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F Golbabaie, M Ostadi, K Mohammad, V Ostadi, M Rismanchian, A Tirgar, Sj Sahtahery,
Volume 5, Issue 3 (4 2007)
Abstract
Background and Aim: Exposure to hexavalent chromium in plating operations is associated with skin ulceration, contact dermatitis, respiratory tract irritation, cancer, and kidney damage. We investigated the possibility of using biological monitoring to assess exposure to hexavalent chromium in chrome-plating workers. We compared mean Cr6 concentrations in the breathing zone plus urine chromium, β2 microglobulin (B2M), and N-acetyl-B-D- glucosaminidase (NAG) at the end of the working shift. Then we assessed the correlation between exposure to hexavalent chromium and biological indicators.
Materials and Methods: This study involved 45 chrome platers (Cases) and 40 zinc platers (Controls) in Isfahan. Air and urine samples were collected at the end of the work shift. Measurement of Cr6 concentrations in the workers' breathing zone was performed using the NIOSH Methods 7600. Urine Cr levels were determined by atomic absorption spectrophotometry, with a graphite furnace (Shimadsu, AA680). B2M and NAG were measured by Kits.
Results: Overall, geometric mean of hexavalent chromium concentrations in the breathing zone was significantly higher among chrome platers (14.577 μg/m3) compared to zinc platers (0.862 μg/m3, p<0.001). Moreover, the mean urine Cr concentrations were higher in chrome platers (9.198 vs. 1.811 μg / g creatinine, p<0.001). Similarly, there were significant differences between mean NAG in chrome platers (12.608IU/gr creatinine) and zinc platers (6.824 IU/g creatinine, p<0.001). Differences in B2M concentrations were not significant (p>0.05). A significant correlation was found between Cr6 concentrations in the chrome platers' breathing zone and their urinary chromium levels (r= 0.838, p<0.001). A similar association was found between concentrations of Cr6 and NAG in the breathing zone (r= 0.304, p<0.05).
Conclusion: As urinary B2M concentration did not change significantly, it may not be a sensitive indicator in evaluating exposure to hexavalent chromium. There were significant differences between mean urinary Cr and NAG concentrations in the two groups. The significant correlations between Cr and NAG concentrations indicate that these markers may be suitable indicators of exposure to hexavalent chromium. Our results indicate that NAG is an early indicator of renal dysfunction in chrome platers.
M Mahmoudi, M Mohebali, H Irandoust , S.h Hejazi , H Abdoli , L Shirani-Bidabadi , F Moaatar , S Charehdar , N Shareghi , A.a Akhavan ,
Volume 6, Issue 3 (13 2009)
Abstract
Background and Aim: Leishmaniasis is a parasitic disease transmitted by sand-flies. Seventeen out of the 30 Iranian provinces are contaminated. Although many therapeutic modalities have been suggested, no definite treatment for this widespread infection is available. Many drugs currently used for cutaneous leishmaniasis have their side effects and create complications-drug resistance, etc. This has prompted researchers to get interested in drugs of a natural origin. The aim of this study was to investigate and compare the efficacies of an extract of propolis and systemic glucantime against cutaneous leishmaniasis in Balb/c mice.
Materials and Methods: Groups of inbred, female Balb/c mice, aged 4-6 weeks, were inoculated with 1.6 × 10 6 viable stationary-phase promastigotes in the base of tail. The mice were provided by Iran Pasteur Institute, Tehran and were randomized into three groups of 9 mice each. Groups 1 to 3 were treated with pure 70% ethanol, systemic glucantime, or the propolis hydroalcoholic extract for a 6-week period the 4th group served as control. The statistical tests including student t-test were used for data analysis.
Results: Overall, 27 mice were studied. We did not observe any statistically significant difference among the groups with regard to the size of the ulcer at the beginning (P>0.01). At the end f the period, there was a significant difference with regard to reduction of ulcer size between the propolis extract and glucantime groups in favor of the propolis extract (P= 0.001). Further analysis of the data showed that the largest reduction in the ulcer size was caused by the propolis extract, as compared with the control, glucantime and alcohol groups.
Conclusion: Our results suggest that the propolis extract is more effective in the treatment of cutaneous leishmaniasis in mice. We suggest that the efficacy of this extract alone or in combination with drugs be assessed against human cutaneous leishmaniasis, using randomized clinical trials.
M Javadi, H Asgari, M Yaghoobbi, H Tavazohi,
Volume 8, Issue 3 (23 2010)
Abstract
Background and Aim: Non-communicable diseases (NCD), also referred to as chronic or lifestyle-related diseases, are a serious health problem in most countries today. The World Health Organization (WHO) has discussed this issue and presented solutions for it in its annual meetings. This paper reviews and reports on the action taken by the Medical University of Isfahan (MUI) through its Non-communicable Disease Control Program based on the WHO "Prevention and control of non-communicable diseases: implementation of the global strategy", which is a comprehensive program for controlling non-communicable diseases.
Materials and Methods: In this descriptive-analytical study, the activities of 21 Non-communicable Disease Units in Isfahan Province affiliated to MUI in its Non-communicable Disease Surveillance System aiming at combating non-communicable diseases were assessed using a self-assessment technique and the relevant documents reviewed. All the NCD officers (n=30) were enrolled in the study. A validated researcher-designed questionnaire containing items related to six areas based on the WHO "Prevention and control of non communicable diseases: implementation of the global strategy", the reliability of which had been confirmed, was used. The data were analyzed using the SPSS software, the statistical tests being the t-test.
Results: The general self-assessment score of MUI in the activities related to non-communicable disease surveillance and control program was 1.44 0.59 (out of 4). From among the six strategies studied, the "increasing public awareness about non-communicable diseases" strategy and the "improving collaboration and participation in prevention and control of non-communicable diseases" strategy achieved the highest and the lowest score, respectively. Documentation was weak (less than 50%), and there was no significant difference between the scores of actions documented and those not documented (P = 0.1).
Conclusion: Isfahan Medical University is one of the leading universities in Iran. It has taken important valuable measures in the area of non-communicable disease control and surveillance programs. However, our findings show that there are several weaknesses in these programs. Not paying sufficient attention to documentation, for example, is a serious weakness, since documentation plays an important role in the performance and excellence of an organization, guaranteeing its success.
E Tavassoli, A Hasanzadeh, R Ghiasvand, A Tol, D Shojaezadeh,
Volume 8, Issue 3 (23 2010)
Abstract
Background and Aim: Today cardiovascular diseases are the main cause of disability and mortality in many countries. This study was performed to determine the effect of health education based on the Health Belief Model on the knowledge, attitude and practice of housewives in Isfahan, Iran regarding improving their nutritional behavior for preventing heart disease.
Materials and Methods: This was a quasi-experimental intervention, including 68 Isfahani housewives randomly divided into an experimental (n=34) and a control (n=34) group. Data were collected using a standard health belief model (HBM) and a food-frequency (FFQ) questionnaire. The experimental group attended, after a pre-test, 6 weekly education sessions. The HBM questionnaire was completed 3 times (before and immediately, and 2 months, after education), while the FFQ questionnaire was completed twice (before and 2 months after education) by the housewives. The data were analyzed using SPSS16 software, the statistical tests being t-test, and repeated measure ANOVA.
Results: The two groups were not significantly different with regard to demographic variables. Similarly, before the intervention they were statistically similar with respect to the scores of the HBM components (P>0.05). After the intervention, significant differences appeared between the experimental and the control groups with regard to all the components (knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived efficacy, and performance in all cases, P<0.001)
Conclusion: Based on the findings, it can be concluded that the intervention had a positive impact on the feeding pattern of the women and was effective in increasing or improving their knowledge, attitude and practice.
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
Fariba Kiani, Hossein Samavatyan, Siamak Poorabdian, Zahra Mansournejad, Effat Jafari,
Volume 9, Issue 2 (21 2011)
Abstract
Background and Aim: Millions of occupational accidents and disease cases are reported from work places annually causing considerable human and financial damages. Safety training is globally considered the best strategy to mitigate these damages. In this project a safety attitude questionnaire was used to obtain the required information. The questionnaire contained items about 13 relevant variables: job conscientiousness, fatalism, leadership, safety consciousness, role overload, work pressure, job safety perception, supervisor safety perception, coworker safety perception, management safety perception, safety program and policies perception, interpersonal conflicts at work, and job involvement.
Materials and Methods: A total of 204 individuals (101 in the control and 103 in the experiment group) in the Isfahan Steel Company completed the safety attitude questionnaire. This was followed by a 4-hour safety training course attended by the experimental group. After 30 days both the experimental and control group completed the questionnaire again. Descriptive statistics and covariate analysis were used the compare the data between the 2 groups.
Results: Safety training in the workplace influenced positively the general attitude of the personnel towards safety issues. Further analysis of the data revealed that the training affected statistically significantly only safety consciousness, leadership, and management safety perception.
Conclusion: Assessment of safety attitude in the workplace and its dimensions can be used to identify those areas of safety training that need more attention and a better design.
Azar Tol, Gholamreza Sharifi Rad, Ahmad Ali Eslami, Fatemeh Alhani, Mohammad Reza Mohajeri Tehrani, Davoud Shojaeezadeh,
Volume 9, Issue 4 (13 2012)
Abstract
Background and Aim: Diabetes mellitus is a widespread disease. Diabetes patients should be fully familiar with the different dimensions of this chronic disease and possess the skills required for self-management and self-care. They should realize that each patient is a different case. It is to be noted that promoting self-management behavior is an essential component of case management in type-2 diabetes mellitus. The objective of this study was to assess self-management behavior of type-2 diabetes patients in Isfahan, Iran and determine factors influencing it.
Materials and Methods: This was a 6-month cross-sectional study conducted in 2011. The study population was type-2 diabetes patients consulting an outpatient diabetes center in Isfahan, Iran. The sample included a group of 350 patients selected by the continuous sampling method. The self-management behavior of the patients was assessed using a diabetes self-management instrument (DSMI), containing questions on 5 domains. The responses were rated on a 5-point Likert scale and SPSS software, version 11.5 was used for analyzing the collected data.
Results: The response rate was 88%. The majority of the patients were 50-60 years (55.52 ± 8.42) old and 54.3% of them demonstrated borderline metabolic control according to the World Health Organization criteria. Mean scores of self-integration, self-regulation, interaction with health professionals and other influential persons, self-monitoring blood glucose, and adherence to recommended regime were 33.67±6.36, 29.09±5.9, 27.08±4.81, 11.71±3.91 and 11.46±2.9, respectively. On the whole, the global diabetes self-management behavior seemed to be not quite desirable (the score was at an intermediate level). Further analysis of the data revealed that self-management behaviors (at 3 levels, namely, desirable, intermediate, and undesirable) had significant associations (p<0.001) with demographic (age, gender, marital status, education level) and health-related (duration of diabetes, diabetes-related diseases, diabetes complications, general health, type of treatment, family income, and serum HbA1C level) variables. Self-management behavior had no association with disease history
Conclusion: Empowerment of patients afflicted with diabetes and, more generally, non-communicable diseases, which are quite prevalent and on the increase, in the area of self-management at the individual and community level will be a vital step towards promotion of health of the population.
Marzieh Javadi, Saeed Karimi, Ahmadreza Raiesi, Maryam Yaghoubi, Asadollah Shams, Maryam Kadkhodaie,
Volume 9, Issue 4 (13 2012)
Abstract
Background and Aim: Responsiveness is of extreme importance in every health system, especially for policy-makers and health managers. Responsiveness relates to how the health system responds to legitimate expectations of the patients regarding non-clinical aspects of health care. Furthermore, justice in an organization requires fair treatment of the patients on the part of the health personnel. In other words, organizational justice relates to how to treat the personnel so that they feel they are treated fairly. The objective of this study was to investigate the responsiveness of hospital as perceived by patients and nurses and the relationship between the responsiveness rate and organizational justice as perceived by nurses in the hospitals.
Materials and Methods: This was a descriptive-analytical study aiming at determining the correlation between responsiveness and organizational justice in 8 elected hospitals (4 private and 4 public) in Isfahan, Iran. The study population was patients and nurses. A total of 320 individuals (160 patients and 160 nurses), selected by stratified random sampling, participated in this study. Two questionnaires, namely the adjusted WHO Responsiveness Questionnaire (for patients and nurses) and the Equity Questionnaire (for nurses), the validity and reliability of both of which had been determined, were used to collect data. The software used for data analysis was SPSS
Results: The overall score (out of 4) of organizational justice was 1.9 0.77, while the mean score of responsiveness as perceived by the nurses and the patients was 2.32 0.54 and 2.48 0.58, respectively. There was no statistically significant difference between the 2 groups with regard to responsiveness, but there was a positive association between responsiveness and organizational justice as perceived by nurses (r = 0.2, p = 0.03).
Conclusion: The variables in the hospitals studied are generally at an intermediate level and there are no statistically significant differences between private and public hospitals. There is no difference in organizational justice between private and public hospitals, but responsiveness is higher in private hospitals as compared to public ones. Thus, the public sector needs to attempt to create more incentives in health professionals in the health sector in order to guarantee higher-quality services and better responsiveness.
Behnam Lashgarara, Mahmood Taghavi Shahri, Agh Babak Maheri, Roya Sadeghi,
Volume 10, Issue 1 (7 2012)
Abstract
Background and Aim: Internet has become an effective medium to transfer new scientific and research findings, knowledge and information in educational processes across the world. It also facilitates essential communication among millions of people globally and offers users plenty of entertainment for their leisure time. However, excessive computer use interferes with daily life and carries a risk of addiction. Therefore, the concept of internet addiction is now considered a social problem. This study was conducted to determine the association between internet addiction and general health among dormitory students of Tehran University of Medical Sciences in 2010.
Materials and Methods: This cross-sectional study, conducted in 2010, included 125 female- and 110 male-students from dormitories of Tehran University of Medical Sciences, selected by stratified random sampling. The instruments for data collection were two standard questionnaires - YANG Internet Addiction and Goldberg's General Health (GHQ). Data were analyzed by SPSS-19, the statistical tests being Kolmogorov-Smirnov, Mann-Whitney U, Chi-square, correlation coefficient, and multivariate regression.
Results: The results showed that, based on the YANG classification, 34% of the students were addicted to the internet. In comparison with ordinary users, the general health of the internet-addicted users was at a higher risk (p<0.001). The two groups were also different with regard to anxiety and depression (p<0.001), but not with regard to physical function or social function.
Conclusion: Internet addiction among dormitory students is a cause for concern. Well-designed programs focusing on education, counseling and behavioral intervention are needed to reduce internet addiction amongst vulnerable students.
Hedayatollah Asgari, Maryam Kheirmand, Mohsen Rohani, Samaneh Sadoughi, Zeinab Malekpour,
Volume 10, Issue 2 (24 2012)
Abstract
Background and Aim: Job satisfaction is one of the most important factors in maintenance of a professional person and the job success, increasing the personal efficiency and the quality of services. On the other hand, it is a tool in the hands of managers in order to maintain the staff in their jobs. The aim of this descriptive study was to investigate the satisfaction of physicians and midwives participating in the family physician scheme with the plan.
Materials and Methods: The study population was made up of 221 physicians and 144 midwifes. The tool was an author made questionnaire certified by experts as a standard, valid and reliable scale via content validity measurements through a pilot study.
Results: The average satisfaction of physicians and midwives was 44.34% while the highest satisfaction was 65% with the location of services and the lowest was 30.6% with the financial issues. In relation to the financial affairs, physicians were more dissatisfied than midwives, so satisfactions were increased by the increase in the amount of salaries.
Conclusion: Over 4 years of implementation of family physician plan, the physicians and midwives satisfaction was shown to be still low. It is necessary to consider re-programming in the scheme in order to increase the amount of payments and create more motivational factors for physicians as well as to reduce working hours for midwives and establish appropriate levels of payments for them.
Saeed Karimi, Marzieh Javadi, Mina Iravani, Elham Chavoshi,
Volume 11, Issue 1 (8-2013)
Abstract
Background and Aim: Global growth in the elderly population for both health care providers and families and also the community is an important challenge . Elders are the largest and fast factor for increasing hospital admissions in Society . Increasing costs of aging is the most concern to elders and their families. This study aimed to investigate the health team s approach about cost–effective alternatives for aging health services.
This study is a qualitative research which was done through content analysis.
18 people consisting of five faculty members , 6doctors , 3 nurses and 4health public health expert were participated. Samples were selected based on purposive sampling . Data were collected through interviews .
Results: Four core themes derived from this study which included: 1- Emphasis on training for aging care ( including training doctors, nurses , health professionals , public health experts, elder sand their family caregivers). 2- Emphasis on proper implementation of primary health care for the elderly. 3- Emphasis on home care for elderly.4-attntion to mental health of elderly.
Conclusion: It seems effectiveness of tree alternatives emphasis to training, home care and mental health for elderly are obvious and evident, so implementing and applying these suggestions would be helpful.
But the second alternative emphasis on proper implementation of primary health care for the elderly must be performed based on a comprehensive needs assessment in elders population. Finally it is stressed that calculating and comparing actual costs of each alternative in elders caring must be measured through quantitative researches.
Mohammad Reza Tavakoli, Saeed Karimi, Marzieh Javadi, Alireza Jabbari,
Volume 14, Issue 1 (6-2016)
Abstract
Background and Aim: In 1995 the new plan (system) of hospital administration plan/scheme (fee for service) was communicated. According to this plan a proportion (percentage) of the hospital income would be allocated to the hospital staff as a fee for service; the remaining would, after deducting other expenditures, be allocated for the autonomy of the hospital. Based on the plan/scheme, the Supervisory Board will consist of two main committees, namely, the High Supervisory Board and the Supervisory Board for the Centers (hospitals). The main objective of this study was to evaluate the performance of the Supervisory Board in the new system of hospital administration plan in selected teaching hospitals of Esfahan, Iran in 2014.
Materials and Methods: This was a qualitative research. Eleven individuals were selected by targeted sampling and interviewed using semi-structured interviews. The thematic analysis method was used to analyze the data.
Result: Based on the thematic analysis results, the main source of weakness in the underlying and structural factors (developing programs and the implementation phase) was the Hospital Administration Supervisory Board in the new system.
Conclusion: It can be concluded that the most notable findings in this study are weaknesses in the underlying and structural factors (developing the program) and weak underlying and structural factors (implementation of the program). The findings will help health policy-makers to develop suitable strategies and a plan of action to minimize weaknesses of the new fee for service scheme/plan.
Somayeh Abedi Mediseh, Nader Pestechian, Mostafa Ghanadian, Mehdi Nateghpour,
Volume 14, Issue 1 (6-2016)
Abstract
Background and Aim: Medicinal plants provide an excellent source of drugs and new drug combinations, including the basis for the development of drug resistance to common anti-malarial treatments. In this study we investigated and compared the effect of an alcoholic extract of saffron and its constituents with that of chloroquine on malaria in mice.
Materials and Methods: A total of 65 male mice similar as regards gender, weight and age were randomly divided into 13 groups of 5 each. Eleven of the groups were infected with Plasmodium berghei and treated with saffron extract and its constituents and chloroquine based on the proposed method of Ryley and Petrs. Upon detecting the parasite in peripheral blood of the infected mice, they were treated with an aqueous, alcoholic or ethyl acetate solution at a dose of 350, 700 or 1050 mg/kg body weight (BW), chloroquine at a dose of 20mg/kg BW, and an iron chelator (50mg/kg BW). The solutions with the most effective concentrations were determined. Oral treatment at every stage lasted for up to 4 days. Parasite reduction in the groups treated with the extract was determined on days 4 and 7 and compared with that in the control, placebo and chloroquine groups. The Group 13 mice had no parasite injection and received no drug and were kept in the animal house only to control accidental death.
Results: Data analysis (t-test; SPSS) showed the most effective concentrations to be 700mg/kg ethyl acetate solution and 350 and 700mg/kg saffron extract, causing a significant reduction of parasitemia in the infected mice on day 7 (p<0.05).
Conclusion: The findings of this study indicate the potential effect of the alcoholic extract of saffron on Plasmodium berghei and, therefore, should receive proper attention.
Ensieh Gheirati, Arezoo Shabanifar, Mahboobeh Akhlaghi, Noushin Peyman,
Volume 14, Issue 3 (12-2016)
Abstract
Background and Aim: Communication is one of the oldest and greatest human achievements underlying our social life. Available literature show factors such as self-esteem, interpersonal skills, establishing desirable communication, goal setting and determining individual values have effective roles in the prevention and reduction of susceptibility to behavioral abnormalities and mental disorders (anxiety, depression, etc.), as well as in the promotion of mental health. The objective of this study was to determine associations between communication skills and mental health in Mashhad University of Medical Sciences (MUMS), Mashhad, Iran.
Methods and Materials: This was a cross-sectional analytical study conducted in 2011. The statistical population was all the MUMS students. A sample of 210 students was selected by stratified sampling and signed an informed consent. Data were collected using Communication Skills and General Health Questionnaires and analyzed using the SPSS 16 software, the statistical tests being Kruskal-Wallis, Mann-Whitney U and Chi-square. In all tests the significance level was 5%. To determine correlations between the variables the Spearman coefficient was used.
Results: The findings showed that 130 of the 210 students (61.9%) were suspected of having a mental disorder. Based on the Spearman correlation coefficient there were no statistically significant relationships between mental health and age (p=0.727) or skills such as listening (p=0.653), understanding verbal and nonverbal messages (p=0.857), awareness of the communication process (p=0.626) and assertiveness (p=0.477). However, a significant correlation was observed between mental health and emotion control skill (p=0.010). Furthermore, the Spearman correlation coefficient indicated no relationships between communication skills and age (p=0.228) or social dysfunction (p=0.074), while significant inverse correlations were found between communication skills and anxiety (p=0.043), physical symptoms (p=0.049) and depression (p=0.049). According to Mann-Whitney test no significant relationships were observed between communication skills and field of study (p=0.806), level of education (p=0.406), sex (p=0.404), place of residence (p=0.277), marital status (p=0.875) or employment status (p=0.274), but significant relationships did exist between mental health and sex (p=0.006), field of study (p=0.036)r and marital status (p<0.001). Finally, no significant correlations were found between mental health and level of education (p=0.080), place of residence (p=0.951) or employment status (p=0.978).
Conclusion: Based on the findings of this study, in an attempt to promote the mental health of the students it is recommended to make psychological assessments of the students, provide consultative services to them, and organize communication skills educational workshops for them.
Maryam Yaghoubi, Marzieh Javadi, Saeid Karimi, Vahid Pirasteh,
Volume 16, Issue 2 (9-2018)
Abstract
Background and Aim: Iran's Health Sector Evolution Plan (HSEP) is one of the most important national health reform plans. HSEP has attracted many criticisms. An important criticism is about its service costs. This article reports the results of a project conducted to compare the costs of normal and caesarian section delivery before and after implementation of the HSEP.
Materials and Methods: This was an applied research project using hospital accounting records as data. A total of 120 delivery files (60 normal delivery and 60 caesarian section) were selected randomly from the accounting software of a large hospital in Isfahan before and after May, 2014.The data in each subject’s file ─ paid shares of the hospital, patient and insurance ─ but not hoteling, inpatient and other costs was extracted. The health service providers’ incomes based on the annual tariffs of the services and changes in payments for each service for gynecologist and anesthesiologists were calculated. Data were analyzed using the excel software.
Results: The costs of normal delivery and caesarian section after implementation of the National HSEP had increased by 193% and 226%, respectively. In addition, of the treating physicians (gynecologists and anesthesiologists) had also increased by 257% for the normal and by 130% for caesarian section. Changes in the sums of money involved in service delivery indicates shifting of parts of the costs from the patients to the health subsidy and insurance systems.
Conclusion: The health System Evolution has not lead to real reductions in the out-of-pocket money paid by the patients. Higher cost of services will imply the need for better cost management. Increased costs of services will be to the benefit of neither patients nor the health system. This would mean that in designing and implementation of the Health Sector Evolution Plan economic aspects should be taken into consideration more carefully.
Nayereh Namazi, Amirmansour Alavi Naini, Firouzeh Mostafavidarani, Zahra Boroumandfar,
Volume 17, Issue 2 (9-2019)
Abstract
Background and Aim: The present study aimed to determine the stages of changes and cognitive and behavioral processes (Transtheorical model) in the use of nutrients in overweight middle-aged women.
Materials and Methods: The present study was a descriptive-analytic. The research sample consisted of 281 middle-aged women with overweight referring to comprehensive health centers in Isfahan. Personal characteristics, stage of change and behavior and cognitive behavioral processes, and FFQ questionnaire (168-item) were completed by Questioning, and then the information entered the N4 and SPSS 18 software, and information was analyzed using descriptive and analytical tests.
Results: 57.7% of the people were inactive (pre-thinking, thinking, preparation) and 42.3% of them were in active phase. There was a significant difference between the different stages of change and the use of behavior change processes (p=0.001) And Benfrown's test shows the increasing use of cognitive and behavioral processes during the stage of change in use of nutrients (p<0.001).
Conclusion: The difference in the mean of changes processes during the stage of change show the impact of these processes on the nutritional individual's behavior, which is recommended to use stage of change and behavioral change processes for education nutrition behavioral.
