changes in drug prescription should be recognized and used. In this review the results of various studies regarding the effects of Ramadan fasting on metabolic control of type 1 and 2 diabetes mellitus have been summarized and provided.Method: Keywords including "Ramadan", "Ramadan Fasting", "Islamic Fasting", Fasting in Ramadan ", Calorie Restriction, Fasting and Starvation with words Diabetes Mellitus, Hyperglycemia, Hypoglycemia, Ketoacidosis, Glucose were searched via PubMed, SID (Scientific Information Database), and some regional journals and all articles (descriptive cross - sectional, cohort, clinical trial and review articles) from 1957 to 2010. The relevant articles were reviewed.Results: In all 86 papers were included in this review. In diabetic patients safety of Ramadan fasting is defined as blood glucose in normal range. In type 2 diabetics with no chronic complication and able to self care, with proper training, planning the time and dose of drug, controlling of diet and physical activity and regular monitoring of blood glucose, fasting is allowed. In type 1 diabetics or insulin users, fasting should be allowed with caution, because, they are more at risk of hypoglycemia.Conclusion: Diabetic patients who wish to fast in Ramadan need to care about time, type and dose of their medications.

Objective (s): To identify the predictive model of road traffic injuries by a time series model.Methods: This was an analytical study involving patients attending central hospital of Masjed-Soleyman (a city in Ahvaz Province), Iran during 24 months, from March 2008 to March 2010. Time series carried out to determine monthly occurrence of road traffic injuries in order to build a statistical model on data. The ARMA Box Jenkins linear model was used and an Autoregressive model was selected.Results: Out of all 1210 injured patients referring to the hospital, 78.5% (n=950) were men. The mean age of patients was 30.57±17.08 years. The majority of injured (35.1%) were 20-29 years old. Autoregressive model was appropriate to describe our data over time. The result indicated the road traffic injuries had an increased pattern by 7 times as compare with previous month on average.Conclusion: The frequency of road traffic injuries is high in men and young age adolescents. The pattern is increasing and there is need for serious public health considerations.

Objective (s): To investigate the effect of training in promoting children’s ability to select safe places to cross roads, and to examine which type of training is more effective that were story-telling or tabletop model.Methods: Sixty preschool and twenty 9 years old children participated in the study. Preschool children were divided into three groups, where 20 received training by means of story-telling, and 20 by tabletop model. The remaining children did not receive any training. The training was implemented in 4 sessions. Preschool children’s ability in identifying safe/dangerous crossing sites was assessed by 10 pictures in pre and post training. For 9 years old' ability was assessed once.Results: In comparison to controls, significant improvement was observed in all children following training. The trained preschool children’s scores were not significantly different from 9 year-old children. Tabletop model was more effective method than story-telling.Conclusion: Training especially by tabletop model might be effective in promoting the perception of traffic dangers in young children. Training can speed up the development of young children's ability.

Objective (s): With the ever-growing increase of knowledge in today’s global society, teachers now feel it is necessary to train students to become reflective thinkers. This issue is particularly important for nursing students who are responsible for taking care of patients.Method: Forty-two nursing students voluntarily participated in this study. After explaining the aims of the study to the participants, they took part in the clinical skills test. They were divided into two equal case and control groups. The control group took part in routine clinical programs and the cases participated in routine clinical programs plus an interventional program. They were asked to reflect on their clinical experiences for the last 12 weeks of their clinical course and take part in the clinical skills test again. Baseline and post-test data were compared among two groups.Results: The results confirmed the role of reflection on clinical competency, and the two groups were different with respect to learning clinical skills.Conclusion: The findings suggest that clinical skills test should be implemented in the nursing curriculum in Iran as one of the necessary criteria for competency.

Objective (s): Sexual dysfunction (SD) in patients with multiple sclerosis (MS) is common, but often overlooked. The purpose of this study was to determine prevalence of sexual dysfunction and its predisposing factors in women with multiple sclerosis.Method: This was a cross sectional study. Participants were recruited from two MS clinics in Tehran. Sexual function and disability status were quantified by the Female Sexual Function Index-FSFI and Expanded Disability Status Scale (EDSS) respectively. Clinical characteristics and the extent of physical disability were examined by a neurologist .Data were analyzed by univariate and multivariate logistic regression.Results: In all 226 MS patients were studied. The mean age of participants was 35.77 years (SD=8.07). Sexual dysfunction were diagnosed in 125 (55.3%) of participants. The most common sexual problem in women was arousal dysfunction (44.2%) and the lowest frequency of the dysfunction was sexual pain (12.8%).Results obtained from multiple logistic regression analysis showed that MS patiants with sexual dysfunctin had lower educational status (Odds ratio=1.95 CI 95%=1.957-0.998), insufficiency low (Odds ratio=3.94 CI 95%=1.614-90619), more than 3 children (Odds ratio=4.659 CI 95%=1.517-14.314) and Secondry Progressive MS-(SPMS) (Odds ratio=3.034 CI 95%=1.447-6.362).Conclusion: Awareness of sexual problems and related factors for the management and treatment of women with MS is necessary .It is suggested that sexual rehabilitation programs compiled as part of the comprehensive care of patients with MS.

Objective (s): To translate and evaluate the validity and reliability of the Seattle Angina Questionnaire, as a disease-specific quality of life scale in patients with angina pectoris.Method: After permission, the questionnaire was translated. Then face validity, content validity, concurrent validity and criterion validity were determined. In order to evaluate the construct validity, known-groups comparison (patients with and without chest symptoms) was performed and to determine its criterion validity the Short Form 36 (SF-36) was used. Cronbach's alpha coefficients and the test retest were used to assess the scale reliability. 100 patients with angina pectoris participated in this study.Results: The criterion validity showed high and significant correlation between most SAQ and SF-36 scores. Cronbach’s alpha of the total scale was 0.85 and test-retest reliability (ICC) within 2 weeks, in all dimensions was greater than 0.90.Conclusion: The findings suggest that the SAQ is a valid and reliable disease-specific scale and can be considered for measuring health outcomes in research and clinical settings.

Objective (s): This study was performed to translate and validatie the Persian version of Critical Care Family Needs Inventory (CCFNI) assessing family needs of admitted patients in the intensive care units and to determine its validation.Methods: After translation qualitative face validity and content validity was established for the questionnaire. In order to evaluate the construct validity, known-groups comparison (nonsurgical versus surgical patients) was performed and to determine its differential validity, intensive care unit were compared with the conventional wards using independent-sample t -test. The internal consistency (Cronbach's alpha coefficients) were used to assess the scale reliability. 150 family members of patients in intensive care units and 150 patients' family members in general medical and surgical wards participated in this study.Results: Significant differences were found between surgical and nonsurgical patients' family (p=0.03) as well as the intensive care unit and conventional wards (p=0.007). There were significant positive correlations between all scale dimensions (0.684≤r≤0.439, p<0.001). Cronbach's alpha coefficient for the total scale was 0.926 while it was more than 0.7 in three dimensions (support, comfort and closeness). It was between 0.6 to 0.7 in the two other dimensions (information and confidence).Conclusion: The findings confirmed that the Iranian version of Critical Care Family Need Inventory is a valid measure for assessing family needs of patients admitted to intensive care units.

Objective (s): To compare prediction power of exercise intention and behavior based on self-efficacy and theory of planned behavior.Methods: This cross-sectional study was conducted in the kahrizak Nursing home in Tehran. Participants were 60 elderly aged 60 to 85 years old. A questionnaire based on theory of planned behavior and self-efficacy was used to collect data. The data were analyzed performing regression analysis.Results: Self-efficacy predicted 35.6% of the Intention to exercise while the theory of planned behavior predicted 32.8%. Self-efficacy predicted 21.3% of the exercise behavior whereas the theory of planned behavior predicted 15.7%.Conclusion: The findings suggest that self-efficacy could predict intentions and bahviors bttter.

Objective (s): To determine the effectiveness of an educational intervention for reducing Paan consumption among adolescents aged 12-14 years in Chabahr, Iran.Methods In this study (105) young adolescents were selected through random selection and divided in two groups (experimental and control). Data were collected in tree stages by a valid questionnair.Results: After educational intervention means score of knowledge, attitudes, affective belief and behavior in reducing Paan consumption increased significantly in experimental group but not in control group.Conclusion: The results of this study indicated that the educational intervention based on affective beliefs was effective in reducing Paan use behavior among adolescents.