[Views of managers, health care providers, and clients about problems in implementation of urban family physician program in Iran: a qualitative study]

Background and Aim: From 2011 to 2013 some efforts had been made in Iran to implement urban family physician program. The aim of this study was to determine the viewpoints of managers, providers, and clients of health care services about the problems in the implementation of urban family physician program in Iran

Materials and Methods: This study was a qualitative study. Data were collected through holding 21 sessions of focus group discussions and 37 individual interviews with managers, providers, and clients of health care services in Alborz, West Azerbaijan, and Kurdistan Provinces in 2014. Data were analyzed by means of content analysis method

Results: According to the results of this study, the problems on the implementation of urban family physician program in Iran can be classified into seven categories including: financial, cultural, educational, motivational, structural, administrative, and contextual problems

Conclusion: We propose definition and stabilization of the financial resources and establishment of appropriate rules for payments to solve financial problems, and also training of general population and staffs and involvement of the mass media in training to solve the cultural problems. In order to solve the educational problems reforms in medical curriculum are recommended. Motivational problems can be solved via encouraging the private sector and experts to take part in the program and also through guaranteeing the continuity of the program. Establishment of appropriate organizations and provision of protocols are recommended to solve the structural problems. Finally, to overcome the contextual problems it is suggested to promote cross-sectoral and inter-sectoral coordination and also attract support from policy-makers

[Epidemiological study of irritable bowel syndrome and its related factors in Sanandaj from 2013 to 2014: a population-based study]

Background and Aim: irritable bowel syndrome is a common gastrointestinal disease which is characterized by abdominal pain and altered bowel habits. This study aimed to investigate the prevalence of irritable bowel syndrome and its related factors in the general population in Sanandaj in 2013-2014

Materials and Methods: this cross-sectional study was conducted in Sanandaj for a period of 12 months, from the summer of 2013 to the summer of 2014. Considering the design effect, a population sample of 430 were selected via random cluster sampling method. ROME III criteria were used for diagnosis of IBS. Logistic regression was used to accomplish the qualitative objectives and multivariate analysis for categorical variables. We used STATA11 software for statistical analysis

Results: we found a prevalence rate of 10.63% for irritable bowel syndrome in the general population in Sanandaj. Concerning gender distribution, the prevalence rates were 11.5% and 9.96% for males and females respectively, which had no statistically significant difference [OR=1.184, 95% CI=0.574 - 2.439]. Although the disease was more prevalent in the patients between 30-40 years of age compared to other age groups, this difference was not statistically significant [OR=0.679, 0.95 CI=0.189, 2.441]

Conclusion: the results of this study showed that the prevalence rate of IBS was higher in Sanandaj city in comparison to other parts of Iran, which can be related to several factors such as diet and lifestyle. Because of the high prevalence of IBS in Sanandaj, we recommend further studies for identification of the causes of this disorder and its exacerbating factors in this city

[Prevalence of gastroesophageal reflux and its related factors in Sanandaj, 2014-2015]

Background and Aim: Gastroesophageal reflux disease [GERD] is one of the most common gastrointestinal diseases and its prevalence rate in various countries, including Iran has been on the rise. The aim of this study was to investigate the risk factors and prevalence rate of this disease in Sanandaj

Materials and Methods: In this descriptive, analytical study, 430 people were selected via random cluster sampling. Data were collected by carrying out interviews with the participants from May 2014 to June 2015. Using a questionnaire, we recorded data about the demographic characteristics, symptoms of gastroesophageal reflux disease and risk factors for the disease. Then, we measured and recorded the participants' blood pressure, height, weight, and BMI. People who had experienced episodes of mild symptoms of heartburn for two days or more in a week or experienced moderate to severe symptoms for more than once in a week were regarded as cases of reflux. Data analysis was performed by using STATA-11 software

Results: From 410 patients, 41% were male and 59% [241 persons] were female with the mean age of 37.75 years. The prevalence rate of gastroesophageal reflux in the study population was 30%. We found no statistically significant difference between the patients and healthy individuals in relation to the risk factors for gastroesophageal reflux

Conclusion: Considering the high prevalence of GERD in Sanandaj, it is of great importance to provide necessary training about the risk factors, prevention, and appropriate treatment of the disease for the public

[Evaluation of Harm reduction Programs in prisons from the attitude and viewpoint of Iranian prison staff]

probably after pestilence, HIV/AIDS is most important and severe health threat for public health. Prisons could facilitate the spread of HIV/AIDS and Hepatitis and transmit it to societies. The main strategy to control HIV/AIDS and hepatitis among Injecting Drug Users is Harm Reduction Programs. These programs are conducted in Iran Prisons. The goal of this study is to evaluate Harm reduction Programs including Methadone Maintenance Therapy [MMT] and Needle exchange from the viewpoint of prison staff in Iran including principals, managers, physicians and counselors. It was a cross sectional study in which 370 prison staff working in prisons all around the country were evaluated to assess their viewpoint and insight about Harm reduction Programs including Methadone Maintenance therapy and Needle exchange. A percentage of 95.23 of prison managers and experts had a positive view toward Methadone Maintenance therapy. 70.25 percent had a positive insight toward needle exchange program. The employment type and work experience was significantly [p<0.05] related to the viewpoint of managers and experts towards Methadone Maintenance therapy program. Age was the only factor that had a significant relationship [p<0.05] with Needle exchange program. MMT has lots of supporters in prisons. The positive insights of managers and experts towards methadone maintenance therapy program demonstrate the high level of staff's approval for conducting this program; it could be interpreted as a sign of success of program in the country. However there is not a comprehensive approval and collaboration with needle exchange program in prisons. Nevertheless, it is alarming that 42.5% of staff believe that conducting methadone maintenance therapy may increase and intensify addiction in prisons

[Evaluation of an awareness of clinical information systems among the staff of medical records departments of hospitals affiliated to the Tehran university of medical sciences, 2011]

The information gathered in hospitals for clinical services is massive and management of this dispersed information is very complicated, however, necessary for medical centers. Considering the computer capabilities, clinical information systems are very useful and efficient in achieving the management goals in medical centers. This study was conducted for evaluating different applications of clinical information systems and staff awareness of Medical Records Department. This study was conducted in two-steps: In the first step, the available resources during 2000-2011 were studied. In the second step, awareness of clinical information systems among Medical Record Department's staff of Tehran University of Medical Sciences hospitals has been evaluated. The validity of the questions raised in questionnaire was confirmed by the expert panel and its reliability was determined to be 80% by test-retest coefficient. The collected data was analyzed using MS Excel 2007 software. The clinical information system consists of different parts and a variety of applications including: clinical documentation, making decision, management of medicine, radiology, laboratory, etc. There are barriers such as financial, behavioral and technical issues to employ these systems. The results obtained from the second part showed that the average of staff awareness of clinical information systems was 49%. Considering the numerous benefits of clinical information systems, using it for supplying information on clinical centers is an inevitable necessity. Selecting a proper system, training users, and paying attention to the factors affecting their implementation in hospitals play a key role in its clinical effectiveness and widespread use of clinical information systems

[Comparison of nested case-control and cohort analysis methodologies using a district TB registry data]

The nested case-control study has become popular as an efficient alternative to the full-cohort design. This study compares the results of a nested case-control analysis approach with the full cohort analysis. A cohort of 276 subjects [new cases from a TB registry] was used for this study. Cox Regression model was used for the full cohort analysis. In order to do the nested case-control analysis, for each death, three random controls were selected from those who did not suffer from the outcome at the time of the outcome took place. Case control data was analyzed by the conditional logistic regression model. Results from both cohort and nested case-control analyses show that treatment group is the only variable that affects on the outcome. Gender, place of residence, and age has no effect on the outcome. For binary exposure variables with trivial effects [e.g. Gender and place of residence], the relative efficiency of nested case-control study design is approximately 75%. Results of this study show that nested case-control study is not only an easy and cost-effective method for data analysis but also is as robust as cohort analysis in rate ratio and its variance estimation

[Prevalence of asthma among 1 5 to 64 years old in Kurdistan, Iran 2006]

There is geographic variability in the prevalence of asthma. Since there is inadequate of study on asthma in Iran, this study was performed in order to determine the prevalence of asthma in Kurdistan province. This cross-sectional study was performed as part of Iranian national survey to determine the risk factors of non communicable disease. This study includes 500 men and 500 women. Prevalence of history of asthma was 2.3%. There was no statistically significant association between asthma and place of residence, smoking and body mass index. Asthma were found in 6 [1.8%] of men and 17 [5%] of women [p=0.02]. Prevalence of asthma increased with increasing age [p<0.001]. The prevalence of asthma in this study was similar with other studies in Iran and seems lower than similar countries

Survey of epidemilogic status and incidence rates of cancers in the patients above 15 years old in Kurdistan province

At the present time, cancer is among the first three causes of death in developed countries and also in Iran. Considering different distribution of different types of cancers in the world and their significance in regard to morbidity and mortality, diagnosis of different kinds of cancers will be the first step in controlling these disorders. By proper planning, we can reduce the incidence rate of all types of cancers. This survey deals with epidemiological study of cancers in Kurdistan province. This was a descriptive study. Data were obtained from cancer registration system, which is a national program. In this system the data of all types of cancers, diagnosed in pathological centers, were collected and entered into the national soft ware program. Different types of cancers were encoded on the basis of ICD"O2. In this study 1294 cases of different types of cancers were collected from pathologic diagnostic centers in Kurdistan province in a period of 2 years [2003-2004]. In this survey the overall incidence rate of all types of cancer in 2003 and 2004, was 60 and 66.9 in 100000 people. 62% of cases were male and 38% female. Generally, the most common cancers in both sexes, were those of skin [22.8%], stomach [20.5%], esophagus [12.8%], urinary bladder [7.5%] and lung and bronchus [4.9%]. The most common cancers in male patients, belonged to stomach, skin, esophagus, bladder, lung, prostate, colorectal; and in female patients, cancers of skin, esophagus, stomach, breast and colorectal carcinoma were the most frequent types, respectively. The highest incidence rate of cancers had occurred in the patients who were older than 75 years. Histopathologically the most common cancers of skin, stomach and esophagus were basal cell carcinoma, adenocarcinoma and squamous cell carcinoma respectively. skin cancers were the most common cancers in Kurdistan province. But the total number of cases of cancers of all parts of Gastrointestinal tract, exceeded those of all other systems. In Females, opposed to males, esophageal cancer was more common than stomach cancer. Histopathologically, there was no significant difference in the prevalence of different cancers in Kurdistan province, in comparison to other parts of the country. The epidemiologic profile of cancers in Kurdistan province is different from other parts of our country, which requires more investigation

[Information [knowledge] management]

Background: Owing to high amounts of information produced in organizations and the necessity to prompt accessibility to information for managerial decision making in other side, the information management specialty has been proposed as a new science in management

Objective: This study was performed to assess the definitions, process and components of information management in exiting resources and also an analysis of modern concepts specially in the field of health care industry

Methods: This systematic review study based on existing resources on internet from 1997 to 2003

Findings: The information management is a modern science. The information management systems developed a great deal during 1980s. In 1994 international network of information management in Europe was accessible on-line. The true introduction time for the term of Information Management refer to 1995

Conclusion: The information management is a process which consist of four basic parts: information production, organization and storage of information, information dissemination and information utilization. These four parts together will satisfy the aims of information management in an organization