Comparing the effectiveness of airway management devices in pre-hospital emergency care: a randomized clinical trial

To assess the effectiveness of laryngeal mask airway, endotracheal tube and oropharyngeal airway for airway management in prehospital emergency care. The study sample of this randomized clinical trial was 54 patients needing pre-hospital airway management. All cases of intubation [ETI] ; after two failed attempts [37 patients], were randomly assigned to the oropharyngeal airway [OPA], and the laryngeal mask airway [LMA] groups. Patients' hemodynamic, SaO2 and airway management parameters, were compared in three groups. The study data were analyzed by the Chi-square and one-way ANOVA, Bonferroni post-hoc, using SPSS, v. 18.0. The results demonstrated that before and after the study, there was no significant difference among the study groups in terms of hemodynamic variables [P > 0.05] expect SaO2 [P < 0.001]. The results also revealed that in the ETI group [n=17], the number of attempts and the time spent on inserting the airway device was significantly more than other two groups [P < 0.05]. Laryngeal mask airway is as effective as oropharyngial airway for pre-hospital airway management by paramedics

Effects of continuous care model based non- pharmacological intervention on sleep quality in patients with type 2 diabetes mellitus: a randomized controlled clinical trial

Sleep is an important aspect of healthy lifestyle. One of the prevalent Diabetes mellitus-related non-vascular complications is sleep problems. The aim of this study was to investigate the effects of a non-pharmacological care plan designed based on the Continuous Care Model [CCM] on sleep quality in patients with type II diabetes with two month follow up. This randomized controlled clinical trial was conducted from May to November 2012 among 68 the patients with type II DM referring to the Diabetes Clinic of Gonabad University of Medical Sciences. The study instrument consisted of a self-report demographic questionnaire and the Pittsburgh Sleep Quality Index. The gathered data were analyzed via SPSS [V. 20] using t-test and Chi-square statistics. After the intervention, the study groups did not differ significantly in terms of sleep quality [0.628]. However, the study findings revealed that the interventional group's sleep quality improved significantly after the intervention [P<0.001]. Non-pharmacologic intervention according to CCM improved the sleep quality in the experimental group. Sleep care is a matter of great importance in diabetes mellitus, which deserves particular attention. The present study adds to the growing literature of the use of non-pharmaceutics intervention to improve sleep disorders of diabetic patients

effect of a multi-strategy program on developing social behaviors based on Pender's health promotion model to prevent loneliness of old women referred to Gonabad urban health centers

Loneliness is one of the most significant problems during aging. This research has been done to determine the effect of a multi-strategy program based on Pender's Health Promotion model to prevent loneliness of elderly women by improving social relationships. In this quasi-experimental study done in 2013 from January to November, 150 old women suffering medium loneliness referred to Gonabad urban Health Centers were enrolled. Data were gathered using Russell's UCLA loneliness questionnaire and the questionnaires based on Pender's Health Promotion Model about loneliness. The results were analyzed by descriptive statistics and Chi-square, T-pair, and independent-T tests through SPSS, version 20. Loneliness decreased significantly in the interventional group compared to the control group [P<0.00]. In addition, mean scores related to variables of Health Promotion Model [received benefits and barriers, self-efficacy, interpersonal effectives of loneliness] in both groups were significantly different before and after the study [P<0.05]. Constructs of Pender's Health Promotion Model can be used as a framework for planning interventions in order to anticipate, improve and modify related behaviors related to loneliness in old women

Adolescents' self-esteem in single and two-parent families

Self-esteem is one of the basic needs for all individuals especially in adolescence. The aim of this study was to determine associations between adolescents' self-esteem and perceived maternal parenting styles as well as its dimensions in terms of family type. In this analytic cross-sectional study, 356 high school students [250 two-parent nuclear family and 106 single-parent family] participated and filled out the Coppersmith self-esteem and the Robinson and colleagues [2001] perceived parenting styles questionnaires. Data were analyzed by SPSS software, version 18. To assess the relationship between participants' self-esteem and parenting styles and dimensions, Mantel-Haenszel Chi-square test was used to adjust the effect of potential confounder variables. P

community assessment model appropriate for the Iranian community

Community assessment is one of the core competencies for public health professionals; mainly because it gives them a better understanding of the strengths and drawbacks of their jurisdictions. We planned to recognize an appropriate model that provides a conceptual framework for the Iranian community. This study was conducted in Tehran, during 2009-2010 and consisted of two parts: a review of the literature and qualitative interview with selected experts as well as focus group discussion with health field staff. These steps were done to develop a conceptual framework: planning for a steering committee, forming a working committee, re-viewing community assessment models and projects, preparing the proposed model draft, in-depth interview and focused group discussions with national experts, finalizing the draft, and preparing the final model. Three different models published and applied routinely in different contexts. The 2008 North Carolina Community Assessment model was used as a reference. Ten national and 18 international projects were compared to the reference and one and six projects were completely compatible with this model, respectively. Our final proposed model takes communities through eight steps to complete a collaborative community assessment: form a community assessment team, solicit community participation and gain inter-sectoral collaboration, establish a working committee, empower the community, collect and analyze community's primary and secondary statistics, solicit community input to select health priorities, evaluate the community assessment and develop the community assessment document, an develop the community action plans

[Development and validation of theory of planned behavior questionnaire for exclusive breastfeeding]

Introduction and Aims: theory of Planned Behavior [TPB] is a social cognitive decision-making model that provides a useful framework for predicting and explaining health behaviors. Based upon our search, there are no studies about validation of exclusive breastfeeding questionnaire, using TPB, at the first six month after birth in Iran. The present study was designed to develop and validate the exclusive breastfeeding questionnaire in Gonabad pregnant women

Materials and Methods: developing exclusive breastfeeding questionnaire; an initial list of 25 questions was prepared with the participation of 20 pregnant women and 12 related professionals. Validating the questionnaire, we applied Face Validity and Content Validity. Cronbach's alpha coefficient and Intra-class correlation coefficient were calculated to determine reliability. Data were analyzed by using SPSS v.16 software

Results: the results showed that all 25 questions of the TPB questionnaire has an acceptable content validity [0.66 to 0.99]. Measures of the Cronbach's alpha coefficient and Intra-class correlation coefficient were 0.79 and 0.81, respectively

Conclusion: our findings indicate that TPB exclusive breastfeeding questionnaire has an acceptable validity and reliability that can be used in research activities

Neighborhood intimacy as perceived by women living in urban areas and its association with personal and social network characteristics

The purpose of this study is to determine association between personal, family, neighborhood, and social network characteristics and perceived intimacy in the neighborhood by the women. In this cross sectional study, we applied a two stage sampling method to choose a representative sample of 150 married women and housewives, aged 15 to 49 years, who had education between six and twelve years and lived in the urban areas of the Khorasan e Razavi province of Iran. Association between personal, family, neighborhood, and social network variables, with the perceived neighborhood intimacy, was assessed through univariate and multiple linear regression. Based on the multiple model, there were significant associations between neighborhood intimacy as perceived by the women and their education level [Standardized Beta= 0.190, P=0.019], length of residence [Standardized Beta=0.175, P=0.029], self rated health status [Standardized Beta=0.177, P=0.029], and their individual social network size [Standardized Beta=0.211, P=0.030]. The potential predictors including length of residence, self rated health, and size of the respondents' personal social networks had a direct association with the women's perceived neighborhood intimacy, while the education level of the respondents had an inverse association with the neighborhood intimacy, as another potential predictor. Neighborhood intimacy could express the social health condition of the community members

Important risk factors of mortality among children aged 1-59 months in rural areas of Shahroud, Iran: a community-based nested case-control study

The aim of the study was to evaluate potential risk factors of children mortality between 1-59 months of age. This nested case-control study was conducted among children born from June 1999 to March 2009 in rural areas of Shahroud, located in the central region of Iran using health care visit reports and follow-up data available in household health records. Mortality was significantly associated with breastfeeding duration [OR: 0.87, 95% CI: 0.81-0.93], total health care visits [OR: 0.90, 95% CI: 0.83-0.98] and low birth weight [LBW] [OR: 7.38, 95% CI: 1.37-39.67]. In our study, a longer breastfeeding period and more frequent health care visits were two important protective factors, while LBW was an important risk factor for 1-59 month child mortality. It seems, that complex and multiple factors may be involved in mortality of under 5-year-old children, so combined efforts would be necessary to improve child health indicators

Equity in health from social determinants of health's point of view

Health, as a public good, and equity in health, as a moral concept are considered as human right. Equity in health is defined as lack of systematic discrepancies in health or social determinants of health among different groups of a community. Social justice is considered as a matter of life and death. It is believe that inappropriate distribution of health services is one of the major determinants of individuals' health situation. But, living in poor and unequal status, which is the results of a combination of unsuitable social policies, unfair economic position, and poor politics, could also effect on the individuals health condition. To meet the equity in health, health systems should determine social determinant of health. In fact, the equity would be afforded by action on the social determinants of health. Besides, there are three principles of action consisting of "improve people's daily living conditions", "tackle the inequitable distribution of power, money, and resources", and "measure and understand the problem and assess the impact of action" which help to achieve the goal. In addition, participation of other organizations with health systems should also be attracted.