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H.r Joshaghani, A.r Ahmadi,
Volume 6, Issue 3 (13 2009)
Abstract
Background and Aim: Organophosphate compoounds are cholinesterase activity inhibitors. Contact with them cause changes in the blood antioxidant enzyme levels and lipid peroxidation. The aim of this research was to investigate the simultaneous changes in cholinesterase, total serum antioxidant levels, and activities of some of the erythrocyte antioxidant enzymes and find possible correlations among these variables in pesticide factory workers.
Materials and Methods: This research was a cohort study carried out, during 2006, on the employees of a pesticide factory in Golestan Province, Iran. Blood samples were taken at the beginning (n=81 subjects) and after 3 months (n=63, of the initial 81). Erythrocyte glutathione peroxidase (GPx), superoxide dismutase (SOD) and total antioxidant levels were determined enzymatically (Randox, UK) and serum SOD was measured by the ELISA method (IBL, Germany). For the determination of malondialdehyde (MDA) a chemical method (based on thiobarbituric acid) was used. Confidence interval was 95% for all statistical tests.
Results: Levels of serum and erythrocyte SOD, serum MDA, and both serum and eryhthrocyte GPx significantly increased (paired t-test, p<0.05), while the serum total antioxidant level decreased (paired t-test, p<0.05). No statistically significnt correlation was seen between cholinesterase and changes in the other variables.
Conclusion: Contact with organophosphorus compounds will cause increases in lipid peroxidation and decreases in total antioxidants. It is suggested that, while more severe physical protective measures are taken, nutritional supplements be taken by the personnel to increase protection against hazardous materials.
Z Rahaei, H Heshmati, Mm Hazavehei, A Hasanzadeh,
Volume 9, Issue 1 (14 2011)
Abstract
Background and Aim: The objective of this study was to determine the relationship between educational practice of volunteer health workers (VHWs) and preventive behavior of households (HH) under their coverage regarding cutaneous leishmaniasis (CL) based on the BASNEF model in Yazd City, Iran
Materials and Methods: In this descriptive cross-sectional study, all the 60 VHWs in the CL-endemic regions in Yazd City were interviewed and completed a valid and reliable questionnaire designed by the investigator. In addition, from among the households under coverage of each one of the VHWs, 2 HHs were selected randomly and their heads were interviewed and completed the relevant questionnaire (total n=120). Data were analyzed using descriptive and inferential statistics.
Results: There was a positive correlation between the knowledge and attitude of VHWs and knowledge of the households, as well as between the VHWs' behavioral intention and households' behavior. Further analysis of the data also revealed a positive correlation between the enabling factors of VHWs and the knowledge, behavioral intention, enabling factors and behaviors of families, as well as between educational behavior of VHWs and knowledge, attitude and behavior of the families.
Conclusion: Volunteer health workers can potentially play an important role in case-finding, prevention and timely treatment of cutaneous leishmaniasis. However, merely promoting their awareness of the disease will not lead to improvements in their educational behavior in the community. More effective education aiming at promoting their awareness and enabling factors, as well as developing better attitude in them, will certainly result in better behavior of households and control of the disease
Hassan Eftekhar Ardebili, Farhad Lashkar Boloki, Abolghasem Jazayeri, Mohammad Ariaei, Mansoureh Minaei,
Volume 12, Issue 2 (10-2014)
Abstract
Background an Aim: Aging trend especially in developing country is increasing. This study aimed to assess the nutritional status of the elderly and its associated factors in Gorgan .
Materials and Methods: This is a cross sectional study that two-stage cluster sampling method was used for considering participant. The data were collected using Mini Nutritional Assessment and anthropometric questionnaire which was referred to the elderly inhabitant in urban area. 541 elder were interviewed and data were analyzed by chi square, independent T test and one way ANOVA tests.
Results : The prevalence of malnutrition was %4/8 and nearly %44/7 of the elderly were at the risk of malnutrition. %51/9 of the elderly were on a special diet due to a disease or specific condition. Malnutrition frequency and the risk of it were higher in woman than men and the difference between sexes was statistically significant. BMI, mid arm circumference and calf circumference measures in elderly with malnutrition were less than elderly with good nutrition, and the difference was statistically significant
Conclusion: The risk of malnutrition in elderly who exposed to socio-economic, mental and also dental difficulties, living alone and female old age was higher than others groups. The implementation of supportive and nutritional programs is more important in this group.
Behzad Damari, Abbas Vosough Moghaddam, Narges Rostami Gooran, Mohammad Javad Kabir,
Volume 14, Issue 2 (9-2016)
Abstract
Background and Aim: The most important healthcare reform in Iran during the last decade has been implementation of the family physician and referral system in rural areas and small towns with a population of less than 20000. The program was expanded (as a pilot project), with small modifications, to rural areas of 2 provinces, namely, Fars and Mazandaran. This study was initiated to assess the achievements, challenges and weak points of the pilot project before deciding to expand it to other provinces.
Materials and Methods: This qualitative study was conducted in winter 2013. Data were collected using document desk reviews, semi-structured interviews with key informants, and focus-group discussions. Relevant family health policy makers, managers and service providers in the two provinces were invited to the meetings. The data were analyzed and categorized based on the content analysis method.
Results: The data showed that the family physician program is faced with several challenges regarding objectives; stewardship; service providing; and human, financial and information resources. It is to be noted, however, that the program has had achievements such as increased access to services, increased coordination among insurance organizations and medical universities, and organizing and managing health files.
Conclusion: The program should not be expanded to other provinces before redesigning in order to assure that it is more complete and comprehensive and create commitment and adequate guarantee among stakeholders. It is essential that all the stakeholders agree on general and specific objectives of a 5-year program and prepare an operational plan for each specific objective.
Alireza Heidari, Mohammad Arab, Kourosh Etemad, Behzad Damari, Mansoureh Lotfi,
Volume 16, Issue 2 (9-2018)
Abstract
Background and Aim: The purpose of phenylketonuria (PKU) screening is to assess the risk of, and prevent, the disease in the newborns likely inflicted with it. The aim of this study was to investigate why and how PKU screening was decided to be included in the national health agenda, initiated and implemented in Iran.
Materials and Methods: This qualitative study was conducted based on the Kingdon’s framework model in 2015. The participants were thirty-eight policy-makers, managers and researchers selected by purposeful sampling.Data were collected using semi-structured interviews and analyzed using framework analysis.
Results: The physical and mental disabilities, medical and maintenance costs and the need for rehabilitation services were examples of the problem stream. In addition, sampling based on the National Congenital Hypothyroidism Program and implementation feasibility at the national level were examples of the policy stream. Finally, pressure by the patients' families, the Scientific Children Association and executive managers were examples of the political will stream. When the three streams occurred simultaneously, health policy-makers agreed to implement the program and then was opened the window of opportunity.
Conclusion: Successful implementation of the National Phenylketonuria Screening Program in Iran has been the result of interactions among three streams, namely, nature of the problem, political will and optimal use of policy-makers of the window of opportunity opened.
Ayoub Sofizadeh, Kamran Akbarzadeh, Zakiyeh Telmadarraiy, Ahmad Gorganli Davaji,
Volume 16, Issue 4 (3-2019)
Abstract
Background and Aims: Ticks are external parasites that can be vectors of several disease agents. This survey was carried out to determine distribution and biological diversity of hard tick species in Maraveh Tapeh County, Golestan Province, Iran in spring 2016.
Materials and methods: In 10 selected villages in the study area, about 29 cattle, 99 sheep, 62 goats and 11 camels were inspected for tick infestation. The ticks isolated were preserved in a solution of 70% alcohol and identified. The Margalef, Shannon-Wiener, Simpson and Evenness indices were used to measure the biodiversity.
Results: A total of 476 ticks were collected. Two hard tick genera (Hyalomma and Rhipicephalus) and twelve species were identified including Hyalomma anatolicum, Hy. scupense, Hy. aegyptium, Hy. marginatum, Hy. dromedarii, Hy. rufipes, Hy. asiaticum, Hy. excavatum, Hy. detritum, Rhipicephalus turanicus, R. bursa and R. sanguineus. Further analysis of the data showed that R. sanguineus and Hy. asiaticum were the most abundant species in the whole area and plateau areas, respectively, while R. sanguineus was most abundant in both hillside and mountainous areas. Based on the Margalef index, the species diversity was higher in foothill areas and it was lower in the goat host than other hosts, while based on the Shannon-Wiener index, the species diversity was higher in plateau areas and in the sheep host it was less than in other hosts.
Conclusion: Ticks population dynamic studies and calculating their biodiversity indices are helpful in understanding the situation of vectors and the future situation of vector-borne diseases.
Ensiyeh Babaie, Fereshteh Bakhshian, Aram Karimian, Reza Saadatmehr,
Volume 17, Issue 3 (12-2019)
Abstract
Background and Aim: Considering that a person’s identity in formed during adolescence and that such identity formation is of particular importance in this period and the many factors that play important roles in it, the present study was conducted to determine the factors related with identity formation among high school students in Mazandaran Province, Iran.
Materials and Methods: This was a descriptive-analytic cross-sectional study. The participants were 394 high school students in Mazandaran Province, Iran selected by random cluster sampling. Data were collected using 3 questionnaires, namely, the Benion and Adams Identity Scale Questionnaire (EOM-EIS-2), the Identification Factors Questionnaire and a Demographic Questionnaire. For data analysis, Wilcoxon, Spearman correlation and linear regression tests were used.
Results: Over half (51.8%) of the participants were girls and 48.2% boys. The results of regression analysis showed that the factors studied (family, personality, school, community and culture and media) could explain 22.7%, 11.2%, 10.5% and 21.2% of the variance in turbulent, early, delayed and advanced self-identification in adolescents, respectively.
Conclusion: Based on the results of this study, it is recommended to organize parenting and student training courses and make the school environment more favorable for the students, as well as include extracurricular activities in the school to help students identify themselves more easily.
Behzad Damari, Alireza Heidari, Habib Allah Masoudi Farid, Arezoo Zokaei,
Volume 18, Issue 3 (11-2020)
Abstract
Background and Aim: Prostitution is one of the alarming social harms in any population with considerable challenges and concerns. Many prostitutes have been victims of unfavorable social conditions. The purpose of this study was to determine and explain the goals, service patterns, challenges and proposed solutions for the Program of Rehabilitation of Socially Harmed Women in the Iranian Welfare Organization (IWO).
Materials and Methods: A qualitative study was conducted in 2016. The participants included managers and experts of the general departments of the IWO in 31 provinces, 21 members of public mediators and stakeholder organizations, and 5 senior staff managers and senior experts of the IWO Deputy Director’s Office for Social Affairs. Data were collected using document analysis and in-depth individual interviews and focus group discussions and analyzed using the content analysis method.
Results: Based on the data collected, the challenges of the program implementation were found to be as follows: non-acceptance of these women by the society, identity problems of the children borne to them (legally), poor chances of employment, sexual abuse of the women by the employers and mental disorders of the women, as well as poor intersectoral collaboration in IWO and lack of sufficient manpower. Proposed solutions for improvement of the situation included increasing financial credits, creating a national database, informing and sensitizing the people and approving some new judicial laws, as well as reforming some of the existing judicial laws.
Conclusion: Despite the services delivered in this national program, the program faces challenges at the government and public levels. In order to improve the current situation, it is essential to apply the proposed solutions, as well as review and modify the relevant processes.
Mohammad Javad Kabir, Alireza Haydari, Mohammad Reza Honarvar, Zahra Khatirnameni, Abbas Badakhshan, Narges Rafiei, Sakine Beygom Kazemi, Seyed Mehdi Sedaghat, Mehrdad Kamangari, Masoumeh Gholami, Maryam Eri, Mansoureh Lotfi,
Volume 19, Issue 2 (9-2021)
Abstract
Background and Aim: The World Health Organization considers the implementation of the referral system to be a key step in improving the quality of services in health care systems. The purpose of this study was to explain the executive challenges of the electronic referral system in Golestan Province, Iran.
Materials and Methods: A qualitative study was conducted in Golestan Province, Iran in 2019 with a content analysis approach. The participants were family physicians, specialists, university staff managers, responsible health officers in the Offices of Deputy Ministers of Health, the General Directorate of Health Insurance, Department of Information Technology, Rural Health Network managers, health network managers and patients selected purposefully. Data were collected through semi-structured interviews and analyzed using the content analysis method.
Results: The main challenges of giving appointments to patients included the lack of time of family physicians, the irregular presence of specialists, difficulty in getting an appointment, and reverse referrals. As regards referrals and waiting times, the main challenges were found to be the lack of sufficient admissions following cancellation of the health insurance contract with the private sector, the delay of physicians in attending the health centers, long waiting times to be visited, and writing the feedback by the physicians. In addition, the main challenges of the visits and diagnosis included the short visiting times, the higher quality of the specialists' visits in the private sector, and the lack of clear guidelines. Finally, the main challenges as regards giving feedback were the reluctance and noncommitment of some specialists to provide feedback, as well as the low quality and lack of usability of the feedbacks given.
Conclusion: Based on the findings of this study, the following actions and measures may help improve the current situation as regards the current referral systems: allocating sustainable resources; allocating financial credits; designing and implementing a reward and punishment system; reforming the queuing system; empowering medical students; and equipping specialists with electronic pens for giving written feedback.
Mohammad Javad Kabir, Alireza Heidari, Nahid Jafari, Zahra Khatirnamani, Mohammad Reza Honarvar, Naser Behnampour,
Volume 19, Issue 4 (3-2022)
Abstract
Background and Aim: Using a proper method to prioritize and develop a basic health services package is a serious challenge. This study was conducted to design a process for developing and revising a basic health services package in Iran.
Materials and Methods: A combined study of quantitative and qualitative methods was used in this study. The qualitative part was conducted through holding 25 in-depth individual interviews and two focus group discussions with experts from the Ministry of Health and Medical Education, Program and Budget Organization and insurance organizations, while the quantitative part was a descriptive cross-sectional study including 277 experts using a valid and reliable questionnaire. Data analysis of the qualitative and quantitative parts was done using a content analysis and the SPSS-23 software, respectively.
Results: The process of developing a basic health services package includes 4 steps, namely, explaining the list of services in the basic health services package, extracting the criteria for including services in the service package, prioritizing the criteria for including services in the package, and comparing services with priority criteria. In the prioritization stage, disease burden criteria, target groups and community needs were found to have the highest means and recognized as the most important criteria.
Conclusion: The process designed in this study for developing and revising a basic health services package provides policymakers with the required scientific evidence by emphasizing the introduction and continuity of services that have higher priorities and the elimination of services that have lower priorities.
