[ intersectoral collaboration document for cancer risk factors reduction: method and stakeholder analysis]

Cancers are one of the most important public health issues and the third leading cause of mortality after cardiovascular diseases and injuries in Iran. The most common cancers reported in the recent years have been included skin, stomach, breast, colon, bladder, leukemia, and esophagus respectively. Control of cancer as one of the three main health system priorities of Iran, needs a specific roadmap and clear task definition for involved organizations. This study provides stakeholder analysis include determining the roles of Ministry of Health and Medical Education as the custodian of the national health and the duties of other beneficiary organizations to reduce the risk of cancer for cooperation with a scientific approach and systematic methodology. This health system research project was performed by participation of Social Determinants of Health Research Center of Shahid Beheshti University of Medical Sciences, Office of the Non-Communicable Diseases of the Ministry of Health and Medical Education and other stakeholders in 2013. At first, the strategic committee was established and the stakeholders were identified and analyzed. Then the quantitative data were collected by searching in national database concern incidence, prevalence, and burden of all types of cancers. At the last with the qualitative approach, a systematic review of the studies, documents and reports was conducted as well as conversing for the national strategic plans of Iran and other countries and the experts' views regarding management of the cancer risk factors. In practice, role and responsibilities of each stakeholder were practically analyzed. Then the risk factors identified and the effective evidence-based interventions were determined for each cancer and finally the role of the Ministry of Health were set as the responsible or co-worker and also the role of the other organizations separately clarified in each case

Research network of Tehran defined population: methodology and establishment

Background: We need a defined population for determining prevalence and incidence of diseases, as well as conducting interventional, cohort and longitudinal studies, calculating correct and timely public health indicators, assessing actual health needs of community, performing educational programs and interventions to promote healthy lifestyle, and enhancing quality of primary health services. The objective of this project was to determine a defined population which is representative of Tehran, the Capital of Iran. This article reports the methodology and establishment of the research network of Tehran defined population

Methods: This project started by selecting two urban health centers from each of the five district health centers affiliated to Shahid Beheshti University of Medical Sciences in 2012. Inside each selected urban health center, one defined population research station was established. Two new centers have been added during 2013 and 2014. For the time being, the number of the covered population of the network has reached 40000 individuals. The most important criterion for the defined population has been to be representative of the population of Tehran. For this, we selected two urban health centers from 12 of 22 municipality districts and from each of the five different socioeconomic of Greater Tehran. Merely 80000 individuals in neighborhoods of each defined population research station were considered as control group of the project

Findings: Totally we selected 12 defined population research stations and their under-covered population developed a defined population which is representative of Tehran population

Conclusion: a population lab is ready now in metropolitan of Tehran

[Comparison of the performance of health volunteers in the health centers of Shahid Beheshti university of medical sciences]

Health volunteers are the women who do charity work to prevent, protect and promote the health status of the covered neighbors and hereby cooperate with the health centers. The aim of this study was to compare the health volunteer's performance in the covered health centers by Shahid Beheshti University of Medical Sciences. This descriptive- analytical study was performed by the participation of 2060 Health volunteers, who were cooperating with 90 covered health centers by Shahid Beheshti University of Medical Sciences. These include Shomal, Shargh, Shemiranat, Pakdasht, Damavand and Firoozkooh. We used census sampling method. Demographic data was gathered through interviews with the health volunteers and their performance evaluated by the supervisor of the volunteers; through the evaluation forms and these data gathered together. The mean [SD] of the health volunteers performance was 30.9 [16.4] in all centers. They were 35.1 [22] in Shargh, 34 [14.5] in Shomal, 32 [11.3] in Firoozkooh, 28.3 [14] in Shemiranat, 7.9 [9.2] in Damavand and 23.6 [8.5] in Pakdasht respectively. The mean [SD] of the efficacy of health volunteers was 8.6 [9.9] in all centers. They were 11.7 [5.6] in Firoozkooh, 10.7 [15.7] in Shargh, 9.4 [6.8] in Shomal, 7.9 [4.9] in Damavand, 7.9 [6.1] in Shemiranat and 4.6 [4.3] in Pakdasht respectively. Older and married volunteers with more experience performed better. There was no significant relationship between the efficacy of health volunteers with their literacy level, employment status and absorber of them. The health volunteers of Shomal, Shargh and Firoozkooh had the best performances respectively. The performances of those in Shemiranat, Damavand and Pakdasht were less than the overall health centers' mean score. The efficacy score of Firoozkooh, Shomal and Shargh health centers were above the overall health centers' mean score respectively. Considering all factors, it seems that the efficacy of the health volunteers of Shomal and Pakdasht were the most and least suitable respectively

[ impact of education on nutritional behavior change among clients of Sardar- Jangal health center in 2012]

Nutrition is one of the effective factors in the protection of health and the prevention of disease. Therefore, determination of the relationship between nutrition choices and health of people is emphasized. The aim of this study is to determine the effectiveness of education and nutrition consultation on changing the unhealthy nutritional habits, and improving healthy nutrition behavior among the clients of Sardar-Jangal health center in 2012. This interventional study was performed with the participation clients of Sardar Jangal health center in 2012. The sample size was 1500 and the sampling method was census. Data was gathered through a questionnaire and interview. The questionnaire included information regarding age, sex, education, employment and nutritional status. The scores between 9-11, 5-8 and less than 5, respectively, were considered as favorable, relatively favorable and unfavorable nutritional status. The participants with relatively favorable and unfavorable status were referred to nutrition education and consultation classes. At the end of the consultation classes, their nutritional status were assessed again. The data was analyzed through SPSS 21, using T-Test. In the study, 1500 clients of Sardar Jangal health center participated. The sample included 383 [25.6%] male and 1117 [74.4%] female. The mean age of male and female was 38.3 +/- 21.1 and 36.9 +/- 17.4 respectively. Before participating in the nutrition education and consultation classes, the nutrition status of 343[30.7%] of females was favorable whilst for 775 [69.3%], the nutritional status was unfavorable. Among 114 [29.8%] of males it was favorable and amongst 268 [70.2%] it was unfavorable. Between the mentioned clients, the nutrition status of 144 [20.1%] females and 28 [12.7%] males improved after nutritional consultation [P < 0.001]. The results showed nutritional education and consultation are effective in improving the nutritional behavior and modifying the incorrect nutritional behavior

Epidemiological features of hepatitis B and C infection in a high risk population: results of screening programs

The aim of this study was to report the epidemiological features of HBV and HCV infection in an Iranian high risk population. Hepatitis B and hepatitis C infections are worldwide serious public health problems. Iran has an intermediate prevalence of infection and a. screening program was started in 2010 among high risk individuals. This cross-sectional study was conducted on 4455 new patients during two past years. Demographic information, age, gender, occupational status, medical history, history of vaccination against HBV, high risk exposure and laboratory findings were collected for each patient. Then distribution of demographic and risk factors was evaluated in each type of hepatitis. The mean age of patients was 45.6 +/- 17.3 years. More than two-thirds of the diagnosed cases were infected with HBV. 74% of patients were carriers of hepatitis virus. 60% of patients had no symptoms at diagnosis. Illicit intravenous drug use was most common high risk exposure in patients under study [n=366, 8.2%]. High risk behaviors including illicit intravenous drug use and unprotected sex were relatively higher in patients infected with hepatitis C compared to patients with hepatitis B infection. Findings of this study suggest that illicit intravenous drug use, contact with an infected household member and unprotected sex are the most common high risk exposure in Iranian patients infected with viral hepatitis. Therefore, preventive strategies such as health education, vaccination and screening programs should be directed to these groups. The results also show that a majority of patients have no symptoms at the time of diagnosis, therefore periodic screening tests in high risk groups is required

[Research priority of cardiovascular research center of Shahid Beheshti university of medical sciences in 2009]

Allocation of limited resources to research proposals with high priority helps achievement of acceptable level of health. Therefore, priority setting in research centers is a necessary action. The objective of this study is to report the research priorities of the Cardiovascular Research Center of Shahid Beheshti University of Medical Sciences in 2009. This study involved 48 faculty members and other stakeholders in 2009. There were five basic principles including stakeholders' participation and consensus, situation analysis, need assessment, defining research priority topics, and scoring the criteria. This is a modified version of the proposed model of "The Council on Health Research for Development [COHRED]. Twenty diseases were determined as research priorities of the cardiovascular research center of Shahid Beheshti University of Medical Sciences. These priorities included myocardial infarction, hypertension, unstable angina, atherosclerosis, dyslipidemia, heart failure, stable angina, metabolic syndrome, coronary bypass complications, pulmonary embolism, heart valve diseases, prevention of deep vein thrombosis, rheumatic fever, cardiogenic shock, cardiac arrhythmia, cardiac arrest and sudden cardiac death, Peripheral vascular disease, syncope, angioplasty and valvuloplasty, cardiovascular diseases: epidemiology, etiology, risk factors, prevention, rehabilitation, socioeconomic factors, knowledge, attitude, and practice to risk factors and prevention. Providing researchers with a list of research priorities and commitment to it, conduct research topics toward priorities and consequently the most productivity is achieved from the limited resources