intermediary role of self-efficacy in relation with stress, glycosylated haemoglobin and health-related quality of life in patients with type2 diabetes

Stress is not always a direct result of stressful conditions, but rather the way they are perceived. Thus individual variables that may be associated with perceived stress should be examined in stress studies. This study investigates the intermediary role of self-efficacy in relation with stress, glycosylated haemoglobin and health-related quality of life in patients with type2 diabetes. All women with diabetes in Yazd Diabetes Research Centre, in 2012, were considered and 80 women were selected by random sampling. They completed Shirer's self-efficacy scale questionnaire, depression, anxiety and stress scale [DASS], and ADDQ0L19 questionnaire. Then they were introduced to the lab for blood test. Data were analysed by SPSS software and stepwise regression method. Pearson correlation test results showed that the hemoglobin A1c [r = 0.35] and Quality of Life [r = -0.22] are associated with stress [P <0.05]. As so hemoglobin A1c [r = 0.83] and Quality of Life [r = 0.37] with variable of self efficacy are associated positively and significantly [P <0.05]. Results of stepwise regression also showed that self efficacy and stress scales 0.697 of variance hemoglobin A1c and 0.140 of variance of Quality of life explaining to do. The impact of stress on blood sugar and patients' health-related quality of life can be influenced by their self-efficacy; therefore it is suggested that an educational intervention is done to increase patients' self-efficacy to better cope with stress in their life

[Leaf flavonoids of Chrozophora neck [Euphorbiceae] members in Markazi province using chromatographical methods]

Flavonoids are as one set of the polyphenolic compounds among secondary metabolites in different organs of plants that are used in plant chemotaxonomy and pharmacognosy. They have basic role in pollination and life cycle of anthmophyllus plants and also their spreading abroad and survival. The aim of this study was to compare the leaf flavonoids profiles of Chrozophora Neck populations in Markazi Province, Iran. Phytochemical studies on 25 collected Chrozophora populations of 2 species [C. hierosolymitana and C. tinctoria: Euphorbiaceae family] from different parts of Markazi Province area were done using 2-dimentional paper chromatography [2-DPC] and thin layer chromatography [TLC]. Voucher specimens of each population were prepared for reference as herbarium vouchers. Results showed all of populations contain flavonoid sulphates, flavone C and C-/O-glycosides and aglycon. Also all of studied populations have apigenin and quercetin while rutin was just found in 4 populations of C. tinctoria species that is recorded first time for Markazi Province. All of studied populations have flavonoid compounds that have variation in their flavonoid type and number

[Attitudes towards oral health behavior among students of dental schools in Tehran]

Effectiveness of oral health promotion programs requires presence of knowledgeable and prevention-oriented dental workforce. The aim of the present study was to investigate attitudes of dental students and its determinants in Tehran towards prevention based on Hiroshima University-Dental Behavioral Inventory [HU-DBI] questionnaire. A Farsi version of HU-DBI questionnaire was prepared, validated and administered to the pre-clinical and clinical students of three dental schools located in Tehran. Chi-square test and logistic regression model served for statistical analysis. In this cross-sectional study, two-hundred students participated. Women were less likely to agree with the statements "I have noticed some white sticky deposits on my teeth", and "I think I can clean my teeth well without using toothpaste" [P=0.04 and P=0.06, respectively], and more likely to agree with "I think that I cannot help having false teeth when I am old" compared to men [P=0.015]. Differences related to the students' schools also existed in the students' reactions to the items "I have used a dye to see how clean my teeth are" and "I use a toothbrush which has hard bristles". Differences related to the students' study year were also found in their attitudes towards prevention. Dental students' prevention-oriented attitudes seem to be associated with their gender and study year. More emphasis should be placed on prevention in Iranian dental curriculum to overcome those differences in the students' attitudes which are related to background and academic characteristics

Gap analysis between perceptions and expectations of service recipients through servqual approach in Yazd, Afshar hospital

The quality of service is a key ingredient in the success of health care, organizations. Parasuraman, et al [1985] defined service quality as the differences between predicted or expected service [customer expectations] and perceived service [customer perception].Recently, service quality has become an important research topic for of its significant relationship to costs, profitability, customer satisfaction, customer retention and service guarantee. Several tools have therefore been developed to measure service quality but the Parasuraman 22 item servqual questionnaire created based on the gap model remains the most widely used tool in a variety of industries. This study attempts to replicate the servqual measurement of Parasuraman et al in determining the gap between perceptions and expectations of service recipients in Afshar hospital. This descriptive - applied study was carried out cross-sectionally in 2010. The research population consisted of patients admitted to Afshar hospital wards. Totally 84 patients were selected by sample size formula. The data were collected by 22-item servqual questionnaire designed according to gap model. Data analysis was carried out through SPSS and LISREL software using Kolmosrof - Smirnoff and paired sample t -test. The results demonstrated that there was a quality gap in Afshar hospital,that is, there were significant differences between expectations and perceptions of patients in servqual dimensions. Also, the study identified some critical and problematic items that have main roles in constructing observed quality gap. The existing quality gap means patients' expectations exceed their perceptions.Thus improvements are needed to be made across servqual dimensions

[Residual refractive errors following cataract surgery and its determinants]

To evaluate residual refractive errors after cataract surgery and its determinant factors at Farabi Eye Hospital, Tehran. Simple random sampling was done among cataract surgery scheduled patients over a 4 year period [2003-2006]. Exclusion criteria were uveitis, previous intraocular surgery and ocular trauma. After applying the exclusion criteria, 423 patients were studied. Lens calculation was performed using the SRK-II formula. Unexpected refractive errors were defined as the difference between postoperative refractive errors with target refraction. Mean and percentage of this variable were reported based on 0.5, 1 and 2 D of ametropia. Of 558 studied patients, 78.1% had biometric data before and refractive data after surgery. Mean absolute unpredictable refractive error was 0.84 +/- 0.89 D. Eyes with normal axial length [AL] had the least [0.76 +/- 0.84] and those with long AL had the most unpredictable refractive errors [P<0.001]. 45.9%, 73.9%, and 91.7% of the study cases had refractive errors within 0.5, 1 and 2 D of emmetropia, respectively. Eyes with short AL had positive refraction and those with long AL had negative refraction after surgery. The majority of keratometric astigmatism followed extra-capsular surgery while the least measures were associated with phacoemulsification [P<0.001]. Axial length was one of the important factors influencing residual refractive errors after cataract surgery. Unpredictable refractive errors were more common in eyes with long and short AL than those with normal AL

Learning critical thinking in virtual medical education: a qualitative study of faculty members' and students' experiences

Background and Purpose: Critical thinking is a high priority outcome of higher education. With the ever-increasing spread of virtual courses, enhancement in the critical thinking in distance learning has become the center of attention for the stakeholders

The present study was conducted to qualitatively examine the experiences of teachers and students in teaching and learning critical thinking in medical education

Methods and Materials: In this qualitative study, 7 E-teachers and 11 postgraduate E-students of medical education were interviewed using a semi-structured method. All interviews were tape-recorded, transcribed and then analyzed through constant comparison based on Strauss and Corbin's method

Results: Three themes were identified in this study; nature of critical thinking, critical thinking within the framework of medical education discipline; and the teaching-learning process of critical thinking in the virtual environment

Conclusion: The participants' experiences indicated that the learning-teaching of critical thinking in virtual education is affected by teaching strategies, the features of course management software, creation of a learner-centered environment and the role of critical thinking as one of the objectives of curriculum and evaluation

IUD survival and its determinants; a historical cohort study

IUD is one of the safest and most widely used reversible methods of contraception. The purpose of this study was to determine IUD survival and reasons for early discontinuation in Bandar Abbas, south of Iran. Probability of IUD continuation rate and factors associated with discontinuation were assessed in a historical cohort study of 400 women records from March 2002 to February 2004. Data were collected from documents in health centers and interview with subjects. Life tables, Kaplan-Meier, log-rank test and cox regression model were used for data analysis. The continuation rate of using IUD at 6, 12, 18, 24, 30, 36, 42 and 48 month were 92%, 87%, 81%, 75%, 69%, 62%, 56% and 50%, respectively. Counseling and desire to becoming pregnant were associated with continuation rate [P < 0.03]. Furthermore the most important reasons for IUD discontinuation were side effects of IUD followed by pregnancy tendency, health concerns, expulsion, and unsatisfied with the method. Conclusion: This study suggested that women should be fully informed about side effects of IUD before inserting it as well as during its using

Conventional and spiral CT dose indices in Yazd general hospitals, Iran

While the benefits of Computed Tomography [CT] are well known in accurate diagnosis, those benefits are not risk free. CT is a device with higher patient dose in comparison with other conventional radiological procedures. Is the reduction of exposures by requiring optimization of CT procedures [a principle concern in radiological protection]

Organ and effective dose arising from conventional diagnostic X-ray examinations by Monte Carlo simulation [MCNP-4C code]

Monte Carlo simulation has been used by many researchers to calculate organ and effective dose of patients arising from conventional X-ray examinations. In this study the radiation transport code, MCNP-4C, has been used to perform Monte Carlo simulations to estimate radiation dose delivered to different organs in conventional X-ray examinations. In this work we have made use of ORNL mathematical phantoms with few modifications which have been made. The source has been defined as a point source, emitting photons into a solid angle. The X-ray beam was shaped by a collimator to produce a rectangular field at the midline of the phantom. To validate the simulation executed in this study normalized organs doses to unit ESD for hermaphrodite phantom were computed. Our results were compared with corresponding values presented by NRPB. In general organs doses obtained by application of MCNP-4C [present study] and corresponding values presented in NRPB were in good agreement. For further evaluation of our phantom, the values acquired for organ and effective doses by MCNP-4C and ODS-60 were compared. The technique we have developed is capable of estimating organ and effective doses with a better accuracy than dose values obtained by employment of NRPB and ODS-60 technique