farhad habibi nodeh

AIM AND BACKGROUND:

Studies show that the risk of musculoskeletal disorders (MSDs) among computer users is more than the other occupations. The present study aimed to determine the effect of educational intervention based on the “stages-of-change” model on practicing the correct posture to reduce MSDs among computer user staff of Tehran University of Medical Sciences (TUMS).

This is a quasi-experimental study which was carried out on 176 staff of TUMS. The study population was divided into two case and control groups, each including 88 participants. A self-structured as well as a standard questionnaire was used to collect the data. Data then were analyzed using descriptive and analytical tests.

There was no significant difference between both groups in terms of mean score of stages of change, perceived benefits and barriers, self-efficacy, and processes of change before the intervention. However, the mean score of these variables increased for case group 3 months after the intervention. In addition, case group participants reported lower MSDs in their neck, lower back, elbow, and knee compared to control group.

Ergonomic educational intervention based on the “stages-of-change” model has a positive impact on reduction of MSDs. Therefore, these disorders can be decreased through reducing working hours, changing the work conditions in accordance with ergonomic principles, dedicating some time for staff exercise, and holding educational courses for the personnel.

Administrative violations of employees at their workplace create a conflict between individual and organizational goals. Due to the long process of handling these violations, this study aimed to identify and present some suitable solutions in order to reduce delay in the health sector.
This study was carried out at three steps. At the first step, causes of delay in handling of administrative violations were extracted along with the proposed solutions using interviews. In second step, Delphi method was applied in order to find out the agreement of experts on the suggested solutions. In third step, practical solutions were prioritized using the analytic hierarchy process.
Overall, 23 out of 39 solutions were certified after consultation with experts running the first round of Delphi using the interview. These solutions were presented to 15 experts using a self-constructed questionnaire and 18 solutions were approved by the experts finally.Solutions were divided into six groups of motivational, organizational, administrative, process, and research group solutions.
Training as the main key to prevent the delay can work effectively at all levels and processes of service delivery. Hiring well-informed and conscious managers at various organizational levels as well as having experienced and mindful research group on administrative violations can speed up the process of handling these violations.

Length of stay is one of the most important and practical indices used in hospitals today which represents the performance and efficiency of the hospitals. This study aimed to identify the factors affecting length of stay in hospitals affiliated to Tehran and Iran Universities of Medical Sciences based on Hierarchical Analysis Technique.
This descriptive cross-sectional study was conducted in 2013. Study population consisted of 40 participants using purposive sampling method in the two groups including 13 matrons (nursing managers) and 27 supervisors (Clinical and educational) of hospitals affiliated to Tehran and Iran Universities of Medical Sciences. Data collection tool was the paired comparisons questionnaire which was confirmed validity by experts using Lawshe and reliability by Inconsistency Ratio. Data analysis was performed using Expert Choice software version 11.
In general, in the studied hospitals, study results revealed that the "diagnostic, treatment and care methods (treatment efficacy)” with the mean of 21.4% and "admission and discharge in the end days of the week and the days off” with an average of 0.36 were the highest and the lowest priority is given to other factors affecting the length of stay of the patient,respectively.
Efficacy of provided treatment through using equipment, appropriate diagnostic and therapeutic procedures and factors related to hospital manpower were effective on length of stay in quantitative and qualitative dimensions. These important issues need more planning and pay attention by hospital officials.

Informal payments can cause delayed access to health care services, forcing people to sell their properties for cost of treatment; and as a result, they lose trust in the health system. Considering the importance of this issue, this study was conducted in 2016 to identify solutions to reduce and eliminate informal payments in Iran’s health system.

Initially, solutions to reduce informal payments were extracted by reviewing resources and searching Persian and English-language databases including Science direct, PubMed, Scopus, Medline, ISC, Magiran, SID using the following keywords: informal payments, under the table payment, bribes, gratitude payment, and informal payments/fees. Then, Iranian context specific solutions were obtained by performing semi-structured interviews with 19 individuals, who were aware of the problem. Next, the identified strategies were confirmed using Delphi technique and with the participation of 50 experts.

Various solutions were identified and confirmed to reduce or eliminate informal payments in Iran’s health system, which are divisible in different economical fields, such as payments to providers based on performance, religious leaders’ fatwa (sociocultural), disclosing the offenders’ names (legal-political), and using family doctor system (structural).

The proposed solutions can be used by policymakers and managers in the health sector to manage informal payments. Careful identification of health care providers and recipients’ motivations and needs can be effective in recognizing and eliminating this phenomenon.

Hospital waste need a very sensitive and cautious attention due to holding hazardous, toxic, and pathogenic factors such as infectious, pharmaceutical, pathological, chemical and radioactive left-overs. Thus, this study aimed to evaluate the observance of safety measures by workers responsible for collecting hospital wastes in the public hospitals affiliated to Tehran University of medical sciences. Methods and Materials: This cross-sectional and descriptive-analytic study was conducted in 1391. Data were collected through using a questionnaire. According to the frequency distribution, total score for participants was divided into three weak (<26), average (26-30), and high (>30) categories. Data were analyzed by the SPSS 18 software using T-Test, one-way ANOVA and regression analysis. Based on the results, 33.3% of hospitals received suitable, 55.5% received average and the remaining (11.2%) received a weak score regarding safety measures. Moreover, there was a statistically significant correlation between cleaning staff’s characteristics (education, age, work experiences and their training) with their safety status score. Implementing current national principles and standards and conquering shortages, proper planning, using young workers alongside with experienced ones, more training courses and respecting and paying enough attention to cleaning staff would help to improve the safety of collecting hospital wastes.

Since Khuzestan province is neighboring cutaneous leishmaniasis endemic foci such as Esfahan، Bushehr and Ilam provinces and also considering the incidence of new foci in this province، present study aims to investigate some epidemiological aspects of cutaneous leishmaniasis and to indicate the importance of controlling this problem in Andimeshk district.

This cross-sectional and descriptive-analytical study was conducted from 2005 to 2010. Epidemiological data، including age، sex، location، occupation، number and wound positions and travel history of 605 patients inflicted to cutaneous leishmaniasis were recorded and analyzed by SPSS15.

Most of the patients were suffered from Anthroponotic Cutaneous Leishmaniasis (61. 2%). According to the chi-square test، there was a significant difference between number of ACL (Anthroponotic Cutaneous Leishmaniasis) and ZCL (Zoonotic Cutaneous Leishmaniasis) (38. 8%). Also، it showed a significant difference between number of male and female patients inflicted to Leishmaniasis (percentage of patients was more among male in comparison with female). Most of the patients had 15-24 year-old (41. 6%) and less than one year age group had the lowest percentage (1. 6%). Among the jobs، military folks were mostly inflicted to Leishmaniasis (31. 2%) and other jobs)nongovernmental Jobs) had the less percentage (4. 2%). Autumn had the most seasonal prevalence (44%). 25. 3% of the patients had expressed a history of residing or travel to endemic areas and 71. 7% of them didn’t have these backgrounds. Discussion &

Incremental trend of cutaneous leishmaniasis in Andimeshk district، which is mainly common among military groups، can indicate its ability to transfer to prone areas due to the military groups’ movement. Therefor finding its risk factors in these groups in order to properly control and prevent its spread to other societal groups should be considered as priority.

Regular physical activity has an important role in reducing cardiovascular risk factors and improving metabolic control in patients with type 2 diabetes. This study aims to investigate the effect of physical activity stage-matched intervention on metabolic control in type 2 diabetes patients.

An 8-week physical activity program conducted with 50 type 2 diabetes females who were physically inactive and in precontemplation, contemplation, and preparation stages of change. Participants were divided into intervention and control groups (each group, n = 25). Data were collected by physical activity stage of change questionnaire and metabolic factors were measured by laboratory tests before initiation program. Subsequently, stage-matched physical activity program was conducted for the interventional group. Control group received routine education from the diabetes center. After 8 weeks, physical activity questionnaire filled out by participants and metabolic factors were evaluated by a laboratory test.

Findings showed patients in the intervention group and compared with control group significantly moved through stages of change after physical activity program (P-value < 0.05). Evaluation of physical activity after educational program demonstrated that the intervention group adopted regular physical activity more than the control group and also the difference between groups was significant (P-value < 0.05). Our findings indicate a significant relationship between physical activity level and moving in stages of change in the intervention group (P-value < 0.05). Comparison of metabolism factors after physical activity program showed significant decrease in glycosilated hemoglobin in the intervention group than the control group (P-value < 0.05). However, significant differences between groups were not observed in other metabolism factors.

Designing and implementing physical activity stage-matched intervention can improve metabolic control and management of type 2 diabetes.