مجله تصویر سلامت
سال هفتم شماره 2 (تابستان 1395)

The Life style promotion project (LPP) is a long term community-based project for prevention and control of non-communicable diseases (NCDs). The design consisted of two stages; phase I was a cross-sectional prevalence study of NCDs and the associ ated risk factors. Phase II is a prospective follow-up study in which data recollection will be performed every 2 years after the intervention initiated. In this study¡ 1¡500 households residing in Tabriz¡ Marand¡ Bonab¡ Oskoo¡ Varzeghan¡ Khodafrin (150 clusters of 10 households) cities which in terms of socio-economic variables¡ distance from the center¡ population and access to medical facilities are in the same category of other cities of province will be examined. A total of 3000 patients (15-65 years) living in East Azerbaijan province will be randomly enrolled. After obtaining informed consent from all participants¡ weight¡ height¡ waist circumference¡ hip circumference and blood pressure will be measured with standard tools. Fasting blood sugar¡ total cholesterol¡ LDL-C¡ HDL-C¡ TG¡ serum vitamin D¡ ALT¡ AST¡ Hb and serum ferritin will be assessed. The questionnaires related to socioeconomic status¡ dietary intake¡ physical activity¡ angina (Rose)¡ asthma¡ anxiety¡ smoking¡ food security and safety will be completed. Necessary data in other variables such as age¡ gender¡ menopausal status¡ medical history and medication use will be collected using questionnaires. The results of this study can be used in formulating long term health programs for the prevention of non-communicable diseases.

In order to optimal use of resources and reducing costs¡ many countries use different strategies such as downsizing. Therefore¡ this study was implemented to evaluate different downsizing methods in teaching hospitals of Tabriz and Ardabil cities.
Material and This study was a descriptive study conducted in 2015 and 2016 in order to identify downsizing methods in teaching hospitals in Tabriz and Ardabil cities. A researcher-made questionnaire was used for data collection. Its content validity was approved by five university professors in health economic and health services management. SPSS v20 software and descriptive statistics were used for data analysis.
Among 13 downsizing methods¡ 11 methods were used in Tabriz hospitals and 6 methods were used in Ardabil hospitals. Outsourcing and cooperation between hospitals were the most frequent methods. Cost reduction was the most important goal of downsizing. Also¡ performance evaluation was the most important control mechanism after downsizing.
The findings showed that the downsizing method especially outsourcing and cooperation have been used widely in teaching hospitals of Tabriz and Ardabil universities of medical sciences. It seems that precise planning¡ variety in applied methods and hospital circumstances are important factors in achieving the downsizing goals.

Familial Mediterranean Fever (FMF) is an autosomal recessive disease. Generally¡ the Mediterranean basin is the region where the first cases of FMF have been identified. The gene responsible for FMF is gene MEFV. Disease occurs due to mutations in the gene MEFV. Our aim was to determine the geographical distribution of the most frequent mutations in Familial Mediterranean Fever Disease in the world.
Material and In this study¡ databases including Google Scholar¡ PubMed¡ Medline¡ Ovid¡ IranMedex¡ Irandoc¡ SID¡ Magiran and published papers were searched with no limitation in time. Then¡ all collected studies without any limitation were assessed to determine relevant studies. At the end¡ world map of the most frequent mutations of FMF was generated by Geographical Information System (GIS) software.
Although more than 290 mutations of the MEFV gene have been described¡ only four mutations (M694V¡ M694I¡ V726A¡ and E148Q) were prevalent among patients with FMF.
The most frequent mutation associated with FMF mutation is M694V all over the world. E148Q mutation was found to be with mild clinical relevance.

This study aimed to assess the knowledge and attitudes of managers of hospitals in Tabriz University of Medical Sciences in the field of strategic planning that was done in 2013. The complexity of the changing environment and needs of the society requires strategic thinking¡ planning and strategic action. The current study explored this issue in teaching hospitals as the key bottlenecks of the health system.
Material and This was an analytical cross-sectional study. Sudy population included 57 individuals selected by sensus method that 39 accepted to participate in the study. Data collection was done by questionare and data were analyzed using ANOVA¡ Pearson correlation¡ independent T-test and post hoc Tukey test.
Managers'' awareness about developing strategic planning and their attitude towards the developing and implementing strategic planning were good and positive. Between knowledge and attitudes and between knowledge and management training records in management and strategic planning of managers was a direct and significant relationship. Educated managers compared to managers who were educated in other disciplines and managers with master degree compared to managers with a bachelor''s degree often had more awareness of how strategic planning are developed and implemented.
Average awareness of manager about strategic planning along with positive attitude towards the developing and implementing strategic planning and understanding importance of it indicates the need for combined strategies to increase their awareness. Service training for management and strategic planning has an important role in raising managers’ awareness in this field. Also¡ the fact that educated managers in the field of management are often more aware in the developing and implementing strategic planning reflects the importance of employing experts in managerial post and developing strategic planning.

Identifying the readiness of hospital and its strengths and weaknesses can be useful in developing appropriate planning and situation analyses and management to getting effective in clinical audit programs. The aim of this study was to design and assess the validity of the Hospital Readiness Assessment Tools to conduct quality improvement and clinical audit programs.
Material and In this study¡ based on the results of a systematic review of literature¡ an initial questionnaire with 77 items was designed. Questionnaire content validity was reviewed by experts in the field of hospital management and quality improvement in Tabriz University of Medical Sciences. For this purpose¡ 20 questionnaires were sent to experts. Finally¡ 15 participants returned completed questionnaire. Questionnaire validity was reviewed and confirmed based on Content Validity Index and Content Validity Ratio. Questionnaire reliability was confirmed based on Cronbach''s alpha index (α = 0.96) in a pilot study by participation of 30 hospital managers.
The results showed that the final questionnaire contains 54 questions as nine category as: data and information (9 items)¡ teamwork (12 questions)¡ resources (5 questions)¡ patient and education (5)¡ intervention design and implementation (5 questions)¡ clinical audit management (4 questions)¡ human resources (6 questions)¡ evidence and standard (4 items) and evaluation and feedback (4 items). The final questionnaire content validity index was 0.91 and final questionnaire Cronbach''s alpha coefficient was 0.96.
Considering the relative good validity and reliability of the designed tool in this study¡ it appears that the questionnaire can be used to identify and assess the readiness of hospitals for quality improvement and clinical audit program implementation

Medication errors can cause serious problems to patients and health system. Initial results of medication errors increase duration of hospitalization and costs. The aim of this study was to determine the reasons of medication errors and the barriers of errors reporting from nurses’ viewpoints.
Material and A cross-sectional descriptive study was conducted in 2013. The study population included all of the nurses working in Tabriz Sina hospital. Study sample was calculated 124 by census method. The data collection tool was questionnaire and data were analyzed using SPSS software version 20 package.
In this study¡ from the viewpoint of nurses¡ the most important reasons of medication errors included the wrong infusion speed¡ illegible medication orders¡ work-related fatigue¡ noise of ambient and shortages of staff. Regarding barriers of error reporting¡ the most important factors were the emphasis of the directors on the person regardless of other factors involved in medication errors and the lake of a clear definition of medication errors.
Given the importance of ensuring patient safety¡ the following corrections can lead to improvement of hospital safety: establishing an effective system for reporting and recording errors¡ minimizing barriers to reporting by establishing a positive relationship between managers and staff and positive reaction towards reporting error. To reduce medication errors¡ establishing training classes in relation to drugs information for nurses and continuing evaluation of personnel in the field of drug information using the results of pharmaceutical information in the ward are recommended.

Accidents and injuries are the leading causes of avoidable illness and death in most of the countries in the world. For health policymakers¡ it is essential to have knowledge about the occurrence of accidents. The aim of this study was to evaluate the incidence of accidents in children under 5 years of age referring to emergency departments in Hamadan province.
Material and This is a retrospective study that all under 5 years of age patients referred to hospitals in Hamadan province were enrolled in the study during 2009 to 2014. Data were extracted from injury register software and by using descriptive and analytic statistics¡ data were analyzed with STATA software version 12 at the level of error less than 5%.
A total of 7409 under 5 years of age patients were registered during this period. 70.4% were male and 38.97% of them were under 1 year old. Home accidents included 45.07% of the accidents. Car accidents (27.89%)¡ hit (22.16%) and fall (16.79%) were the most occurred accidents in both sexes.
Due to the high incidence of accidents at home and roads¡ necessary precautions should be taken in this regard

In the information society¡ the production¡ distribution and use of information are freely and widely available for all issues of life. Proper and appropriate use of reliable information is especially important in health care. The present study introduces the concepts and benefits of health literacy and information literacy and its role in improving health literacy. This study was a review based on the concepts of information society¡ information literacy and information education to present importance of promoting information literacy on health literacy in the information society. The information society is presented by providing a platform of information technology and computer systems to attempt to exchange and develop information among people in the community. Currently¡ electronic and web-based health information in the mass form is available. Information as a fundamental base of the information society is a phenomenon that our decisions are affected in relation to various issues such as safety and health issues. It is important to avoid the mass of invalid¡ incorrect and inappropriate information which is available on the internet. This requires information literacy skills such as identifying¡ accessing and evaluating information. In general¡ it can be said that the promotion of health literacy in communities requires learning different skills in the form of information literacy.Data obtained from this study can be used in developing the long term health programs to prevention of non-communicable diseases in our country