[Incidence rate of gastric cancer and its relationship with geographical factors using GIS in Khuzestan Province between 2009 and 2013]

Background and Aim: Cancers have a special place in health programs because of the costs of diagnosis and treatment as well as their irreversible complications. Distribution of diseases and their relationship with certain geographical areas is a confirmed subject producing a scientific background for medical geography. This study aimed to determine the five-year incidence of gastric cancer and its relationship with geographical factors in Khuzestan Province between 2009 and 2013

Materials and Methods: In this cross-sectional study we assessed the incidence rate and relationship of gastric cancer with environmental, geographic and climatic factors. The study included all patients with gastric cancer in Khuzestan Province, between 2009 and 2013. The demographic and pathologic data of the patients had been recorded in a comprehensive cancer registration system. Using SPSS version 16, data were analyzed by independent T-test, Kruskai-Wallis test and ANOVA. Mapping of climatic factors was performed by Arc GIS.ver10.3 software

Results: 1587 patients with gastric cancer had been recorded between 2009 and 2013 in the province's comprehensive cancer registration system. The mean age of the patients was 62.57 +/- 14.17 years. 1047 patients [66%] were male, and 540 [34%] were female. The cumulative incidence of gastric cancer, was estimated as 35 per hundred thousand people. The relationship between gastric cancer and mean rainfall was statistically significant [p: 0.04]

Conclusion: The incidence rates of gastric cancer in different regions of the Khuzestan Province were not the same which can be related to the demographic variables as well as different geographic and climatic factors. Therefore, in order to identify the related risk factors in different regions further epedemeological and etiological studies are recommended

[Association between hypertension and dietary patterns among adults residents of Khorramabad]

Hypertension is a common public health problem, both in the developed and the developing countries. In Iran approximately one in every four adults has high blood pressure. Many factors, e.g dietary pattern, can affect the incidence of high blood pressure. The aim of this study is to determine the relationship between hypertension and dietary patterns. In this cross-sectional study, the 973 participants were residents of Khorramabad. Food intake assessments were measured by a validated semi quantitative 201-item food frequency questionnaire [FFQ]. Hypertension was identified as systolic blood pressure>140 mm/Hg and/or diastolic blood pressure>90 mm/Hg. Dietary patterns were identified by factor analyses. Multivariate logistic regression was used to determine the associations of dietary patterns and hypertension. The three major dietary patterns identified were the Traditional Dietary pattern [TDP], the Healthy Dietary Pattern [HDP], and the Western Dietary Pattern [WDP]. Subjects in the highest quintile of the WDP scores had a greater odds ratio for hypertension [odds ratio: 2; 95% CI: 1.04-3.85; P=0.037] than those in the lowest quintile. Before BMI adjustment, compared with those in the lowest quintile, subjects in the highest quintile of HDP scores had lower odds for hypertension [0.56; 0.34-0.93; P=0.043], a relationship however that was not significant after BMI adjustment [P=0.06]. TDP consumption and hypertension were not significantly associated [0.71; 0.37-1.35; P=0.29]. The WDP had a direct association with the risk of hypertension. More longitudinal studies are needed to clarify the exact association between dietary patterns and hypertension

[Clinical manifestation of patients with acquired pneumonia admitted in the respiratory ward of Imam Khomeini hospital in Ahvaz]

Introduction: Pneumonia is an infection in the gas exchange units of the lung. This disease is one of the most common causes of admission in the hospital. Regarding the pneumonia, we aimed to evaluate the mean age, sex and incidence of some important clinical manifestation and the duration of the admission in the hospital

Methodology: In this cross sectional cases were selected from patients referring to Imam Khomeini hospital in Ahvaz during 2007-2004 with the diagnosis of the Community Acquired Pneumonia. During this study 365 patients were evaluated. Patients› data such as age, sex, and clinical manifestation were collected using a questionnaire and analyzed by statistical software

Results: Mean age of the 365 patients was 60.6 years. Out of them 47.4% were <65 years old and 52.6% were > 65 years old. 51.2% were male and 48.8% were female. Most common manifestations were cough [87.9%], dyspnea [81.4%], sputum [72.9%] and fever [55.6%] respectively, and hemoptysis with 24.1% was the least common manifestation

Conclusion: This study showed high prevalence of community acquired pneumonia in the studied population. It also showed that age and sex are effective factors in the presentation of the clinical manifestations of this disease

[Nursing professional excellence: mutual effect of the talent management and professional extra role behaviors]

Introduction: Improvement and progress of each organization depending on the staff and situations improvement. Knowledge is a base of the knowledge oriented organization and excellent staff can make knowledge to the excellent services and products. To have an excellent organization we need to knowledgeable, motivated and excited personnel to have an excellent organization. This motivation and knowledge along with self believe can cause the bright results. To achieve to this results we need to convergent, satisfaction, general identification and cultural strategies that these strategies are in the professional excellence and including productivity, active, efficient, independent and knowledge oriented personnel. Therefore it is necessary to clear the professional excellence process systematically. This research aimed to explain the process of the professional excellence of nurses, assisted by "Grounded" Theory

Method: This qualitative study was carried out on the basis of "Grounded Theory" of Corbin and Strauss copy in 2008. Participants in this study were among nurses and from different ranks. Participants were selected based on assigned indicators, "Snowball Sampling Method" and theoric. Data are collected through in depth semi-structural interview. In this study, nineteen interviews were held with fifteen participants

Results: Upon the analysis of the data and doing constant comparisons for the purpose of conceptual accumulation, 1450 primary codes, 35 primary category,8 sub category and 3 themes were derived in the frame of a conceptual model that consisting of extra role professional behaviors, strategic professional insight, and the professional talents management

Conclusion: The research results imply to the differences between excellence nurses behaviors' and their specific characteristics. Emerge of the extra role behaviors need to abet and prod. The role of the managers is important in this situation. They should deduct the appropriate policy and strategies for emerging of the extra role behaviors in nurses and improve quality of care services. With application of the nursing professional excellence model in medical centers, we can insure the quality of care services and commitment to continual improvement of the nursing services

[Survey on satisfaction from quality of passed educational course from last year students' perspective of Hamadan university of medical sciences]

Introduction: Using a descriptive cross-sectional approach, this study was conducted to assess the quality of passed educational course among different medical sciences' disciplines in Hamadan University of Medical Sciences in 2010

Methods: Including last year students of all disciplines of Hamadan University of Medical Sciences as study population, this research was done. Consequently, random stratified sampling was performed among last year students of each. Data were collected by applying a two-parted questionnaire as: A] Demographic section [such as age, gender, type of discipline, level of interest about discipline when arrived, level of interest to discipline at commence and now [last year] and etc. B] CEQ questions that's about teaching, aims and standards, whole content of lessons, material and resources, evaluation and general satisfaction. Data were analyzed by statistical software SPSS16 using descriptive statistics and correlation coefficient

Results: The results indicated that there was a significant relation between students' satisfaction on the quality of passed educational course and level of interest regarding to discipline at the last year of study. Minimum correlation revealed between total CEQ score and its various parts in evaluation part. Maximum CEQ score was gotten in Dentistry and minimum of it was obtained in Emergency Medicine Technicians

Conclusion: Data indicated that the competent, up-dated and expert teachers together with appropriate clinical education, suitable teaching-learning occurrence and interest to the discipline at entrance are all most important influencing factors on satisfaction of quality of passed educational course

[Decision making in prehospital emergency nurses: a qualitative research]

The patients' first encounter is usually with the prehospital emergency. In order to meet the clients and beneficiaries' needs, it is necessary the prehospital emergency nurses be a competent decision maker based on the patients' unstable conditions. This study aims to examine the factors influencing on the manner of prehospital emergency nurses' decision making in emergencies and during the mission. In this qualitative study, 18 nurses of prehospital emergency bases of Shahrekord University of medical sciences were studied. Data was collected by using semi-structured and in-depth interviews, and also it was used content analysis to analyze the qualitative data. The interviews were transcribed verbatim and analyzed concurrently with the data collection. By analyzing the data, five main themes were known as the influencing factors in prehospital emergency nurses' decision making which are as follows: 1] patient-related factors; 2] nurse-related factors; 3] environmental factors; 4] colleagues related factors; 5] the factors related with the type of event and mission. The findings provide a deep understanding of the effective factors in prehospital emergency nurses' decision making. Deep understanding of the manner of prehospital emergency nurses' decision making can facilitate more effective decisions in emergencies, during the mission as well as its related factors and also influence on the output of nursing and medical cares

[ investigation of the effect of rehabilitation program on the spastic diplegia patients' oxygen pulse and aerobic capacity]

Despite the voluminous amount of studies in the field of exercise sciences over the past three decades, there remains a paucity of information on the activity patterns and physiological responses to exercise in people with disability. The aim of this study was to investigate the effect of an exercise-rehabilitation aerobic program on the cardiovascular fitness, maximal oxygen uptake [VO[2 max]] and oxygen pulse for children with spastic cerebral palsy [Diplegia] and their comparison with healthy children. The experimental group for this semiexperimental study comprised of 18 [10-14 years old] diplegic spastic cerebral palsy children [CP] with average height [131 +/- 6.34 cm] and weight [29.83 +/- 5.64 Kg] selected with the consent of their parents as well as specialist physician. Eighteen normal children were randomly designated as the control group. The variables of the experimental group were measured before and after the exercise-rehabilitation program according to Mac Master protocol on cycle ergometer at the laboratory conditions. Then these values were compaired with those of the control group. The experimental group performed exercise program for a period of three months, three times a week with intensity average 144 bpm of heart rate. Each session lasted 20-25 minutes for each subject. The exercise-rehabilitation program led to enhancement of the maximal oxygen uptake [VO[2 max]] at the patient group. The oxygen pulse [VO[2]/HR] of the patient group was significantly lower than that of the normal group and the exercise program improved this variable [p<0.05]. This study indicated that in the spastic patients the lack of activity and being sedentary for a long time increases spasticity, the involuntary movements lead to a decrease in cardiovascular fitness and aerobic capasity and an increase in energy cost during exercise or daily activity as compared with normal people. The Rehabilitation program and exercise, even for short time or at low intensity leads to an improvement in the variables under study and enhances cardiovascular efficiency in these patients