مجله سلامت جامعه
سال هفتم شماره 4 (زمستان 1392)

Euthanasia means mercy killing، nurses and physicians of intensive care units are often the first people who are encountered with the request for euthanasia from the patients. The purpose of this study was to investigate the attitudes of nurses and physicians in the intensive care units toward euthanasia in the university hospitals of Yazd. This cross - sectional analytic study was performed on a random sample of 110 nurses and physicians of intensive care units. Data was collected by the use of a standard self-reported questionnaire consisting of 4 parts: demographics، admission of active and passive euthanasia، Trolley Dilemma and measure of attitudes to euthanasia. The reliability of the questionnaire in Aghababaei study was verified with alpha 0. 88. Collected data was analyzed using SPSS18 software by t-test، ANOVA، χ 2، the correlation coefficient and regression. The mean of the attitude towards euthanasia was 45. 05±15. 48. Eighty nine was the highest scores and 24 was the lowest score. Distribution of attitudes toward euthanasia showed undesirable (negative) attitude to euthanasia with 60. 9% as the highest frequency. The mean of the attitude score showed significant differences based on age، the time of service in the ICU ward، the service records and gender. The attitude scale was consistent with the Trolley Dilemma acceptance of active and passive euthanasia. According to the results، the general attitudes toward euthanasia were undesirable. However، considering easier acceptance of the men as well as the more experienced personnel towards euthanasia، training programs must be designed and implemented in order to increase the knowledge and improve the attitudes and morale of the personnel and increase their patience and tolerance.

Otitis Externa is one of the most common diseases that physicians deal with. The purpose of this study was to find out the prevalence of microbial agents and pattern of antimicrobial resistance in patients with acute otitis externa in the desert region of Rafsanjan. After examination and diagnosis of acute Otitis externa، a sterile swab sample was taken from the ear. The culture was then performed on the Triptic soy broth environment. If the microbial culture was positive، antibiogram was performed according to NCCL standard. Out of 124 patients with Otitis Externa، 88 showed positive culture and 36 had negative culture. The most common microorganism isolated was Staphylococcus aureus (29%) followed by Pseudomonas aeruginosa (25. 8%). In 12 cases (11. 88%)، fungi was found alone and in nine cases (7. 24%) fungi and bacteria were found together. In 14 cases (11. 29%) out of the 124 cases، there were two or more bacteria in microbial cultures. The most sensitive of antibiotics were ciprofloxacin and vancomycin and the most resistant type of antibiotics were cotrimoxazole and cephalexin. In this study، the effects of weather and climate variability on antimicrobial agents were observed in Otitis Externa. It is recommended that before the start of the treatment، laboratory investigations be performed to identify the causative agents.

Health training is considered the most important component of the preliminary health care and is among the fundamental duties of the health workers. Therefore، the current study aims to examine the training performance of the healthcare workers. This is a descriptive cross sectional study conducted in Mashhad’s health care centers in 2013 through using classifying cluster probability sampling. A total of 250 heath care workers in the departments of vaccination، mothers and babies، disease fighting، midwifery and environmental health participated in the study. The research instrument included checklist of observing the measurement of training performance of the workers. The data were analyzed using descriptive analysis and analytical tests including Pearson correlation test، independent sample T-test، and ANOVA. The results showed that the training performance of 166 workers (66. 4%) (13. 21±1. 79) were at good and acceptable level. There was a significant difference between training performance of the workers with their individual characteristics such as marital status، work place، employment status، and the experience of participating in training workshop. (p<0. 05) Appropriate training performance is the most important strategy in preliminary health care. In the present study، the training performance of the health workers and the factors influencing it were specified. Planning for promoting both training and assessment of the staff performance apart from their general performance is vital. So، further research is recommended in this area.

Decline in the general health not only causes problems for nurses، but also by affecting the provided services by them، will impact the health of society. The aim of this study was to determine the relationship between nurses general health role in the occurrence of nursing errors among the nurses at Rafsanjan University of Medical Sciences in 2012. This cross-sectional study was conducted on 522 nurses working in Rafsanjan University of Medical Sciences. In order to collect the data three questionnaires including demographic data، general health (General Health Questionnaire -28)، and Nursing error were used. The data were analyzed based on Logistic regression and T-Test. The results showed that the General health of nurses declined with: being female (p=0. 026) and an increase in the number of night shifts (p=0. 021). Four subscales of public health (Physical، Social، Anxiety، Depression) were also investigated. 53. 7% of nurses experienced high anxiety. The results showed a statistically significant relationship between Nursing error and general health (P=0. 000). Nursing errors was higher in women than in men (p= 0. 003). Factors such as the number of night shifts (p=0. 023) and having children under one year old (p=0. 05) was significantly associated with nursing error. Nursing error is known to be a factor in the reduction of the quality of patient care. A change in the occupational factors such as age، sex، marital status and reduction of number of night shifts can improve the general health of the nurses and ultimately promote the quality of caring in patients and reduce nursing errors.

The need for education is the most basic of human needs، and this is more pronounced in the elderly patients. Evidence suggests that older patients are usually not given adequate training. The aim of this study was to investigate the barriers to the education of the elderly patients، hospitalized in the teaching hospitals of Bushehr University of Medical Sciences from the view points of nurses. In this cross-sectional study. a total of 50 nurses working in the surgical wards and 50 elderly patients، were selected. Data was collected through interviews and questionnaires and using descriptive statistics and independent t-tests، Pearson and Spearman were analyzed. The mean age of the elderly patients was 67. 12 ± 6. 53 and for nurses it was 29. 04 ± 3. 94، respectively. In the area of ​​patient-related barriers to learning، from the perspective of nurses، physical disadvantage of the older patients (64%)، and low literacy and illiteracy among older patients (70%) and in the area of ​​educational barriers shortage of the nursing staff was seen as a major barrier to the elderly patients'' education. Considering the association of the two perspectives on barriers to educating the elderly patients، improving the quality of training programs in the elderly patients require action by the board of directors. Also، adding to the nursing workforce، establishing specific duties for patient education and teaching communicative methods، especially with the older patients seem necessary.

Diabetes Mellitus is a prevalent disease that is concomitant with hyperglycemia and lead to dammage in the different organs of the body. Scrophularia Striata is one of the medicinal plants and in the traditional medicine many properties have described for this herb. As the glucokinase is a liver enzyme which has an important role in the cabohydrate metabolism، the present study was aimed to survey the effect of the airial parts extract of this plant on glucokinase gene expression in the liver of type 1 diabetic rats. In this experimental- interventional study، 32 male Wistar rats wre divided into 4 groups as: normal control (group 1)، diabetic contro l (group 2)، and dibetic rats that received 100 mg/kg (group 3) and 200 mg/kg [group 4] of the plant extract orally for 6 weeks. At the end of the experiment، the blood samples from the heart of rats were collected and blood serum and liver tissue were extracted and Stored in -200 C. Real Time PCR was used for the analysis of the glucokinase gene expression. Resuls: The RT-PCR results showed that Glucokinase gene expression in the diabetic group which had received 200 mg/kg of Scrophularia Striata extract was increased significantly compared to control diabetic group. The results of our study showed that Scrophularia Striata can increase glucokinase gene expresion and probably has got insulin-like effect، therefore it can be used as a complementary glucose lowering agent in dibetic patient but further studies should be carried out.

ETT (Exercise Tolerance Test) is a prognostic and diagnostic method for assessing the ischemic heart patients. The aim of the present study was to determine the relationship between cardiovascular risk factors and results of exercise test on patients who referred to a hospital in Urmia Iran in 2009. This descriptive study was conducted on 500 patients with typical and non-typical pain referred to the cardiac ward of Taleghani hospital. After the interview examination and laboratory tests، the patients under went ETT with treadmill according to Bruce protocol in four steps. The present study showed that exercise test was positive for 106 (21. 2%) patients. 58 (54. 7%) patients with positive test were male and the majority of them (46 patients) (43. 4%) were between 51-65 years. The results of this study showed that diabetes، hypertension، high age، hyperlipidemia، smoking (over 3 years) and family history of cardiovascular disease have a significance correlation with the result of exercise test. Paying attention to serious signs and symptoms of various diseases is among the main educational priorities for the prevention of cardiac infarction. Exercise test is an important method to diagnostic evaluation of risk factors in cardiovascular patients.

Air pollution has an adverse effect on the health of the whole society. The main objective of the present study was to investigate the effects of climatic factors on the quality of air in Birjand city in the year 2012. In this cross-sectional study، air quality index was calculated among the concentrations of 5 major pollutants. Statistical analysis was performed using the Statistical Analysis Software SPSS17 and ANOVA. The results indicated that the pollutants had exceeded the standard limit in ten days. The study also showed that monoxide carbon and particulate matter are responsible pollutants for air pollution in Birjand city. Statistical analysis represents a significant direct relationship between wind speed with particulate matter and monoxide carbon with temperature. The increase in population، modern life style، login pollutants from the west، vehicles، increased use of fossil fuel and inversion in winter and autumn seasons and also the city of Birjand being surrounded by mountains are some of the main causes for accumulation of pollutants in the air.