Hakim Journal
Year:2009 | Volume:12 | Issue:2|Papers Count:8

Introduction: The ultimate goal of all health studies is to promote human health and increase equity in health. Many decisions are made at international and regional level to achieve these goals. How much the research is utilized in these decision makings? This study was designed to throw light on the utilization of knowledge in the health sector’s policy makings.Methods: This study was done qualitatively, through 10 in-depth interviews and 6 focus group discussions with researchers of macro level (Ministry of Health managers and policy makers) and peripheral level (researchers and service providers).Results: Many problems were seen at different levels of knowledge utilization in the knowledge producing and utilizing sectors and in the exchange atmosphere between them. These problems were classified into characteristics of research, researchers and decision makers, human resources management, research and plan management, and politics in research and decision making. Absence of a clear plan for connecting knowledge producers and users is another barrier in reaching an ideal level of knowledge translation.Conclusion: Barriers and their respective solutions need to be identified through a comprehensive study at various levels in order to strengthen knowledge utilization in the health sector. Focus needs to be laid on the National Innovation System as one of the necessary infrastructures for conducting such purposeful plans.

Introduction: As prevalence of developmental disorders is higher in high-risk infants and more frequent and special follow-up is required for this group of children during the early years of life, determining the risk factors in every society is of utmost importance.Methods: This was a descriptive-analytical (case-control) study conducted during 2005-2006 on 283 infants which had been referred to heath-care centers in the north and east of Tehran. The first 143 infants with risk factors, who also had a developmental quotient (DQ) score of less than 70 according to a pediatrician’s assessment, comprised the case group, and the first 140 infants, without risk factors, who had a DQ score of more than 70 comprised the control group. The odd’s ratio [OR] was used for correlating risk factors to the developmental status.Results: The following factors were significantly related to child motor developmental disorders: perinatal asphyxia (neonatal convulsion, fetal distress, and Apgar score of 0-3 at 20 minutes), low birth weight, prematurity, and premature rupture of membrane.Conclusion: Regarding the effect of the risk factors mentioned above in developing motor developmental disorders, attempts should be made for the prevention of these factors in order to decrease the incidence of future disabilities. Developmentally delayed infants also should be diagnosed as soon as possible in order to apply early intervention and to achieve better results.

Introduction: World Health Organization emphasizes on promotion of male participation in perinatal care to decrease maternal mortality and improve maternal health; this is possible through education. This study aimed to assess the educational needs of fathers for their participation in perinatal care.Methods: This was a qualitative research, using focus group discussions that were performed in eight groups of men and women in the hospitals affiliated with Shahid Beheshti University of Medical Sciences. The tool of the study was a semi-structured questionnaire with 7 guided questions. Participants were interviewed by a facilitator and a note-taker. All the procedure of discussion was written, tape-recorded and analysed.Results: The majority of men and women mentioned that male participation is their emotional support of women and their involvement in household responsibilities. Changes in life style and Nuclear-family type of current decades were mentioned as the reasons for the importance of participation. The majority of them mentioned long work hours of men besides cultural believes as the main barriers. The majority of the participants emphasized on importance of education about emotional support, physiological changes and warning signs and symptoms during pregnancy. They also mentioned the role of mass media for promotion of male participation.Conclusion: Fathers’ education is necessary considering appropriate content, place, time and duration according to the couples’ needs. Male involvement in perinatal care should be considered in premarital and perinatal classes.

Introduction: Obesity is considered as one of the main challenges of the present era. Many physicians and nutritionists seek new and efficient ways to overcome this problem. Using supplements in addition to the routine diets is among these methods. The aim of the present study is to investigate the effect of fish oil in addition to the low calorie diet on the weight loss of obese women.Methods: In a randomized controlled trial, 40 obese (BMI>30) women were randomly assigned to either low-calorie diet or low-calorie diet plus a daily supplement of three-gram fish oil. Their weight loss was measured after eight weeks. Data were analyzed by paired and independent sample t-test and chi-square test.Results: The two groups did not differ in terms of age, BMI, education, marital status, and occupation. The mean weight loss of the 15 women in the low-calorie diet plus fish oil group was 3.73±1.62 Kg which did not differ significantly from 17 women in the low-calorie diet group with mean weight loss of 4.33 ± 2.16 Kg (P=0.404).Conclusion: Our findings showed that adding three grams of fish oil to daily diet did not have significant impact on weight loss; however, 87% of those in the supplement group were willing to continue the given diet compared to 47% of those in non-supplement group. This confirms the positive psychological effect of fish oil on the continuation of weight loss diets.

Introduction: Protecting the public from financial costs of healthcare and the equitable contribution to healthcare costs is one of the main goals of a health system. We aimed to quantify and compare the proportion of households facing catastrophic healthcare expenditure in years 2003 compared to 2008, and to identify the factors that contributed to these expenditures.Methods: In 2003, the World Health Survey questionnaire was used to collect data on a 2-stage cluster sample of 635 households. In 2008 data was collected from the same sample. Proportion of households facing catastrophic healthcare expenditure was estimated using the households’ capacity to pay. The determinants of household catastrophic healthcare expenditure were identified using chi-square test.Results: The proportion of households facing catastrophic healthcare reduced from 12.6% in 2003 to 11.8% in 2008 and the change was statistically non-significant. The key determinants of catastrophic healthcare expenditures for both years were healthcare utilization (especially inpatient and dentistry care). Household economic status, having member over 65y and having disabled member influenced exposure to catastrophic healthcare expenditure in 2008.Conclusion: Our findings demonstrate that use of expensive inpatient care, use of essential dental care (not covered in insurance packages), having member over 65y, having disabled member, and lower economic status increase the households' exposure to catastrophic expenditures which should be considered in formulating policies and strategies of protecting households from economic impacts of illness. It seems that there has been no significant change in the proportion of such expenditures in recent years.

Introduction: For implementing the programs of tobacco control, important actions including legalization of production, import, supply and sale of cigarettes are needed. This aim can not be achieved and its outcome can not be assessed unless we have good baseline information about different aspects of cigarette use, such as presence of legal versus illegal, and domestic versus foreign cigarettes; or the fact that which group of people we are addressing, male versus female and young versus old, and how tobacco is supplied. This study was designed to gather such information.Methods: This was a cross-sectional study performed during 2008-2009. 630 Smokers with more than one year of smoking history were questioned about the history and pattern of tobacco consumption and their demographic data. The method was direct observation and sampling was randomized by chance selection of smokers at different locations in Tehran.Results: In this study, 630 smokers were questioned with mean age of 39.9±12.2 years. 61.9% of the cigarettes consumed by the society were foreign and 22.5% of them were illegal. 67% of the cigarettes with a foreign brand were produced or imported legally. Furthermore, 6% of the domestically used cigarettes were illegal.Conclusion: The result showed that the trend towards illegal cigarettes use is high. So planning tobacco control programs and implementing the laws in this regard are essential, and more comprehensive and completing studies are recommended.

Introduction: Drug addiction is one of the most important social, economic and health problems of the country. Due to special geographic location of IRAN, every year millions of dollars are spent to combat this problem. In this article, we tried to gather the comments of related policy makers about the harm reduction approach (in drug misuse) and community participation.Methods: This was a qualitative research. Interview questions focus on addiction and the concept of harm reduction and the perspective of participants regarding community participation in this program. Interviewees identified the role of interest and power of their centers in this process along with barriers for implementation of harm reduction programs. Interviews were done with representatives of governmental organizations, public and private institutions.Results: About the causes of addiction, most of the interviewees believed that many factors are responsible for drug addiction. This attitude among policy makers is very precious because for years, there were limited methods for reduction of addiction in Iran. About participation of people, although there was general agreement, but a strong emphasis on its limitations; some declared that it must be completely defined.Conclusion: This study determined that despite an initial resistance to harm reduction programs among staff, now there is a sense of cooperation and coordination among them. This study revealed that there is a lack of legal and administrative infrastructure in macro-level which results in reduction of cooperation between organizations. This interaction is the basis for community participation.

Introduction: Tehran is one of the most pollutant cities in the world that results in its residents’ cardiovascular, respiratory and stroke disease. In this study, the mortality and air pollution data has been used during 2002-2005. The aim of this research is analysis of the correlation between air pollution and mortality rate due to cardiovascular, respiratory and stroke in Tehran.Methods: The spatial analysis was carried out for air pollution and human mortality; correlation statistic methods and regression was used to analysis correlation between human mortality rate and air pollution. Results: The results showed that there is significant correlation between human mortality and air pollution. People older than 65 years were sensitive to air pollution. The correlation coefficient between air pollution and cardiovascular, respiratory and stroke disease mortality was 0.73, 0.70, 0.69 and 0.67 respectively that are significant at 0.01 confidence level. The central zones are most pollutant.Conclusion: The highest correlation between air pollution and cardiovascular, respiratory and stroke disease mortality is in the October, January and November respectively. In general, the highest correlation between air pollution and total mortality is in autumn season (October, November).