Journal of School of Public Health and

  Background and Aim: Urinary Incontinence (UI) as a main health problem affects on Quality of Life negatively. UI prevalence is reported between 3-57.1% in different countries. Nevertheless, there are limited studies about probable risk factors, e.g. type and number of delivery and related disorders such as anal incontinence. This study was aimed to investigate the UI risk factors and related disorders in our society.

  Materials and Methods : A cross-sectional study was conducted on 166 women with UI and 90 healthy subjects, aged 26-70(45.3±7.9) and 20-64(38.2±8.4) years respectively. After completing a designed questionnaire, assessment of vaginal tone, Pelvic Floor Muscles'(PFM) strength and endurance carried out. Independent t-test and Pearson correlation test were used to analysis the data. Values of p<0.05 were considered to be significant.

  Results: Our data showed that the mean of age, Body Mass Index (BMI) and number of deliveries in women with UI were significantly higher than that women without UI were (P<0.05).There was a significant difference regarding to the prevalence of anal incontinence and constipation between two groups (P<0.05). Reduced vaginal tone and lower strength and endurance of PFM were seen in women with UI (P<0.05).

  Conclusions: Regarding high prevalence of some pelvic floor disorders such as constipation in incontinent women, we recommend performing further epidemiologic and etiologic investigations , also emphasis on establishing multidisciplinary approach health/therapeutic centers to provide better services to these patients.

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.