Journal of Health System Research
Year:2021 | Volume:16 | Issue:4|Papers Count:10

Background: Accidents are one of the most important health-threatening factors among different age groups in the society, especially in older people. Due to the growth of older people population and increasing their participation in social activities, studying the trends of accidents in older people can be useful in identifying research priorities and specific interventions. Methods: This research with a cross-sectional descriptive approach has been done on 27332 injured elderly who referred to hospitals of Isfahan Province, Iran, between 2012 and 2015. Data were retrieved from elderly accidents registration software, then were analyzed in SPSS software using descriptive statistics. Findings: Most and least accidents in men and women have been occurred, respectively, in the age group of 60 to 64 years and 85 years and older. 65. 34% of the accidents have been happened among elderly men and 34. 65% in elderly women. Totally, streets and alleys (39. 62%) and sports and recreation centers (0. 48%) were the most and least scenes of the accidents. The highest and the lowest rates of the accidents occurrence (27. 39% and 23. 58%) have been reported in 2013 and 2014, respectively. Moreover, the top cause of accidents in women (29. 87%) and in men (25. 82%) was crash and the least cause in both genders (0. 01%) was drowning. Conclusion: Older people need special attention in accidents due to their physical conditions, comorbidities, and exacerbation of complications. Regarding the growing trend of population aging, it is recommended to provide dedicated services and notification to prevent accidents incidence in the elderly.

Background: This study aimed to compare the coping strategies and hardiness in mothers of children with autism spectrum disorder (ASD) and mothers of children with attention deficit hyperactivity disorder (ADHD) in Isfahan, Iran. Methods: In this study, we used the causal-comparative research method. The statistical population consisted of mothers of children with autism covered by Autism Society of Isfahan and mothers of children with ADHD who referred to the counseling clinics of Isfahan. Finally, 73 and 64 mothers from each group were respectively selected based on convenience sampling. The research tools were Coping Health Inventory for Parents (CHIP) and Family Hardiness Index (FHI), which were studied and answered by mothers. Data were analyzed by SPSS software. Findings: Based on the analysis of variance results, there was a significant difference between coping strategies used by the mothers of children with autism and mothers of ADHD group (P = 0. 009, F = 6. 956). Meanwhile, no significant differences between the hardiness of the two samples were observed (P = 0. 069, F = 3. 381). Conclusion: Since effective coping strategies increase the level of resilience, hardiness, and wellbeing of mothers and their families, therapists and specialists must necessarily pay more attention to coping patterns and strategies of mothers and design the most effective and appropriate intervention program based on their demographical and personality characteristics.

Background: Multiple sclerosis (MS) is one of the most common and debilitating neurological diseases at the young age. Previous studies have suggested that nutrition as an environmental factor plays an important role in the development of the disease and its relapse. Therefore, this study aimed to identify inappropriate diet in patients with MS with relapses in the past year. Methods: This study was conducted in a qualitative paradigm with a phenomenological approach in 2019. 15 patients with MS and 5 specialists from Rasht City, Iran, participated in the study. Participants were selected by purposeful sampling method with maximum diversity, and the unstructured interviews were done to the point of theoretical saturation. Data were analyzed using Attride-Stirling thematic analysis approach. Findings: From the total interviews, three global themes were identified: 1-eating behaviors, 2-self-regulation in eating behaviors, and 3-malnutrition. Organizing themes for eating behaviors included “ eating ready meals and inappropriate cooking” , for self-regulation in eating behaviors included “ temptation, purpose, and meal management” , and for the malnutrition included “ insufficiencies and excesses” . Conclusion: The results of this study suggest that the diet of people with MS with a history of relapsing, in the field of nutritional behaviors, self-regulation, and malnutrition has some deficiencies that the patients and specialists’ perceptions have an effective role in relapse of the disease. Accordingly, it seems that further research and development of educational interventions to improve the diet of these people is necessary.

Background: Metabolic syndrome refers to a cluster of disorders including abdominal obesity, glucose intolerance, hypertension (HTN), hypertriglyceridemia, and low high-density lipoprotein (HDL) levels. The metabolic syndrome increases the risk of developing cardiovascular disease (CVD) and type 2 diabetes. Recently, it has been found that selenium can also be effective in the carbohydrates and fat metabolism. The aim of this study was to evaluate the effects of selenium supplementation on glucose homeostasis parameters and lipid profile in women with metabolic syndrome. Methods: This randomized, double-blind, placebo-controlled trial was conducted among 70 women diagnosed with metabolic syndrome and aged 20-49 years old. Participants were randomly divided into two groups to receive 200 μ g per day selenium supplements (n = 35) or placebo (n = 35) for 8 weeks. Fasting blood samples were taken at baseline and after 8 weeks of intervention to quantify fasting blood sugar (FBS), insulin, and lipid concentrations. Findings: After 8 weeks of intervention in two groups, there was no significant difference between the two groups in the studied variables including FBS, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), triglyceride (TG), total cholesterol (TC), HDL, and lowdensity lipoprotein-cholesterol (LDL-C(. Conclusion: Supplementation of 200 μ g of selenium for 8 weeks had no significant effect on glucose homeostasis and lipid profile in the participants with metabolic syndrome.

Background: Perfectionism is a personality trait whose negative aspect becomes obsessive and causes many problems for the individual and the family. In addition to perfectionism, many variables make couples' compatibility difficult which different therapies seek to reduce them. Methods: This semi-experimental study was conducted with two experimental groups and a pretest-posttest design with 40-day follow-up. The statistical population of this study included 200 self-reported couples who referred to Isfahan Social Emergency Counseling Center (Mosalla), Isfahan, Iran, for their marital problems in 2016. The sample group was voluntarily selected from among clients referring to the Social Emergency Counseling Clinic. Group couple therapy based on reality therapy and acceptance and commitment therapy (ACT) was done for both groups in eight sessions of two hours. Data were collected through Perfectionism Questionnaire and basic needs adjustment questionnaire, and were analyzed using repeated measures analysis of variance (ANOVA) via SPSS software. Findings: There was no significant difference between the effectiveness of group couple therapy based on reality therapy and ACT on adaptive perfectionism, but there was a significant difference in maladaptive perfectionism (P < 0. 050). Besides, there was a significant difference between the effectiveness of group couple therapy based on reality therapy and ACT on adjustment of couples' needs (P < 0. 050). Conclusion: The results of this study showed that reality-based couple therapy was effective in reducing incomplete perfectionism, and ACT was effective in adjusting the needs of couples. Therefore, these two approaches can be used in couple counseling.

Background: Congenital malformations are one of the causes of infants’ disability and death. This study was performed to determine the incidence of major congenital anomalies and their relationship with some related factors at birth. Methods: In this cross-sectional study, all newborns born in hospitals of Chaharmahal and Bakhtiari Province, Iran, were evaluated for major congenital malformations at birth. Information recorded in the case file including parent and infant characteristics was extracted from the Iranian Maternal and Neonatal Network (IMaN). Data were analyzed using generalized linear model (poisson regression). Findings: Of 19666 newborns studied, 63 (3. 2 per 1000) had major congenital malformations at birth. In the crude model, pregnancy age, neonatal birth weight, neonatal height, and neonatal head circumference variables were significantly associated with congenital malformations. In adjusted model 1, residence was significantly related to the incidence of congenital malformations and in adjusted model 2, the incidence of congenital malformations was related to neonatal pregnancy age, neonatal birth weight, and neonatal head circumference. Conclusion: In some congenital malformations, disability can be prevented by early diagnosis and treatment. Therefore, the emphasis on public education to consider appropriate gestational age, proper nutrition before and during pregnancy, and emphasis on pre-pregnancy and during pregnancy care is necessary to prevent congenital anomalies.

Background: Fruit leather has always been a popular product especially among children. In this study, the effect of spirulina (Arthrospira) platensis microalgae on the formulation of kiwi leather has been studied in order to produce a healthy snack with high nutritional value. Methods: Microalgae powder was used at the levels of 0, 0. 5, 0. 75, 1, and 1. 5 percent in order to produce the samples. Then, physicochemical analysis and sensory evaluation were performed. Statistical analysis of the results was performed by Minitab software. Findings: There was no significant statistical difference in the amount of ash and fiber of the samples (P > 0. 05). The lowest pH was observed in the control and the highest was seen in the sample containing 1. 5% of Arthrospira. The protein and iron levels increased by increasing microalgae concentration and a reduction trend was observed in vitamin C (P < 0. 05). The brightness and yellow color of the samples decreased by increasing of Arthrospira and also the green color of the samples increased compared to the control (P < 0. 05). Utilizing the higher level (1. 5%) of Arthrospira reduced the hardness compared to the most samples (P < 0. 05). The results of sensory evaluation showed significant differences in some of the indices especially in the sample containing 1. 5% of microalgae, compared to other samples (P < 0. 05). Conclusion: Utilization of spirulina (Arthrospira) platensis up to 1% in formulation of kiwi leather resulted in a product with high nutritional value and also acceptable quality characteristics. Therefore, this product can be recommended as a snack with high nutritional value compared to common high-calorie snacks with low nutritional value especially for children.

Background: Awareness of people about the risk factors of the disease and prevention strategies has a significant effect on the prevention and treatment of diseases. Considering the high prevalence of cancer in Iran, the present research was carried out to determine the awareness and health beliefs of staff of Shahid Beheshti University of Medical Sciences, Tehran, Iran, on colorectal cancer and related factors using Health Belief Model (HBM). Methods: In this cross-sectional study, 101 employees were selected from among 4 schools of Shahid Beheshti University of Medical Sciences through cluster sampling method. Data collection tool was a valid and reliable researcher-made questionnaire including demographic questions and health belief and behavior pattern items. Data were analyzed by independent t-test, one-way analysis of variance (ANOVA), and Pearson correlation coefficient using SPSS software. P-value less than 0. 050 was considered as the significance level. Findings: The mean score of participants' knowledge was 66. 80 ± 18. 37; 48. 5% of them had low, 28. 7% had moderate, and the rest had high level of knowledge about colorectal cancer. Perceived benefits and perceived sensitivity had the highest and the lowest mean, respectively. Increasing age, family history of cancer, and education were factors that influenced employees' awareness of colorectal cancer. Conclusion: Considering that about half of the staff had low level of awareness about colorectal cancer, it is suggested that programs be conducted to change the behavior of individuals in order to prevent the onset of this cancer, so that in addition to increasing awareness and promoting health beliefs, an ever greater reduction in the incidence of this disease occurs.

Background: This study aimed to reduce the sugar amount used in Luz production and promote its nutritional value by stevioside and Spirulina platensis. Methods: In this study, the effects of sugar replacement with stevioside-isomalt (0%-100%), almond replacement with Spirulina (0%-100%), and cooking temperature (50-70 ° C) on density and hardness of dietary Luz were investigated. Formulation optimization of enriched dietary Luz was performed by Response Surface Methodology (RSM) and central composite design (CCD) with Design Expert software. After determining the optimal point, the results of physicochemical and textural properties were analyzed by SPSS. Findings: The density of treatments decreased with decreasing levels of Spirulina replacement. The interaction between stevioside and Spirulina showed that decreasing levels of stevioside caused a significant (P < 0. 050) increase in hardness. The process of texture hardness change with increasing levels of Spirulina replacement was first decreasing and then increasing. The optimum formula of dietary Luz was predicted as 76% stevioside-isomalt, 57% Spirulina, and cooking temperature of 70 ° C, and 39% stevioside-isomalt, 100% Spirulina, and cooking temperature of 62 ° C. A comparison between the optimal sample and the control sample showed that protein, calcium, and iron contents of the optimal sample were higher than the control sample (P < 0. 0500). Conclusion: The sugar content of Luz can be reduced using stevioside, and application of Spirulina platensis in Luz formula improves the nutritional properties of the product.

Background: Postpartum depression (PPD) is the most common psychological disorder after childbirth, which may cause serious effects on mothers, infants, and families. The present study aims at identifying factors related to PPD, according to social determinants based on the World Health Organization (WHO) model. Methods: In this review of literature, the keyword of "postpartum depression" was searched in Persian and English languages and within the time period of 2010 and 2020, in national and international databases including Scientific Information Database (SID), PubMed, ProQuest, Elsevier, and Scopus. Considering the inclusion criteria, 38 articles were finally selected. Findings: 31 factors in two structural and intermediate dimensions were extracted. The relationship between PPD and socio-economic situation, race, place of residence, perceived social support, marriage satisfaction, home violence, history of depression and psychiatric disorders, psychological pressure, daily stresses, and breastfeeding self-efficiency was verified in the articles. Type of pregnancy, problems and side effects of it, preterm delivery, low weight of infant at birth were factors influencing PPD. Proper breastfeeding played an important role in reducing maternal depression. A relationship was observed between PPD and mother and infant emotional relationships and neonatal outcomes. On the other hand, neonatal disorders and diseases in the first four weeks had a positive significant relationship with PPD. Training and quality of pregnancy and postpartum care were also related to PPD. Conclusion: The conclusions gained from studying the review of literature shows that the WHO model is capable of determining the social factors related to PPD.