مجله تصویر سلامت
سال دهم شماره 2 (تابستان 1398)

The role of community participation in health care has been confirmed in order to achieve fair and equitable results. The aim of this study was to determine the factors affecting community participation in primary health care delivery.

This study was carried out in combination (quantitative and qualitative). At first, 25 experts were selected and 200 clients from networks and health centers affiliated to Shahid Beheshti University of Medical Sciences participated in this study, and were selected by using available sampling method and analyzed using SPSS software and LISREL software version 7.8.

Factors affecting community participation in providing health care, including "exchanging information between health care organizations and people", "encouraging and preparing people", "reviewing and transforming health centers and homes", "direct role and the effectiveness of the people and informing them "," the equal relation of people and authorities, and the participation of the people in all stages of decision-making " and " timely informing the clients about the opportunity to decide on their participation "and, finally," trust and the reliance of the clients on the system of health and accountability and the promotion of their efficiency "and" development of social capital ".

The present study, with regard to the specific context of the social and political environment in Iran, identified the factors influencing community participation in primary health care. This study provides a practical guide for policymakers and primary health care managers to participate in decisions that affect their lives, which ultimately lead to improved quality of service and patient and community satisfaction.

Hypertension is one of the main risk factors of cardiovascular diseases and associated with mortality and morbidity all over the world. This study was designed to evaluate the rate of blood pressure (BP) control and its associated risk factors in Tabriz University of Medical Sciences.

This cross-sectional prospective study was conducted for a ten-month period in patients with hypertension and concomitant cardiovascular disease. The BP of participants was measured by the cardiologist. Demographic information, drug and medical history, lab data, smoking, use of opium or alcohol or amphetamine were recorded in a data collecting form. The Spearman and logistic regression analysis were performed to access the association of study risk factors and control of hypertension.

Totally, 314 patients were entered to the study. The mean age of patients was 62.7±12.2. 139 (44.3%) of the patients were female and 175 (55.7%) were males. The mean systolic BP of patients was 131.6 ± 2 and diastolic BP was 78.3 ± 12.9 mmHg. Approximately, half of patients had an uncontrolled BP (n=114, 45.9%). The most common drug regimen is associated with dual therapy in 152 cases (48.4%). The ACEI/ARBs and beta-blockers were the most commonly used drugs. There were significant association between not-controlling BP and age (r=0.29, p=0.022) and diabetes (r=0.273, p=0.024).

The results showed that BP in about half of patients was not in goal and this observation was seen more commonly in older and diabetic patients. This study raises the concern about the control of hypertension among health care providers and patients.

Regarding the prevalence of psychological problems in cancer patients, some reports have considered the effectiveness of self-efficacy model prior to previous conventional psychological therpaies to increase the well-being of cancer patients. Therefore, the aim of this study was to determine the effectiveness of pain self-efficacy training on improving the physical performance of cancer patients in Urmia Omid hospital.

The present study was a quasi-experimental study. The statistical population of this study was all patients with cancer of Urmia Omid hospital in 2018. The samples consisted of 40 patients with cancer of Urmia Omid Hospital and randomly divided into two experimental and control groups. First, a quality of life pretest was performed and then the self-efficacy-based intervention was conducted in 10 sessions of 90 minutes, one session per week. After completing the sessions, the quality of life test was repeated for the post-test on two groups.The statistical analysis was done using SPSS software version 21.

Data analysis showed that there was a significant difference between the mean post-test scores of the experimental and control groups (P <0.01), so that self-efficacy training improved the symptoms of quality of life in the experimental group (P <0.01).

Considering the positive effect of pain self-efficacy training, the use of these capacities and training in planning mental health interventions are recommended especially for cancer patients

The Drug Package Insert (PI) is a written information provided by drug manufacturers to deliver essential information for the consumer. This study aimed to investigate quality of the labeling and content of PIs to identify if they meet the criteria of Iran’s Food and Drug Administration (FDA).

A cross-sectional descriptive study was used to evaluate the PPIs of top selling cardiac medications in Iran during March and September 2015 formed the population of this study. We used comparative and descriptive methods in conduction of the study. An evaluation checklist was built based on the regulations of PPI of Iranian Food and Drug Administration (FDA). The presence of criteria was considered as conformity and scored “1” and lacking the criteria was scored “zero”. The descriptive statistics parameters were used for data analysis using SPSS v.20.

A total of 66 PPIs of 13 cardiac drugs from top 33 selling medicines were evaluated using 27 criteria. None of the drug boxes included patient and professional package inserts separately, but the criteria of ‘general guidance to patients’ was observed in 59(89.39)of package inserts. About 64.59% of the information in PPI was consistent with the regulations of drug regulation of the FDA of Iran. All PPIs (100%) included brand name, contraindication, keeping conditions, and the name of the manufacturer. the revision date and resources observed in 4 (6.06%) and 19 (28.71%), respectively. Of total 64.59%.

PPIs need to be improved by both quantity and quality to be appropriate use of patients and consumers

Visceral leishmaniasis is a zoonotic diseases and is endemic in northwest of Iran and annually 100-300 positive cases are reported. The aim of this study was to determine the spatial distribution of visceral leishmaniasis in East Azerbaijan province.

This is a retrospective cross-sectional study that was done on visceral leishmaniasis patients from 2009-2016 which is analyzed based on interpolation and SPSS v.25 and ArcMap10.4.1 have been used.

Totally 78 patients were identified during the study, of which 57.7% were living in rural areas and 42.3% in urban areas. More than 90% of cases have occurred in children under the age of 5 years. The northeastern part of the province, which has a higher average rainfall and a moderate temperature, was identified as a high risk area of the disease and a hot spot of disease among the Kalibar and Ahar counties.

Visceral leishmaniasis has increased by 3-4 times since 2013 in East Azarbaijan province and residents of border areas with Ardebil province and Azerbaijan Republic are at the risk of transmitting the disease

The high rate of neonatal mortality is a major problem in health care systems all around the world. The accurate estimation of neonatal mortality is a prerequisite for the development of future health strategies that leads to the improvements in neonatal health. Providing a predictive model is, therefore, essential to reduce the neonatal mortality rate and reducing health care costs. The purpose of this study was to produce a model based on the data mining techniques to increase the accuracy of the prediction of the outcome of the neonatal mortality using a bagging neural network model in Rapidminer software.

This study was conducted on 8053 births (including 1605 cases and 6448 controls) across the country in 1394. The study variables including maternal diseases, mother age, gestational age, child gender, birth weight, birth order, abnormalities were selected as predictive factors for bagging neural network method. We compared bagging neural network with neural network, decision tree and nearest neighbor. Some criteria including the area under ROC curve, precision, accuracy and classification error rate were considered in comparing with other data mining models.

The comparison of bagging neural network with other data mining models showed that the bagging neural network gives better results compared to other models: precision (99.21), accuracy (99.17), classification error rate (0.83) and AUC value (0.992).

We conclude that the bagging neural network may help to reduce the cost of health care system, and to improve the community health by preventing the mortality and adverse outcomes in neonates.

Asthma is one of the chronic diseases and as in chronic diseases the quality of life changes, studying the quality of life in these patients is important. The present study aimed to investigate the effect of teaching mindfulness-based stress reduction on the quality of life of patients with asthma.

The research method was semi-experimental and pre-test and post-test with control group. Among 114 asthmatic patients referring to special lung clinic in Tohid hospital of Sanandaj city and private offices of lung specialists in this city in 1395 completed the AQOL questionnaire, 26 were randomly selected and randomly assigned to experimental and control groups each containing 13 individuals. The experimental group received 8 sessions of mindfulness-based stress reduction therapy (for one and a half hours each week for two months); meanwhile control group received no intervention. SPSS v.20 and univariate and multivariate analysis of covariance were applied for data analysis.

The mean score of experimental and control groups, pre- and post-intervention in quality of life and the area of overall understanding of health were significantly different but in asthmatic symptoms, mood performance and physical activity, the difference was not significant.

According to the results of this study, it is recommended to use mindfulness-based stress reduction therapy to improve the quality of life of patients with asthma along with routine medical treatments.

Nowadays efficiency analysis due to identification of weaknesses, strengths and amount utilization of available resources is important. The purpose of this study was efficiency analysis and ranking of provincial units of Social Security Organization (SSO) in indirect treatment sector.

In this descriptive cross-sectional study, technical, managerial and scale efficiencies of SSO in 31 provinces of Iran by input oriented model of Data Envelopment Analysis (DEA) with assuming variable returns to scale were analyzed and the provinces were ranked using the Anderson-Peterson model. The input variables included number of specialized staff, number of support staff, income amount of each province and the output variables included number and cost of prescriptions that have been investigated. The required data were adapted from the 2017 SSO Statistical Yearbook and data analysis was performed using DEAP 2.1 and EMS 1.3.0 software.

Average scores of technical efficiency 0.880, managerial efficiency 0.818, and scale efficiency 0.928 were calculated. Based on above efficiency scores, Kohgiluyeh and Boyerahmad and Tehran ranked first and Kerman ranked last.

In general, there is capacity of technical, managerial and scale efficiency improvement respectively 12%, 18.2% and 7.2% in indirect treatment sector of SSO. Therefore, weak and inefficient provinces should be placed in the priority of improving efficiency. This can be achieved through imitation of efficient provinces, implementing electronic prescribing and more accurate management of SSO revenues and number of human resources employed in the indirect treatment sector.