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Mehrasa Mohammadsadeghi, Niaz Mohammadzadeh Honarvar, Mostafa Qorbani, Anahita Mansouri, Fariba Kouhdani,
Volume 16, Issue 2 (9-2018)
Abstract
Background and Aim: Lipoprotein disorders are an integral component of type-2 diabetes mellitus (T2DM). Therefore, early diagnosis and treatment of lipid disorders can be beneficial in prevention and treatment of many complications associated with T2DM.The aim of this study wasto determine the effect of docosahexaenoic acid (DHA) supplementation on the serum levels of apolipoproteins (Apos) A1, A2, B48 and C3 in patients withT2DM.
Materials and Methods: In this 8-week randomized, double-blind, placebo-controlled clinical trial, 44 T2DMpatients were randomly assigned to either an experimental group (n=22, receiving daily 2.4 g DHA) or a placebo group (n = 22, receiving paraffin). The serum levels of AposA1, A2, B48 and C3 were measured in all the patients at the beginning and at the end of the period.
Results: There was a statistically significant increase in the mean serum level of ApoA1 in the DHA group (p = 0.014). In addition, a significant difference was observed in the serum level of ApoC3 after intervention between the DHA and placebo group (p=0.031). There were no significant differences between the two groups as regards the mean changes in serum levels of ApoA1, ApoA2, ApoB48 and ApoC3.
Conclusions: Dietary supplementation with docosahexaenoic acidhasno effects on the serum levels of apolipoproteins in patients with type-2 diabetes.
Kourosh Holakouie Naieni, Mohammad Ali Mansournia, Farzad Khodamoradi, Zahra Hosseinkhani, Mehdi Ranjbaran, Zohreh Foroozanfar, Yousef Alimohamadi, Solmaz Farrokhzad,
Volume 16, Issue 2 (9-2018)
Abstract
Background and Aim: Diabetes mellitus is one of the most prevalent and important health problems in the world.Considering the high prevalence of metabolic syndrome in diabetic patients and the potential effects of its components on HbA1C in these patients, the present study was conducted to determine the effect of metabolic syndrome components on HbA1C in type-2 diabetic patients.
Materials and Methods: This retrospective cohort study was conducted on 157 diabetic patients regularly referring to the Diabetes Control Center in Qazvin City during 2014, where complete data about theirmetabolic syndrome components, as well as HbA1C levels were available. The data were analyzed using multiple linear regression (α=0.05 for statistical significance).
Results: Based on the regression model, the effects of age, HDL-C and fasting blood glucose on HbA1C were statistically significant; the effects of other variables were nonsignificant. The R2value for the variables entered for prediction of HbA1C was found to be 0.45 (R2 = 45%).
Conclusion: Considering the significant relationship between some components of the metabolic syndrome such as HDL-C and fasting blood glucose on HbA1C in diabetic patients, it is essential to design and implement programs to reduce the level of HbA1C in these patients.
Jafar Yahyavi Dizaj, Sara Emamgholipour, Abolghasem Pourreza, Farogh Nommani, Somayeh Molemi,
Volume 16, Issue 3 (12-2018)
Abstract
Background and Aims: Population aging is one of the most important economic, social and health challenges of the twenty-first century. The increasing rate of aging in the population will increase the risk of households being confronted with catastrophic health expenditure (CHE). The purpose of this study was to determine the effect of aging on households' CHE in Iran.
Materials and Methods: The data on household income-expenditure were obtained from the annual Iranian Statistical Center reports for the period 2007-2016. The statistical technique used for data analysis was the regression Logit technique, the software for the final data analysis being the Excel and STATA.
Result: The results showed that increased numbers of elderly people in a household would increase the probability of the household being confronted with CHE. Additionally, the following households were also more likely to be at risk of CHE: urban families; female-headed families; those not owning private homes; those with no income or with an unemployed head; and those in the lower income deciles. Moreover, no insurance coverage would decrease the likelihood of a household to be at risk of CHE.
Conclusion: Considering the findings of this study and the aging of the Iranian population, it is essential that the government, in line with fair financing and reducing the economic burden of health expenditures on households with an elderly member, try, through special support packages for the elderly, to prevent confrontation of such families with catastrophic health expenditures.
Ahmad Ali Noorbala, Hossein Malek Afzali, Nasrin Abedinia, Marzieh Akhbari, Alireza Moravveji, Fatemeh Vaseghi, Zahra Nakhi, Mamak Shariat, Maryam Mirzaeeneyestani, Fatemeh Sadat Ghoreishi,
Volume 16, Issue 3 (12-2018)
Abstract
Background and Aim: Stress during pregnancy can have a lasting effect on the mental health of women after childbirth. Statistics show that about 18% of pregnant women have major or partial depression during pregnancy, but many have not been screened or treated. Lack of treatment can have serious consequences for the mother and her child. The purpose of this study was to determine the mental health status and marital satisfaction of pregnant mothers in Kashan city, Iran in 2015.
Materials and Methods: This was an analytical cross-sectional study. Using the convenience sampling method 202 pregnant women were selected from four urban health centers in Kashan, Iran and entered the study. Data were collected using a Diagnostic Interview, the General Health-28 Questionnaire and the Golombok Rust Inventory of Marital State. Descriptive statistics was used for data analysis, the statistical tests being one-way ANOVA, chi-square test, Pearson correlation test and logistic regression.
Results: The results showed that 26.7% of the pregnant women were suffering from psychiatric disorders, the most and least serious disorders being related to physical activity and depression, respectively. About 80% of the women expressed very good marital satisfaction. Further analysis of the data showed statistically significant associations between depression and age and anxiety, insomnia and duration of marriage, marital satisfaction and delivery type, and mental health and marital satisfaction. Furthermore, marital satisfaction had a negative association with education. (p<0.05).
Conclusion: It seems that it is essential to develop and implement a therapeutic, psychiatric and health care model for women at risk of psychiatric disorders during pregnancy and after childbirth in the health service delivery system in Iran.
Niroomand Romiani, Bi Bi Sadat Miresmaili, Kamal Azam, Zahra Yousefi, Moslem Romiani,
Volume 16, Issue 3 (12-2018)
Abstract
Background and Aim: The Internet is a tool that responds to many human needs, but this technology can also have an impact on people's lives. This study aimed to examine the role of the Internet in family values.
Materials and Methods: This descriptive-analytic cross-sectional study was conducted in 2015 in Tehran, Iran. The research population consisted of all the students of Tehran University of Medical Sciences, Tehran, the sample size being 384. Data were collected using a questionnaire, as well as The Young's standard questionnaire, and analyzed by the SPSS software version 22, the statistical test being one-way analysis of variance.
Results: The findings showed statistically significant positive associations (p<0.05) between the student's dependence on the Internet on the one hand and the following variables on the other: intimacy among users, family awareness and information, and the extent to which the students were using the Internet. However, no statistically significant relationship was found between Internet use and anonymity on the Internet.
Conclusion: The constant use of the Internet and accepting it as the main reference and channel for obtaining information have caused negative effects on family life and the relationships and values within the family framework. Therefore, university students should try to make optimum, more proper use of the Internet. It is also recommended that responsible authorities adopt appropriate policies and implement cognitive-behavioral interventions aiming at changing the patterns of Internet use.
Hossein Dargahi, Alireza Darrudi, Mehrzad Rezaei Abgoli,
Volume 16, Issue 3 (12-2018)
Abstract
Background and Aim: All hospitals need to be monitored and continuously evaluated. Pabon Lasso graphical model assesses the efficiency of hospitals using a combination of their input data and performance indicators. The aim of this study was to determine the effects of Iran Health System Evolution Plan on Tehran University of Medical Sciences (TUMS) hospitals’ performance indicators using the Pabon Lasso model in 2016.
Materials and Methods: This was a descriptive-analytical and cross-sectional study including 8 general and specialized hospitals. The hospital input data and performance indicators were collected by permission of TUMS Vice-chancellor’s Office for Therapeutic Services. Chi-square and the two-sample T2 tests were used for data analysis, and hospital performance was assessed using the Pabon Lasso Model.
Results: The results showed that the number of TUMS hospitals located in zones 3 and 4 had increased after implementation of the Iran Health System Evolution Plan, which indicates improved efficiency of these hospitals, as confirmed by the chi-square test.
Conclusion: Based on the Pabon Lasso graphical model, it can be concluded that the performance indicators of the hospitals show improvements in performance after implementation of the Iran Health System Evolution Plan. The successful experience in the management of the hospitals in this study can act as a practical guide for managers of other hospitals throughout the country for better management.
Elham Faez, Seyed Abolfazl Zakerian, Kamal Azam,
Volume 16, Issue 3 (12-2018)
Abstract
Background and Aim: Ergonomics climate indicates employee perceptions of the extent to which the organization emphasizes and supports the design and modification of work, so that both performance and well-being of the personnel are improved. The purpose of this study was to determine the validity and reliability of the Persian version of the ergonomics climate assessment questionnaire in order to create a suitable tool for determining the overall values of an organization in connection with ergonomics and climate assessment.
Materials and Methods: First, the ergonomics climate assessment questionnaire was obtained from the Colorado State University of America, where it had been developed. The back-translation method was used to confirm its language suitability and precision. The content validity of the questionnaire was assessed by 10 relevant experts, followed by a cross-sectional study using a sample of 50 employees of a power generation plant using Cronbach's alpha to determine its reliability.
Results: The content validity ratio (CVR), content validity index (CVI) and reliability of thequestionnaire were found to be 0.90, 0.94 and 0.96 (a for the 59 items), respectively. These resultsindicating that the questionnaire is a valid and reliable tool.
Conclusion: Considering the acceptable validity and reliability of the ergonomic climate assessment questionnaire, it can be used as a valid and reliable tool to assess and analyze the status of ergonomic climate in different industries and organizations in Iran.
Mohsen Roshanpajouh, Roksana Mirkazemi, Mehrdad Ehterami, Houman Narenjiha, Hossein Malek Afzali, Hamidreza Sarrami, Majid Rezazadeh, Fatemeh Abbasi, Saeid Noroozi,
Volume 16, Issue 4 (3-2019)
Abstract
Background and Aim: Drug abuse is a long-standing social and public health problem in Iran. Access to accurate, reliable and up-to-date data related to drug use is essential for planning and policy-making for prevention of, treatment of, and harm reduction related to, drug abuse. The purpose of this study was to access accurate data regarding drug abuse prevalence and substance use in Tehran Province population.
Materials and Methods: This study was a cross-sectional household survey with a sample of 6024 individuals aged 15-64 years residing in Tehran Province. Data on demographic characteristics and drug use during the previous week, month and year and the whole lifetime were collected using a researcher-designed questionnaire.
Results: A total of 5646 individuals participated in the study. The lifelong prevalence of cigarette-smoking, hookah-smoking, alcohol consumption and drug use were 21.9%, 26.8%, 12.1% and 7.3%, respectively. The corresponding proportions during the previous week were 12.9%, 10.5%, 1.8% and 2.2%.
Conclusion: The prevalence of cigarette-smoking, hookah-smoking, alcohol consumption and drug use is high in Tehran Province. The prevalence of lifelong cigarette and hookah smoking and alcohol consumption is higher, while that of drug use is lower, than the respective national averages.
Ali Mohammad Mosadeghrad, Abolghasem Pourreza, Fatemeh Yaghubi-Fard,
Volume 16, Issue 4 (3-2019)
Abstract
Background and Aim: Burn injuries cause severe devastating losses and early death. Care and treatment of burns patients is very costly. The purpose of this study was to calculate the economic burden of care and treatment of burn injuries in a hospital in Ahvaz, Iran.
Materials and Methods: This descriptive and cross-sectional study was carried out in 2015 in Taleghani Hospital, Ahvaz, Iran. A total of 315 patients participated in the study. Data was collected, using a valid and reliable questionnaire, through interviews with patients or their relatives on the day of discharge and examining their medical records. Data analysis was done using standard statistical tests and the SPSS (V.22) software.
Results: The mean total cost of care and treatment of an inpatient with burns was 117,071,803.00 Iranian Rials (equivalent to US$ 4,063.00), the mean daily cost being 8,501,946.00 Iranian Rials (equivalent to US$ 295.00). Direct medical costs, direct non-medical costs and indirect costs accounted for 94.1%, 1.4% and 4.5% of the total cost, respectively. The patients’ out-of-pocket payment was 7.7% of the total direct costs. Surgery, drug and diagnosis costs accounted for the largest fraction of the total treatment cost.
Conclusion: The total cost of care and treatment of burns patients in the hospital is very high, imposed on patients, their relatives, government and health insurance companies. The government and insurance companies should provide financial protection to facilitate the process of care and treatment of burns patients.
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.
Rahimeh Abdoli, Mohammad Mehdi Sedaghat, Mohammad Ali Oshaghi, Hamideh Edalat, Zakieh Telmadarraiy, Sahar Azarmi, Mohammad Javad Rafinejad,
Volume 17, Issue 1 (6-2019)
Abstract
Background and Aim: Ixodidae (hard ticks) are obligate blood-feeders of vertebrates with majorroles in transmission of pathogenic microorganisms including theileriosis, babesiosis and CCHF virus, as well as relapsing fever, to domestic animals and humans. This study was conducted to determine the distribution of ixodidae species, vectors of Crimean-Congo hemorrhagic fever (CCHF), in the border areas in North West of Iran.
Materials and Methods: This was a descriptive cross-sectional study conducted in Ahar and Kaliybar Counties, East Azarbaijan Province, Iran. Randomized cluster sampling was done in villages in the forest and mountainous regions. Ticks were isolated by forceps from the animals, kept in sampling tubes and transferred to the laboratory. Then the tick samples were identified using taxonomical keys.
Results: A total of 2022 hard ticks were isolated from 1400 head of livestock (1000, 200, 180 and 20 head of sheep, goat, cow and buffalo, respectively). On the average, the infestation rate was 1.44 per head of cattle ─ 0.11% in goats, 0.32% in sheep, 0.90% in buffaloes, 9.25% cows. Out of the ticks isolated, 498 (24.63%) were male, 741 (36.65%) were female and 782 (38.67%) nymph, plus one larva. The ticks belonged to the lxodidae family, including four genera: Hyalomma (88.82%, with the following three species: Hyalommaanatolicum (39.22%), Hyalommamarginatum (9.15%) and Hyalommaasiaticum (0.69%)); Rhipicephalus (8.8%); Dermasentor (1.58%); and Haemaphisalis (0.8%). The others identified were Hyalomma nymph (38.67%), Hyalomma sp. (1.04%) and Hyalomma larva (0.05%), Rhipicephalus bursa (5.19%), Rhipicephalussanguineus (3.61%), Dermasentor marinates(1.58%), Haemaphisalissulcata (0.59%), and Haemaphisalispunctata (0.15%), as well as Haemaphisalisconcinae (0.05%). Hyalommaanatolicum was the dominant species.
Conclusion: The dominant tick species in the regions studied was Hyalommaanatolicum, a tick having a major role in transmission of many disease vectors including CCHF, ovin babesiosis, theileriosis, anaplasmosis, ehrlichiosis, etc. It is essential that the provincial Contagious Disease Center and Veterinary Department take appropriate action with the collaboration of other relevant departments to combat the tick.
Mohammad Mehdi Soltan Dallal, Rozhin Ghahremani, Abbas Akhavan Sepahi, Zahra Rajabi,
Volume 17, Issue 2 (9-2019)
Abstract
Background and Aim: Food-borne diseases, with an upward trend worldwide, are a major public health issue. On the other hand, resistance to antimicrobial agents is also a global problem. Thus, a knowledge of antibiotic resistance is vital for the proper treatment of food-borne diseases. The aims of this study were to determine the frequency, antimicrobial resistance and serotyping of Shigella-contaminted food samples in foodborne disease outbreaks in Iran.
Materials and Methods: This was a descriptive study including 1012 fecal swab samples from 239 foodborne disease outbreaks in different provinces of Iran during the period 2005-6. The isolated Shigella samples were transferred to a microbiology laboratory for microbial culture, serogrouping and antibiogram tests.
Results: Out of the1012 fecal swabs collected 29 (2.86%) isolates contained Shigella. The largest Shigella outbreaks (20.6%) were found to have ocurred in 3 provinces, namely,Esfahan, Kurdistan and Semnan. The most common clinical symptoms were abdominal cramping, vomiting, nausea and non-bloody diarrhea. Th frequency of contamination with Shigella Sonnei and Shigella flexneri was 16 (55.2%) and 13 (44.8%), repectively. The rate of resistance to ciprofloxacin was reported to be 3.4%.
Conclusion: Considering the frequency of food contamination with Shigella in the summer and its in resistence to ciprofloxacin, assessment of its antimicrobial resistance are very important as regards reduction in treatment costs and taking action to control and prevent the disease.
Neda Karimi, Shahrzad Saadat Gharin, Azar Tol, Roya Sadeghi, Mehdi Yaseri, Bahram Mohebbi,
Volume 17, Issue 3 (12-2019)
Abstract
Background and Aim: Since many of the healthy behaviors are adopted and develop during adolescence, proper choice of such behaviors is very important in this period of life. In addition, paying attention to the health of girls is crucial because they will transfer such behaviors to the next generation. Therefore, this study aimed to identify the role of health literacy and demographic variables in determining health-promoting behaviors among second-grade high school girl students in the City of Tehran, Iran.
Materials and Methods: This descriptive-analytic cross-sectional study was conducted on 370 female students using cluster sampling method in 2018. Data were collected using demographic, Health Literacy Measure for Adolescents (HELMA) and Health-Promoting Lifestyle Profile II (HPLPII) questionnaires and analyzed using SPSS25.
Results: The results of multivariate regression analysis revealed that there were statistically significant direct associations between health-promoting behaviors and the following variables: one’s health literacy (β= 0.39, p<0.001), interest in health topics (β= 1.35, p<0.001), reading of journals and newspapers (β=0.76, p= 0.007), father's education (p= 0.002), body mass index (p= 0.022), field of study (p<0.001), the first source of health information (p<0.001) and place of residence (p = 0.023). Further analysis of the data showed an indirect association between health-promoting behaviors and age (β= -1.69, p<0.001) and health assessment (β=-1.67, p<0.01).
Conclusion: Based on the findings it is concluded that the subjects’ health literacy and health-promoting behavior scores were “not sufficient” and “intermediate”, respectively. It is recommended to design and implement appropriate training/intervention programs aiming at increasing the heath literacy and promoting health behaviors of female students.
Maryam Jamshidi Moghadam, Gholam Reza Jahed Khaniki, Abbas Rahimi Foroushani, Nabi Shariatifar,
Volume 17, Issue 3 (12-2019)
Abstract
Safe food and proper nutrition play a vital role in the health of populations. Food-borne diseases are a serious public health problem. Food handlers working in the kitchen play an important role in the transmission of foodborne diseases. Food-borne diseases, especially those caused by bacteria, viruses, parasites and fungi, are preventable. Proper manpower training is a key factor in provision of safe food and prevention of malnutrition.
Materials and Methods: A descriptive, cross-sectional and applied study was conducted in 10 hospitals affiliated with Tehran University of Medical Sciences in 2017. The knowledge, attitude and practice of 136 food handlers working in the kitchens of the hospitals was assessed using questionnaires.
Results: Analysis of the data showed that 8.08% of the participants had a good knowledge about food hygiene and safety (a score above 75%), while 16.7% of them achieved the full score as regards attitude. The hospitals’ performance was at a desirable level. The level of food hygiene and safety knowledge of the food handlers was significantly associated with their refresher trainings (p <0.05).
Conclusion: It can be concluded that the awareness of food handlers in most of the hospitals about food hygiene and safety is not sufficiently high. It is suggested to design and implement proper refresher training crash courses, as well as sensitize the personnel.
Negin Bolourchi, Elham Ebrahimi, Jalil Falah, Ali Javadi, Seyed Saeid Eshraghi,
Volume 17, Issue 3 (12-2019)
Abstract
Background and Aims: Nocardia asteroides complex is the most common cause of infectious diseases due to nocardiosis. Interspecies differentiation of Nocardia genera is essential for prognosis and timely proper treatment, as well as for epidemiological studies. Since each genus has its own antibiotic resistance, precise careful diagnosis is of prime importance. As compared to biochemical and phenotypic methods, the efficacy of molecular methods for fast and accurate identification of Nocardia species has been proven. The aim of this study was to detect for the first time Nocardia asteroides complex in clinical isolates using real time polymerase chain reaction (Real-Time PCR).
Materials and Methods: Out of the 25 clinical isolates suspected to be Nocardia asteroides genus 10 were identified as Nocardia asteroids complex by biochemical and phenotypic methods, followed by genomic DNA extraction of the suspicious isolates. Nocardia asteroides complex positive controls were prepared using standard strains. Real-time PCR was conducted on all the 10 suspicious isolates. The final real-time PCR samples were sent for sequencing to verify the identified species.
Results: Based on sequencing results 3 of 10 clinical isolates suspected to be identified as Nocardia asteroides complex were confirmed as belonging to the Nocardia asteroids complex genera ─ Nocardia asteroids, Nocardia farcinica, and Nocardia nova.
Conclusion: This study shows that, as compared to biochemical and phenotypic methods, real-time polymerase chain reaction is faster and more specific, and is considered as an efficient method, for Nocardia interspecies identification and differentiation.
Hojjat Rahmani, Farshid Nasrolah Beigi, Somayeh Nikan, Ghasem Rajabi Vasoukalaei,
Volume 17, Issue 3 (12-2019)
Abstract
Background and Aim: Human resources are of paramount importance in the success of any organization. In the health care system, nurses play a great role in the delivery of high-quality care. In this regard, in the process of providing high-quality and efficient healthcare delivery, justice perception of performance appraisal system and organizational citizenship behavior (JPPAS & OCB) are strong tools for performance management. The aim of this study was to determine the association between JPPAS & OCB among nurses in Tehran University of Medical Sciences hospitals in Tehran, Iran.
Materials and Methods: This was a cross-sectional study with a sample size of 346 nurses working in Tehran University of Medical Sciences hospitals. Data were collected using two questionnaires, namely, the JPPAS & OCB and a general demographic questionnaire. SPSS 24.0 for windows was used for statistical analysis of the data.
Results: Analysis of the data showed that justice perception of performance appraisal system (2.70) and organizational citizenship behavior (2.66) are at a moderate level. Based on the correlation analysis, a significant positive association was found between performance appraisal and organizational citizenship behavior. In the final analysis it was shown that performance appraisal could predict organizational citizenship behavior (30.9% of the variance).
Conclusion: Justice perception of performance appraisal system can positively influence loyalty, job satisfaction and employees’ commitment, as well as create organizational confidence, enhance productivity and improve participation.
Leila Allahqoli, Azam Rahmani, Reza Ghanei Gheshlagh, Arezoo Fallahi, Masoumeh Hashemian, Hamed Fallahi, Babak Nemat-Shahrbabaki,
Volume 17, Issue 3 (12-2019)
Abstract
Background Aim: Job burnout among health educators is increasing with serious physical, psychological and social consequences. The purpose of this study was to explore the causes of job burnout from the perspective of health educators and identify their needs for reducing it.
Materials and Methods: This qualitative study was carried out in comprehensive health service centers of Sanandaj, west of Iran, in 2017, including 15 health educators selected by purposive sampling. The data were collected through individual interviews and semi-structured group discussions, observation and field notes and analyzed using the conventional content analysis approach with due consideration of acceptability, verifiability and transferability to ensure the accuracy and strength of the data.
Results: The causes of job burnout were extracted in 5 categories including "issues related to comprehensive health service centers", "individual challenges of staff members", "management weakness", "executive system challenges" and "issues related to clients". The participants emphasized the following actions for reducing job burnout: strengthening individual skills, effective evaluation and management support, providing recreational and welfare facilities, reducing job stress, and strengthening intra- and inter-sectoral communications.
Conclusion: The results of this study show that various factors contribute to job burnout among health educators. Improvements in management, laws and welfare facilities not only would reduce job burnout but also may increase the efficiency of health education programs.
Maryam Tajvar, Alimohammad Mosadeghrad, Mehdi Yaseri, Maria Mohammadi,
Volume 17, Issue 4 (3-2020)
Abstract
Background and Aim: Iran is experiencing a very fast population ageing, ranking 3rd globally in terms of pace of population ageing. The increase in the elderly population has been accompanied by an increase in demand for health services. A knowledge and understanding of the utilization of health services by the elderly are essential for resource allocation and health planning. This study aimed to investigate the utilization of in-patient services by the Iranian elderly and explore its determinants.
Materials and Methods: This study was a secondary analysis of the data of a cross-sectional National Study on the Utilization of Health Services in Iran, including 22470 households across the country. The study population was people aged 60 years and over, the sample size being 8205 individuals selected by stratified random sampling from provinces, towns and villages. A questionnaire was used to collect information on the need of the individuals to hospitalized services during the last one year and receiving the required services and analyzed using multilevel logistic regression to identify the factors related to the utilization of inpatient health services.
Results: Of the 8205 participants, 1411 (17%) reported that they needed in-patient services at least once during the previous year, about 93% of whom referred to a hospital, of whom about 1288 (97%) finally had finally received the required services. The factors related to inpatient service utilization were age (p=0.03) and having insurance status (p<0.001), such that the older individuals and those with no insurance, although they had higher inpatient service needs, received less services. The most important cause of dissatisfaction in the towns was related to the behavior of nurses and non-physician personnel and in villages long waiting time for receiving a service. Finally, the most important causes being not willing to be hospitalized were the high service cost and no health insurance coverage.
Conclusion: The older people and those with no insurance should be priority groups in health service utilization policy-making and planning, so that they can access and receive better services. The causes of low inpatient service utilization and dissatisfaction should be taken into consideration seriously by health service providers and managers.
Alimohammad Mosadeghrad, Ali Akbarisari, Parisa Rahimitabar,
Volume 17, Issue 4 (3-2020)
Abstract
Background and Aim: Good governance results in better health outcomes for the society thorugh improving health system performance. The governance of Iran health stsyem faces some challenges. Hence, this study aimed to propose and verify a model for strengthening Iranian health system governance.
Materials and Methods: This descriptive study was conducted in 2016 using the Delphi method. A health governance model with six dimentions including sturucture, communication, regulation, policy making and planning, stewardship and evaluation and accreditation has been proposed. Then, the proposed model verified using 25 Iranian healthcare experts’ opinions in two rounds.
Results: Developing an integrated health system model comprising health system enablers and results, downsizing and reducing the number of directorates in ministry of health,determining basic principles for regulation, enhancing communication with other external organizations affecting people health, using more evidence in policy making and planning, developing a strategic plan and national health policy, enhancing leadership, management and stewardship; and developing comprehensive systemic standards for evaluation and accreditation of healthcare organizations are recommended to enhance the effectiveness and efficiency of Iran health system governance.
Conclusion: Iran health system governance faces numerous challenges. Using successful countries’ experience and internal health care experts’ opinions help to reduce the current challenges and achieve health system goals.
Mo0hammad Mehdi Soltan Dallal, Mahdiyeh Poormoradian, Sheyda Asadpour,
Volume 17, Issue 4 (3-2020)
Abstract
Background and Aim: Salmonella species is one of the important pathogens causing food poisoning and gastroenteritis. The aim of the present study was to assess the quality of traditional creams as regards bacterial contamination.
Materials and Methods: This was a cross-sectional study including a total of 250 traditional cream and 50 pasteurized cream samples collected in the south of Tehran retail shops. The samples were diluted in a phosphate-buffered saline, transferred to a rappaport-vassiliadis salmonella (rvs) enrichment broth according to the CDC procedures and incubated at 37° C in Hektoen enteric agar and bismuth sulfite agar media for 24 hours. Antimicrobial susceptibility testing was done using the Clinical and Laboratory Standards Institute (CLSI) procedures. On the following day the suspected colonies were examined for phenotype and finally confirmed by the API 20 E test.
Results: Of the 250 unpasteurized cream samples 15 (6%) were contaminated with Salmonella. Of the 7 serotypes identified, the most frequent Salmonella serotype was the infantis serotype with 7 cases (33.3%). Furthermore, Coliform bacteria such as Escherichia coli, Enterobacter, Klebsiella and Citrobacter were also isolated. The highest antibiotic resistance was to nalidixic acid (93.3%), tetracycline (73.3%) and trimethoprim (66.7%). None of the pasteurized cream samples was contaminated with Salmonella.
Conclusion: The results confirm the need for more effective control and monitoring of the traditionally prepared cream marketed in the city by the Food Control Authority. In addition, educating the public about the consumption of pasteurized cream can play a good role in reducing foodborne illnesses.
