HAKIM RESEARCH JOURNAL
Year:2012 | Volume:15 | Issue:1|Papers Count:10

Introduction: One of the most important issues about transgenic animals is using their organs for transplantation to human body. This issue has raised a lot of ethical and scientific controversies. Considering ethical issues, the range of received criticism is so large that we can divide them into two comprehensive groups, the first group is known as intrinsic ethical criticisms, and other group is called extrinsic criticism.We can still divide the second group criticism into two subgroups, the first subgroup studies the problem from a human-centered point of view, and the second deals with the problem from the animal-centered viewpoint rejecting such activities.Methods: In this article, through the use of published books and manuals about transgenic animals and by the help of descriptive approach, the writer aimed to fully discuss the raised ethical conflicts so that it is made clear whether xenotransplantation is acceptable regarding the ethical criticism and scientific ambiguities or not.Conclusion: It is noteworthy that the present studies point out that despite proposing the precautionary principle, which has ethical and legal background, in this step, due to the presence of ambiguities and the uncertainty of accepted scientific theories, transplantation of animal organ into human body is found to have perils for human life and animals. So it is considered unethical.

Introduction: Given the ever-increasing importance and value of information, providing the management with a reliable information system, which can facilitate decision making regarding planning, organization and control, is vitally important. This study aimed to analyze and evaluate information needs of medical equipment offices.Methods: This descriptive applied cross-sectional study was carried out in 2008. The population of the study included the managers of statistic and medical records at the offices of vice-chancellor for treatment in 39 medical universities in Iran. Data were collected using structured questioners. With regard to different kinds of designing information systems, sampling was done by two methods, BSP (based on processes of job description) and CSF method (based on critical success factors). The data were analyzed by SPSS-16.Results: Our study showed that 41% of information needs were found to be critical success factors of managers of office. The first priority of managers was "the number of bed and bed occupancy at hospitals".Of 29 identified information needs, 62% were initial information needs of managers (from the view points of managers). Of all, 4% of information needs were obtained through the form, 14% through both the form and database, 11% through the web site and 71% had no sources (forms, databases, web site).Conclusion: Since 71% of the information needs of statistic managers had no information sources, development of information system in these offices seems to be necessary. Despite the important role of users in designing information systems (identifying 62% of information needs), other scientific methods is also needed to be utilized in designing information systems.

Introduction: As a worldwide phenomenon, aging has an adverse effect on Health-Related Quality of Life (HRQoL) of elderly people. Developing measurement instruments are necessary for measuring HRQoL.The objective of this study was to develop an instrument for measuring the HRQoL of elderly people.Methods: Development of the EHRQoL instrument was made up in three stages including: 1) Concept definition, 2) Items selection, and 3) Psychometrics properties (validity and reliability) of EHRQoL. The first and second stages were including literature review and semi-structured interviews with the elderly. The third stage included assessments of contents validity, face validity, construct validity (factor analysis), criterion related validity (concurrent validity), internal consistency (alpha Cronbach) and stability (test-retest reliability) of elderly people. In this stage, 400 elderly participated in the study based on random sampling method.Results: The HRQoL of elderly people was defined as elder people perceptions of absence of disease and treatments, autonomy, empowerment, healthy mind, family integrity, social engagement and spiritual wellbeing.The EHRQoL was developed in 121 items within five-pointy likert scale. After content and face validities, 105 items remained in the instrument. The results of factor analysis revealed 50 items with six factors: social engagement, not being sick, healthy mind, spiritual well-being, autonomy and family integrity.The results of criterion-related validity revealed linear, positive and significant relations between the HRQoL and criterion instrument. The results of internal consistency and alpha Cronbach revealed reliability coeffients of 0.83-0.96 for the EHRQoL.Conclusion: The EHRQoL with 50 items in five-point likert scale is a valid and reliable instrument for measuring HRQoL of elderly people.

Introduction: The old version of the USA tariff book (California Book) has been the basis for paying physicians' fees of surgeries and other invasive procedures in Iran for a long time. In 2010, Iran Ministry of Health and Medical Education (MOHME) translated the new version of the USA tariff book (CPT/RVU 2008) to replace the old version. This study aimed to explore the financial effects of implementing the new tariffs on physicians’ fees of invasive procedures in public and private hospitals in Iran.Methods: Using the databases of main medical insurance organizations, the old tariff book and new tariff book (book of CPT / RVU 2008), and excluding the duplicate procedures, we selected a list of 54 procedures. Considering the population covered by the insurance organizations and the total population of the country, we estimated the total number of invasive procedures for each selected type of procedure. Then, according to the fees paid to physicians in public and private hospitals, we estimated the possible changes in the physicians' income.Results: The estimated total number of invasive procedures in Iran was about 4, 894, 000 per year, of which about 2, 600, 000 (53%) was related to the 54 selected types of procedures. The overall increase in the costs of invasive procedures was 767, 833 million IR Rials and the reduction in the costs was 810, 665 million IR Rials in both sectors.Conclusion: Implementing the new tariff book will result in a small reduction in overall costs of the health services and will improve the appropriateness and equity of paying physicians' fees for invasive procedures. This, however, might lead to more induced demand and informal payments, so any changes should be introduced gradually and with careful monitoring.

Introduction: Despite several health benefits of fruits and vegetables (F&V), intake of these food groups among most adolescent girls in the city of Tehran is less than recommended. Based on investigations, there is close association between parental beliefs and practices with children's F & V intake.Methods: A total of 283 adolescent girls and their parents, (136 as intervention group and 147 as controls) were participated in the study. Social Cognitive Theory provided the theoretical basis for the design of the intervention. The intervention included, three sessions of parents education through group discussion in which a booklet and three pamphlets were also distributed. Adolescents F&V intake by a 24- hour recall and a FFQ, fruit and vegetable availability, outcome expectation, preference, skill, knowledge, observational learning and self-efficacy were measured at baseline (before intervention) and at the end of study (after three months intervention).Results: F&V consumption significantly increased post-intervention in the intervention group (from 6.25±4.62 to 7.22±4.6 servings/day pre- and post intervention, respectively. p=0.02). No significant changes were observed in the control group. Among SCT constructs, only knowledge of the intervention group increased significantly (0.3±0.5 and 0.6±0.7 pre- and post intervention, respectively. p<0.001).Conclusion: The family-based interventions appear to be feasible and effective in increasing F& V consumption in adolescents.

Introduction: Addiction is a major health problem worldwide. Regarding young population in Iran, about 44 million individuals are at risk for addiction. Studies have shown that the self-efficacy is a main predictor of health behaviors. The aim of this study was to study validity and reliability of the Bramson's quit addiction self-efficacy questionnaire.Methods: After doing translation-back translation processes, the questionnaire along with the general self-efficacy questionnaire were completed by 150 addicted clients who were selected randomly from the rehabilitation and treatment Mehr and Piroozi addiction clinics in mashhad. The reliability was calculated using the Cronbach's alpha coefficient.Results: Pearson correlation coefficient showed that there was high correlation between the two questionnaires (general self-efficacy and Bramson's quit addiction self-efficacy, r=0.67, p<0.001). Factor structure of the questionnaire was confirmed using the confirmatory factor analysis. The Cronbach's alpha was 0.90. The results of the factor analysis identified four factors: problem-solving skills, decision making, assertiveness, and communication (The alphas were between 0.72 and 0.78).Conclusion: The validity and reliability of the questionnaire seemed to be appropriate

Introduction: Undoubtedly, any health care system could not meet all health needs of people. So prioritizing of the needs is necessary. Needs assessment does not mean one need is superior to another. It determines most important needs, common needs, and importance of each need in health care planning. The aim of this study was to assess the psycho-emotional needs of female adolescents.Methods: In this cross-sectional study, 2010 middle- and high-school female adolescents were recruited from randomly selected schools in Mazandaran province, Iran. Psycho-emotional needs of participants were assessed using the self-administrated culturally-sensitive Iranian Female Adolescents Health Needs Questionnaire (IFAHNQ). Data were analyzed using Pearson Correlation Coefficient, Independent T-Test, One-Way Anova and Multivariate regression.Results: Mean scores of psycho-emotional needs of participants were 35.83±14.23. The urban adolescents' scores (36.85±14) were significantly higher than the rural habitats (24.82±14.99) (p<0.001).There were significant relationships between psycho-emotional needs' scores with age (p<0.001) and mothers' education (p=0.03).Conclusion: Further studies should be conducted to investigate psycho-emotional needs of female adolescents and its different dimensions.

Introduction: Nowadays, family planning is a separate concept from contraceptive tools. It is considered as a fundamental element in accessing to fertility rights, empowering women, and promoting women's status in societies. It aims to empower women for appropriate decision-makings about family planning and help them to have aware decisions. To be assure of women's empowerment, while giving family planning services, is an essential prerequisite for enhancing reproductive health. This study aimed to explore women's perceptions about role of family planning services in empowering them.Methods: In this qualitative study, data were gathered from 37 married women who were using contraceptives and were willing to participate in the study. Seven focus group discussions and five individual interviews were recorded and analyzed using qualitative content analysis method.Results: Analysis of data emerged four main categories about the role of health centers in empowering women: calling for men's participation in family planning counseling by health providers, providing comprehensive reproductive health services, extending free family planning services, and applying suitable technology for informing society.Conclusion: The results showed that present physical access to health centers and free family planning services cannot help women to fulfill their needs. Health centers should provide new approaches to provide comprehensive reproductive health services. This will result in helping women to decide consciously and voluntarily to have more control over their fertility.

Introduction: Effectiveness of health services depends on appropriate communication and active participation of health service providers/receivers. Patients' and care providers' rights should be mentioned in health centers. This mutual commitment guarantees population health in the highest levels. This study aimed to assess the degree of adherence to patient rights from the perspectives of pregnant women in health centeres in Tabriz.Methods: In this cross-sectional study, 185 pregnant women were recruited at the 9th month of pregnancy from 40 health centers and health posts in Tabriz in 2010-11. A range of 3-8 individuals were selected randomly from each health center and health post. Data was collected using a self-structured valid and reliable questionnaire. Adherence of care providers to the patients' rights were measured among the women.The questionnaire measured 12 aspects of 4 main domains of the Iranian Patient Rights Charter with scales from "0=poor performance" to "10=good performance". Data were analyzed in the SPSS.Results: From the perspectives of pregnant women, performance of the health care providers in all domains was good or fair. Of 12 aspects of patients rights, confidentiality, privacy, accessibility and continuity had the highest performance scores (³9). The aspects of communication, prompt attention, basic amenities and autonomy had moderate scores (7-8.99), and the right of choosing care provider, safety, dignity and providing necessary information and education had the lowest performance scores (<7). There were no complain management system in the health centers.Conclusion: Regarding importance of patient rights during pregnancy, health centers and health posts should pay more attention to the aspects with poor performance and should develop a complaint management system in health care centers.