[Community based participatory research, a model for health promotion]

Current traditional research methods for solving social problems were challenged due to limited participation of community. The health companion project was carried out with the aim of determining effective model of community participation for solving health problems in Boyerahmad and Dena township. This study is a community based participatory research performed in Kohgiloyeh and Boyerahmad province 2005-2009.The study population was the entire rural and urban households of Boyerahmad and Dena county. The strategic committee of project including academic researchers, managers of health and health related sectors was formed and this committee selected six regions for research activities. In each region local directing group; [health companion] was established with participation of stakeholders: academic researchers, local leaders, health providers and public representatives to guide all aspects of project. The members of the group empowered and enabled by attending training workshops for need assessment, priority setting, research methodology that through these activities the health problem priorities of the regions were recognized, the research area determined and intervention programs were designed and implemented according to these research area. The most important achievement of this project is the methods of activities to reaching goals. Implementation of six participatory interventional proposal for solving health problems and needs are the other achievement. The frequency and means of health problems and their risk factors significantly reduced after the completion of intervention program in each region. Establishing and activities of health companion groups followed model of Planned Approach to Community Health [PATCH] that help community to form health promotion team, collecting and organizing of data, choosing health priorities, developing a comprehensive intervention plan and evaluation

[Anxiety-depressive disorders among irritable bowel syndrome [IBS] patients]

Psychiatric disorders are common in Irritable Bowel Syndrome [IBS] patients. Prevalence of psychiatric disorders varies in IBS patients in different societies. To determine the prevalence of psychiatric disorders [anxiety-depression] in IBS patients in Rasht. In this cross-sectional study, 256 IBS patients were selected [using criteria of Rome III] and evaluated for psychiatric disorders. In the first phase, subjects were screened by GHQ28. In the second phase, those patients who had scores equal or more than 23 were assessed through semi-structured psychiatric interview. Socio-demographic variables including age, gender, marital status, educational level and occupation, were recorded as well. P-values less than 0.05 were considered statistically significant. Among 256 subjects 30 patients [11.7%] had no significant psychiatric symptoms and 226 subjects [83 male, 143 female] suffered from some degrees of psychiatric problems. After performing semi-structured psychiatric interview; 190 subjects [74.2%] had anxiety-depressive problems [89 patients were suffered from pure anxiety disorders, 41 patients suffered from depressive disorders and 60 patients had co-morbid anxiety-depressive disorders]. In anxiety disorders; generalized anxiety disorder [53.7%] and in depressive disorders; dysthymia [53.5%] had the most frequencies, 53.7% and 53.5% respectively. In comparisone of anxiety-depressive subjects [190 persons] and normal subjects [66 persons], there was a significant statistical differences between the gender [P=0.019], occupation [P=0.002] and intensity of IBS [P<0.001]. Although, further studies are needed to determine the relations of demographic variables and types of IBS with psychiatric disorders, it seems to more attention to the psychiatric disorders of some specific patients suffering from IBS is helpful to their treatment

[Effects of community based educational prevention program of drug abuse in reduction of high risk behavior]

Overcoming social problems requires a participatory approach. This study was performed in order to determine the effect of community based educational prevention program of drug abuse in reduction of high risk behavior. This study was a community based participatory research. According to planned approach to community health model, "the health companion group" was established with participation of public representatives of villages, researchers, and managers of health sectors. Need assessment and priority setting of health problems was done. Drug abuse was selected as the topmost priority of health problems. By interviewing 10 year olds and older members of households, the questionnaires were completed. By conducting workshops, distributing educational pamphlets and face to face training for six months, the educational program was carried out. After this period, the study population was interviewed again. Data was analyzed by SPSS software, X2, and T tests. The mean score of drug abuse related high risk behavior was 26.8 +/- 2.05 before educational program and 25.2 +/- 2.3 after the program. The mean score of psychological health was 26.2 +/- 5.8 before educational program and 26.4 +/- 5.7 after the program. The rate of negative drug abusing related behavior decreased and positive behavior increased after the educational program. The community based participatory research with participation of the public can be a proper pattern to prevent drug abuse and related high risk behaviors and as a result reduce costs and complications of this problem

[ estimation of production function in Orumieh Medical Sciences University hospitals]

Hospital is known as an important and the most costly performing unit of health care systems, therefore, economic analysis of this unit is very important This study designed to estimate hospital production function in Orumieh Medical Sciences University hospital's. for this study 16 hospitals were studied. We used panel data for estimation of mentioned function, data were gathered from 2000 to 2006. A double- logged form of the Cobb-Douglas production function has been estimated. The dependent variable is inpatient admissions, the explanatory variables that are included are the umber of doctors, nurses, beds, other staffs and average length of stay [ALOS]. As a result of study the elasticity of doctors is EY. P =1.08, the elasticity of nurses is EY. N =3.4, the elasticity of beds is EY. B =1.4, and the elasticity of other staffs is EY. P P =2.8. There was not significant correlation between ALOS and the number of admission. The marginal production of inputs are MPP =391, MPN=244, MPB=103, MPP P =273, and, there is an increasing return to scale. Also, we have investigated MRTS1 between production factors. Results of this study show that, the maximum elasticity is attributable to the number of nurses and then respectively to, other staffs, beds and doctors. The marginal production of inputs shows an important role of doctors in production. The decision makers, in critical circumstances can substitute inputs with considering MRTS between inputs. There is an increasing economic of scale and in long-term there will be a monopolistic competition market, therefore, for achievement to equity issue, the intervention of government in this hospitals market is necessary