Epidemiology and Health System Journal
Year:2018 | Volume:5 | Issue:1|Papers Count:8

A regular activity in all human societies is the evaluation and control of important socioeconomic indices. Unemployment rate is one of these indices, which is very important in evaluating and applying policies for control or preparation of desired changes in economy; in fact, it is a challenge for policy makers. Employment and unemployment are 2 words that have different definitions among people and professional centers of statistics. Since the statistics and methods applied for calculating Iranian employed and unemployed people have been provided by Statistical Center of Iran (SCI), the comparison of these definitions with recommended ones defined by International labor organization (ILO) may project 2 different items. In accordance with the definition of unemployment by ILO and SCI, each person who works at least 1 to 2 hours a week, even without receiving money, is considered as an employed person, otherwise is named as unemployed. Considering this definition, a new question may arise: in Iran, with consideration of location, subsistence, and labor market conditions, could people be satisfied with their living situation? Perhaps in some countries, this definition may be operational but not for Iranian worker community; in fact, no one in Iran and many other countries would be satisfied with one-hour work per week as an employed person.

Background and aims: Behavioral counseling centers are the main health organizations which are responsible for providing treatment and care for the patients living with HIV (PLWH). HIV-positive patients receive services through a unique counseling process called voluntary counseling and confidential testing (VCCT). Although there are reports regarding VCCT evaluation from other countries, not such an evaluation was found in Iran until this study, to the best of our knowledge. The study was performed to fulfill this necessity.Methods: Using consecutive method sampling, 314 subjects were sampled from the patients referred to Behavioral Counseling Center of Imam Khomeini hospital, Tehran, Iran. A combination of process and output evaluation of VCCT was performed in the biggest Behavioral Counseling Center of Iran at Imam Khomeini hospital, Tehran, Iran. Data were analyzed using descriptive statistics (percentages and averages).Results: Participants’ response rate was 95.54%. Two shortcomings were found in the counseling process. Cronbach alpha reliability coefficient for this scale was 0.899, which was a desirable reliability for the questionnaire. As the main finding of the study, 48.33% of patients were not using antiretroviral medications regularly. An average number of patients (2.88) had HIV related stigma and fear of disclosure. In a quantitative study before testing in the study, it has been found that HIV patients did not have adequate information about their disease.Conclusion: Defects in the consultation process for the patients with HIV infection in the hospital were concluded. The quantity of consulting services for patients was in low level; therefore it is essential to improve consulting services for health promotion of the HIV patients.

Background and aims: The most common cause of acute flaccid paralysis of all ages is Guillain-Barre syndrome (GBS). Further understanding of this disease is important because of its life-threatening nature in life. The aim of this study was to conduct a 10-year survey on epidemiological and clinical features of GBS in Tohid and Besat hospitals, Sanandaj, Iran, from 2005 to 2014.Methods: This study was a retrospective study, based on medical records, in which 98 hospitalized cases in Tohid and Besat hospitals (tertiary referral hospitals), Sanandaj, Iran, between 2005 and 2014 were investigated. The epidemiological and clinical information was obtained from eligible cases. Data analysis was performed using SPSS version 16. Chi-square and t test were used for analyses. The significant level was considered at P<0.05.Results: The mean age of cases with GBS was 22.16 years. Among final 69 patients who were studied, 36 cases (52.2%) were male and 33 cases (47.8%) were female. Most cases of disease occurred in the spring. Thirty-nine patients (56.52%) had risk factors like history of gastrointestinal infections, respiratory infections, and surgery 2-4 weeks before the disease onset. Four cases (10.25%) needed mechanical ventilation. The most common protocol of treatment was IVIg (n=47, 68%). More than half of the patients (52.2%) achieved relative recovery. In 6 patients, (8.7%) relapse was occurred.Conclusion: Our study showed that there was a significant relationship between sensory- motor involvement, gender and age. Moreover, the relationship between gender and prognosis was indicated (P<0.05).

Background and aims: The concept and meaning of futile care depends on the existing culture, values, religion, beliefs, medical achievements, and emotional status of a country. In Iran, futile care has become a challenge for nurses working in intensive care units (ICUs). Considering the differences observed in defining futile care based on the patients’ conditions and the nurses’ personal values, we aimed to define the dimensions of futility at the end of life from the viewpoints of nurses working in ICUs. This qualitative phenomenological study was done to understand the experiences of nurses working in ICUs with respect to the dimensions of futility.Methods: this research was a qualitative phenomenological study. The statistical population of this study included nurses working in the ICUs of 11 teaching hospitals and hospitals affiliated to the Social Security Organization in Qazvin province, northwest of Iran. Personal interviews and observations of 25 nurses working in the ICUs of 11 hospitals were collected. All interviews were recorded and codes and themes were extracted using Van Manen’s analysis method.Results: Initially 80 codes were extracted. During data analysis and comparison, the codes were reduced to 65. Ultimately, one theme and 2 sub-themes, and 5 categories were emerged: "futile medical orders, futile diagnostic procedures, and category of nursing which included futile nursing interventions and irrelevant duties to nursing".Conclusion: Considering that nurses play a key role in managing futile care, being aware of their experiences in this regard could be the initial operational step for compiling useful care and educational programs in ICUs.

Background and aims: Squamous cell carcinoma is one of the most common cancers in the oral cavity. The aim of this study was to assess the rate of awareness of people referring to medical clinics in Kerman because of the oral cancer and its risk factors from 2015 to 2016.Methods: This cross-sectional study was conducted on a sample size of 1200 subjects between April and December 2016 in Kerman, Iran. The participants were selected based on stratified sampling from dental clinics of 4 different areas of the city. After filling the informed consent form, they were asked to complete a self-administered questionnaire. The questionnaire included demographic information, awareness of subjects about common characteristics of oral cancer, and predisposing risk factors. To analyze the data, chi-square and analysis of variance (ANOVA) tests were used by means of SPSS 21.0. A value of P £ 0.05 was considered to be significant.Results: A total of 58.8% of the participants showed intermediate level of knowledge regarding oral cancer. Knowledge about risk factors and symptoms was also at an intermediate level (57.2% and 65% respectively). Knowledge of women was significantly more than that of men (P=0.02). moreover, subjects who were married presented more correct answers than single ones (P=0.01). Moreover, urban dwellers were found to be more knowledgeable than rural populations (P=0.03).Conclusion: Although the public information on oral cancer is improving compared to a study carried out 7 years ago in Kerman, the level of knowledge is still not satisfactory. Indeed, much more efforts to increase public information by social media is needed.

Background and aims: Toxoplasmosis is a very common disease in the world. Two types of acquired toxoplasmosis have been detected. In the chronic toxoplasmosis, the abnormality of tissue function is little but, in acute toxoplasmosis, function of RES system becomes interrupted. The assessment of toxoplasma antibody with tissue enzymes in this stage is very important. Furthermore, serum ferritin in some conditions became high in acute phase of infectious disease.Methods: This study was based on comparative abundance study. Materials consisted of 980 serum and amniotic fluid samples collected from human blood with high level of IgG antibody against Toxoplasma gondii in Rajaie center, Tehran, Iran. The standard test was ELISA assay to detect these antibodies and the main test was measurement of liver transaminases (SGOT, SGPT) bilirubin and ferritin to evaluate acute toxoplasmosis. Data analysis was done by SPSS version 18.0. This study was done during March to June, 2017.Results: Results showed that in some patients with high level of IgG AVIDITY antibody against T. gondii the level of liver transaminases, serum bilirubin and ferritin became increased. For example in 120 patients with acute toxoplasmosis the mean serum levels of SGOT were 108 IU/L and in 80 patients the mean serum bilirubin were about 5 mg/dL.Conclusion: In acute congenital toxoplasmosis, the evaluation of IgG AVIDITY was first step and then the measurement of biochemical factors such as serum transaminases, serum Bilirubin and serum Ferritin were important.

Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system (CNS). This highly disabling disorder is characterized by a variable clinical course. MS is a heterogeneous disease with a complex pathology and significant social and economic impact. MS is associated with dysfunction of parts of the nervous system which results in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. There is no definite treatment for MS. Iran has been thought to be located in the low risk zone of MS prevalence. However, recent studies and investigations in some cities such as Isfahan, a central province of Iran, have suggested a medium-to-high risk level of MS prevalence. Pathophysiological processes in MS contribute to the disease course and clinical manifestations. Therefore, biomarkers that are indicators of these events would provide significant potential for diagnosis, prediction of disease course, and optimization of therapeutic responses. This review provides information on the prevalence of MS and some risk factors among Iranian people.

Background and aims: Prayer means reading and asking for help and satisfying the need. The prevalence of mental diseases has had an increasing trend in Iran. The aim of this study was to know the role of attitudes and praying-related behaviors in the treatment of patients with depression in Iran.Methods: By searching in the databases such as SID, Magiran, Medlib, Iranmedex, Google Scholar, Web of Science, Scopus, and PubMed, 16 relevant articles were extracted. Data were analyzed by using meta-analysis (random effects model). Moreover, heterogenecity of the studies was checked using Q and I2 statistics.Results: To examine the relationship between the rate of depression and praying, it analyzed in both case and control groups as pretest and posttest. It was reported that the rate of depression before the test in the case group was 49.4 (95% CI: 34.04-64.04) and in the control group was 27.51 (95% CI: 15.51, 39.51). For the case group, it was reported that the rate of depression decreased to 12.43 (95% CI: 2.4-22.4) and for the control group it was 19.83 (95% CI: 11.8-27.83).Conclusion: The attitude and the praying-related behavior had positive effects on the depression of individuals and it could cause the depression level diminishing. Therefore, this therapeutic approach can be considered as a common method in the treatment of mental disorders and the psychologists and the therapists can use this method for the treatment of their patients in therapeutic centers.