Health and Development Journal
Volume:4 Issue: 2, 2015

Owing to the growing importance of medicines in treatment of diseases، as well as their role as alternatives for expensive and often unsafe procedures; economic examination of factors associated with their demand is necessary. Hence، this study aimed at exploring factors affecting the demand of specialty medicines. In this descriptive-analytic study، data was collected from questionnaires completed by 280 patients with multiple sclerosis، hemophilia، thalassemia، and chronic kidney disease. Then data was entered into Stata 12 and after estimating the model، by using the Probit model، their final effect was evaluated. We found that patient need (ME=0. 858)، deterioration of patient health (ME =-0. 001)، situation of house ownership (ME =-0. 002)، gender (ME =-0. 048)، income (ME =-0. 001)، education (ME =-0. 002) and job (ME =-0. 001) are significant variables that affect demand for specialty drugs. Health insurance coverage (P =0. 631) had no significant correlation with demand. Consideration of factors affecting patients’ need can help policy makers in anticipation of special patients’ need to specialty drugs. Also demand can be manipulated by working on some patients’ characteristics such as their education level.

With regard to novel plans in the health sector، including “Health Sector Evolution” and changes of hospitals’ issues، change and innovation skills are considered essential for hospital administrators. This study aimed to determine the relationship between management style and change and innovation skills of administrators in Teaching Hospitals of Shiraz University of Medical Sciences in 2009. This was a cross-sectional and descriptive-analytical survey. Study samples were 9 managers and 135 headquarter staff of hospitals affiliated to Shiraz University of Medical Sciences. Data were collected using the management style questionnaire of Rensis Likert and questionnaire of change and innovation skills. Data were analyzed through SPSS16 and using descriptive statistics (frequency، percentage and mean) and analytical statistics (t-test and ANOVA. ( Most hospital administrators of Shiraz University of Medical Sciences had consultative management style. The majority of headquarter staff were in the age group of 20-40 years. There was a significant relationship between change and innovation skills of hospital administrators and their management styles (P<0. 001). It seems that in order to implement the change and innovation plans in hospitals، implementing a successful participatory management style is very effective، because with honest participation، the organizational goals will be more achievable.

Pregnancy is a physiological process in any women''s life، but in some cases it might be ended in maternal death tragedy. However، most cases of maternal deaths are preventable. Reviewing maternal death cases، for the purpose of identifying the related factors is beneficial for future planning. The aim of this study was to assess the current statuses of maternal death and its causing factors in hospitals affiliated to Kerman University of Medical Sciences. In this cross-sectional study، all cases of maternal deaths during 2010 to 2012 were studied and a designed data entry form was completed for each case. Data analysis was done through SPSS17. During the 3 years of study، 28 maternal deaths had occurred and the ratio of maternal death was calculated as 23. 57 per 100000 live births. Preeclampsia was the most common direct cause and heart disease was the most common indirect cause of maternal deaths. Maternal deaths were related to shortcomings in all stages of before pregnancy، during pregnancy and post partum period. In order to minimize the number of maternal deaths، more attention should be paid to the quality of maternal care before pregnancy، during pregnancy and in post partum period.

Hospitals are one of the most important health care institutions that should provide a safe environment for their patients. This study was conducted on hospital staff in Kerman to evaluate their culture in regard to patient safety. In this cross - sectional study، data were collected from 439 hospital staff affiliated to Kerman University of Medical Sciences through using “Hospital Survey on Patient Safety Culture” (HSOPSC) questionnaire. Data were analyzed by SPSS16 software and using descriptive (mean and standard deviation) and analytical (t-test and ANOVA) statistics at a significance level of P< 0. 05. The dimension of «Management support for patient safety”، with an average positive response of 72. 20% received the highest and the dimension of» Non punitive response to error«with an average positive response of 56. 30% received the lowest scores. Subjects aged over 35 had a better overall understanding of patient safety than those younger than 35 years. The overall perception of patient safety showed no significant difference between men and women who participated in the study. Attention to patient safety culture by health care providers، especially managers is essential، but has not been enough. Therefore، it is recommended to implement rewarding systems and to hold comprehensive educational programs about patient safety culture for hospital staff in order to improve the quality of health care services.

Papsmear is one of the most effective screening tests for the diagnosis of cervical cancer. In this study the health belief of women referred to health care centers in Bandar Abbas، Iran about undergoing Papsmear was assessed on the basis of the Health Belief Model. This cross- sectional study was done on 363 women (aged 15-49 years old) referred to Bandar Abbas health care centers. For data gathering a valid and reliable questionnaire (Cronbach''s alpha= 0. 9) including three parts of demographic variables، health behaviors and health belief model was completed through interview. Data analysis was performed through SPSS 17 and using t-test، ANOVA and Pearson correlation coefficient. Mean scores of HBM items were not in a desirable level. Mean score of preceived sensitivity was 11. 69 ± 3. 85 from 25 and mean score of perceived barriers was 17. 32±4. 81 from 35 which was in a lower level in comparison with other items. In some Health Belief model items، increase of age and educational level led to higher scores­. There was statistically significant associations between undergoing Papsmear and perceived benefits and barriers scores. Educational programs for improvement of women`s belief and behavior about papsmear based on HBM are suggested. Education and follow up for screening tests such as popsmear in health care centers have important roles in prevention and diagnosis of women’s malignancies، especially cervical cancer.

Improvement of sleep quality is one of the major issues of human life that can help people maintain their energy resources and has beneficial effects on many behaviors. The aim of this study was to determine the sleep quality and its associated factors among students of Razi School of Nursing and Midwifery، Kerman، Iran. A total of 349 students were included in this cross-sectional study. The demographic، PSQI، POMS، MES and SUDS questionnaires were used for data gathering. The obtained data were analyzed by descriptive statistics، X2، ANOVA and multivariate logistic regression. Results of this study showed 79. 4% of students were females with mean (±SD) age of 22. 69 (± 5. 24) years. Most students were single (75. 1%). 71% of students had poor sleep quality. The results of multivariate regression showed a significant relationship between unsuitable sleep quality and the habit of listening to music before bedtime and negative mood states (anxiety، depression، anger، fatigue and confusion). These results demonstrated a high prevalance of poor sleep quality in nursing and midwifery students. It seems that implementation of strategies for reducing the associated factors is very important. Also، more studies are recommended to find other related factors.

Evaluation of marital satisfaction using valid and reliable tools is crucial in Iran، regarding the increasing rate of divorce. In Western countries، the Kansas Marital Satisfaction Scale (KMSS) and ENRICH Marital Satisfaction Scale (EMS) showed acceptable reliability and validity in determining how satisfied couples were in their marital relationship. The objective of this study was to examine the psychometric properties of the two questionnaires. This study was done on 100 subjects referred to the pre-divorce counseling centers and 200 participants from the general population of Rafsanjan City. The EMS (as a brief version of ENRICH) containing 10 satisfaction questions and KMSS containing three items were evaluated. Cronbakh’s alpha and item-scale correlations were calculated in order to assess the reliability of the tools. For testing construct validity three methods were used: convergent validity، known group comparison and factorial validity. The Cronbach’s alpha of EMS and KMSS were 0. 74 and 0. 98، respectively. EMS consisted of two factors and KMSS had one factor. Satisfaction score obtained by both questionnaires were lower in the divorce group than the general population (P<0/001). Correlation coefficients between EMS and KMSS، and ENRICH were 0. 82 and 0. 32، respectively. The Persian version of the KMSS and EMS questionnaires showed acceptable reliability and validity.

Arsenic causes a variety of health effects. Arsenic is increasingly incorporated in industries and this has led to environmental contamination of arsenic. Despite this fact، there is no thorough information about human exposure to arsenic in Iran. This systematic review tries to provide a comprehensive picture of arsenic concentrations in the human body and its side effects in the Iranian population. Relevant studies were obtained through searching PubMed، Scopus، Science Direct، Cochrane، Google Scholar، SID، Magiran and IranMedex. Primary studies that had assessed arsenic concentration in biological samples or had investigated its health effects were included after quality assessment and information regarding the population under investigation، place of study، specimen type، arsenic dose، source of exposure and health effects were recorded. Eighteen studies were included. Arsenic levels were higher than standard in street children، inhabitants of some villages of Isfahan، Khorasan and Kurdistan provinces and fishermen of Persian Gulf ports. Chronic arsenic poisoning was the major type of poisoning and keratosis، hyper-pigmentation، Mee’s lines and chromosomal abnormalities was the main symptoms in this regard. Major sources of arsenic contamination were chronic exposure to contaminated water، soil، food stuff and air. Body concentration of arsenic is higher than standard in some regions of Iran. This is indicative of environmental contamination. Promotion of environmental health standards، monitoring arsenic levels in high risk populations and conducting timely public health interventions is recommended to overcome this public health problem.