Journal of School of Public Health and

Background and Aim: In the past few years publications in the field of medicine have increased considerably in Iran and knowledge production in this country shows the greatest growth rate in the entire Middle East region. Considering the fact that 12% of all faculty members in the health and medical sector in Iran are employed by Tehran University of Medical Sciences, this university is regarded as the country's leading research institution. This study is focused on the behavior of the researchers in this university in terms of collaboration in research and factors that affect such behavior.

Materials and Methods: Our samples included all research projects in Tehran University of Medical Sciences that had obtained grants from inside and outside the university in 2004, had registered their contracts, had been finished by the time of this study (October 2006- March 2007) and whose final reports had been submitted (315 projects). The data collecting forms were filled for 301 files. The researcher's questionnaire was sent to the principal investigators of the projects and eventually 208 questionnaires were collected. We used the SPSS software package and the usual statistical tests (frequency ratio, chi square, analysis of variance and multiple linear regression with the Enter method) to assess the factors affecting the participation scores of individuals. Based on the data gathered from the forms, we used the UNICET software to analyze the 'cooperation network' between project directors and their principal co-workers and the relationship between different sections of the university.

Results: Only in 2.2 percent of the projects whose contracts were arranged in 1383 there has been some cooperation between the project director/principal coworkers and non-academic organizations. This ratio reaches 2.5% for collaboration with other universities. Among all projects, health system research programs show a better status of collaboration. Linear regression analysis showed that another important factor affecting the participation score is the "method for choosing the research topic". University-affiliated research centers only collaborate with the Schools of Medicine and Public Health, while in the School of Rehabilitation and Physical Medicine all projects are defined within the School's own structure, with virtually no collaboration with any other sections of the university.

Conclusion: The present study showed that research programs in this university include little collaboration with organizations outside the university or with other universities. Part of this is related to the current structure of the research sector in the country, which is largely financed by the government with hardly any participation by the private sector. Current potentials within the University make it possible to embark upon joint research initiatives with other academic institutions. As the possible effect of intervention on health system research has been shown, policies can be implemented to promote effective collaborative research at university and national level.

Background and Aim: Inequality in the distribution of hospital recourses is a great obstacle in planning and provision of health care. This inequality in mainly observed in the government hospitals in a country. The objective of the present study was to determine the distribution of specialized physicians and active beds in the Iranian government hospitals between 2001 and 2006

Materials and Methods: The method used in the study was retrospective, descriptive- analytical. The data were analyzed (Lorenz Curve and Gini index estimation), using the Excel Software.

Results: Based on the Gini coefficient, the distribution of specialized physicians during the 5-year period (2001-2006) was 0.0876, 0.0874, 0.0909, 0.0329, 0.0951, and 0.0520, respectively. The corresponding figures for active beds were 0.024, 0.0171, 0.0208, 0.0251, 0.0212, and 0.084.

Conclusion: The findings of the study indicate that, in spite of differences in the proportions of specialized physicians and active beds among the provinces with regard to their populations, the distributions in the government hospitals have been equitable. The results of this study can provide useful insights for the country's Health Ministry policy-makers.

  Background and Aim : It is impossible to deny the threats and risks endangering the process of health care when offering the services. Confirming this fact does not mean ignorance the risk, or allowance to medical and nursing mistakes to happen however, it can mean approaching the problem to come up with practical solutions and minimize the risks in the process of providing health care services. The present study was conducted periodically as an applied multi-stage research.

  Materials and Methods : To do a model of clinical risk management, different authentic texts on risk management in health sector were reviewed focusing on the models available. All such models were tabulated, analyzed and compared together which resulted 62 primary variables. The variables were, then, validated being used in a questionnaire responded by 20 nurses and doctors which, this time, produced a confirmed questionnaire of 40 variables. After that, 215 subjects chosen through a random and a stratified sampling were asked to respond to that questionnaire, making an exploratory factor analysis as well.

  Results : This study was done, using principal components analysis as with a rotation of Varimax loadings showed a variety of factors (19 factors) available in the models of clinical risk management were loaded as "organizing and policy-making" factor. This factor illuminated a sum of 25.3% of variances in the model of clinical risk management. The results also showed the loading factor of variables as among 0.5 and 0.7 which indicated a fine correlation among them and the participants' view.

  Conclusion: It was concluded that "the best care of the patient is accepted as a common perspective in organization" and "the effect of the treatment team's clinical performance on their financial payments" are the most and the least important variables respectively with 0.739 and 0.548 as factor load.

  Background and Aim: The community assessment is the basis of strategic policies for health professionals and managers. The aim of community assessment is collection of the data that relating to public health problems, data analysis and concludes about necessary capacities for providing the necessary resources to resolve problems.

  Materials and Methods: In this study the databases of Scientific Information Database, MagIran, MEDLINE, Google Scholar, and IranMedex were searched up to April 2014 (farvardin1393). All papers of community assessment in the country according to our standard community assessment model were included in this study.

  Results: Overall 11 studies were evaluated and the common feature of all research is to identify problems of society and local problems. The drug addiction was classified in 3 of the studies as a main problem and in 7 of studies was classified in the ten major problems. Poverty and unemployment are allocated to the next priority, the second priority in 2 studies, the third priority in 3 studies and the fourth priority in 3 studies. Environmental health problems and socio-cultural problems were the next priorities.

  Conclusion: The proposed model can be used to suggest new health services with due consideration of community problems, as well as develop suitable, effective intervention strategies. This type of community study should not be conducted only once. Rather, it should be repeated periodically in any community, results compared and used for policy-making.

Background and Aim: Self-medication, as a common risky health behavior, has financial and non-financial costs for Iranians.  This study aimed at determining the situation of self-medication and factors influencing it among women in Yasuj, Iran.

Materials and Methods: This cross-sectional study was performed on 192 women referred to urban health care centers in Yasuj, selected randomly from the existing health files at the centers. Data were collected using a standard questionnaire based on the Health Belief Model and analyzed by SPSS 16 statistical software.

Results: The most widely used medicines for self-medication were those for common cold and antibiotics from among over-the-counter (OTC) drugs and prescription-only-medicines (POM), respectively. Perceived susceptibility (17.63± 3.46) was the main construct associated with self-medication among women.

Conclusion: Once the causes of self-medication and its relationship with the Health Belief Model constructs are known, designing and implementing educational programs aiming at promoting awareness and perception of population groups, especially women, seems necessary.

Background and Aim: In Iran the rate of Cesarean section is reported to be 48%, which is higher than the acceptable rate recommended by WHO (15%). This study was conducted to determine the effect of an intervention based on social marketing on the reduction of intention to choose Cesarean section by primigravidae in Boyer-Ahmad County, Iran in 2015.

Materials and Methods: In this field trial 39 primigravidae three to four months pregnant who had an intention to choose Cesarean section for delivery participated. A formative research (a quantitative survey and a qualitative study) was done to achieve the social marketing mix, and based on the results a tailored intervention was designed and pretested on the subjects. The final intervention was implemented for a period of one month and its effectiveness assessed after at least one month by a proportion test.

Results: The average age of the women was 25.82 years. The proportion of the women with a high school (or lower) and university education was 38.5% and 61.5%, respectively. One month after the intervention thirty of the pregnant women expressed willingness and intention to have a normal delivery, which was a statistically significant change (p=0.01).

Conclusion: An educational intervention based on the consumer-oriented social marketing theory can be effective in designing, implementing and evaluating a program aiming at reducing Cesarean section intention.