نازیلا اساسی

Unstable angina (UA) patients are the majority of hospitalized patients in CCU exposed to high probability of recurrence. Most often re-hospitalization of these patients is due to lack of enough information and not obeying medical advice. The main objective of this study was to determine the impact of an educational intervention based on Health Belief Model on knowledge and attitudes of unstable angina patients in Mashhad university hospitals. An interventional study was conducted on 180 patients with unstable angina, consisting of 90 cases and 90 controls, who were hospitalized in the Heart Wards of two university hospitals in Mashhad. Randomly, the patients of one of these hospitals were selected as the case (intervention) and those in the second as control group (90 patients each). Professional physicians and nurses instructed the patients in the intervention group before and after discharge for two months. Data were obtained through a questionnaire before and after intervention in both groups. Then, the data were analyzed by SPSS (11.5) & STATA (8.0) software’s, using chi-square and ANCOVA tests. In all statistical analyses α=0.05 was taken as the significant level. The analysis of covariance (ANCOVA) showed that, compared with the subjects’ pre-intervention knowledge status score, there was a significant increase in the score of the intervention group (P<0.0001). The intervention resulted in improving the attitude status in the group (P<0.0001). But there was no significant increase in these variables in the control group. It is possible to use nurse's capacities in improving heart patient's knowledge and attitudes. Thus, it is necessary that instructional service by nurses be offered under a well-planned program in order to improve the quality of life of heart patients.

Group B Streptococcus (GBS) (Streptococcus agalactiae) is the leading cause of morbidity and mortality of newborn infants and accounted as a leading factor causing septicemia after birth in mothers. Infections in infants are usually acquired by contact with the genital tract of the mothers during labor and delivery. In two last decades, significant progress toward detection, prevention and treatment of pregnant women carrying GBS has been achieved. A rapid screening test for GBS that could accurately identify pregnant women carrying the bacteria at the time of delivery would obviate the need for prenatal screening. The standard method for the diagnosis of GBS colonization consists of culturing vaginal and anal secretions in a selective broth medium which inhibits the growth of other microorganisms. Today, it is accepted that PCR has a high sensitivity and specifically in diagnosis. The goal of this study was to screen pregnant woman carrying GBS by PCR. Samples were taken from anal and vaginal mucus of 125 pregnant women who were at 28-38 weeks of ingestion by swab. Samples were tested by standard culture using Todd Hewitt Broth and Blood Agar and also by PCR using primers specific for cfbgene. Culture identified 10 (8%) women as carriage of GBSout of 125 women tested. On the other hand, the PCR assay could identify 12 (9/6%) women positive for GBS. In comparison to culture results, sensitivity, NPV, specificity, and PPV of PCR were 100%, 100%, 98%, and 83%, respectively. The time required for PCR assay and culture were 2h and 36h,respectively. We found that GBS can be detected rapidly and reliably by a PCR assay using combined vaginal and anal secretions from pregnant women at the time of delivery. Also this study shows that the rate of incidence of GBS is high in Iranian pregnant women. We, therefore, recommend screening of pregnant women for detecting of GBS emphatically

To examine nutrition education as perceived by school children and their mothers.

This was a qualitative study using focus group discussion (FGD). The research team consisted of a coordinator, one or two observers and two note takers Each FGD was held with 6 to 8 person and each session tasted about 60 minutes. The fieldwork ecuvtues of the study included 20 FGD sessions, 16 for children grades I" to 4•h and 4 for mothers. The study was held in 2 districts of Tehran. At the end of each group discussion all notes were completed, coded, analyzed and classified by team members.

The findings showed that children were eager to learn on effects of healthy foods. Children indicated that TV was the most important and effective teaching medium, In addition to TV, food advertisements, school staff especially teachers were among the most common named on children's nutritional behaviors. Most of children preferred to learn nutritional subjects from father, mother and other family members. The mothers preferred teachers, health instructors' parents and classmates as the source of knowledge and schools as the most effective place for teaching/or educating nutritional subjects.

The study results suggest that children need to learn more about nutrition and foods. Designing longitudinal nutrition education projects aiming at children through TV or other effective media arc essential

As adoptin and maintenance of healthy eating behaviours is an important factor for Ischemic Heart Disease (IHD) prevention, this research was conducted to determin dietetic risk factors in relation to IHD. This is a case – control study conducted in fall 2003 in Tehran Heart Center and Tehran Shahid Rajaii hospital. 100 subjects with IHD, as cases and 100 controls with no cardiovascular disease in their medical history, participated in the study.Nutritional data was collected by Food Frequencey Quastionnaire. Some important risk factors including hypertention, hyperlipidemia,diabetes, Body Mass Index (BMI) and physical activity were evaluated. There was a positive association between IHD and consumption of fats and a negative association between IHD and consumption of fruits and vegetables.The most important factors were low intake of fish and high intake of fried foods that increased the risk of disease 13.96 and 54.65 times, respectively. Also 73% of patients had high risk diet while only 17% of controls had high risk diet. High risk diet increased the risk of cardiovascular diseases approximately 20 times. The main dietetic risk factors in this study were: low intake of fish, fruits and vegetables and lower consumption of oiles; while hydrogenated fats with undesirable trans-fatty acid content, were the main source of dietary fat, in case group. Therefore; community-based educational programmes are nesseary to promote healty nutrition.

To assess the burden of suicidal behaviors in Ilam, Iran. This was a cross-sectional study. 606 cases of attempted completed suicide were reviewed. Burden calculation was done using the disability adjusted life years (DALY) index. There was a total loss of 4891 DALY’s lost in the Ilam population, equivalent to the crude rate of 9.7 per 1000. Women bore 64% of the total burden. The 20-29 y and 10-19 y age groups accounted for most of the total disease load (41 and 33% respectively). Unfortunately, suicidal burns represent 73% of total burden of suicidal behaviors. We found a higher disease load in women while in the other studies such as WHO’s global burden of disease study (2000) it is the men who bear the greatest burden of suicidal behavior.

To determine the level of knowledge and to assess attitudes and lifestyles in patients with unstable angina. A descriptive study was conducted among CCU patients in Mashad hospitals. 180 subjects were chosen by sequential admission. They filled an 82-item questionnaire covering demographic variables (4 items) - knowledge (5 items) –attitude (56 items) – lifestyle (17 items). Findings indicate that the global level of knowledge is sufficient on issues such as cardiac risk factors, current treatments, and treatment compliance. The same patients showed very low knowledge of pain-inducing behaviors. Meanwhile, attitude scores turned out to be relatively low in some areas including perceived threat of disease (severity and susceptibility) and internal health Locus of Control. Health care professionals (physicians, nurses,..) tended to ignore the need for proper education of cardiac patients. There is a strong need to promote patient education in order to enhance knowledge and bring about a change in attitudes.

We performed a cross sectional study with the aim of assessing levels of habitual physical activity and associated factors (barriers and motivators), finding the stage of change among high school girls, and exploring relationships between physical activity and the following set of factors: age, parent education, type of school attended, knowledge, and attitude. 457 girls in the 1SI to 3rd grade of high school with a mean age of 15.6 (%95.3 cases were 14th to below 17Ih years old) in Tehran's second region of educational office district were selected via proportional-to-size and cluster sampling methods. These girls attended 4 different types of facilities (public and private high schools / public and private vocational schools). The data were gathered through self-administered questionnaires. Our results indicated that %58.6 of students were in pre-contemplation and contemplation stages, while 24.7% were in action and maintenance stages of change.The mean level of physical activity at work (in school) was 2.22, which was significantly lower than 2.75- the minimum acceptable level of physical activity at work (p<0.00). The mean level of sport activity was 2.73, significantly (p<0.001) higher than 2.33 (minimum acceptable level of sport activity). The mean level of physical activity at leisure time was 2.50, which had no significant difference with the minimum acceptable level of 2.50. (Note: all max. acceptable level is 5).The most important barriers identified were: time constraints, lack of companions, lack of suitably located facilities and a general state of lassitude.The most important motivators were individual interest, desire to lose weight, company of friends, and support of parents. The level of exercise did not show a significant relationship with age, probably because of the limited range of age categories enrolled in this study. Levels of physical activity at work and sport activity (p=0.004 for ph.act.work and p=0.012 for sport) showed a significant positive relationship with the mother's level of education. No significant relationships were found between any type of physical activity and the father's education. The level of sport activity in private high schools was significantly (p=0.005) higher than in public high schools. On the other hand no significant differences were observed between levels of physical activity in private or public high schools compared to private or public vocational schools. Only sport activity had a significant positive relationship with higher knowledge (p=0.005) and attitude (pO.OOl).The majority of our population (%58.6) was in pre-cont. and cont. level of stage of change. Therefore more emphasis should be placed on improving health education. We must also teach our teenagers to organize their leisure time so they can do some simple and inexpensive physical activities like brisk walking between home and school or while shopping.

To assess knowledge, attitudes and lifestyle in unstable angina patients. Material &

A descriptive study was conducted among patients hospitalized in C.C.U in Mashhad. In all 180 subjects were entered into the study. They answered to an 82-items questionnaire consisting of questions on demographic factors (4 items), knowledge (5 items), attitude (56 items) and lifestyle (17 items).

The findings indicated that the global level of knowledge about cardiac risk factors, available treatments, compliance to treatment, was insufficient but it was very low about pain inducer behaviors. Patients' attitudes toward perceived threat (severity and susceptibility) of the disease and internal Health Locus of Control was relatively low.

There is a strong need to promote angina patient education and this should be deliverd by health professionals.