مجله سلامت جامعه
سال هفتم شماره 2 (تابستان و پاییز 1392)

The national rural family physicians and insurance plan، as one of the major reforms of the health system implemented since 2005، need to be supplied with the resources and facilities required. In this regard، the present study was carried out to evaluate the quantity of essential resources and requirements provided in family physician program in the northern provinces of Iran.

This cross-sectional study was conducted in the second half of 1391; 25% of centers implementing rural insurance and family physician programs in three provinces of Golestan، Mazandaran and Gilan –a total of 139 centers out of 552 centers performing the program– were selected through systematic random sampling as the study samples. A researcher-made questionnaire was used for data collection، the validity and reliability of which were confirmed. Data were analyzed by tests of chi-square and Kruskal– Wallis.

Out of the 139 centers studied، 48 centers (34. 2%) had public pharmacies، 62 centers (44. 6%) had private pharmacies، among which 72 centers had a total of 279 items of drugs. 133 centers (96%) had injection and dressing room facilities، 84 centers (60%) had oral health unit (30. 2%) and 42 centers (30. 2%) had an active lab unit; 138 centers (99%) were found with at least one normal-operating computer، 135 centers (97%) with at least one oxygen capsule، 131 centers (94 percent) with emergency tralee and at least one intact tracheal tube، 129 centers (93%) with at least one intact four (dry heat)، 92 centers (66%) with a normal ECG. Out of the 188 family physicians working in the study centers، 140 physicians (74%) had separate rooms (clinics)، 165 physicians (88%) had a normal desk، 144 physicians (76%) had a normal otoscope، 71 physicians (38%) had an intact ophthalmoscope and 131 physicians (66%) had a normal-operating computer. There was a significant difference in the levels of some resources and facilities provided in the northern provinces of Iran (p<0. 05).

The study findings confirmed that enough facilities and equipments are not provided in a number of centers implementing the program، and effective measures should be taken to supply these items.

Islam as the last and most complete religion has introduced ordering for promotion of virtue and prevention of vice. The aim of this study was to determine the viewpoints of Rafsanjan University of Medical Sciences (RUMS) students regarding ordering for promotion of virtue and prevention of vice. In this descriptive study، 351 students of RUMS were evaluated. The sampling method was random and the research method included a two-part researcher-made questioner. The data were then analyzed with SPSS 17 and chi square. The results showed that 91. 7% of the respondents believed that promotion of virtue and prevention of vice is among the imperative rules of Islam. 83. 1% thought that it is necessary to have promotion of virtue and prevention of vice in their lives. Significant statistical difference was observed for the male students compared to female students (p=0. 001). A significant relationship was also found among the item: «in current society there is no need for ordering for promotion of virtue and prevention of vice» (p=0. 013). Students in this study believed that ordering for promotion of virtue and prevention of vice is an imperative subject in Islam. Considering the fact that they think university is a good place for practicing promotion of virtue and prevention of vice there should be planned appropriate and practical programs for this imperative.

Lack of mental health interferes with one''s individual achievement and ability for undertaking the responsibilities. Studies have shown that religious orientation and parenting styles have an important role in one''s increasing general health and psychological well-being. The aim of the current investigation was to study the effects of religious orientation and parenting styles on students'' mental health. This study was carried out on 278 students (124 boys and 154 girls) of Bukan''s high schools. The participants were asked to complete the Religious Orientation Inventory، mental health questionnaire and Parenting Style questionnaire. The obtained data were analyzed through the SPSS software، Version 18. The Pearson''s correlation coefficient and regression analysis were used for determining the relationships among the variables of the study، The results of the investigation indicated that internal orientation and authoritative parenting styles have significant effect and positive correlations with mental health while the autocratic style exterior orientation has significant negative relationship with mental health. The results of regression analysis showed that well-being is predictable by internal orientation and parenting styles. Evaluation and knowledge of parenting styles and religious orientation and their relationships with mental health can provide the significant implications on the provision of students'' general well-being. Parenting styles and religious orientation، as significant variables in mental health، need more clinical research and attention.

Providing health care is not limited to a particular time and place and Employees in the health system must have acceptable physical and mental health to provide the best services to the public. The aim of this study was evaluation of marital satisfaction in the employees of Rafsanjan University of Medical Sciences that were directly or indirectly involved in health care system. In addition، effects of some factors on marital satisfaction were evaluated. In this cross-sectional study، 386 employees from Rafsanjan University of Medical Sciences were selected using stratified random sampling. ENRICH marital satisfaction questionnaire was used and Demographic features were added to it. Descriptive statistics، correlation coefficients، T-tests، ANOVA and regression was used for presentation and analysis of the data. Sixty one point four percent of the participants reported to be satisfied about marital satisfaction. Sexual relationship، conflict resolution and personality issues were among the most common components in marital satisfaction with the lowest scores in the group of women. Sexual relationship got the lowest score from the men. T tests revealed a significant difference between the men and women for sexual relationship and Pleasure activities. Marital communication and financial management were a strong predictor of marital satisfaction. Considering the fact that the two components of marital relationship and financial management had an important role in marital satisfaction prediction، it seems that professional counseling about improving relations، and improving the financial situation to be effective in enhancing the marital satisfaction.

The positive effects of exercise training on some physiological indices of hypothalamic-pituitary-adrenal axis function may improve the brain and peripheral devices، and as improvement of depression. The purpose of this study was to determine the effect of eight weeks of water aerobics on levels of beta-endorphin of women with moderate and mild depression. In this experimental study 18 nonathletic females in Yazd Khatam Alanbiya Clinic with mild depression (n=9) moderate (n=9) which had been determined by the Beck Inventory were divided into two groups. Before and after eight weeks of water aerobics، blood samples were taken to measure the Beta-endorphin. Data were analyzed using descriptive and inferential statistics such as t-tests and person’s correlation. The mean and standard deviation of Beta-endorphin before and after the 8-week water aerobics in the mild depression group and moderate depression were 303 ± 374، 298 ± 401 and 73±240، 76±247 respectively. The results also indicated that 8 weeks of water aerobics did not have a significant effect on plasma β-endorphin levels in the depressed patients (p>0. 05). Results showed an increase in the beta endorphin serum of women with mild and moderate depression، but this increase was not significant.

Medication errors can occur during all the stages of medication process and based on the present documents most of the errors are not reported. One of the important duties of nursing students is drug administration. The present study was carried out to evaluate the type and ratio of medication errors that are made by nursing students and factors in preventing of the reporting of them in Rafsanjan University of Medical Sciences. In this descriptive– cross sectional study data was collected using a researcher made questionnaire containing demographic data, number and type of medication errors, and factors preventing the reporting of the errors. Questionnaires were completed by all the nursing students who had passed the pharmacology course and also had had clinical field experience of at least one semester. Questionnaires were completed and self reported. Data was analyzed by SPSS 12 software using statistical tests such as independent t-test, chi square and ANOVA. 27.5% of the student had experienced the medication errors.Total number of the medication errors were 45. Most of the errors were related to the wrong dosage (37.78%) and IV routs (65%). Half of the students had reported their errors. The most important factors preventing the reporting of the errors were as follows: "fear of the reaction from the instructors"," fear of the evaluation scores "," insufficient knowledge" and "non significant error". Based on the findings, in order to prevent the occurrence of the errors and increase the reporting of them, modifying of educational methods of drug administration with emphasis on drug calculations, instructor supervision during medication administration and using non punitive strategies are recommended.

Spiritual intelligence (SI) by integration of internal values with the external environment solves our problems of meaning and value; and may be associated with achievement motivation. This study was carried out to investigate the relationship between SI with achievement motivation and academic success of students. 285 students of Fasa University of Medical Sciences were randomly selected for this cross-sectional study. They filled the demographic questionnaire of Badie Spiritual intelligence and Herman’s achievement motivation. Having an average grade mark of 15 out of 20 and not having failed in any subjects at any time during their courses of study were the criteria for the educational achievement in this study. Ranges of spiritual intelligence scores were 42-210 and for Achievement Motivation was 29-116 respectively. Chi-square, t- test, ANOVA and Pearson correlation were used for comparing the groups. 83% of the students were considered among the successful groups and in comparison to the unsuccessful students had higher spiritual intelligence scores but this difference was not statistically significant; 152.6±16.8 vs. 148.8±18.2. Grade point average and last semester's grade point average had a positive and significant relationship with self-consciousness and overall self beliefe (p<0.01). The SI scores were not significantly different in quartiles of achievement motivation scores. Academic achievement based on grade point was related to SI field. Achievement motivation was not correlated to SI.

Human milk contains a wide variety of proteins that contribute to its unique qualities. Many of these proteins are digested and provide amino acids profile to rapidly growing infants. This study was carried out to determine the milk protein and infants'' weight gain referring to the health care centers in Rafsanjan in 2006. In this cross-sectional study conducted in 2006، 221 infants aged 1. 5 or 3 months who were breast fed and 50 formula fed infants، in the same age، were selected consecutively among those referred to seven Health Centers of Rafsanjan city for growth monitoring and immunization. Individual questioner was completed. Infants'' weight and height were measured and compared to the curve of NCHS (National Center for Health Statistics). The mothers were asked to exploit 4 ml of their milk in a test tube. Protein concentration was then measured using the modified Bradford assay. Other required information was collected through questionnaires. Data were analyzed using independent t-tests، chi-square test، and one-way ANOVA. Findings revealed amount of Breast milk protein is 10. 87±3. 12 g/L. The average weight gain among breastfed infants (both sex and age groups) were more than formula fed infants (p<0. 001). Furthermore، comparing weight gain relative to birth weight among the two groups was shown that breast fed infants had a significant increase in weight than the formula fed counterparts (p<0. 05). Results showed that balance of amino acids and proteins component in mother’s milk can lead to suitable growth among breast fed infants.

Diabetes is a metabolic disorder that affects multiple organs and with self-care can prevent many of this complications. Therefore، this study was designed to survey glycemic control of diabetic patients Diabetes clinic in Rafsanjan University of Medical Sciences in 2013-2014. This cross-sectional study was carried out on all the patients with diabetes in the diabetes center of Rafsanjan University of Medical Sciences. Data was collected via the use of delivery records of hospital medical documentary unit. HbA1c was used to classify samples into two groups with good blood sugar control and without control. For data analysis، independent chi-square and Fisher''s exact tests was used. Overall، 3621 patients with diabetes were studied. Mean±SD of age was 51± 13. 51 years and 33 percent (1185 ones) were male and 67 percent (2436 ones) were female. Mean ±SD HbA1c levels in subjects covered 8. 64±2. 21mg/dl، respectively. Glycemic control in subjects covered was 19%. The mean±SD duration of diabetes was 6. 8 ± 6. 5 years. Results show that people with higher levels of education، women and persons with HDL> 60 mg/dl have a low level of HbA1c، but the difference was not statistically significant: p= 0. 172، p=0. 208، p=0. 176 respectively. However، results indicated a non significant difference in HbA1c level in rural people compared to the urban populations (p=0. 109). Results of this study imply less amount of blood sugar control in people were directly associated with lower education levels، being male، urban populations and HDL cholesterol levels. These results need further attention in future planning for these patients.