فهرست مطالب

Journal of Education and Health Promotion
Volume:4 Issue: 2, May 2014

  • تاریخ انتشار: 1393/04/10
  • تعداد عناوین: 25
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  • Sima Ajami*, Parisa Lamoochi Page 26

    One of the methods, especially those living in remote areas or have crashed and does not have access to specialists is telemedicine. Telemedicine describes the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status and care. Travel and wait times between the initial consultations with the patient’s own general practitioner and referral to specialist can be reduced and specialists have successfully provided remote triage and treatment consults of victims via the robot. The robot proved to be a useful means to extend resources and provide expert consulting if specialists were unable to physically be at the site. In fact, the telemedicine system is providing health care services for individuals who are not available because of geographical and environmental conditions. The aim of this study was to identify telemedicine applications in disaster, and proposed use of this technology in areas where the shortage of specialists in remote areas in disasters. This study was un-systematic (narrative) review. The literature was searched for using of telemedicine in disaster and remote places with the help of libraries, conference proceedings, data bank, and also search engines available at Google, Google scholar. In our searches, we employed the following keywords and their combinations: telemedicine, remote place, earthquake, disaster, war, and telecommunication in the searching areas of title, keyword, abstract, and full text. In this study, more than 85 articles and reports were collected and 26 of them were selected based on their relevancy. This literature review helps define the concept of “components and usages of the Telemedicine in disaster” as the new technology in the present age.

    Keywords: Earthquake, remote place, telecommunication, telemedicine
  • Mahmoud Keyvanara, Saeed Karimi, Elahe Khorasani*, Marzie Jafarian Jazi Page 27
    Context

    One of the most important subjects in health economics and healthcare management is the theory of induced demand. There are different views about the concept of induced demand. Extensive texts have been presented on induced demand, however a compatible concept has not necessarily been provided for this phenomenon and it has not been defined explicitly.

    Aims

    The main aim of this article is to understand the concept of induced demand with the use of experts’ perceptions of Isfahan University of Medical Sciences. Settings and Design: The research was done using a qualitative method. Semi-structured interview was used for data generation. Participants in this study were people who had been informed in this regard and had to be experienced and were known as experts. Purposive sampling was done for data saturation.

    Materials and Methods

    Seventeen people were interviewed and criteria such as “reliability of information” and “stability” of the data were considered. The anonymity of the interviewees was preserved. Statistical Analysis Used: The data are transcribed, categorized and then the thematic analysis was used.

    Results

    In this study, 21 sub-categories and three main categories were derived. Three main subjects were included: Induced demand definition, induced demand elements, and induced demand methods. Each of these issues contained some sub-subjects.

    Conclusion

    The result of this study provides a framework for examining the concept of induced demand. The most notable findings include the definition of induced demand, induced demand elements, and method of induced demand. In induced demand definition, an important issue that is often overlooked is that inducing regarding to the effectiveness of clinical services and medical values can lead to better or worse outcomes for patients. These findings help the health policy makers study the phenomenon of induced demand with clear-sighted approach.

    Keywords: Concept, healthcare services, induced demand
  • Mohammad Hossein Yarmohammadian*, Tahereh Naseri Boori Abadi, Shahram Tofighi, Sekine Saghaeiannejad Esfahani Page 28
    Introduction

    Cognizance of any error-prone professional activities has a great impact on the continuity of professional organizations in the competitive atmosphere, particularly in health care industry where every second has critical value in patients’ life saving. Considering invaluable functions of medical record department — as legal document and continuity of health care — “failure mode and effects analysis (FMEA)” utilized to identify the ways a process can fail, and how it can be made safer.

    Materials and Methods

    The structured approach involved assembling a team of experts, employing a trained facilitator, introducing the rating scales and process during team orientation and collectively scoring failure modes. The probability of the failure-effect combination was related to the frequency of occurrence, potential severity, and likelihood of detection before causing any harm to the staff or patients. Frequency, severity and detectability were each given a score from 1 to 10. Risk priority numbers were calculated.

    Results

    In total 56 failure modes were identified and in subsets of Medical Record Department including admission unit dividing emergency, outpatient and inpatient classes, statististic, health data organizing and data processing and Medical Coding units. Although most failure modes were classified as a high risk group, limited resources were, as an impediment to implement recommended actions at the same time.

    Conclusion

    Proactive risk assessment methods, such as FMEA enable health care administrators to identify where and what safeguards are needed to protect against a bad outcome even when an error does occur.

    Keywords: Hospital, medical record department, quality improvement, risk assessment, risk management
  • Mina Tootoonchi, Nikoo Yamani*, Tahereh Changiz, Fariba Taleghani, Zahra Mohammadzadeh Page 29
    Introduction

    One of the important criteria in the promotion of faculty members is in the scope of their educational roles and duties. The purpose of this study was the assessment of reasonability and attainability of educational criteria for scientific rank promotion from the perspective of the faculty members of Medical Sciences Universities in Iran.

    Materials and Methods

    This descriptive study was conducted in 2011 in 13 Universities of Medical Sciences in Iran. Through stratified sampling method, 350 faculty members were recruited. A questionnaire developed by the researchers was used to investigate the reasonability and attainability of educational criteria with scores from 1 to 5. The self-administered questionnaire was distributed and collected at each university. The mean and standard deviation of reasonability and attainability scores were calculated and reported by using the SPSS software version 16.

    Results

    Faculty members considered many criteria of educational activities reasonable and available (with a mean score of more than 3). The highest reasonability and attainability have been obtained by the quantity and quality of teaching with the mean scores (3.93 ± 1.15 and 3.82 ± 1.17) and (3.9 ± 1.22 and 4.13 ± 1.06) out of five, respectively. The mean and standard deviation of total scores of reasonability of educational activities were 50.91 ± 14.22 and its attainability was 60.3 ± 13.72 from the total score of 90. Discussion and

    Conclusion

    The faculty members of the Universities of Medical Sciences in Iran considered the educational criteria of promotion moderately reasonable and achievable. It is recommended to revise these criteria and adapt them according to the mission and special conditions of medical universities. Furthermore, providing feedback of evaluations, running educational researches, and implementing faculty development programs are suggested.

    Keywords: Academic promotion, criteria, education, faculty member, Iran, universities ofmedical sciences
  • Archana Ramalingam, Sitanshu Sekhar Kar* Page 30
    Background

    The advent of internet has triggered a growth in provision of more interactive health promotion messages, which are likely to enhance the potential for behavior change especially among children. We intended to find out the determinants and prevalence of use of internet among school students of Puducherry.

    Materials and Methods

    An exploratory study was carried out among all the students belonging to the standards VI to IX (n = 421) in three schools from urban areas and two schools from rural areas of Puducherry. A pretested, self-administered questionnaire which sought information on sociodemographic details (age, gender, standard of education, occupation of father, and type of school), use of internet, and place of accessing internet, hours of use, and reasons for use was utilized. The statistical significance between the categorical variables was done using chi-square test. All significance tests were two-tailed and statistical significance was defined as a value of P < 0.05.

    Results

    Majority (72.2%) were boys. Less than one-third (23.8%) of the students used internet. The use of internet was found to be significantly higher in mid-adolescents (Adjusted OR: 2.205); among boys (Adjusted OR: 3.835) and students from urban areas (Adjusted OR: 4.694).

    Conclusion

    There is a geographical and gender divide observed among the school children in the use of internet. Taking the steps to bridging the digital divide will help utilize internet as a media for health promotion.

    Keywords: Digital divide, health promotion, school children
  • Lalit Prashant Meena*, Shant Kumar Pandey, Madhukar Rai, Anju Bharti, Jaya Chakravarty, Shyam Sundar Page 31
    Background

    Majority of HIV/AIDS patients who are on Highly Active Anti Retroviral Therapy (HAART), are not aware about drug adherence and its importance which is the most important factor for drug adherence.

    Objectives

    To study the level of drug adherence in patients accessing antiretroviral therapy (ART) through the National program and factor influencing drug adherence.

    Materials and Methods

    In present study, we enrolled 102 newly diagnosed patients, among them in 79 patients, ART was started. To study the drug adherence a pretested, semistructured questionnaire was formed and patients were followed up for 6 months of the study. Pretest and posttest counseling was done to all such patients.

    Results

    A total of 28 patients missed the dose in 1st follow-up, nine patients missed in 2nd follow-up, eight patients missed in 3rd follow-up. Three patients lost follow-up in 2nd follow-up, three patients further lost follow-up in 3rd follow-up. Running out of pills (40.0%), side effect (15.5%), and family problem (13.3%), poor transport facility for taking drug (8.9%) and forgetfulness (11.1%) are five major causes related to miss dose. In females patients, drug adherence (69%) was initially less than male patients (76%) but latter on female patients (96.3%) had better adherence than males (95.2%).

    Conclusion

    This study suggest that drug adherence can be increased by proper counseling and close monitoring of the patients which may have a great role in preventing the drug resistance and ART response.

    Keywords: Adherence, HIV, AIDS, antiretroviral therapy adherence, counseling
  • Nizal Sarrafzadegan*, Katayoun Rabiei, Khadijeh Fereydoun Mohaseli, Leila Manzouri, Hamidreza Roohafza, Roya Kelishadi, Heidarali Abedi, Hasan Azaripour Masooleh, Mousa Alavi, Gholamreza Heidari Page 32
    Context

    Studies on the World Health Organization Frame‑work Convention on Tobacco Control(FCTC) are scarce in Iran and the Eastern Mediterranean region (EMR).

    Aim

    This study was conducted in 2007‑2008 in Iran to design a practical evaluation model of the implementation of FCTC with the potential to be adopted in the EMR. Given that, the findings of this evaluation can be useful in increasing political and public support for enforcing the implementation of legislations, testing their feasibility, and maintaining sustainability. The viewpoints of tobacco growers as part of stakeholders in this regardwould have an influential role. Settings and Design:This study was a qualitative one to investigate the tobacco growers viewpoints about thestrengths/weaknesses of FCTC implementation in Iran.

    Materials and Methods

    In this study, we conducted semi‑structured in‑depth individual interviews with 5 tobacco growers. All interviews were carried out with their permissionwere recorded and were assured that their interviews will be kept confidential. All questions were related to different FCTC articles, then written transcripts were prepared and the basic concepts were extrapolated. Statistical Analysis:After transcribing the recorded interviews, we extracted first level codes and main concepts from them.

    Results

    The findings suggested that although tobacco growers agreed with FCTC implementation, however, subjects like the necessity to support tobacco growers and obtaining insurance from the government, the necessity of the enforcement of national tobacco control law and planning to decrease access to tobacco by policy makers were the most key points that tobacco growers pointed to them.

    Conclusion

    Our results showed that tobacco growers agreed with the implementation of FCTC but they worried about their job and the expenses of their daily life. Therefore, it seems that policy makers have to design a plan to support tobacco growers for changing tobacco with a safe cultivate.

    Keywords: Frame‑work convention on tobacco control, policy makers, tobacco growers
  • Fariborz Khorvash, Sahar Vesal, Nikoo Yamani*, Arash Hadadgar, Nooshin Mehrbod Page 33
    Introduction

    Studies showed that lack of interest in the field of study in the 1st year of residency could create stress and then causing psychological problems like anxiety. The purpose of this study was the evaluation of relationship between interest to the specialized field of study and the level of medical residents’ anxiety in 2010.

    Materials and Methods

    This study was a cross‑sectional study. The statistical population of this study was the medical residents (1st‑4th year) from the Universities of Medical Sciences of Isfahan, Gilan, Sanandaj and Kashan (370 residents). They were selected by stratified sampling method proportional to size and were included in this study. Data was collected by using the researcher‑made questionnaire of demographic characteristics, the questionnaire about the field of study selection and Zung anxiety self‑assessment standard questionnaire. The findings were analyzed by using the SPSS statistical software version 16, descriptive and analytical tests (t‑test, one‑way ANOVA and Pearson). The significance level was considered as P ≤ 0.05.

    Results

    The results showed that more than 92% of the surveyed residents did not have anxiety and were in the normal group. There was a significant correlation between the specialized field of interest and anxiety scores of the residents (P < 0.05). In particular, the following cases had a direct effect on interest rates and anxiety in residents: the amount of time for visiting and patient care, job stress, time for personal affairs, the ability to predict the agenda and job security.

    Conclusions

    The relationship between various factors and anxiety level was corroborated that the residents’ interest and success in studying was the result of their choices and management plans to eliminate barriers for the selection of the field and the favorite city by the officials and planners.

    Keywords: Anxiety, interest in specialized field, medical residency
  • Mohammad Mehdi Hassanzadeh Taheri, Hamid Reza Ryasi*, Mohammad Afshar, Mohammad Reza Mofatteh Page 34
    Introduction

    University teachers are one of the main pillars of university and the quality of their performance must continuously and systematically be evaluated. This evaluation can be carried out in various ways. The aim of the present study was to survey and to compare the evaluation of faculty members in the medical school in Birjand University of Medical Sciences by three different sources: Student rating, self‑assessment, and evaluation by head of related department.

    Materials and Methods

    This descriptive analytical cross‑sectional study was conducted in the academic year 2009‑2010. Sampling was drawn from all students studying basic science and clinical training in the first and the second semesters. All heads of departments in basic science and clinical training and their faculty members took part in this study. Means of data collection were four different questionnaires designed in the education development center (EDC) and their validity and reliability had been verified by the center. These questionnaires were based on student rating, self‑assessment, and evaluation of faculty members by heads of clinical and basic sciences academic departments. After the questionnaires were filled out, the obtained data was analyzed by Statistical Package for the Social Sciences (SPSS) software (version 13), independent t‑test, and Pearson’s correlation coefficient at the significant level of  = 0.05.

    Results

    In the present study, 2417 students completed the questionnaires regarding 63 faculty members, 87 faculty members completed the self‑assessment form, and for 60 faculty members, 48 members in clinical and 12 members in basic science, the questionnaires were completed by heads of respective departments. Mean and standard deviation of student evaluation, self‑assessment, and teachers evaluation by heads of departments were 3.23 ± 0.38, 3.51 ± 0.33, and 3.60 ± 0.32, respectively, and the difference between student rating and self‑assessment was significant (P = 0.02). In comparing between managers scores with students evaluation, no significant difference was observed (P = 0.68). Comparison between self‑assessment and teachers scores by managers showed a significant difference (P = 0.04). Mean scores of faculty members in clinical training and in basic science were 3.23 ± 0.73 and 3.31 ± 0.69 on the part of students, respectively; thus, the difference was significant (P = 0.004).

    Conclusion

    Since, the present study was inconsistent with similar previously carried out investigations, the observed difference among the three procedures was statically significant; hence, it can be suggested that student’s scores of teachers evaluation, previously used as the only one of evaluation source is not enough and other sources such as assessment by the respective department heads, dean of faculty, and self‑assessment must also be taken into consideration. This collection can definitely yield a more favorable evaluation of faculty members and feedback can be more acceptable to them and it will be more effective in improving their education.

    Keywords: Evaluation, faculty member, head of department, self‑assessment, student
  • Hossein Shahnazi, Seyede Shahrbanoo Daniali*, Gholamreza Sharifirad Page 35
    Background

    Due to the importance of health care organizations with significant responsibility for prevention and care, assessment of job satisfaction among health care staff is essential. Quality of health services will be decreased provided they are not satisfied.

    Materials and Methods

    This study was a cross‑sectional analysis of health care staff in Khomeinishahr (centers, buildings, and networks) If they had at least 6 months work experience, they could enter the study. Data included a two‑part questionnaire with a standardized questionnaire, demographic variables, and Smith job descriptive index, which is a questionnaire with six domains. Reliability was obtained for each domain and its validity was reported 0.93.

    Findings

    The results showed an overall satisfaction score averages 43.55 ± 12.8 (from 100). Job satisfaction score was not significantly different between the sexes. However, within the current attitude toward job satisfaction, men scores was better than women (P = 0.001). Highest score in job satisfaction was related to relationships with colleagues and lowest score was related to the income, benefits, and job promotion.The more the years of work, the less the job satisfaction was. The attitude toward the current job had a direct relationship with income (P = 0.01). There was a significant inverse relationship between educational level and job satisfaction in domains promotion, income, and benefits (P = 0.01). The staff with higher education levels was less satisfied with income and job promotion qualification.

    Conclusion

    Managers should focus on job qualification to increase job satisfaction and improve the quality of work.

    Keywords: Health care providers, health services administration, job satisfaction
  • Ahmad Papi, Davoud Khalaji*, Hasan Ashrafi Rizi, Ahmad Shabani, Akbar Hassanzadeh Page 36
    Introduction

    Commitment to abstracting standards has a very significant role in information retrieval. The present research aimed to evaluate the rate of Commitment to ISO 214 Standard among the Persian abstracts of approved research projects at School of Health Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran.

    Materials and Methods

    This descriptive study used a researcher‑made checklist to collect data, which was then analyzed through content analysis. The studied population consisted of 227 approved research projects in the School of Health Management and Medical Informatics, Isfahan University of Medical Sciences during 2001‑2010. The validity of the checklist was measured by face and content validity. Data was collected through direct observations. Statistical analyzes including descriptive (frequency distribution and percent) and inferential statistics (Chi‑square test) were performed in SPSS‑16.

    Results

    The highest and lowest commitment rates to ISO 214 standard were in using third person pronouns (100%) and using active verbs (34/4%), respectively. In addition, the highest commitment rates to ISO 214 standard (100%) related to mentioning third person pronouns, starting the abstract with a sentence to explain the subject of the research, abstract placement, and including keyword in 2009. On the other hand, during 2001‑2003, the lowest commitment rate was observed in reporting research findings (16/7%). Moreover, various educational groups differed significantly only in commitment to study goals, providing research findings, and abstaining from using abbreviations, signs, and acronyms. Furthermore, educational level of the corresponding author was significantly related with extracting the keywords from the text. Other factors of ISO 214 standard did not have significant relations with the educational level of the corresponding author.

    Conclusions

    In general, a desirable rate of commitment to ISO 214 standard was observed among the Persian abstracts of approved research projects at the School of Health Management and Medical Informatics of Isfahan University of Medical Sciences. However, commitment rates differed between years. In addition, commitment to ISO 214 standard was not significantly related with educational group and level.

    Keywords: Abstracts, research design, universities, ISO 214
  • Omolbanin Motamed Rezaei, Mitra Moodi*, Nahid Moazam Page 37
    Background

    Achieving a balanced and proper nutrition is one of the most important health objectives in the early years of the child’s life. The aim of this study is to determine the level of knowledge and attitude of the mothers covered by the urban health centers of Birjand about nutritional behaviors.

    Materials and Methods

    This descriptive‑analytical study was conducted on the mothers with children less than five years referring the health centers of Birjand, in 1387. A questionnaire was prepared for data collection. Data were analyzed using SPSS software, Chi square, ANOVA, Tukey’s post hoc and Pearson correlation coefficient statistical tests with a accuracy level of P < 0.05.

    Results

    Two hundred ninety four patients were studied. A meaningful difference was observed between the knowledge and attitude scores in terms of the mothers’ education stand (P = 0.002). Eighty three point seven percent, 65.6%, 82.7% and 64.6% of mothers were aware about the importance of iron absorption, the onset of iron supplement drop, the minerals and vitamins in the body, and the effects of vitamin A deficiency, respectively. The mothers’ knowledge and attitude about the nutritional behavior was evaluated at the average and good level, respectively.

    Conclusions

    Considering the average level of the mothers’ knowledge and attitude about children’s nutritional behaviors, the retraining of family physicians and health centers staff about the importance of nutritional behaviors is recommended.

    Keywords: Attitude, Birjand, knowledge, mothers, nutrition
  • Farooq Ahmad Ganie*, Mohd Saleem Wanie, Shabir Ahmad Ganie, Hafezulla Lone, Masaratul Gani, Mohd Farooq Mir, Naseer Ahmad Khan Page 38
    Objective

    To estimate the incidence of hyperechoic, hypoechoic, isoechoic, prostatic cancer in TRUS (transrectal ultrasound guided) guided prostatic specimens.

    Materials and Methods

    Four hundred and ninety three patients with raised serum prostatic specific antigen (PSA) and abnormal DRE findings were subjected to TRUS‑Guided prostate biopsy. Lateralized sextant biopsy plus prostatic cores from suspicious areas were obtained.

    Results

    Out of 493 patients who were enrolled in the study, 65 (13.18) patients showed hyperechoic lesions on TRUS and 211 (42.79) patients had hypoechoic lesions on TRUS.

    Conclusion

    Our study has revealed that hyperechoic lesions on transrectal ultrasonography have more chances of prostatic cancer as reported in previous literature, so we suggest that we should take additional biopsy of hyperechoic lesions and perhaps it should be part of the standard protocol in patients suspected cancer prostate

    Keywords: Pca, prostatic cancer, serum prostatic specific antigen, serum psa, transrectalultrasonography, transrectal ultrasound guided
  • Sakineh Saghaeiannejad-Isfahani, Razieh Mirzaeian, Hasan Jannesari, Asghar Ehteshami, Awat Feizi, Ahmadreza Raeisi* Page 39
    Objective

    Supporting a therapeutic approach and medication therapy management, the pharmacy information system (PIS) acts as one of the pillars of hospital information system. This ensures that medication therapy is being supported with an optimal level of safety and quality similar to other treatments and services.

    Materials and Methods

    The present study is an applied, cross‑sectional study conducted on the PIS in use in selected hospitals. The research population included all users of PIS. The research sample is the same as the research population. The data collection instrument was the self‑designed checklist developed from the guidelines of the American Society of Health System Pharmacists, Australia pharmaceutical Society and Therapeutic guidelines of the Drug Commission of the German Medical Association. The checklist validity was assessed by research supervisors and PIS users and pharmacists.

    Findings

    The findings of this study were revealed that regarding the degree of meeting the standards given in the guidelines issued by the Society of Pharmacists, the highest rank in observing input standards belonged to Social Services hospitals with a mean score of 32.75. Although teaching hospitals gained the highest score both in process standards with a mean score of 29.15 and output standards with a mean score of 43.95, the private hospitals had the lowest mean score of 23.32, 17.78, 24.25 in input, process and output standards, respectively.

    Conclusion

    Based on the findings, it can be claimed that the studied hospitals had a minimal compliance with the input, output and processing standards related to the PIS.

    Keywords: Clinical pharmacy information system, evaluation, information system, pharmacy
  • Javad Harooni, Akbar Hassanzadeh, Firoozeh Mostafavi* Page 40
    Introduction

    Health promotion behavior is one of the main criteria for determining health that is recognized as the basic factor in catching numerous diseases. Observing such behaviors by the elderly prevents affliction to various diseases and has potential effect in promoting health and increasing the elderly quality of life. This research was done for the aim of determining effective factors on health promotion behaviors and health status in the elderly of the Dena province.

    Materials and Methods

    One hundred twenty elderly of over 65 years of age were selected randomly to do this descriptive‑analytical study (cross‑sectional type). The questionnaire regarding health promoting lifestyle profile 2 (HPLP2) was used for measuring the rate of health promotion behaviors. The data was collected by personal interviews and face to face method for completing the relevant questionnaire and was analyzed by SPSS software version 20 and also proper tests.

    Results

    The average score of the elderly health promotion behaviors in the Dena province (143.8) indicated the acceptable level of performing health promoting behaviors in this group, such that 85% of the elderly had intermediate health promoting behaviors and 15% had proper behaviors. Also, the results showed that the average score of the physical activity and nutrition sub‑measuring conditions was lower than the average score of other sub measures of prevention had the highest average. Moreover, comparison of the correlation of health promotion behaviors with the sub‑measures showed that apart from the healthy nutrition sub‑measure, all the other sub‑measures have significant correlation with health promotion behaviors.

    Conclusion

    From the findings of this study, the authors recommend health providers to promote elderly health promotion behaviors in all communities by identifying health promotion behaviors in other parts of the country, and also designing suitable intervention programs based on effective factors on health promotion behaviors of the elderly people

    Keywords: Elderly, health promoting behavior, pender model
  • Mehdi Tazhibi*, Zahra Fazeli Dehkordi, Shadi Babazadeh, Maryam Tabatabaeian, Parisa Rezaei, Mehri Faghihi Page 41
    Background

    Breast cancer is the most common cause of death in women in the age range of 35‑55 years. Each year, one or two cases of breast cancer per 1000 women are diagnosed as new cases. Despite the serious prognosis and high rate of morbidity, mortality, and pathogenicity, in the case of early diagnoses, the prognosis will be better. The aim of this study was to investigate the age trends in breast cancer patients with different sizes of tumors in Breast Cancer Research Center of Isfahan University of Medical Sciences in 2001‑2010.

    Materials and Methods

    The information in radiotherapy and oncology of Isfahan University of Medical Sciences and Milad Hospital from 2001 to 2010 were coded and analyzed. Frequency of patients’ age groups, tumor sizes and the year of cancer diagnosis were calculated. Correlation test was used for data analysis in statistical analysis in social science (SPSS) software version 18.

    Findings

    Among the 3722 patients with breast cancer, the highest relative frequency distribution, respectively was observed in the age of 40‑49 years (34.4%), 50‑59 years (26.6%), 30‑39 years (17.7%), 60‑69 years (13.2%), 20‑29 years (2.5%), 70 years and older (5.2%) and less than 20 years. Relative frequency distribution of tumor sizes in a variety of 5 cm (T2) was with the frequency of 59.8%, and then 26% at 5 cm (T3), 10.5% at 2 cm (T1), 3.1% at T4 and 0.6 at In‑situ, respectively.

    Conclusion

    The investigation of age trends showed that diagnosis rate of breast cancer increased from 2001 to 2004. It reached its highest value in 2006 at the age range of 30‑39 years. Then, the trend has been downward, and it has continued to decline until 2010, which could be the result of the equipping screening system and recording the malignant cases. 85.8% of the examined tumors in T2 and T3 group were visible and may be disturbing. Comparing the frequency distribution of the infected population showed that the highest incidence of breast cancer diagnosis were in the age range of 40‑49 years. It seems that as long as the mass has not reached an obvious palpable state, it has not been diagnosed.

    Keywords: Age trends, breast cancer, Isfahan, tumor size
  • Seyyed Salman Alavi, Fereshte Jannatifard, Mohammad R. Maracy, Hamed Alaghemandan*, Mehrdad Setare Page 42
    Backgrounds

    The present study was carried out in order to compare national and personal identity and their subscales in internet addicts and nonaddicts.

    Materials and Methods

    This study was a descriptive-analytical research, and was carried out on 384 student internet users in different universities in the city of Isfahan who were selected using quota sampling. Subjects completed the questionnaires, then, subscales of personal and national identity questionnaires in internet addict and nonaddict were analyzed via SPSS16 software.

    Results

    Results indicated a significant difference between the scores of national identity and personal identity as well as all subscales in internet addicts and nonaddicts, except for national heritage and homeland defence factors. In addition, there was a negative and significant relationship between addiction to internet and personal and national identity, except for the fourth and fifth factors of national identity (viewpoints of others considering the national group and homeland defence). Moreover, after controlling for the sex variable, internet addiction had an effect on personal and national identity.

    Conclusion

    The findings of this research indicate that an excess of internet use and overinvolvement in cyberspace and the addiction to them, could be associated with defects in some aspects of national and personal identity.

    Keywords: Internet addiction, internet user, national identity, personal identity
  • Mohsen Rezaeian, Gholamreza Sharifirad, Firoozeh Mostafavi, Mitra Moodi, Mohammad Hadi Abbasi* Page 43
    Introduction

    Breast cancer is an international health problem in the world over. Mammography screening behavior has critical role in early detection and decreasing of its mortality. Educational programs play an important role in promoting breast cancer screening behaviors and women health. Health belief models (HBM) is the most common models that have been applied in Mammography screening behaviors. The aim of this study was to determine the effect of breast cancer screening education using HBM on knowledge and health beliefs in 40 years women and older.

    Materials and Methods

    In this Population‑based controlled trial, 290 women of 40 years and older were divided randomly into experimental and control groups. Health beliefs determined using the Persian version of Champion’s health belief model scale (CHBMS). Questionnaires were completed before and 4 weeks after intervention. Four educational sessions were conducted each session lasting 90 min by lecturing, group discussion, showing slide and educational film based on HBM constructs. The obtained data were analyzed by SPSS (version 18) and statistical test at the significant level of a = 0.05.

    Results

    Mean scores of perceived susceptibility, perceived severity, perceived benefits, barriers and self‑efficacy of mammography and health motivation in the experimental group had significant differences in comparison with the control group after educational intervention (P ≤ 0.001).

    Conclusion

    The results of this study have confirmed the efficiency of educational intervention based on HBM in increasing of knowledge and health beliefs about breast cancer and mammography screening behavior. Hence, implementing appropriate educational programs with focus on benefits of Mammography in early detection of breast cancer and creating positive motivation for health among women, can increase their practice of having mammography screening.

    Keywords: Breast cancer, educationintervention, health belief model, mammography screening
  • Ladan Zarshenas, Shahla Momeni Danaei*, Elham Mazarei, Hooman Zarif Najafi, Mahsa Shakour Page 44
    Introduction

    The dental students, the same as other students, during their academic courses are required to learn a wide range of scientific subjects. Obviously, choosing the inappropriate method of study leads to confuse and disenchantment of students and it causes wasting of their energy. The purpose of this study was to assess the existing strengths and weaknesses of the skills and study habits in Dental Students of Shiraz University of Medical Sciences in 2009‑10.

    Materials and Methods

    In this cross‑sectional study, all of the dental students (n = 274), who studied at the time of study at all levels in the academic year of 2009‑10, were selected by the census. Data were collected by using the Huston University questionnaire consisted of two parts of demographic questions and 64 specific areas of study skills in eight domains of time management, concentration/ memory, study aids/note taking, test strategies, information processing, motivation, self‑assessment/reading, and writing skills. Following the retranslation of the questionnaire, the validity was confirmed by using the content validity method. The reliability was obtained by using the Cronbach’s Alpha of 0.92. The data were analyzed with SPSS software version 17 and using analytical statistic tests.

    Results

    Students who have previously participated in the study skills workshops had stronger skills in comparison with the students who had not participated in these workshops. Time management skills (P = 0.04), motivation (P = 0.0001) and information processing (P = 0.03) in students with professional status were in a more favorable position and showed significant differences in terms of educational levels. The study skills mean score of the students living in student housings in comparison with the other students were significantly higher (P = 0.04). Marital status showed no significant differences in reading skills. Conclusion and Recommendations: The review of study skills in the undergraduate and post‑graduate dental students indicated that the residents had higher reading skills. By recognizing the existing strengths and weaknesses and holding programs through counseling centers can develop the study skills in the students.

    Keywords: Dental students, study habits, study skills
  • Tikhe Sham Ganpat*, Sasmita Dash, Nagendra Hongasandra Ramarao Page 45
    Background

    Students need emotional intelligence (EI) for their better academic excellence. There are three important psychological dimensions of EI: Emotional sensitivity (ES), emotional maturity (EM) and emotional competency (EC), which motivate students to recognize truthfully, interpret honestly and handle tactfully the dynamics of their behavioral pattern.

    Objective

    The study was designed to assess ES in the students undergoing yoga therapy program in the form of yoga instructor’s course (YIC) module.

    Materials and Methods

    One hundred and eighty four YIC students with 25.77 ± 4.85 years of mean age participated in this study of 21 days duration (a single group pre‑post design). The ES data was collected before (pre) and after (post) YIC module using Emotional Quotient test developed by Dr Dalip Singh and Dr N K Chadha. Statistical Analysis: Means, standard deviations, Kolmogorov‑Smirnov test, and Wilcoxon signed rank test were used for analyzing the data with the help of SPSS 16.

    Results

    The data analysis showed 3.63% significant increase (P < 0.01) in ES.

    Conclusion

    The present study suggests that YIC module can result in improvement of ES among university students, thus paving the way for their academic success. Additional well‑designed studies are needed before a strong recommendation can be made.

    Keywords: Academic success, emotional sensitivity, yoga instructor’s course
  • Manni Balasubramaniam Sudharsanam* Page 46
    Background

    Topics on environmental health are usually neglected by students and it is necessary for them to learn this area with a public health perspective as environment plays a vital role in multi‑factorial causation of diseases. Hence there is a need for alternative teaching/learning methods to facilitate students in acquiring the required knowledge.

    Objectives

    To increase the student interest and enhance their participation in acquiring knowledge in public health perspective of environmental health. Teaching Objectives/Learning Were: At the end of the session students should know the importance of air as an environmental factor in disease causation in special reference to public health hazards, the major sources of air pollution, major pollutants causing the health hazards, the way to measure pollutants and control them.

    Materials and Methods

    The whole class of students was divided into two batches and one session was planned for each batch. Each batch was divided into six small groups. The groups were given task of exploring the internet on the different topics mentioned in the learning objectives. All the students were asked to explore, compile information and collectively prepare a presentation and present their findings based on their reviews. Students’ feedback was collected at the end of each session.

    Results

    Eighty five percent of them were clear about the learning objectives and interested about internet learning. Most of them gave a positive opinion about the newer teaching learning method.

    Conclusions

    Internet assisted group study served as a valuable alternative, innovative, and interesting tool to teach and learn the environmental health as revealed by students’ feedback.

    Keywords: Active learning, environment, health, internet assisted learning
  • Manjunatha Goud*, Narendra Pamidi, Oinam S. Devi, Bhavn Nayal, Ullas Kamath, Raghuveer Page 47
    Background

    The physical activity in teaching faculties is an important aspect to maintain good health. This not only prevents the various non - communicable diseases but also has role in secondary prevention of diseases. It is also proven that the growing epidemic of obesity mostly in children is linked to recent decline in physical activity levels both in home, school and working places. Social class is thought to have a bearing on physical activity. On basis of this, the survey was done to assess the physical activity levels in higher social class population i.e. on teaching faculty of Melaka Manipal Medical College, Manipal, Karnataka, India.

    Materials and Methods

    Questionnaire study was implemented in 2010 as the design of this research without any manual intervention. No experiment was conducted in the research. Questions were specific and related to the physical activities in home and also in working environment.

    Results

    The study found that in medical college the lifestyle is restricted mostly to sedentary and moderate work. Most of faculties were using bike and cars to reach there working place and also we found the physical activities in the form of exercise and sports activity were lacking.

    Discussion

    In addition to the importance of a physical activity professional’s potential influence on others as a model, engaging in a physically active lifestyle is very important for personal reasons. Achieving and maintaining a health-enhancing level of physical fitness is one of the basic standards for good teaching and maintaining good health. Physical activity in professionals leads to both personal health benefits, and improve job satisfaction.

    Conclusion

    Infrastructure improvements such as sports activity in colleges among faculties, combined with regular exercise provide additional physical activity that would help reduce obesity and non-communicable diseases.

    Keywords: Exercise, physical activity, sports, teachers
  • Zamzam Paknahad*, Noushin Mohammadifard, Zahra Bonakdar, Akbar Hasanzadeh Page 48
    Introduction

    Osteoporosis is a multifactorial disease and one of the most important modifiable factors in the development and maintenance of bone mass are nutrition nutritional status and its relationship with Bone Mass Density (BMD) in postmenopausal women admitted in osteodensitometry Center, Isfahan, Iran.

    Materials and Methods

    Seventy‑two postmenopausal osteoporotic women were studied. BMD of the lumbar spine and total hip were measured using dual‑energy X‑ray absorptiometry. Demographic and dietary intakes were collected by interview and using a validated food frequency questionnaires. T‑scores, Pearson correlation and one way analysis of variance tests were conducted to analyze the data.

    Results

    Mean of age and duration of menopause was nearly 57.5 ± 7.2 and 10.6 ± 7.1 years, respectively. The mean t‑scores for BMD of spine and hip were 0.877 ± 0.179 and 0.997 ± 0.21, respectively. The mean of calcium (Ca), phosphorous (P), fluoride (F), Vitamin D, K and Zn were less than DRI and Na more than it (all P value less than 0.0001). BMD of hip was significantly correlated with dietary Ca, animal protein, Zn (P < 0.05), but BMD of spine did not show any significant correlation with nutrients (P > 0.05).

    Conclusion

    Most of the postmenopausal osteoporotic women in this study had a considerable deficiency in terms of micronutrients such as Ca, vitamin D and P, which can be deleterious for bone health.

    Keywords: Bone mineral density, diet, nutrition, women
  • Hasan Ashrafi‑rizi*, Zahra Ghazavi Khorasgani, Fateme Zarmehr, Zahra Kazempour Page 49
    Introduction

    Media literacy is a 21st century approach to education. It provides a framework to access, analyze, evaluate, and create messages in a variety of forms ‑ from print to video to the Internet. Also, it builds an understanding of the role of media in society as well as essential skills of inquiry and self‑expression necessary for citizens of a democracy. The purpose of this research was to determine the rate of media literacy among Isfahan University of Medical Sciences’ students using Iranian Media Literacy Questionnaire (IMLQ).

    Materials and Methods

    This is a survey research in which the data were collected by a researcher‑made questionnaire. Its validity and reliability were confirmed by Library and Information Sciences specialists and Chronbach’s alpha (r = 0.89), respectively. Statistical population consisted of all students in Isfahan University of Medical Sciences (7000 cases) and the samples were 364. Sampling method was random stratified sampling. Data were analyzed by descriptive (frequency distribution, mean) and inferential (T‑test, ANOVA, and one‑sample t‑test) statistics through SPSS16 software.

    Results

    The findings showed that the mean level of media literacy among Isfahan University of Medical Sciences’ students was 3.20 ± 0.558 (higher than average). The highest mean was skill in avoiding confusion and focus on activates such as watching television, listening to radio, reading newspaper, and using internet; and the lowest mean was skill in membership and subscription in useful society networks. The mean of evaluation of media messages dimension was more than others. The lowest mean of dimensions was for selective and purposeful use of media with 2.99 ± 0.761. Comparison between gender, married status, educational degree, and college type and the rate of media literacy among Isfahan University of Medical Sciences’ students showed no significant difference.

    Conclusion

    The results showed that the rate of media literacy among Isfahan University of Medical Sciences’ students was higher than average. But students didn’t have enough skill in membership and subscription in useful society networks and Skill in tracking news about your favorite artists and musicians. Generally, all students and education practitioners should pay special attention to factors affecting in improving media literacy as a basic capability in using media.

    Keywords: Iranian Media LiteracyQuestionnaire, Isfahan University of MedicalSciences, Media Literacy, students
  • Ali Noorafshan, Leila Hoseini, Mitra Amini, Mohammad‑Reza Dehghani, Javad Kojuri, Leila Bazrafkan* Page 50
    Objective

    Learning by lecture is a passive experience. Many innovative techniques have been presented to stimulate students to assume a more active attitude toward learning. In this study, simultaneous sketch drawing, as an interactive learning technique was applied to teach anatomy to the medical students.

    Materials and Methods

    We reconstructed a fun interactive model of teaching anatomy as simultaneous anatomic sketching. To test the model’s instruction effectiveness, we conducted a quasi‑ experimental study and then the students were asked to write their learning experiences in their portfolio, also their view was evaluated by a questionnaire.

    Results

    The results of portfolio evaluation revealed that students believed that this method leads to deep learning and understanding anatomical subjects better. Evaluation of the students’ views on this teaching approach was showed that, more than 80% of the students were agreed or completely agreed with this statement that leaning anatomy concepts are easier and the class is less boring with this method. More than 60% of the students were agreed or completely agreed to sketch anatomical figures with professor simultaneously. They also found the sketching make anatomy more attractive and it reduced the time for learning anatomy. These number of students were agree or completely agree that the method help them learning anatomical concept in anatomy laboratory. More than 80% of the students found the simultaneous sketching is a good method for learning anatomy overall.

    Conclusion

    Sketch drawing, as an interactive learning technique, is an attractive for students to learn anatomy.

    Keywords: Active learning, anatomy, sketch, teaching