فهرست مطالب

Shiraz Emedical Journal - Volume:20 Issue: 12, 2019
  • Volume:20 Issue: 12, 2019
  • تاریخ انتشار: 1398/09/13
  • تعداد عناوین: 8
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  • Firooz Esmaeilzadeh, Mojtaba Sepandi, Farzad Khodamoradi, Yousef Alimohamadi*, Manijeh Alimohammadi* Page 1
    Background

    Under-five mortality and life expectancy are two important health indicators that may be associated with GDP. Thus, the evaluation of the relationship between these indicators can be important in health planning.

    Objectives

    Due to the lack of such study in Iran, the current study aimed to assess the correlation of under-five mortality and life expectancy with GDP in Iran during 1990 - 2015.

    Methods

    In this ecological study, all data were extracted from the Gapminder website. The data were analyzed by Pearson correlation coefficient at α = 0.05 as the significance level. All analyses were done using Stata14 and Excel 2010 software.

    Results

    During the study period (1990 - 2015), the life expectancy and GDP were increasing and under-five mortality was decreasing. The correlation of GDP with life expectancy and under-five mortality resulted in r = 0.94 (P < 0.001) and r = -0.95 (P < 0.001), respectively.

    Conclusions

    Considering the correlation of GDP with life expectancy and under-five mortality, the share of GDP allocated to the health sector should be increased to improve these indices in Iran.

    Keywords: GDP, LifeExpectancy, Under-FiveMortality, Iran
  • Soraya Nouraei Motlagh, Saman Ghasempour, Razyeh Bajoulvand, Sara Hasanvand, Sheida Abbasi Shakaram, Mohammad HasanImani Nasab* Page 2
    Background

    To achieve evidence-based policymaking to improve access to dental services and reduce inequality in the utilization of these services, the identification of effective factors on the use of dental services is essential.

    Objectives

    Therefore, the present study was conducted to investigate the most important socioeconomic factors affecting the demand and utilization of dental services among households in Khorramabad, Iran.

    Methods

    This cross-sectional study was performed among 500 households in Khorramabad city in 2017. The participants were selected using a randomized stratified sampling method. Logistic regression was used to determine the most important factors affecting the utilization of dental services and linear regression to examine income elasticity. To measure inequality among income groups, the concentration index was employed. Data analysis was performed using STATA-14 software and the inequality measurement was carried out using DASP-2.3 in STATA software.

    Results

    The mean number of visits by the respondents was 2.78 ± 1.8. Income elasticity and concentration index for these services were estimated to be 0.31 and 0.207, respectively. Increasing household income, advancing age, higher education level of the head of the household, and having complementary insurance coverage (OR = 1.72) had positive relationships with the increased utilization of dental services. Also, a female head of the household (OR = 0.39) and increased household size (OR = 0.9) led to a reduction in the utilization of these services.

    Conclusions

    Inequality is observed in the use of dental services between different socioeconomic groups. Therefore, health policymakers should implement interventions such as dental health insurance to reduce this inequality in such a way that inequalities between socioeconomic groups are reduced.

    Keywords: DentalServices, Utilization, SocioeconomicFactors, Iran
  • ZohrehGhazivakili, RaziehLotfi*, RoohangizNorouzinia, andKouroshKabir Page 3
    Background

    Emotional maturity and mental health are the foundation of a successful marriage and indeed emotional maturity is the key to a satisfying happy life.

    Objectives

    This study aimed to assess emotional maturity and mental health among couples referred to pre-marriage health centers in the city of Karaj.

    Methods

    A cross-sectional study was conducted in the main center of pre-marriage testing in Karaj from March 2012 to August 2012. Using randomized sampling method 547 couples participated and filled the questionnaires, including a demographic scale, emotional maturity scale (EMS), and Mental Health Inventory (GHQ 28). Data were analyzed using ANOVA, t student, Pearson, and Multiple Regression tests to assess the correlation between variables.

    Results

    Results showed a significant positive relationship between emotional maturity and mental health of couples (r = 0.67; P < 0.05). There was an association between couples’ emotional maturity and sex, religion, occupation, and previous marital history. Also, the relationship between mental health of couples and gender, place of birth, employment history and previous marital history was significant. Regression analysis also indicated that mental health and having a permanent job were predictors of emotional maturity (P < 0.05). The mean score of emotional maturity was detected 91.3 ± 21.6, which was interpreted as emotional instability, and the mean score of mental health was determined 16.2 ± 9.9.

    Conclusions

    The mental health and having a constant job can predict the level of emotional maturity. In addition, the results suggested that emotional maturity has a positive correlation with mental health.

    Keywords: Marriage, MentalHealth, EmotionalMaturity
  • Azita Jaberi, Marzieh Momennasab *, Mohammad AliCheraghi, Shahrzad Yektatalab, Abbas Ebadi Page 4
    Background

    Spiritual health has attracted wide attention in health-related and nursing sciences. However, most research on this complex and ambiguous concept has been conducted from the Judeo-Christian philosophical worldview, and the Muslim community that comprises a large population of the world, and particularly the Iranian population, has not been investigated.

    Objectives

    The present study aimed to explore the experiences of Iranian Muslim adults regarding spiritual health.

    Methods

    This qualitative content analysis was conducted among 14 participants. Semi-structured interviews were used for data collection, and Granheim and Lundman (2004) method was used for qualitative content analysis. The results were categorized into six major themes.

    Results

    The six major themes extracted for spiritual health included harmonious reciprocal connectedness, moderation, spiritual striving, transcendence, purpose seeking and wisdom thinking, and faith. These characteristics were reciprocally interconnected and intertwined. It should be noted that some of the extracted attributes were quite new.

    Conclusions

    Considering the cultural and philosophical foundations of different communities, assessment of spiritual health in different societies would reveal novel and innovative aspects of this concept. Paying attention to these aspects is essential in the health promotion.

    Keywords: SpiritualHealth, ContentAnalysis, Faith, Transcendence
  • Aziz Rezapour, Abdoreza Mousavi*, Farhad Lotfi, Maryam Soleimani Movahed, Samira Alipour Page 5
    Background

    Health expenditure is among the factors affecting the improvement of a society’s health status. Hence, recognizing the effects of public and private health expenditure on health status is vital for making the required decisions.

    Objectives

    This study aimed to compare the effects of different levels of health expenditure on life expectancy, infant mortality rate, and under-five mortality rate as health indicators.

    Methods

    The current study is an analytical research, which was conducted based on a cross-sectional and annual time series data. In this study the effects of private and public health expenditure on health indicators from 2000 to 2015 were investigated. The selected countries had the middle or high-income level and were classified into three groups based on the public health expenditure rate and k-mean method. The required data were collected from the World Bank site and for estimating the model, panel data regression models were used.

    Results

    Public health expenditure had a significant effect on health indicators in all groups, thus, an increase in public health expenditure led to increasing life expectancy and decrease infant and under-five mortality rate in all groups. Also, the group with the highest share of health expenditure had a greater impact on life expectancy and infant mortality, however, in regards to the under-five mortality rate, it was contrary. The effect of private health expenditure was different and in most cases it had no significant effect.

    Conclusions

    The findings of this study indicated that public health expenditure is more effective than the private health expenditure and it also improved health status by creating positive external effects. Therefore, the governments must provide enough required financial resources for improving health status.

    Keywords: PublicHealthExpenditure, PrivateHealthExpenditure, LifeExpectancy, MortalityRate
  • Farzin Heravi, Taraneh Zeynalzadeh Ghoochani, Arezoo Jahanbin, Amin Askary* Page 6
    Introduction

    Treatment of cleft lip and palate is usually achieved by intraoral molding plates. However, this method requires an intraoral impression, which is difficult to perform in infants, and uses plates that can increase the risk of injury to the oral tissue. Here, we introduce a simpler approach, which makes the treatment less costly, reduces the risk of injury, and is easier for parents and caregivers to manage.

    Case Presentation

    Here, we present a case that a neonate before lip surgery was treated by the nasal elevator device and the tapes for three months. We measured the width of the cleft, anterior width, and arch length on the maxillary casts. Columella deviation angle, nostril width and height, and soft tissue cleft ratio were measured on photographs. After NAM, the cleft width was reduced and the nasal architecture was improved.

    Conclusions

    NAM, with nasal elevation, considerably reduced the cleft width and the nasal architecture was improved by this technique.

    Keywords: CleftLip-Palate, Infants, NasoalveolarMolding, OrthodonticApplianceDesign
  • Masoumeh Esmaeily, Saeed Taherian, Zohreh Shahghasemi, Shahab Rezaeian* Page 7
    Objectives

    This study aimed to investigate the relationship between perceived social support dimensions and desire for marriage among students.

    Methods

    This cross-sectional study was conducted among all male and female students of Allameh Tabataba’i University in the academic year 2015 - 16. The sample studied consisted of 200 students (100 males and 100 females). The research instrument was the “multidimensional scale of perceived social support (MSPSS), 1988” and “questionnaire to evaluate interest in marriage”. Data analysis was performed by the independent samples t-test, Pearson correlation coefficient, and stepwise regression.

    Results

    The results showed that the variable “significant others” could explain the feedback towards marriage, the attitude to the consequences of marriage, and the total score of desire for marriage. Also, the total score of perceived social support could explain the readiness and desire for marriage. The results of the regression coefficient showed that the total score of perceived social support could predict barriers to marriage.

    Conclusions

    The results of this study confirmed the role of perceived social support and its dimensions in predicting students’ desire for marriage. These findings can be used in public health interventions related to marriage and the family.

    Keywords: PerceivedSocialSupport, WillingnesstoMarry, DesireforMarriage, Students
  • Siamak Soltani, Mohamad Hoseini Kasnavieh, Hosein Shaker, Ahmad Abbasian, Alireza Amanollahi, Ali Tahmasebi* Page 8
    Background

    Appropriate allocation of resources is an important issue in the delivery of services that can reduce the health system costs. The inappropriateness of healthcare services is one of the problems that increase the pressure on hospitals and patients.

    Methods

    In this study, the data were collected using the appropriateness evaluation protocol by a medicine specialist at Rasoul Akram Hospital. In total, 248 participants were selected through systematic sampling. To calculate the financial burden simultaneously with the evaluation of inappropriate hospitalization days, the medicine and facility costs along with the cost of bed-day were estimated. Data were analyzed by SPSS software.

    Results

    The type of treatment was surgery in 56.8% of the patients and 43.2% of them were admitted to the hospital for internal medicine. The mean length of stay was 4 ± 6 days. The inappropriate admission rate was estimated at about 6% and the rate of inappropriate hospital stays was 21.5%. The most important factors influencing the inappropriateness of hospitalization were delayed medical consultations, delayed surgery, conservative practitioner, and the follow-up of clinical test results. The sum of the direct financial burden of inappropriate hospitalization for the patients was estimated at around 1060 dollars.

    Conclusions

    The findings of this study indicated that inappropriate hospitalization and admission imposed a huge financial burden on the health system and community. Hospital authorities by considering issues such as delayed medical consultations and delayed surgery can decrease the financial burden of inappropriate hospitalization to a large extent.

    Keywords: AppropriatenessEvaluationProtocol(AEP), Inappropriateness, FinancialBurden