نشریه پژوهش سلامت
سال چهارم شماره 3 (پیاپی 15، بهار 1398)

Due to the high level of medical care and the high economic costs imposed on health systems, special care units are particularly concerned. The purpose of this study was to determine the causes of mortality in futile patients in the ICU of the selected military hospital between 2011-2017. This descriptive cross-sectional study was conducted over a period of six years in ICU with a review of 283 patients records. Variables such as age, sex, marriage, blood transfusion, occupation, education, place of residence, duration of hospitalization, physical shift, immediate cause of death, causes of death, accompanying illnesses and their final illness were collected. The causes of mortality in this study were categorized into nine groups based on ICD-10 international classification. The data were analyzed using SPSS-25 software, descriptive statistics and Chi-square tests. The results of the study showed that 54.1% (153 cases) of death cases were male and 45.9% (130) were female. The highest mortality was in the age group of 70-79 with 89 cases (31.4%). Cardiovascular diseases by 171 cases (42.4%), neurological diseases (84.8%) and infectious diseases (57.1%) (14.1%) were among the most causes of immediate deaths. Also, the most types of injuries were in head and hip with the average severity of 18.8 (18.63). In addition, 181 cases (64%) of patients received blood infusion. Based on the findings of the present study, a large part of the risk factors of increasing mortality in the intensive care unit are predictable and preventive and so, health and therapeutic teams should have a more accurate planning to reduce it.

Promoting community health and preventing dangerous diseases such as cancer, especially in metropolitan areas such as Tehran, today may have become the main concern and concern for managers, authorities and health professionals in the country. Achieving this goal involves the deployment of active information networks and effective systems for collecting information and identifying factors that affect cancer. The present study was conducted on the basis of Quo's method and exploratory factor analysis in six stages: the preparation and production of Qi samples, the selection of 12 cancer experts using a targeted sampling method as contributors to the design, Qi ranking in a spectrum 9 degrees based on the importance of each item (index), data recording using SPSS 25 software, statistical analysis through Qi statistical analysis (principal component analysis), and finally interpretation of results. By studying the results, 24 effective factors in the prevalence of cancer in Tehran were identified in three categories: nutrition, physical activity, medical and psychiatric, health, and environmental. The present research is a basic research for discriminating mental patterns of cancer patients in Tehran, which introduces cancer-causing factors to modify supervision and policies, provide appropriate cancer services, and prevent them.

Disturbance disorders not only cause inefficiencies, but also disrupt their function in all areas. Therefore, this study was conducted with the aim of effectiveness of teaching tolerance skills, self-esteem, adjustment and interpersonal efficacy on risky and healthy behaviors in children with stuttering. 

The present study was based on a pre-test and post-test pre-test and placebo group design. The statistical population of the study included mothers of elementary school students with stuttering. Twenty-two subjects were selected from both experimental and placebo groups by cluster sampling. Psychological evaluation included the Barat Impact Scale (2004), Beck Depression Inventory (2000) and Beck Anxiety Inventory (1988). The training of dialectical behavioral therapy skills was performed according to the Linnaean treatment protocol during the 8 sessions of 60 minutes in the experimental group. The placebo group was not educated, but the treatment was 8-session group meeting. The pre-test, post-test and 3-week post-test scores were analyzed for both groups by descriptive statistics and mixed ANOVA. 

The results showed the impact of training on risky behaviors in the experimental group. However, there was no significant difference in placebo group, but in the depression scale, the placebo group significantly decreased the dialectic behavioral therapy group. There was also a significant difference between the two groups in dialectical behavioral therapy and placebo group in the relative relief anxiety scale (P = 0.001). 

The Dialectical Behavioral Therapy Training Program can be part of interventional programs at the levels of children with verbal disorders and improve mental health of students and reduce the pain and suffering of family members.

Aesthetic surgery is considered a medical-cultural practice, which is essentially carried out in the absence of obvious physical signs and to improve the psychosocial function of the individual. This multidimensional concept depends on many factors, including anxiety and disapproval. Therefore, the purpose of this study was to compare the incidence of deformity and social anxiety in women undergoing cosmetic surgery and control group. The research project was a non-interventional comparative study conducted in the first half of 1395 in Shiraz. The research community included all female applicants and non-resident housewives for cosmetic surgery. Regarding previous research in this field, 126 people (2 groups of 63) were selected by random sampling method based on Cohen charts. The instrument used was Depression disorder and social anxiety disorder. Finally, the data were analyzed using multivariate analysis of variance (MANOVA). Women under the aesthetic surgery have significantly higher scores in body disfigurement and social anxiety than other women. Also, the results indicated that women undergoing surgery in the sub-scales were significantly higher than those in the other group. Overall, it was concluded that women undergoing cosmetic surgery are more likely to suffer from deformity and social anxiety than non-cosmetic women. According to this study, it can be concluded that psychiatric disorders are also higher in societies with more cosmetic surgeries, and these people need external stimuli to confirm.

Evidence suggests that self-compassion affects life satisfaction and overall cognitive assessments of life. Although the relationship between self-compassion and life satisfaction has been examined, there are few studies on the mediating mechanism of this relationship. Therefore, the present study aimed to determine the mediating role of hope in the relationship between self-compassion and life satisfaction. The present study was descriptive and correlation type. Among undergraduate students of Islamic Azad University, South Tehran Branch, 250 students were selected through multistage cluster sampling and completed Hope Scale, Self-Compassion Scale and Satisfaction with life scale. The collected data were analyzed using Pearson correlation and structural equation modeling. The results showed that the self-compassion has a direct, positive and significant correlation with life satisfaction (β=0.527) (P<0.01); self- compassion has a direct, positive and significant correlation with hope (β=0.453) (P<0.01); and hope has a direct, positive and significant correlation with life satisfaction (β=0.445) (P<0.01). Also, the results of the Sobel test showed that hope has a mediator role in the relationship between self-compassion and life satisfaction (β=0.445) (P<0.01). The present study emphasizes the direct role of self-compassion on life satisfaction and the mediating role of hope as an important mechanism in the relationship between self-compassion and life satisfaction. Therefore, improving self-compassion and hope can be a good way to support individuals in everyday life and increases their positive assessments of their lives.

Although untreated tetanus is a very rare problem in developed countries, it is still a serious challenge in other underdeveloped nations. However, underdeveloped or developing countries such as Afghanistan focus most of their health policies on eliminating and preventing maternal and neonatal tetanus. The present study aimed to estimate the prevalence of this disease in other geographical and adult areas of the country. The present study is a cross-sectional study that investigated non-neonatal tetanus cases during 2018-2017 in Afghanistan. All patients are referred to the Antani Rifal Hospital, one of the largest referral centers for communicable and non-communicable diseases in the Middle East. In all cases, due to the deteriorating condition of the patient, information was obtained from the patient. Finally, we used descriptive statistics including frequency table, mean and percentage to analyze the patients. During the study period 10 patients with non-neonatal cesarean were identified. Of these, 9 were male and 1 was female. Mean age of recognized patients was 19.5 ± 8 years. All patients were from the villages or towns with a lower or middle social class. Nine patients had a history of traumatic or penetrating ulcers, 5 had a foot and 4 had a wound. A history of dog bites and a drug abuse with no trauma or wound were identified. All cases were referred to the hospital with the onset or exacerbation of trismus and painful muscle contraction. All patients received standard treatment and eventually  60% complete remission achieved. The present study clearly addresses the urgent need to provide health-medical programs and policies in developing or under-developing countries for the prevention of tetanus, especially non-communicable tetanus; which is a highly dangerous and potentially preventable disease.

Peroxisome proliferator-activated receptor alpha (PPAR-α), which belongs to the nuclear receptor family of ligand-activated transcription factors, was first described as gene regulators for metabolic pathways including lipid metabolism, insulin sensitivity, and glucose homeostasis. Were raised. This nuclear receptor is widely expressed in various tissues, providing a wide range of effects to stabilize one's health. Activation of PPAR-α has been reported to protect neurons in neurodegenerative diseases such as Alzheimer's disease, Parkinson's, and multiple sclerosis. There is also growing evidence that activation of this receptor following neuronal ischemia produces neuroprotective effects including antioxidant, anti-apoptotic, and anti-inflammatory effects. It has also been reported that the use of these receptor agonists protects against complications and damage to small vessels in diabetics. However, no existing scientific literature has reported on the effects of PPAR-α activation on blood-brain barrier permeability and brain edema formation in cerebral ischemia-reperfusion injury. Given the role of hypoxia-1α-inducible factor (HIF-1α) in causing damage to the blood-brain barrier and the interaction between PPAR-α and HIF-1α in some body tissues, it seems that PPAR-α acitivation by reducing HIF-1α, can reduce the damage to the blood-brain barrier during ischemia of the brain. Therefore, this study aimed to evaluate the possible protective roles of PPAR-α activation on neurovascular unit protection in ischemia-reperfusion injury.

The digital divide means economic and social inequality for access to and use of ICT. Information and communication technology, despite the spatial and temporal barriers, can provide a valuable opportunity for patients to access health information. The aim of this study was to identify factors affecting the digital divide in patients and ways to reduce it. This study was a systematic review by searching online databases, reputable journals and Google Scholar search engine and related books using keywords digital gap, health information technology, patients from 2010 to 2018. 110 articles were found out of which 70 were included in the study and then the articles were evaluated for title, abstract and full text and after excluding duplicate and unrelated cases, about 20 research related articles were selected. Significant differences in patients' ability to find the health information needed on the Internet are among the most important issues in the information gap with the use of health information technology. Accordingly, the most important factors affecting the information gap are geographic location, skill level, computer use, race and ethnicity, education level, age, income, and gender. It also offers solutions such as computer training, introducing reputable health websites, encouraging and educating the elderly, investing and providing government assistance for home computers, providing free internet access, and providing the infrastructure needed for High-speed Internet can help digital divide the use of information technology. Reducing the digital divide in patients will increase the readiness and motivation of patients to use information and communication technology and improve the quality of health care.