[Effect of education on management of blood glucose in children with diabetes]

Adequate education of patients and good metabolic control can improve clinical outcome in children with diabetes. This study aimed to investigate the effect of education on management of glycemic control in diabetic children aged 10 to 14 years in Diabetes Research Center of Hamadan, Iran in 2013. This quasi-experimental study had a single-group with pre-post test design. Forty diabetic children from 10 to 14 years of age were selected by random sampling. In order to empower them, we conducted four sessions of group training; each session took 30 to 45-minutes. The scales included a record form of blood glucose levels and diabetic children behavioral management questionnaire. Cronbach's alpha of 0.74 -0.93 indicated stability of the questionnaire domains. Data analysis was conducted using SPSS version 19 using descriptive statistics and paired t-test, Kolmogorov-Smirnov, and Pearson correlation coefficient at 95% confidence level. There was a statistically significant difference between mean scores of behavioral management of diabetic children in four domains: "blood glucose measurement [t=7.44, P<0.001]", "following principles of insulin therapy [t=7.43, P<0.001]", Observing Dietary Behaviors [t=9.72, P<0.001] and "physical activities [t=12.18, P<0.001] ". Moreover, there was a statistically significant difference between mean level of recorded blood glucose in the diabetic children a week before and a week after training intervention [t=-3.97, P<0.001]; as well as, between mean level of glycosylated hemoglobin before and three months after the intervention [t=-5.23, P<0.001]. Systematic training and empowering children with diabetes aged 10-14 years to perform blood glucose measurements, observing insulin therapy principles, Observing Dietary Behaviors, and doing physical activities reduces blood glucose and HbA1C. Therefore, systematic training and involvement of diabetic children in the care and treatment can improve management of blood glucose

clinicopathological survey of basal cell carcinoma in an iranian population

Statement of Problem: Basal cell carcinoma [BCC], the most common skin cancer, is a locally invasive malignant epidermal tumor with ulceration and destruction of underlying structures

Purpose: The purpose of this study was clinicopathological evaluation of BCC in the state and the private pathology centers in Hamadan province during 1990-2010

Materials and Method: In this retrospective study all histopathologically proven cases of BCC were reviewed and the related information including age, gender, place of residency and number of tumors for the patients alongside with the site of occurrence, size, histopathological and clinical type of the lesions were collected and then statistically analyzed, using SPSS software

Results: A total of 804 incidents of BCC were diagnosed in 746 patients [296 females and 450 males] with the most affected site being in the head-face [84.8%], neck [2.6%], trunk [1.6%] and limbs [0.9 %] and 10.1% cases with unknown site. The mean age for the patients was 61.77+/-13.75 years [63.07+/- 13.44 for males, 59.81 +/- 14.01 for females] and the highest frequency [27.2%] occurred among 60-69 years age group. Nodular type was the most common clinical and histopathological BCC lesions studied whereas the mean size of the lesions was 15.67 +/- 11.06 mm with more frequency rate in urban than rural regions

Conclusion: This study focuses on the survey of BCC in Hamadan province but regarding to insufficiency of the data collected by state and provincial pathology centers about the BCC cases reported; it is highly recommended to apply comprehensive questionnaire, which are designated by skillful professionals who are familiar with the lesion nationally

[Association between perceived social support and quality of life in patients with heart failure]

Patient with heart failure have a low quality of life because of experiencing emotional, financial, and physical pressures. Perceived social support plays an important role in health maintenance and reducing negative effects of environmental and social related stressors. This study was conducted with the aim of determining the association between perceived social support and quality of life in patients with heart failure. It was cross- sectional, correlational study. The study sample consisted of heart failure patients admitted to Hamedan city educational heart centers from 2008. Sixty patients were recruited by purposeful sampling. Data was collected by Minnesota Living with Heart Failure Questionnaire [MLHFQ] and perceived social support in heart failure questionnaire and analyzed using SPSS-PC [v.13]. The finding indicated that%46.7 of the patients have enjoyed moderate levels of quality of life and%61.7 have enjoyed low levels of perceived social support. There was a significant relationship between perceived social support and quality of life [r=0.721, p=0.00]. The results reveals the importance of health sector professionals' attention to perceived social support. Therefore nurses should pay more attention to designing supportive and effective care programs to help to promote the quality of life of these patients

Effect of educational interventions based on theory of planned behavior [TPB] in selecting delivery mode among pregnant women referred to Rasht health centers

In recent years, most developed countries have aimed at reducing the cesarean rate through education and other interventions. In our country, however, despite all efforts, the cesarean rate remains very high. The aim of this study was to determine the effects of educational intervention based on the Theory of Planned Behavior [TPB] on choosing delivery mode in pregnant women, who were referred to the Rasht Health Centers. This quasi-experimental study included 72 pregnant women referred to various Health Centers in Rasht in the spring and summer of 2010. After a pre-test by using a valid and reliable questionnaire for both groups, specific training was provided for the intervention group based on the Theory of Planned Behavior. At the end of the pregnancies, post-test were performed in both groups and the results were analyzed by SPSS-13 software. The results indicate that there were significant differences in the mean knowledge, evaluations of behavioral outcome, attitude [P =0.000], perceived behavioral control, subjective norms, and behavioral intention [P < 0.05] among pregnant women in the test group compared with the control. There was a significant difference in behavior between the two groups [P < 0.05]. The results show that maternal educations in the field for persuasion of normal delivery had been effective. Therefore, we recommend implementing training programs based on Theory of Planned Behavior, in order to persuade pregnant women for normal delivery and decreasing the rate of the cesarean section

Classification of death rate due to women's cancers in different countries

The two most frequently diagnosed cancers among women worldwide are breast and cervical cancers. The objective of the present study was to classify the different countries based on the death rates from sex specific cancers. In this cross-sectional study, we used dataset regarding death rate from breast, cervical, uterine, and ovarian cancers in 190 countries worldwide reported by World Health Organization. Normal mixture models were fitted with different numbers of components to these data. The model's parameters estimated using the EM algorithm. Then, appropriate number of components was determined and was selected the best-fit model using the BIC criteria. Next, model-based clustering was used to allocate the world countries into different clusters based on the distribution of women's cancers. The MIXMOD program using MATLAB software was used for data analysis. The best model selected with four components. Then, countries were allocated into four clusters including 43 [23%] in the first cluster, 28 [14%] in the second cluster, 75 [39%] in the third cluster, and 44 [24%] in the fourth cluster. Most countries in South America were to the first cluster. In addition, most countries in Africa, Central, and Southeast Asia were located to the third cluster. Furthermore, the fourth cluster consisted of Pacific continent, North America and European countries. Considering the benefits of clustering based on normal mixture models, it seems that can be applied this method in wide variety of medical and public heath contexts

Evaluation of pre-analytical biopsy specimen errors in the pathology laboratory of Hamadan school of dentistry [2009-2010]

Statement of Problem: Oral biopsy is important in the definite diagnosis of oral and maxillofacial lesions. This procedure as well as other laboratory services is prone to errors affecting the patients' safety

Purpose: The purpose of this study was to evaluate pre-analytical biopsy specimen errors in the Oral Pathology Laboratory of Hamedan School of Dentistry, west of Iran

Materials and Method: Ninety-one oral biopsy samples, obtained from departments of oral and maxillofacial surgery [34 samples, 37.3%], oral medicine [22 samples, 24.3%] and periodontics [10 samples, 10.9%], as well as private offices [16 samples, 17.6%] and hospitals [9 samples, 9.9%] were received and evaluated in the Oral Pathology Laboratory of Hamedan School of Dentistry considering pre-analytical errors

Results: The errors in the request forms included unmentioned names of patients [7.7%], age [3.3%], clinical history [4.4%], site of biopsy [10.9%], differential diagnosis [18.7%] and the name of the requesting clinician [8.8%], as well as lack of radiographs [4.4%] and previous biopsy results [2.2%]. Use of inappropriate fixative [5%], and specimen-containers with non-proportional volume [3%], and their small size inlets [3%] was also reported. Non-standard containers were seen in 19% of the cases, and mislabeling errors [31 missed, 2 incomplete defects, and 1 incorrect] in 34% of the cases. Of 105 specimens, 6.67% were small in size, 1.90% superficially removed, and 0.95% had been traumatized. Out of the 5 containers with more than one specimen, 4 containers did not have any markers

Conclusion: Considering the biopsy errors in the study specimens, training and surveillance to reduce the frequency of such errors seems necessary

[Women's attitudes toward elective delivery mode based on the theory of planned behavior]

Cesarean section [CS] delivery is more risky than normal vaginal one for both mothers and neonates. However, due to various reasons, the rate of CS is rising unfortunately. Unawareness and unfounded attitudes are among the more common reasons for this increasing rate of CS. To survey women's attitudes toward elective delivery mode based on the Theory of Planned Behavior [TPB] in Rasht, northern Iran. This descriptive-analytical study was carried out with 207 women referred to health centers in Rasht, using cluster sampling, in winter 2010. Questionnaires were used to collect the respective data which were analyzed by SPSS-13. Findings showed that 43% of the women have had normal vaginal delivery, 36.2% caesarean section for medical reasons and 20.7% elective cesarean section. In the elective cesarean section group, the mean scores of knowledge, attitude, evaluation result and perceived behavioral control were 42.56, 55.87, 60.33 and 47.28, respectively. The tendency of more than 70% of the women was CS absolutely while the two other groups favored normal delivery. All the three groups support the physician as the best source to consult for the selection of delivery mode. As demonstrated, the mean scores of knowledge, attitude, evaluation result and perceived behavioral control for the women with elective cesarean section were lower than the corresponding scores for the two other groups. Since the majority of the women in the study were primiparous, appropriate strategies including training programs for pregnant women and young girls based on behavioral theories and models such as TPB, and counseling with families, arranged by health centers and the mass media can be suggested

Determinants number of cigarette smoked with Iranian adolescents: a multilevel zero inflated poisson regression model

The present study was conducted to know about the association between amount of smoking and mental health plus demographic factors in the Iranian adolescents. Data of this research was drawn from the National Health Survey in Iran from April 1999-March 2000. All 1745 adolescents aged 15-20 yr that were residence in the eight northwest provinces of Iran, were included in this study. In order to evident zero-inflation and because of sampling design, multilevel zero-inflated Poisson [ZIP] regression applied for analysis of data. We analyzed data with programs written with s-plus. Zero-inflated part of ZIP model shows that gender of female effects to increase the chance of "not to smoke cigarette at all" [P< 0.001] and older adolescents are less at risk of smoking than younger [P= 0.036]. It also shows that, unemployed [P= 0.028] and Housewife [P= 0. 003], adolescents are more at risk of smoking compare with student adolescents. Under Poisson part of this model, depression [P= 0.012] and gender of female [P< 0.001] are indirectly associated with number of cigarette smoked per day by adolescents. Among adolescent smokers, males smoke more number of cigarettes than females, younger teenager are more at risk of being a smoker than older ones and dropping out of high school is an important risk factor for smoking. We did not find any relation between mental disorders and being a smoker while we did for the relation between Number of Smoked Cigarette [NSC] and depression

Evaluation of injuries among a manufacturing industry staff in Iran

Occupational injury is related to personal characteristics. This phenomenon is a controversial issue. This paper presents the relationships of certain occupational and individual characteristics with frequency of occupational injuries. A standardized injury questionnaire was completed for 199 employees in a big Iranian industrial company [MAPNA Group] by the researcher in the presence of the subjects. The data were analyzed using zero-inflated Poisson regression with random effects. We demonstrated a significant relation between the marital status [P< 0.001] and score of injures [P < 0.001] with number of injuries by employees. Technicians and supervisors have high chance of [not to be injured at all] relative to workers [P< 0.05]. Technicians and supervisors have less number of injuring than workers have [P< 0.05]. In addition, increasing assessment score decreases the number of injuring of employees [P< 0.001]. Due to being aware of the risks and remedial measures, married employees and workers should be assisted by occupational specialists

[Postretirement employment and quality of life [QOL] indicators]

The number of elderly persons in our country [more than 7.8% of Iran population] is increasing more and more. Tehran province has the most number of retired with male to female ratio: 2/1. So, in the field of [quality of life] [QOL] increasing needs for giving care [physical and socioeconomic] to these groups have been appeared. In view of the aging process in our population there is a need to identify effective methods to prevent disadvantageous effects of this trend. The main purpose of this research was assessment and comparing of health-related quality of life [HRQOL] between retired staffs and labors. Also the effect of postretirement employment on HRQOL was explored. This study was carried out cross-sectionally and with the participation of 80 retired labor men and 80 retired staff men in Tehran University of medical science. The main purpose of this research was assessment and comparing of QOL items between retired staffs and labors. Also the effect of postretirement employment on QOL items was explored. Other variables such as; age, marriage status, education grade, house ownership were assessed too. In this research, we studied QOL variables in terms of quantitative and used t test. Finding showed that in retired staffs and labors, there was significant difference between quality of life variables. In other word, in staff group in comparison with labors group, there was better state from aspect of physical function, role- physical limitation, general health, social function, mental health, role-emotional limitation, total scores of physical health, mental health and quality of life. These differences were significant. There was a significant relationship between postretirement employment and quality of life [QOL] variables such as: physical function, role- physical limitation, role-emotional limitation, vitality, total scores of physical health, mental health and quality of life. Quality of life in elderly and retirees has relationship with all aspect of health and been influenced by many factors such as economic, mental, physical and social factors. So, based to these conclusions and similar studies, we can go toward quality of life promotion and increasing of community participations. Doing educational, cultural planning and policy making base upon real needs of elderly and retired can be mentioned. The overall improvement of self-reported QOL among elderly people suggests that the onset of disabilities could be postponed, especially if health-related circumstances were more evenly distributed at the start of or even before retirement age. These results suggest we should design appropriate programs to increase elderly people's interaction with others and establish new social networks for them which may enhance a sense of positive self-concept