JOURNAL OF SCHOOL OF PUBLIC HEALTH AND INSTITUTE OF PUBLIC HEALTH RESEARCH
Year:2006 | Volume:4 | Issue:3|Papers Count:12

Background and Aim: To describe the trends in research articles in the field of mental health. Materials and Methods: The articles that we reviewed belonged to the fields of psychiatry, psychology, and neuroscience. We limited the search to the literature published over the 30-year period from 1973 to 2002. The following types of data were extracted: areas of research, specific topics, study design, location for data collection, funding sources, and the different types of working relationship among the authors.Results: Analysis of publication trends in 3031 articles showed a marked increase in the total number of publications with time, especially over the last 5 years. As for different research areas, we detected a growing proportion of articles in the field of neuroscience and a decline in articles dealing with mental health. The volume of research in the fields of psychology, epidemiology and clinical sciences remained relatively constant. There was a rise in the proportion of cross-sectional studies and clinical trials in the second half of the 30-year period.Conclusion: It is important to find the reasons and implications for the waning interest in mental health. Our results could provide an empirical basis in policy making and strategic planning for research in this area.

Background and Aim: In breach of all international conventions, Iraq frequently used chemical weapons against both military and civilian targets in its 8-year war with Iran. The most frequently used agent was sulfur mustard. The effects of mustard gas may be divided into early and late categories. Late lesions, due to the agent's mutagenic and carcinogenic potential, are mainly the results of its action on intracellular particles, probably nucleic acids. Although the occurrence of cancer has been proved following long-term exposure, the presence of a carcinogenic effect in acute, short-term contact is still in doubt.Materials and Methods: To determine the relationship between cancer and acute exposure to mustard gas, a historical cohort study was carried out in Isfahan province, involving 500 chemically-injured soldiers with at least one episode of exposure to mustard gas. The incidence of cancer and the death rates in these subjects were compared with similar rates from i) 500 unexposed soldiers in the same area and ii) nationwide figures.Results: All the subjects were male. The mean age in the exposed and unexposed groups were 41(±10.8), and 40(±7.6) years respectively. Within the exposed group, the mean age at first exposure was 24.1(±13) years; the mean age at first injury in the unexposed group was 23(±11) years. Eighty-one percent of the cases lived in cities and 19% in rural areas. For 395 persons (84.5%) in the exposed group, education was at high school level or below. Within the same group, 481 subjects (96.2%) were married. Sixty-three people (12.6%) were servicemen and 366 (73.2%) had civilian jobs. Three cases of cancer were observed in those exposed to mustard gas. No cases occurred in the unexposed group. Ten people in exposed group and 7 in the unexposed group were dead at the time of the study. Relative risks for cancer and death were estimated at 4.02 (CI 95% = 0.45-36.1) and 1.44 (CI 95% = 0.54-3.81) respectively.Conclusion: The results failed to show a statistically significant relationship between cancer incidence and acute exposure to sulfur mustard.

Background and Aim: With growing emphasis on cost containment, optimal use of resources and increased productivity, the health sector is now adopting an increasingly customer-oriented approach within its administrative and managerial structure. One way to assess hospital performance and service quality would be to measure the level of satisfaction in hospital inpatients, as this group comprises the principal users of medical services within any health care system.Materials and Methods: In this descriptive-analytic study we explored the factors affecting patient satisfaction. Our sample consisted of 400 randomly-selected inpatients who answered the research questionnaire at the time of discharge. We used univariate statistical analysis to examine the effects of various factors on patient satisfaction.Results: Of a total of 13 variables that were analyzed, 9 showed a statistically significant relationship with the outcome variable. These were age, education, marital status, occupation, hospital where interview is performed, hospital type (specialized versus general), type of ward, costs borne by the patient, and system of payment.Conclusion: The strongest effects were observed for marital status, education, hospital type, type of ward, and cost borne by the patient. Results from this study could help to recognize the current flaws within the hospital management system and thus can aid decisions aimed at optimizing hospital services and maximizing patient satisfaction.

Background and Aim: Pap smear test is considered the best screening method for cervical disease, especially for malignant lesions. The crucial factor here is obtaining high-quality samples, as poorly-prepared ones cause a great deal of confusion for patients and physicians alike. Attempts to define an ideal sampling technique have been going on for many years, and in this study we compare three different sampling methods to determine which one provides the best quality.Materials and Methods: This interventional study was performed in a private obstetrics-gynecology clinic and involved 600 women who met the criteria for cervical screening. The Pap test was done by three different methods: "Swab spatula", "Cytobrush- spatula" and "Spatula only".Results: Each method was performed on 200 randomly-selected patients. Cytopathologic examination was done by a single pathologist and in a blind fashion. For each specimen, a quality rating was reported as "satisfactory" or "unsatisfactory".Among the 200 samples obtained by the "Swab spatula" method, 150 (75%) were of satisfactory quality and the remaining 50 cases (25%) were rated as unsatisfactory. As for the cytobrushspatula group, 88 samples (94%) were satisfactory and 12 (6%) were unsatisfactory. Finally, 179 samples (88%) in "Spatula-only" group were satisfactory and 24 (12%) were unsatisfactory. The difference in the proportion of good-quality samples was significant in pairwise comparisons between the three methods: swab-spatula versus spatula-only (P = 0.0013), swab-spatula versus cytobrush-spatula (P = 0.0001) and cytobrush-spatula versus spatula-only (P = 0.036).Conclusion: The study revealed that the cytobrush-spatula sampling method yielded the highest proportion of high-quality samples. Hence, it would be desirable to familiarize physicians, midwives and other health care workers in this country with the technique of cytobrush cervical sampling and its potential advantages. However, financial and cultural aspects must be taken into account before adopting the procedure for routine cervical screening in Iran.

Background and Aim: One of the most important responsibilities of managers is leadership. Leadership styles are the constant behavioral models used by managers when working with others in organizations.The main purpose in this research was gaining an insight into the leadership styles of hospital managers (manager and chief) and to see if there is relationship between managers and employers' personality traits and the style of leadership adopted by the hospital manager.Materials and Methods: This was a cross-sectional study involving all the hospital managers and 385 hospital staff in the province of Qom. We gathered data through a questionnaire based on the Likert system. We thus recognized four different styles of leadership: Exploitive-Authoritative, Benevolent - Authoritative, Consultative, and Participative. Data were analyzed using the SPSS software package.Results: 1-Overall, the managers' leadership styles were found to be mostly of the consultative type but the staff regarded their managers' style of leadership as mainly Benevolent- Authoritative, 2- There was no statistically significant relationship between the managers' personal characteristics and their leadership styles, 3- There is a significant association between the staff members' characteristics and their perception of the manager's leadership styles.Conclusion: The managers' personal traits do not appear to have an effect on their leadership styles but the same traits in employees can have a bearing on how they perceive leadership in their managers.

Background and Aim: Cholera is one of the most important endemic and epidemic diseases in our country. Therefore, keeping track of the changes in antibiotic resistance patterns and continuous genotyping and serotyping of the isolates is essential.Materials and Methods: One hundred stool samples were collected from the patients with cholera in different cities, including Tehran, Kashan, Kermanshah and Ahwaz. The specimens were subjected to a series of diagnostic tests. Strains were identified by serotyping and their antibiotic resistance profiles were defined through susceptibility tests. We also used a polymerase chain reaction (PCR) assay to identify the hlyA gene.Results: Group-specific antisera were used for identification of Ogawa, Inaba, Hikojima and NAG (Non-agglutinable) strains, which constituted 74%, 3%, 0% and 23% of the isolated strains respectively. Antibiotic susceptibility tests showed that all the strains were sensitive to ciprofloxacin, gentamicin and doxycyclin, but there was widespread resistance to Co-trimoxazol (74%), erythromycin (64%) and tetracycline (53%). Vibrio cholerae E1 for isolates were 100% positive for hlyA gene amplification, but hemolytic activity was seen in 95% of the cases on blood agar.Conclusion: Compared to previous studies, there appears to be a higher degree of resistance to tetracycline, hence there may be a need to switch to other agents for the treatment of cholera. The predominant serotype and the antibiotic resistance pattern in Kashan were different from those seen in other cities.

Background and Aim: There is a close relationship between working posture and workstation design so that the postural problems appear to be largely caused by improperly designed workstation. There can be no more fundamental aspect of occupational ergonomics than the concern with the design of the workstation. There is general agreement that health, well-being and productivity of workers are strongly dependent on the success of workstation design. In ergonomic design of workstation, different factors should be taken into consideration, above all posture determinant factors. Regarding this, factorial design is a very useful methodology for identifying posture determinant factors. By this methodology, workstation variables which affect working posture can be identified. Then, optimum values of these variables are determined for working posture improvement. By this means, workstation design guidelines can be developed. In this paper, which has been prepared with the aim of introducing factorial design in ergonomic studies, an example of factorial design application in developing workstation design guidelines for weaving operation is presented.Materials and Methods: In a factorial design of 3x3, nine sets of experimental conditions were tested. The nine sets of experimental conditions consisted of different combinations of seats and weaving heights. Thirty professional weavers participated in the experiments and performed their normal weaving task in 9 experimental sessions. The effects of weaving height and seat type on postural variables were tested by Analysis of Variance (ANOVA) for Repeated Measures.Results: The results obtained in the nine settings were compared and the setting in which optimum working posture adapted was determined. Based on the results, weaving workstation guidelines were developed.Conclusion: It is believed that the recommended workstation improves working posture and results in reduced postural stress on weavers' bodies and, consequently, reduced prevalence of MSDs symptoms.

Background and Aim: The purpose of this study was the assessment of inappropriate admissions and hospital stays and reasons for this in the hospitals affiliated to Tehran university of Medical Sciences.Materials and Methods: We used the Appropriateness Evaluation Protocol (AEP) to evaluate the appropriateness of 258 admissions to Dr. Shariati and Imam Khomeini hospitals and 1732 days of hospital stay for the same patients.Findings indicate that on the whole, 22.8% of admissions were inappropriate and the length of stay for patients who were inappropriately admitted was significantly shorter than for those whose admission was judged to be appropriate.Results: Results show that 8.6% of the total number of patient stay days was unnecessary; the figures differ significantly between the two hospitals. The most frequent reason for inappropriate hospital stay was the delay in the discharge process. Consultations and delay in surgical operations were other causes of inappropriate patient stay.Conclusion: A substantial proportion of hospital admissions and stays were found to be inappropriate due to hospital procedures and inadequacies in the lower levels of healthcare.Efficient use of hospital resources should be promoted by modifying procedures, improving the performance of the healthcare system and revising insurance policies.