Inequalities in access to hospitals: a case study in the Islamic Republic of Iran 1997–2012

Background: Nowadays, the significance of applying Geographic information system (GIS) to survey accessibility to hospitals and understanding disparities in this regard has increased.

Aims: The main aim of this descriptive–analytical research was to study the spatial accessibility of the population of Kermanshah for 3 years 1997 (n=693157), 2007 (n=794863), and 2012 (n=851 405) to hospitals based on age and gender groups through GIS.

Methods: The study was conducted based on network analysis models, mean centre, and standard distance in the environment of Arc/GIS. A standard radius of 1500 metres was set for the medical centres, and a 25-minute walking span was set for the distance of each person from home to the nearest hospital.

Results: The results of the network analysis demonstrated that the hospitals were inaccessible to the populations according to our criteria, and their geographical access to hospitals measured 68.80%, 64.23% and 66.20% in 1997, 2007, and 2012, respectively. Women aged 65 years and above were more at risk in this regard.

Conclusions: Over the total period under study, the results revealed that hospitals were concentrated in the central and southern areas of Kermanshah

Mediator role of experiential avoidance in relationship of perceived stress and alexithymia with mental health

This cross-sectional study investigated the mediatory role of experiential avoidance in the relationship between perceived stress and alexithymia with mental health. We enrolled 440 students [age 18-30 years] at Kermanshah University of Medical Sciences through stratified random sampling method. The study tools were demographic checklist, GHQ-28, Toronto Alexithymia Scale-20 and Perceived Stress Scale. Data were analysed by SPSS-18 and AMOS-18 using Pearson correlation, hierarchical regression analysis and structural equation modelling [SEM]. There was a significant positive correlation between perceived stress and experiential avoidance, and alexithymia and mental health problems [P < 0.001]. SEM showed that the relationship between perceived stress and mental health problems by experiential avoidance was 0.19 [[beta = 0.19; standard error [SE] = 0.09; P = 0.001], and the relationship between alexithymia and mental health problems through experiential avoidance was 0.09 [beta = 0.09; SE = 0.43; P = 0.01]. The mediatory role of experiential avoidance was confirmed in such a way that the effects of alexithymia and perceived stress decreased

Perceived Stress, Alexithymia, and Psychological Health as Predictors of Sedative Abuse / 가정의학회지

BACKGROUND: The harmful effects of sedative medications and substances in conjunction with limited research regarding predictive psychological constructs of drug abuse necessitate further investigation of associated factors. Therefore, the present study aimed to elucidate the roles of perceived stress, alexithymia, and psychological health as predictors of sedative abuse in medical students. METHODS: In this cross-sectional study, 548 students at Kermanshah University of Medical Sciences, Iran, were selected using stratified random sampling. The data were obtained using the Perceived Stress Scale, an alexithymia scale (Farsi version of the Toronto Alexithymia Scale-20), and a General Health Questionnaire to assess psychological health. Data were analyzed using discriminant analyses. RESULTS: The results demonstrated that the user and non-user of sedative substances groups had significantly different predictive variables (except for social function disorder) (P>0.05). Physical complaints, alexithymia, and perceived stress, which had standard coefficients of 0.80, 0.60, and -0.27, respectively, predicted sedative drug use. CONCLUSION: The results of the present study indicate that perceived stress, alexithymia, physical complaints, anxiety, and depression are associated with sedative drug abuse.

relationship between rural women's health-related quality of life and domestic violence

Nowadays, by development of societies, health related quality of life has become a very important issue. Traditionally for health assessment, some indexes such as; morbidity, mortality, and life expectancy, have been taken into consideration but these factors are not able to assess life satisfaction. The present study was aimed to investigate the relationship between rural women's health-related quality of life [HRQOL] and domestic violence. This cross-sectional study was carried out in the rural districts of Kermanshah, Iran, 2012. Using multistage cluster sampling, 394 women were selected. They completed WHOQOL-BREF and Conflict Tactics Scale [CTS] questionnaires. Data analyzed by SPSS 16, using Pearson correlation and regression tests. The mean scores of total QOL were 55.8 +/- 12.9. There was significant inverse correlation between domestic violence dimensions and all health-related quality of life domains [P < 0.01]. Domestic violence can affect rural women's health-related quality of life negatively. Regarding the hidden nature of domestic violence and its presence in all communities, taking into consideration policies to reduce violence through legal education and raising women awareness can positively affect women's quality of life

effects of acetazolamide on ischemia reperfused isolated hearts of 2- and 8-week-old rabbits

To investigate the effects of acetazolamide on the ischemia-reperfused isolated hearts of 2- and 8-week-old rabbits. This study was conducted at the Kermanshah Medical Biology Research Center, Kermanshah, Iran from March to September 2011. Two- [n=17] and 8-week old [n=17] rabbits were separately divided into 2 control [n=9], and test [n=8] groups. Isolated hearts were subjected to 35 minutes ischemia and 30 minutes reperfusion. Acetazolamide [100 microgr/l] was added to the perfusion solution for 10 minutes before ischemia in the test group. Cardiac parameters including ventricular pressure, heart rate [HR], and rate pressure product [RPP] were measured. Data sets were analyzed by t-test. Following acetazolamide administration the change percentage of HR was significantly different in the 2-week [91 +/- 1.1%] compared with the 8- week [96 +/- 0.8%] test groups [p=0.0016]. Recovery percentage of RPP in reperfusion was lower [p=0.005] in the 8- [28.9 +/- 3.4%] than the 2-week test groups [45.2 +/- 3.5%]. The 2-week hearts elicited more rapid response to carbonic anhydrase [CA] inhibition than the 8-week group. However, acetazolamide does not exacerbate ischemia-reperfusion [I/R] injury in the 2-week hearts. Therefore, it was revealed that after inhibition of CA, the age dependent pattern of I/ R injury was similar to that of the normal hearts. Inspite of the CA important role in the normal heart function, it is not a determining factor in I/R injury in different ages

effect of repeated diazepam administration on myocardial function in the ischemia-reperfused isolated rat heart

To evaluate whether repeated diazepam administration affects the heart in ischemia- reperfusion. This study was performed at the Medical Biology Research Center, Kermanshah, Iran, from March to September 2008. Four groups of rats were subjected to a daily injection of diazepam [group 1 [0.5 mg/kg for 21 days], group II [2.5 mg/kg for 5 days], and group III [5 mg/kg for 5 days] intraperitoneally], and saline solution [21 days] in the control groups. Isolated, perfused hearts were subjected to 40 minutes global ischemia, and 45 minutes reperfusion. The left ventricular developed pressure [LVDP], heart rate, and coronary flow were measured. Rate pressure product [RPP] was calculated. In reperfusion, released lactate dehydrogenase [LDH] enzyme in effluent was measured. It was observed that the recovery of the RPP and LVDP in reperfusion significantly decreased in the test group III [n=9] in comparison to the control [n=8]. During the reperfusion period, the released LDH significantly increased in test group II [n=8] and group III in comparison with the control. The results show that repeated administration of diazepam [5 mg/kg for 5 days] reduced the cardiac performance in reperfusion, and significantly exacerbated the ischemia-reperfusion injury. It is probably mediated by the changing of cardiac susceptibility in ischemia due to repeated administration of diazepam

effects of diazepam in cardio depressant concentration on the function of isolated rat heart in ischemia-reperfusion

To investigate the effects of cardio depressant concentration of diazepam on the function of isolated rat heart in ischemia-reperfusion. This study was performed at the Medical Biology Research Center, Kermanshah, Iran from November 2006 to March 2007. Isolated, perfused rat hearts were subjected to 40 minutes normothermic global ischemia and 45 minutes reperfusion. Diazepam 100 micro molar was added to the perfusion solution for 10 minutes before ischemia in the test group. Different cardiac variables including left ventricular developed pressure, heart rate, and coronary flow CF were measured. Rate pressure product RPP was calculated, during the ischemic period time until onset of ischemic contracture and maximum contracture were determined. In reperfusion, released lactate dehydrogenase enzyme in effluent was measured and cardiac functional recovery was determined. It was found that diazepam significantly decreased RPP and increased CF before ischemia. In the diazepam group n=10, during ischemia, maximum contracture was significantly lower than the control group n=14. Also, diazepam significantly increased functional recovery and coronary flow in reperfusion. Diazepam 100 micro molar significantly decreased maximum contracture during ischemia, improved the recovery of myocardial function and CF in reperfusion. The results show that the cardio depressant concentration of diazepam is safe and relatively protective in the ischemia-reperfused isolated rat heart. These effects may be mediated by inhibition of calcium current in cardiomyocytes