Impact of twice weekly versus daily iron supplementation during pregnancy on maternal and fetal haematological indices: a randomized clinical trial

A randomized clinical trial examined the efficiency and tolerability of twice weekly versus daily iron supplementation during pregnancy. A total of 370 pregnant women were randomly assigned to receive either daily or twice weekly iron supplementation during pregnancy. There were no significant differences in initial and delivery haemoglobin and haematocrit levels between the 2 groups. Ferritin concentrations were significantly lower in the twice weekly group at delivery, but hypoferritinaemia [ferritin < 15 microg/L] was not observed in either group. The frequency of nausea, vomiting and constipation were significantly lower in the twice weekly group. Birth weight and length were significantly higher in the daily supplemented group. In non-anaemic mothers, a smaller dose of iron may be sufficient and also might prevent the complications of iron excess

Assessing hospital performance by the pabon lasso model

The Pabon Lasso model was applied to assess the performance of six State-run hospitals in the province of Kohgilooyeh and Boyer-Ahmad, to produce information that used by policy makers in their attempt to make the health care system more productive. This cross-sectional study involved all the six public hospitals in the province, with 607 registered beds. Data collection accomplished by the use of two ad hoc questionnaires that dealt with both general information and admission data from various hospital wards. The statistical software SPSS-13 used to derive three basic performance indicators, namely average length of stay, bed occupancy rate and bed turnover, which analyzed in Pabon Lasso model. The overall average length of stay, bed occupancy and bed turnover rates were 2.99 days, 62.78% and 76.73 respectively. Two hospitals were in Zone III of the model, indicating a satisfactory level of efficiency. Three hospitals demonstrated inefficiency and underutilization of resources by falling into Zone I. one hospital placed in Zone IV. The best approach to address the existing inefficiencies would lie in stopping the expansion of the current facilities [e.g. not adding any more beds]. As any further expansion will only serve to make hospitals more inefficient. Future research should focus on why the performance is not at a desirable level and how the situation can be improved

Small group teaching in epidemiology courses

Small group teaching [SGT] is a known method for developing intellectual skills, changing attitudes and encouraging the taking of responsibilities for learning. This study was an attempt to compare students' attitudes and knowledge scores on SGT and lecture -based teaching [LBT]. 22 first year medical students were enrolled in a course using two methods [lecture- based and small group discussion] for teaching basic epidemiology. Data about attitudes and knowledge scores of the two methods were collected at the end of the course and analyzed using a two-sided Wilcoxon test. The students were satisfied and preferred SGT in terms of Evaluation method for the course, Participatory learning and team working, effectiveness and developing self learning skills [P<0.001], and scored higher on topics of SGT [p<0.01], but believed that they needed longer discussion of the topics. Better question design and course organization and creating a safe, comfortable environment is essential for good performance. Integrating this teaching strategy in medical education curricula with appropriate professional and organizational development is suggested

Patterns of contraceptive use in urban areas of Kohgiluyeh-Boyerahmad in 2004

Achieving comprehensive reproductive health services, including family planning as the basis of family health and sexual health, has been internationally the main objective of governments and health policy makers in the past decades. Improving modern family planning facilities would lead to a promotion in population control. This study investigates family planning indices, its short comings and mean of reproductive variables in the urban areas of Kohgiluyeh-Boyerahmad province in comparison with the data from Demographic Health Survey carried out in Iran in 2000. Considering the high coverage of households by urban health centers in the province, 1540 married women were randomly selected from the list of names in each health center and they were interviewed during 2004. A researcher-devised questionnaire, [content validity determined by experts], was used consisting of demographic variables, family planning awareness status methods, the contraceptive method used by the couples and the number of a desired and live children. Using SPSS, version 13, the data were analyzed in a descriptive-analytical fashion with a significance level of 0.05. The mean age of the respondents was 33.2 +/- 9.4 years. The mean numbers of pregnancies and children were 3.7 and 3.2 respectively. There was a significant relation between the mean number of children and women's educational status and job [p-value <0.001]. A significant difference was also observed between the mean and the desired number of children [t=4.46, p-value <0.001]. The most common family planning methods were OCP and TL [40.4% and 18.7% respectively]. The highest knowledge about family planning methods was on OCP, condom and TL [94%, 65.4% and 45.2% respectively]. Highest number of women with one child and women with >/= 3 children were in the 21-30 and 31-40 age groups respectively. The findings indicate that family planning programs have had a relatively appropriate effectiveness on population control in Kohgiluyeh-Boyerahmad province and family dimension is relatively satisfactory but despite better knowledge about modern contraceptives, use of modern family planning methods is not desirable. Considering the high number of children by women from older age groups, the need for educating and promoting the use of modern contraceptives is still of importance