Distribution of ophthalmologists and optometrists in Islamic Republic of Iran and their associated factors

We aimed to determine the distribution of ophthalmic care providers and its correlation with health and socioeconomic status and health system indicators. Data were gathered from the Iran Medical Council and the Iranian Societies of Ophthalmology and Optometry. Concurrent indicators were collected from the Statistical Center of Iran and national studies. A population-adjusted number of combined ophthalmologists and optometrists was used as the main dependent variable. Optometrist/ophthalmologist ratio was 0.9. We had 1 ophthalmologist and 1 optometrist for every 40 000 and 45 000 individuals, respectively. We observed a direct correlation between the number of ophthalmologists, optometrists and life expectancy at the provincial level. Gross provincial income and expenditure and provincial literacy were correlated as well. Provincial unemployment had a negative correlation. Provincial hospital statistics and population density were also significantly correlated. The Islamic Republic of Iran has met the World Health Organization's desired per capita number of ophthalmologists and optometrists, but there is wide variation in their density

[Factor analysis of social capital questionnaire used in urban heart study in Tehran]

Social capital composed of networks, norms and values, which facilitates cooperation within and between groups to achieve mutual benefits and common goals. Social capital increases the benefits of investing in physical and human capital. In a society that favors more social capital, collaboration is easier. This study investigates the validity and reliability of a social capital tool, which had been administered through a large population-based survey using factor analysis. Data were obtained from Urban Health Equity Assessment and Response Tool [Urban HEART-1] survey in Tehran. Factor analysis is a method of discovering structural position of variables to reduce them into a limited number of components which are more fundamental. The reliability of the questionnaire and main components of the tool were investigated through factor analysis. According to factor analysis, three main components of social capital including, individual trust, cohesion/ social support and social trust/associative relations, were recognized. These three components explained 66.14% of total variance of the social capital tool. Also, overall Cronbach's alpha coefficient was 0.88 which indicates high reliability of the questionnaire. Social capital tool, which was administered in Urban HEART project, covers the main components of social capital framework with high reliability and validity, which is suitable to be used in other population-based surveys

[Qualitative and quantitative performance of equipment and non-structural vulnerability in selected public hospitals in Tehran city during an earthquake]

One of the important tasks of medical centers is to provide emergency services to the injured during an earthquake. Therefore, these medical centers always should be prepared to deal with such circumstances. Non-structural elements are the important components of medical centers that should be considered. In this study, qualitative and quantitative performance of equipment and non-structural vulnerability of seven public hospitals in Tehran city have been evaluated during an earthquake. In this cross-sectional research, all public hospitals in Tehran city were studied including governmental or public, private, military and also social security. Using WHO/PAHO Standard Checklist, seven public hospitals were selected and evaluated by convenience sampling method in eleven sections. According to the results, the lowest functional level was observed in emergency exit systems, communication systems, furniture and equipment. The studied hospitals were at a satisfactory level in heating and cooling systems, ventilation systems of care units, fire detection and extinguisher. Although 56% of the mentioned hospitals were at a satisfactory level in overall assessment of performance in non-structural features, the critical, vital and effective sections of the hospitals were functioning at an average and some in even low levels of safety. Totally, the hospitals lacked a proper preparation in disaster in non-structural evaluation; furthermore, there was a standard instruction in non-structural immunization that hospitals should consider in preparation

Standardization of three hope scales, as possible measures at the end of life, in Iranian population

Hope is an essential and dynamic life force that grows out of faith, is supported by relationships, resources and work circumstances, which lead to the energy necessary to live for a desired future. Hope gives meaning and happiness. Four central attributes of hope are: experiential, spiritual, relational thought, and relational process. A sound instrument to measure hope, which should be theoretical base, fairly vigorous psychometric and user-friendly, would be a useful complement to interviews for assessing hope in palliative care. Assessment of 'hope' is a necessary foundation for enabling the implementation of various intervention strategies to foster hope especially in cancer patients and their family members. There is no suitable instrument to measure hope in palliative care for Iranian patients; therefore the aim of this study was to assess the understandability, reliability, validity and superiority of three relevant instruments to measure hope. Three questionnaires including the Herth Hope Index [HHI], Herth Hope Scale [HHS], and Miller Hope Scale [MHS] alongside with a generic health-related quality of life tool [EQ-5D] were completed by 70 normal randomly selected individuals aged 14-73 years. Cronbach's alpha was 0.76 for HHS, 0.67 for HHI and 0.81 for MHS, indicating satisfactory internal consistency. Concurrent criterion-related validity was assessed by calculating the correlations of the HHS and the MHS [r = 0.43], HHS and HHI [r=0.49] and MHS and HHI [r=0.62], at <0.001 significance level. MHS discriminated significantly better most of EQ-5D components including anxiety and depression, pain, personal and usual activities. Finding suggested that these instruments have satisfactory reliability and validity to be used in Iranian population. Miller Hope Scale showed superiority among these tools

concept of palliative care practice among Iranian general practitioners

General Practitioners [GPs] have the main responsibility in medical and particularly palliative care provision in most of countries, though this is not the current case in Iran. Development of 'family physician' approach in rural and most of the urban areas in Iran, GPs will have the main role in care provision. There is no formal palliative care education during general medical training in the country so far. Regarding the increasing number of people in need of palliative care services, it is essential to assess GPs' knowledge about palliative care to develop special palliative care educational programmes. A cross-sectional questionnaire survey was conducted on general practitioners participated in a formal Continuous Medical Education programme, using three scales. 216 GPs returned the completed questionnaires. More than half scored their knowledge about palliative care as weak, which was significantly related to their previous experience in caring of a terminally ill patient [p=0.001]. Less than one third stated their good ability to either assess or manage pain in end of life. Major gender differences were seen in different subscales such as communication with patients and carers, patient management, palliative care knowledge and skills, and psychological stress. This study revealed a profound lack of knowledge and experience among Iranian general practitioners about palliative care which was mostly in more complicated areas rather than common symptoms relief

study in the efect of education through health belief model on the perceptions of girl students in primary school about breakfast and snack in noshahr-2007

Attentions to girls feeding situation have important designation to their health and prevention diseases of malnutrition in next year's. Breakfast has important role to student thought and body health. Education is one of the methods to increase student Perceptions. A study in the effect of education has done through health belief model on the perceptions of girl students in primary school about breakfast and snack in noshahr-2007. -This research is performed with the aim of studying the affect of health education by health belief model on the perceptions of girl students in primary school about breakfast and snack in noshahr-2007. In this quasi experimental study that was case control test, 100 students selected through application of randomized cluster sampling methods, and formulas of sample size from schools. Health belief model used in education for presenting the educational content. We used different educational methods such as lecture, question and pamphlet. The time of education was 1 session of 30 min subjects were evaluated in two stages. Primary test was before application of educational program to case and control and secondary test was implemented after education program by questionnaire. Which was included the demographic, perceptions questions.The statistical analysis was done by paired t - tests and Independent t- tests ,ci squre, correlation correlation Pearson's test was used for determining correlation between perceptions. In this research, the Results of the paired t- test among mean of perception scores of students was found significant difference, before and after educational program implemented [P<0/001]. paired t - tests and ci squre showed significant correlation after the educational program the mean of Perceived benefits in case students [from 13.14 to 14.12], Perceived Barriers [from 20.1 to 22.52], Perceived Susceptibility [from 5.26 to 5.74] and Perceived Severity [from 15.10 to 16.34]. In this study, the mean of perceived benefits changes was significant in comparison to the occupation of the father [P=0/02]. The mean of perceived benefits changes was significant in comparison to literacy of the mother [P=0/05].Correlation Pearson's test showed significant correlation between all perceptions of students in health belief model before and after educational program [P<0/001]

Spiritual care at the end of life in the Islamic context, a systematic review

According to the statistics over 30000 deaths occur annually in Iran due to cancer with an incidence of over 70000 new cases; this growing rate is similar to the developing world. These figures do not take into account other chronic illnesses like diabetes, heart failure, gastro-intestinal disorders, chronic neurological disorders and lung disease, which all warrant palliative care. A systematic review was conducted until the end of 2007, to find out the ways that palliative care services are provided for Muslim patients suffering from cancer. Only three papers met the criteria as being original research either quantitative or qualitative, published during the last 10 years. Our findings conceded that very few papers are available in Islamic context about spiritual care at the end of life, where only one was quantitative. While cancer is rapidly increasing specially in developing world, the need of terminally ill patients with other conditions should be equally considered. Despite the fact that spirituality in Islamic societies exists profoundly, spiritual care must be institutionalised for patients who are in most need at their end of life, which needs more evidence