Showing 54 results for Rahimi
Mh Kaveh , D Shojaezadeh , D Shahmohammadi , H Eftekhar Ardebili , A Rahimi , J Bolhari,
Volume 1, Issue 4 (8 2003)
Abstract
Approximately 21% of children and adolescents experience signs and symptoms of aDSM-1V disorder during the course of a school year, yet fewer than 20% of those needingmental health services actually receive any. Research suggests that schools and teacherscan help promote mental health, delect children at risk, and refer them for psychiatricassistance. This study aims to determine the effects of an educational intervention onteachers' knowledge, attitude, self-reliance and practice.This study was carried out in 24 State-run elementary schools in the city of Khorramabadin Lorestan province. Iran, during the academic years 2001 - 3.Of the 64 teachers initially selected, 57 agreed to participate in the study 27 of these wereplaced in the intervention group and the remaining 30 in the control group.The intervention group attended a 3-day workshop. Self- administered questionnaireswere filled before and after the workshop, and at the end of the project data were collectedfrom teachers and students. Statistical analysis was done by the SPSS package, usingmainly nonparametric tests.49% of the participants were men, 42% had a high school diploma and others haduniversity degrees. Findings showed significant improvements in teachers' knowledge.attitude, and practice in the intervention group. Nosuchimprovement was observed incontrols. Teachers in the intervention group were able to identify and refer 106 suspectedcases, of whom 79 had a mental disorder confirmed by a psychiatrist. Within the sameperiod, only 2 cases had been referred by the control group. Students' knowledge, themain criteria of teachers' practice in mental health education, had significantly improvedin the intervention but not in the control group. Results suggest that female teachers hadhigher KAP levels than their male colleagues.The study confirms that trained teachers have the capabilities required for participating inSchool - Based Mental Health Services. It also appears that schools are indeed a crucialplace for helping children in need of mental health services.
M Tabatabaei , A.r Dorosty , F Siassi , A Rahimi,
Volume 2, Issue 1 (2 2004)
Abstract
The increasing prevalence of adult obesity, and its individual as well as public consequences has always been a major concern for nutrition and health specialists. The last decade has also witnessed a sharp rise in childhood obesity rates worldwide. There is little reliable information on childhood obesity rates in Iran, hence the need for prevalence studies in different parts of this country. These studies are complicated by a paucity of baseline (reference) data on obesity in Iranian children. This study aims to determine the prevalence of obesity in Ahwaz primary school pupils by using three different sets of baseline values, namely IOTF, CDC and local data from Iran. Using two-stage cluster sampling, a total of 3482 students aged 6-12y (1843 boys & 1639 girls) were randomly selected from Ahwaz primary schools. Weight and height were measured and BMI calculated. Obesity was defined as having a BMI ≥ 95th percentile of each of the three sets of reference values. Prevalence rates according to Iranian reference data, CDC 2000, and IOTF 2000 were %10/9, %5/2, and %3/6 respectively. Obesity is quite common among school children in Ahwaz and further studies are required to determine risk factors. In addition, different reference data produce different prevalence estimates.
E.m Razzaghi , A Rahimi Movaghar , K Mohammad , M Hosseini ,
Volume 2, Issue 2 (4 2004)
Abstract
There are about 200,000 injecting drug users (IDUs) in Iran. HIV/AIDS is closely associated with IDU in Iran. The objective of this study was to explore unhealthy sex behavior and the interventions for its control in IDUs.
A qualitative method was employed. Six districts in Tehran with a population of 400,000 were selected. These districts differed in socioeconomic characteristics, urban structure, IDU prevalence and crime rates. A total of 81 key informants from different sectors and 154 IDUs were selected by purposeful, opportunistic and snowball sampling, and interviewed individually or in groups. Ethnographic observations were done to study life situation in the subjects.
In one district no cases of IDU were found. In others, sexual promiscuity in IDUs was reported to be common. IDUs report sexual relationship to be more common with sex wrkers. In most of these areas, access to commercial sex is believed to be easy. Sex workers, themselves are commonly drug users, half of them are actually IDUs. Safe sex (e.g., use of condoms) is not a common habit. Homosexual relationship seems to be uncommon in IDUs and there were no reports of condom use in this type of contact. According to IDUs, dealing with this problem would require financial support and drug distribution for preventing sex work, and settlement and organization of sex workers as a prelude to effective sex education and promotion of condoms.
Expansion of injecting drug use and its relationship with blood-borne infections in recent years necessitates rapid interventions for controlling injection drug use and the associated risks. As unhealthy sex behavior seems to be common in IDUs, sex education, free condom distribution in drug abuse treatment centers and other health facilities (with the use of outreach methods) is highly recommended.
E Jaberi , A Jazayery , A Mohagheghi , A Rahimi ,
Volume 2, Issue 2 (4 2004)
Abstract
On the basis of recent retrospective and prospective studies, it is now widely accepted that increased total plasma homocysteine is a strong, independent risk factor for cardiovascular disease. Some studies have detected hyperhomocystememia in more than one - third of patients with coronary vascular disease. With an increase in total homcysteine (tHcy) concentration of 5 janol/L, the relative risk of cardiovascular disease has been estimated to increase by 60% for men and 80% for women. In a cross-sectional study we investigated tHcy concentration in 35-65 year-old ischemic heart patients (n=348, 157 men and 191 women) in a clinic in Tehran.
Fasting total homocysteine level was measured by high-performance liquid chromatography (HPLC) and using the internal method. The data were analyzed statistically using one-way analysis of variance (ANOVA) and the independent t-test. The results showed that while 18.96% of the patients had a normal tHcy level (<8 /imol/lit), in 27.52%, 50.52%, and 2.8 % of them the level was almost high (8-<12 /imol/L), high (12-<25 /imol/L), and abnormally (>25 /imol/L), resapectively. The mean tHcy concentration in men was significantly higher than in women ( P= 0.02). More extensive studies should be conducted to assess the tHcy status in the Iranian population at large.
M Tslimi Talaghani, A Jazayeri, A Keshavarz, H Sadrzadeye Yeghaneh, A Rahimi,
Volume 2, Issue 4 (7 2004)
Abstract
Many studies indicate that the nutritional knowledge and practice of adolescent girls are inadequate. Few surveys were performanced about effect of nutrition education on knowledge, attitude and practice in this vulnerable group. The purpose of this study was to compare the effect of two nutrition education methods (guidebook and group discussion) on the nutritional knowledge, attitude and practice of first-grade guidance school girl students in Tehran ’s 8th district, in 2003.A total of 300 students were selected from 11 guidance schools by simple random sampling and divided into three 100-student groups: 1-guide-book, 2-group discussion, and 3-control. Data on the nutritional knowledge, attitude and practice were collected using pretest and posttest questionnaires. The students in group1 were given the guide-book and required to study it at home, while group 2 students were told to discuss among themselves the contents of the guide-book. The control group were given nothing to study or to do. The pre-test showed that the mean scores of nutrition knowledge (K), attitude (A) and practice (P) were not statistically different among the 3 groups. The scores for the 3 variables increased in the guide-book and discussion groups significantly at the end of the study period (in all cases, p<0.001), while the inter-group comparisons also showed that the K and A scores were statistically different among the 3 groups the P, however, was not different among them. Conclusion: Both methods (guide-book and group discussion)increased the level of nutritional knowledge and attitude as compared to (a) – the control group,and (b) – the initial values. Also both methods increased the level of nutritional practice as compared to (b) – the initial values. The group discussion method was more effective than the guide-book method in the promotion of the nutritional knowledge of the students.
S.j Shahtaheri , F Ghamari , F Golbabaei , A Rahimi Froushani , M Abdolahlli ,
Volume 3, Issue 2 (3 2005)
Abstract
In this study, parameters affecting on SPE of trance trance muconic acid (t,t-MA), including sample pH, sample concentration, sample volume, sample flow rate, washing solvent, elution solvent, and type of sorbent were evaluated. After sample preparation of muconic acid as urinary metabolite of benzene, it was determined by HPLC-UV. In chromatographic analysis, column was C18 (250 cm × 4.6 mm id, 0.5 µm), UV wave length was 259 nm, mobile phase was H2O/methanol/acetic acid (69:30:1 v/v/v) was run at flow rate of 1 ml/min. Through experimental evaluation, a strong anion exchange silica cartridge (SAX) has been found successful in simplifying sample preparation compare to C8 and C18. There were significant difference between recoverie of muconic acid when different washing solvent, sample volume, and sample flow rate were used (p< 0.001). An optimum recovery was obtained when sample pH was adjusted at seven. Other optimum conditions were: sample flow rate 1 ml/min washing solvent acetic acid 1% , and acetic acid 10% as elution solvent. In this study, there was no significant difference when different sample concentrations were used (p>0.05). Recovery of spiked urine sample at concentrations of 0.1, 1, 10 µg/ml were more than 95%. The limit of detection of the optimized method was 0.01 µg/ml, showing 20 times less than biological exposure index (BEI). The optimized method was then validated with three different pools of samples at above mentioned concentrations and showed a good reproducibility over six consecutive days as well as six within-days experiments.
R Rad Goodarzi , A Rahimi Movaghar , E Sahimi Izadian , M.r Mohammadi , M Vazirian ,
Volume 3, Issue 3 (3 2005)
Abstract
The aims of the present study were to assess preparedness and function of health system in the management of withdrawal symptoms in opioid dependents after Bam earthquake, the methods that medical staff used for identification of dependents, the viewpoints of the medical staff as well as opioid dependents about the roles of health system, and the appropriate methods for managing opioid dependence after disaster.
This qualitative study was carried out in the city of Bam, one of its nearby villages and eight hospitals in Tehran and Kerman, admitting earthquake victims. Our analysis was based on 163 semi-structured interviews, with drug abusers, their family members, people living in Bam, service providers, and the authorities.
No specific training for drug abuse was reported by medical staff. No guideline or program was available for prevention and management of drug dependence in disasters. Most of the medical staff had negative attitudes toward involvement in treatment of opioid dependence. During the first two weeks after the earthquake, medical management of the withdrawal symptoms was inadequate. Most of the interviewees suggested managing the withdrawal symptoms with prescribing opioid agonists and then treating the opioid dependence following improvement of physical injuries and stability of social situation.
In disaster situations, the consequences of inadequate management of opioid dependence can be ominous. Such consequences consist of a change in incidence of substance use, intensity of use and dependence, type of substance and route of use to more dangerous ways. Therefore, a practical protocol (disaster planning) is needed for prevention and management of substance dependence in the times of crises.
H Sadrzadeh-Yeganeh , P Angoorany , S.a Keshavarz , A Rahimi , B Ahmady ,
Volume 4, Issue 1 (2 2006)
Abstract
Background and Aim: Children, who go to school without breakfast or have breakfast that is not nutritious enough, will not be able to meet their nutritional needs for growth. Nutrition education can be instrumental in providing knowledge, desirable attitude, and changing behavior concerning breakfast. The purpose of this study was to compare two method of nutrition education – booklet and lecture- on practice of fourth grade girls.
Material and Methods: Using three stage random sampling a total of 150 students were randomly selected and divided into 3 equal groups booklet, lecture, and control. At the beginning of the study, an assessment of practice was conducted for all groups. Education through booklet and lecture was provided. Two weeks after the education, an assessment of practice was conducted again. To collect data two types of questionnaires - general and practice - were used.
Results: The result showed a significant difference of means of practice (P=0.002) score among three groups. The mean score of practice in the lecture against the control group and that of the booklet against control group increased 0.84 (P=0.005), 0.76 (P=0.014) respectively, but no significant increase was observed between lecture against the booklet group. After omitting the effect of independent variables in question, education still increases the difference of means of practice scores significantly (P=<0.05). Lectures are a more dynamic method for nutrition education.
Conclustion: Considering the large number of students in primary schools and lack of access to a direct method of education, using booklets is an appropriate method.
Gh Pourmand , M.r Pourmand , S Salem , M Taheri Mahmoudi , A.r Mehrsai , R Ebrahimi , M.r Nikoobakht , K Nouri Jelyahi ,
Volume 4, Issue 2 (3 2006)
Abstract
Background and Aim: Infectious complications after renal transplantation are associated with significant morbidity and mortality. We evaluated post-transplant complications due to infections and their relationship with graft function, immunosuppressive drugs and mortality.
Materials and Methods: Over a 2-year period (2002-2004), 179 renal transplantations were performed in our center. Of these, 142 cases were followed for a period of one year. The immunosuppressive regimen included cyclosporin A, mycophenolate mofetil and prednisolone. Each patient was assessed through regular visits and according to the ward protocol. Results of the investigations (infections and their relationship with age, sex, donor type, creatinine level, acute rejection, immunosuppressive drugs, graft and patient survival) were recorded and analyzed.
Results: The overall incidence of infection was 54%. The most common sites were lower urinary tract (42%) and respiratory tract (6%). The most frequent causes were Klebsiella (24%) and Cytomegalovirus (18%). Wound infection occurred in 5% of the patients. The overall mortality was 7.7%, and almost half of the death cases (3.5%) involved sepsis development. Graft loss occurred in 16 (11%) of the cases: 2 developed Cytomegalovirus infection, 2 experienced urinary tract infection (UTI) and 5 developed sepsis (and expired). Mycobacterial and hepatitis C infections were noticeably low compared to other studies. The hazard rate in occurrence of UTI, CMV, acute rejection and mortality were higher in cadaveric transplant recipients than in others.
Conclusion: This study identifies infections as a major cause of morbidity and mortality in the post-transplant period. Patients having higher creatinine levels and those receiving high doses of drugs at discharge are considered to be at high risk and should be evaluated thoroughly.
R Goodarzi Rad , V Sharifi , A Rahimi-Movaghar , A Farhoudian , E Sahimi, M.r Mohammadi , N Mansouri , A Nejatisafa ,
Volume 4, Issue 3 (3 2006)
Abstract
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
A Pourreza , Z Yousefi , A Rahimi ,
Volume 5, Issue 1 (2 2007)
Abstract
Background and Aim: Health and access to health facilities are now regarded as basic human rights and a fundamental social objective. Reproductive health is essential to promote quality of life and satisfy the need for an enjoyable parenthood.
Material and Methods: This was a descriptive-analytic study on 430 women of reproductive age who were receiving health services from urban PHC clinics run by Tehran, Beheshti and Iran medical universities. With the help of a questionnaire we gathered data on factors related to reproductive health knowledge and attitude and analyzed the data using x2, OR, Parson correlation coefficients.
Results: Knowledge and attitude was found to be significantly related to education and employment (p<0.00). There was also an association between knowledge and attitude on one hand and husband's education and employment on the other (p<0.00). Age was not found to have an influence on knowledge and practice (p<0.757).
Conclusion: This research shows that education can have a major effect on empowering women to demand and exercise their basic rights, including those related to reproduction and childbearing.
A Rahimi Foroushani , K Mohammad , M Mahmoodi , F Siasi ,
Volume 5, Issue 2 (3 2007)
Abstract
Background and Aim: Breastfeeding is one of the most important health determinants in infancy and childhood: physical growth and mother-child bonding in this period are two factors that program cognitive ability in later life. The main aim of this study was to examine the long-term effects of breastfeeding on subsequent cognitive performance.
Material and Methods: A cohort of 5362 births registered over a period of one week in March, 1946 was selected by stratified sampling, based on the subjects' social class. We collected data for ages 2, 8, 11, 15, 26, and 46 years, and these data were analyzed in 2004-2005 at the school of public health, Tehran. Linear structural equation models were fitted to the data by LISREL 8.12 software in order to find path models.
Results: Descriptive findings showed that children weighing ≥3500 grams at birth acquired the ability to walk, talk, stand, and sit earlier than others. Also, subgroups within the cohort showed different patterns of change in their cognitive scores. Analysis of variance revealed that after adjustment for sex, social class, age of talking, and age of walking breastfed children still had higher means of verbal and nonverbal scores at ages 8 and 15 compared to never-breastfed children. Path analysis indicated that breastfeeding and birth weight could program later-life cognitive performance directly or indirectly through the ages of 2, 8, 11, 15, 26, and 43 years. For instance, path coefficients from breastfeeding to ages of talking and walking, to 8-15 verbal scores, to 26-year cognitive scores, and then to memory and visual scores at age 43 were estimated -for females and males, respectively- and form left o the right as follows: -0.12 (se=0.02), -0.05 (se=0.02), 0.71 (se=.05), 0.10 (se=0.04) for women -0.01 (se=0.02), -0.07 (se=0.01), 0.75 (se=0.06), 0.13 (se=0.06) for men.
Conclusion: There are significant relationships between some early life determinants and later cognitive performance we conclude that in longitudinal studies of later life abilities, early-life nutrition and birth weight should be incorporated in the path analysis of aging.
L Moghadam Banaem , H Eftekhar Ardebili , F Majlesi , A Rahimi Foroushani , A.r Amini Manesh ,
Volume 5, Issue 2 (3 2007)
Abstract
Background and Aim: We studied 1800 pregnant women receiving routine prenatal care in the urban and rural health centers of Shahr-e-Rey in south of Tehran, for a comparative assessment of 5-minute neonatal Apgar Scores in wanted versus unwanted pregnancies.
Material and Methods: The subjects were studied in 2 groups, each comprising 900 pregnant women. Group A consisted of mothers with wanted pregnancy and group B of mothers with unwanted pregnancy. Inclusion criteria were gestational age less than 28 weeks at the time of entering the study. The two groups were followed through their prenatal care to the time of delivery. For each neonate, we extracted the 5-minute Apgar score from the birth certificate.
For a more precise assessment, the impact of conditions affecting the Apgar score of newborns (such as normal vaginal delivery vs. caesarean section, premature birth, low birth weight, congenital anomalies, and birth place (hospital and health center, or house) was assessed by logistic regression.
Results: We found 15 cases (0.4%) of low 5-minute Apgar score (under 8) among newborns of wanted pregnancies and 4 such cases (1.1%) among those of unwanted pregnancies. The difference between the 2 groups was significant (P= 0.011). After applying the logistic regression model to adjust for other factors, unwanted pregnancies still had a significant association with low Apgar scores (increasing the risk 3-fold).The attributable risk for low 5-minute Apgar score in unwanted pregnancies was 0.54 (CI.95 = 0.132 to 0.813).
Conclusion: The estimated attributable risk means that with 95% confidence, between 13.2% and 81.3% of the low Apgar scores could have been prevented by eliminating unwanted pregnancy. As there have been no similar studies in Iran, more research with larger samples must be performed to assess these results more precisely.
M Firouzbakht, H Eftekhar Ardebili, F Majlesi, A Rahimi, M Ansari Dezfooli, M Esmailzadeh ,
Volume 5, Issue 4 (5 2008)
Abstract
Background and Aim: Hearing impairment is one of the most common congenital defects. Unfortunately there have been no studies so far on the prevalence of various degrees of neonatal hearing, loss in Iran. As accurate determination of prevalence is crucial in estimating disease burden and planning subsequent interventions, we carried out this study to determine the prevalence of neonatal hearing impairment.
Materials and Methods: In this study, we assessed the prevalence of hearing loss among the newborns in province capitals and also looked at the role of some putative risk suggested by the Joint committee on Infant Hearing (JCIH). In this research, 76500 newborns who had undergone audiologist-administered screening tests were assessed by a special questionnaire designed specifically for this study.
Results: After trapshooting the overall prevalence of hearing loss was estimated and then cases were classified as moderate (40 - 65 db HL), severe (65 - 90 db HL), or profound (>90 db HL) hearing loss. Among the newborns examined, a total of 362 were diagnosed with hearing loss and hence the overall prevalence was estimated at 4.7 per thousand 168 cases had moderate (2.2 × 10 -3), 114 cases had severe (1.5 × 10 -3) and 80 cases had profound (1.1 × 10 -3) hearing loss.The prevalence rate ranges from 2-3 × 10 -3 (in Hamedan and Mazandaran) to 7-8 × 10 -3 (in Yazd and Chaharmahal-Bakhtiari). In newborns with a family history of sensory-neural hearing loss the prevalence was 16 × 10 -3, compared to 18 × 10 -3 in those requiring blood transfusions, 15 × 10 -3 in newborns with a history of admission to neonatal intensive care units, 17 × 10 -3 in those with craniofacial anomalies, and 19 × 10 -3 in newborns with birth weights below 1500 grams. The sample included 39376 boys and 37124 girls 193 boys (5 × 10 -3) and 169 girls (4.6 × 10 -3) were affected. The stratified prevalence in males (193) was 477 × 10 -3 for intermediate, 311 × 10 -3 for severe and 202 × 10 -3 for profound deafness. The rates in the female population were 437 × 10 -3 for intermediate, 320 × 10 -3 for severe and 273 × 10 -3 for profound hearing loss.
Conclusion: The results confirm the need for extensive neonatal screening programs, and the significant difference in prevalence between high-risk groups and the normal population provides justification for continuous audiologic screening in this group of newborns.
Sm Hosseini Shokouh, M Arab, A Rahimi, A Rashidian, N Sadr Momtaz,
Volume 6, Issue 3 (13 2009)
Abstract
Background and Aim: Hospital disaster-management planning and preparedness are essential, considering earthquake threats in Iran. The objective of this study was to assess preparedness of hospitals affiliated to Iran University of Medical Science (IUMS) in Tehran against earthquakes in 2007 (1386 Iranian year).
Materials and Methods: This was a cross-sectional, descriptive-analytical study, involving 21 governmental and private hospitals affiliated to IUMS selected by random sampling. Data were gathered using checklists, questionnaires, interviews, and observation. The SPSS software was used for analysis of the data, and the Fisher exact test was employed for statistical analysis.
Results: The data showed that, on the whole, 28.6 %, 61.9 %, and 9.5 % of the hospitals were at a weak, moderate, and good preparedness level, respectively. The hospitals preparedness level with regard to equipment safety and hazardous materials planning increases with their degree of specialization, the association being statistically significant (p = 0.038). The findings also show that there is a significant relationship between the hospital preparedness level (as regards planning for building dangers reduction) and crisis management training courses (p = 0.034).
Conclusion: Training courses are very effective for creating hospital preparedness against earthquakes.
F Golbabaee, A Esmaeilzadeh, A Rahimi, Sj Shahtaheri ,
Volume 6, Issue 3 (13 2009)
Abstract
Background and Aim: Laboratory fume-hoods are the first-level protection for the laboratory staff against hazardous chemical pollutants. Considering the large numbers of personnel, especially in petrochemical industry laboratories, this project was carried out in order to assess the performance of laboratory hoods based on tracer gas (SF6).
Materials and Methods: In this project 22 hoods in the laboratories of a petrochemical industry were studied. Operation of the hoods was assessed based on quantitative (with SF6 as tracer gas) and qualitative (face velocity measurement, using thermal anemometer) tests, according to ASHRAE 110 stndard.
Results: In comparison with the minimum acceptable face velocity (80 fpm), the mean values of face velocities of only 9.09% of the hoods passed the test (P=0.001) and were at an acceptable level. As regards the tracer gas test, the results were even worse: only 4.5% of the hoods passed the acceptability test (p=0.001). In addition, non of the hoods having an acceptable face velocity passed the tracer gas test. Similarly, no hood with an accepatable tracer gas performance had an acceptable face velocity.
Conclusion: Since there is no consistency between face velocity and tracer gas tests, performance of laboratory hoods can necessarily be assessed on the basis of the tracer gas quantitative test. The face velocity test is a supplementary test, which, if used alone wil give false results.
M Behzadpoor, H Zeraati, M Mahmoudi, A Rahimi,
Volume 7, Issue 1 (23 2009)
Abstract
Background and Aim: Like other cancers, gastric cancer is due to uncontrolled growth of tissues. Although there are different therapy methods to treat it, such as surgery, radiation therapy, chemotherapy, and multimodality therapy, relapse and death may occur. Reports show that in Iran gastric cancer is the first cause of death among deaths due to cancers. The purpose of this study was to determine the two-year survival rate after relapsing and its associated factors among gastric cancer patients who had undergone surgical treatment in Iran Cancer Institute, one of the most important cancer treatment centers in Iran.
Methods and Materials: A total of 330 patients with gastric cancer who had been admitted to and operated on at the Iran Cancer Institute between January 1996 and April 2000 were enrolled in this study. The patients' life expectancy after relapse was determined. Survival was defined as the elapsed time between the two successive events, relapse and death, neither of which can be determined exactly therefore the data are doubly censored failure time data. Thus, the relationships between life expectancy at relapse and such variables as age, gender, and factors related to the disease, such as the cancer site, pathologic type, stage, and sites of metastases were determined using the Cox proportional hazards model.
Results: The two-year survival rate after relapsing and the median life expectancy after relapsing were 15% and 10.15 months, respectively. Univariate analysis showed that except disease stage, no other variable (age, gender, cancer site, pathologic type and sites of metastases) affected life expectancy after relapsing significantly. The Cox proportional hazards model for doubly censored failure time data showed that age, gender, and pathologic type had the highest influence, in a decreasing order, on the rate of survival after relapsing.
Conclusion: Two-year survival rate after relapsing is very low in gastric cancer patients. One of the most important reasons seems to be delayed consultation and diagnosis. Most patients seek medical advice first with the disease in the late stages, when most have lymph node, liver or even distant metastasis which makes treatment even more complex, and when the risk of relapse and death would be increased. Thus, early diagnosis and therapy for a common stomach illness could help prevent a potential gastric cancer.
A Pourreza, R Khabiri, M Arab, A Akbari Sari, A Rahimi, A Toll,
Volume 7, Issue 2 (4 2009)
Abstract
Background and Aim: Factors determining the health care-seeking behaviors of an individual are social, cultural, and economic (treatment costs). Utilization of a health care system by a person will, on the whole, depend mainly on the socio-economic and demographic factors, cultural beliefs and practices, gender discrimination and women's status, the economic and political systems, environment, patterns of illness, and the health care system itself. The main objective of the present study was to examine current patterns of health care-seeking behavior in residents of Tehran, Iran in 2007.
Methods and Materials: In a cross-sectional study a two-stage cluster sampling method was used to select neighborhoods at the first stage and households at the second. The sample included a total of 1882 individuals over 18 years old in the households. The data were collected using a questionnaire. For analysis of the data the exact fisher test, X2, and multivariate logistic regression were used the software used was SPAA.3
Results: About 22/9% (431 persons) of the participants reported 1-2 illnesses during the previous month. Multivariate logistic regression indicated that age, sex, perceived severity of the illness, educational level, and marital status were all statistically associated with an attempt to seeking care, whether self-treatment or consulting a health center. The effects of different variables on decisions related to seeking care from a health care center versus self-care were also examined. The data showed that age, sex, perceived severity of the illness, income, educational level, household size, and method of payment were statistically the most significant variables affecting seeking care from a health center.
Conclusion: Based on these findings, it may be concluded that increasing social awareness about side effects of medicines, potential dangers of self-treatment, continuous education and training of physicians and pharmacists, improving health insurance systems and universal insurance coverage will be appropriate strategies for better utilization of health care services by the people.
Sh Rahimi Kamal, J Nasl Saraji, I Mohammad Fam ,
Volume 7, Issue 4 (27 2010)
Abstract
Background and Aim: Human error often plays an important role in accident causation either through direct action or poor design . The focus of this work is was on prediction of human error probabilities during the process of emergency musters on in gas compressor stations . This paper aims to present a brief description of Human Error Probability Index (HEPI) for the on gas compressor station musters process.
Materials and Methods : Due to a lack of human error databases, and in particular human error data on gas compressor station musters, an expert judgment technique, the Success Likelihood Index Methodology (SLIM), , was adopted as a means to predict human error probabilities Two muster scenarios of varying severity (gas release, fire and explosion) were studied in detail . A total of 34 reference graphs provided data for both the weighting and rating of six performance shaping factors and the data were subsequently processed by means of SLIM to calculate the probability of success for 16 muster actions ranging from point of muster initiator to the final actions in the temporary safe refuge (TSR). The actions were categorized into 4 phases, namely, awareness, evaluation, egress, and recovery phases. The six performance shaping factors considered in this work were stress, complexity , training, experience, event factors, and atmospheric factors .
Results: Human error probabilities in the egress phase were highest, followed by those in the evaluation phase the lowest were in the awareness phase.
Conclusion: The HEPI can be applied to limit the chances of human error occurrence and mitigate the consequences of such errors through changes in training, design, safety systems, and procedures, resulting in a more error-tolerant design and operation .
H Rahimifard, N Hashemi Nejad, A.r Choobineh, H.r Haidari, H Tabatabaei,
Volume 8, Issue 1 (10 2010)
Abstract
Background and Aim: In the raw furniture preparation workshops, in which the workers usually have an undesirable postures when at work, ergonomic assessment and the work environment improvement seem essential. Developing checklists and calculating ergonomic indices would be useful in this assessment. This study was conducted with the objectives of assessing musculoskeletal disorders (MSDs) risk factors and determining types of corrective measures in raw furniture preparation workshops.
Materials and methods: After conducting task analysis, 268 workers were assessed using an ergonomic checklist developed for the purpose and ergonomic indices were calculated. The Nordic musculoskeletal disorders questionnaire was used to determine the prevalence rate of MSDs among the workers. Data were analyzed using the t-test and the test of proportions.
Results: The highest prevalence was in the lower back (38.4%) and the knees 36.2%). Statistical analysis revealed that there were significant associations between MSDs and calculated ergonomic indices (p<0.001). In addition, calculation of OR revealed that ergonomic conditions were associated with MSDs in different body parts (OR=2.90-9.49, p<0.001). On the whole, the working conditions of 32.46% of the workers studied were poor from an ergonomic point of view.
Conclusion: The checklist developed was found to be an appropriate and low-cost tool for ergonomic assessment. The most important problems in the workshops were due to inappropriate general working conditions, inappropriate organization, and unsuitable work stations.
