Years of life lost because of premature death due to intentional and unintentional accidents in Ghazvin province from 2004 till 2008

Background: Accidents are the second cause of death in Iran and one of the significant challenges in public health. They can affect people in all ages. In this study, we try to calculate years of life lost due to intentional and unintentional injuries, which is considered as one of the main indicators for prioritizing public health problems

Methods: This study is a practical cross sectional survey research HSR [health system research] that uses secondary analysis on the death data of Ghazvin province. The calculations also take into account the WHO standards in age group, sex and years of life lost [YLL] due to death

Results: This study showed that the unintentional accidents were the leading cause of death based on YLL from 2004 until 2008 in Ghazvin province. The number of deaths due to intentional and unintentional accidents was 3796 deaths as of which 2954 [77.8%] was male and 842 [22.2%] female. In general three quarter of the YLL due to early death relates to accidents for males and less than a quarter relates to accidents for females. Between 2004 until 2008, the maximum number of years of life lost [YLL] in both sexes is for the age group of 15 to 49

Conclusion: Considering the high level of years of life lost [YLL] due to accident in this province, especially in men, more appropriate interventions for the more risk prone age groups and male in general need to be taken into account

Application of capture-recapture for fine-tuning uncertainties about national maternal mortality estimates

Maternal mortality ratio [MMR] is one of the main indicators of the millennium development goals and its accurate estimation is very important for the countries concerned. The objective of this study is to evaluate the applicability of capture-recapture [CRC] as an analytical method to estimate MMR in countries. We used the CRC method to estimate MMR in Iran for 2004 and 2005, using two data sources: The maternal mortality surveillance system and the National Death Registry [NDR]. Because the data registry contains errors, we defined three levels of matching criteria to enable matching of cases between the two systems. Increasing the matching level makes the matching criteria less conservative. Because NDR data were missing or incomplete for some provinces, we calculated estimates for two conditions: With and without missing/incomplete data. According to the CRC method, MMR in 2004 and 2005 were 33 and 25 in the best-case scenarios respectively and 86 and 59 in the worst-case scenarios respectively. These estimates are closer to the ones reported by United Nations Agencies published in 2010, 38 and Hogan's study, 30 in 100,000 live births in 2005. The MMR estimation by CRC method is slightly different from the international studies. CRC can be considered as a cost-effective method, in comparison with cross-sectional studies or improvement of vital registration systems, which are both costly and difficult. However, to achieve accurate estimates of MMR with CRC method and decrease the uncertainty we need to have valid databases and the absence of such capacities will limit the applicability of this method in developing countries with poor quality health databases

Drug literacy in Iran: the experience of using "the single item health literacy screening [SILS] tool"

Drug and health literacy is a key determinant of health outcomes. There are several tools to assess drug and health literacy. The objective of this article is to determine drug literacy level and its relationships with other factors using a single item screening tool. A cross- sectional survey was conducted among 1104 people in Qazvin province, Iran. Based on the proportional-to-size method, participants over 15 years old with ability to read were recruited randomly from 6 counties in Qazvin province and were interviewed directly. To determine drug literacy relationship with other variables, Chi-Square and t-test were used. Also, logistic regression model was used to adjust the relationship between drug literacy and other relevant variables. Response rate in clusters was 100%. Findings showed that inadequate drug literacy in Qazvin province is 30.3% and it was in association with [1] age [p = .000], [2] marital status [p = .000], [3] educational attainment [p = .000], [4] home county [p = .000], [5] residing area [p = .000], [6] type of basic health insurance [p = .000], [7] complementary health insurance status [p = .000], and [8] family socioeconomic status [p = .000]. After adjusting for these variables using logistic regression model, the association between [1], [3], [4], [5] and [8] with drug literacy level was confirmed. The analysis also showed that this method can also be used in other health care settings in Iran for drug and health literacy rapid assessment

The perspectives toward patient safety culture among nurses staff in educational hospitals in Gorgan in 2011

The basic responsibility of nurses is to maintain patient safety including notifying patients and colleagues about risk and risk reduction methods, supporting the patient safety and reporting events to a responsible person. Without creating a safety culture in all health facilities a sustainable development in the patient care do not occur. This study aims to determine the patient safety culture in teaching hospitals in Gorgan. In this cross-sectional study, a target group includes nurses at 5 Azar, Taleghani and Deziani Hospitals in Gorgan in 2011. The study population included 348 nurses in these hospitals. The data collection instrument was a questionnaire with 43 questions. Statistical tests were ANOVA and T-Test. Twenty four percent of nurses believed patient safety culture is weak, 46.8% of them, moderate and 30.7% good. The weakest dimension was non-punitive response to error and strongest dimension was organizational education. Statistic test showed significant relationship between patient safety culture and experience [p= 0.021], employment status [p= 0.001], hospital [p= 0.001], ward [p= 0.003]. The status of the patient safety culture was related moderate from the nurses' view point but it is necessary it improved in dimensions of the non-punitive response and the staff workload to note that it is highly recommended to take some actions in this regard. [Kabir M. Heidari A. Jafari N. Vatankhah S. Etemad K. Aarabi M. Aghapour SA. Lotfi M. The perspectives toward patient safety culture among nurses staff in educational hospitals in Gorgan in 2011. IJHS 2013; 1[1]:75-83] http:/jhs.mazums.ac.ir

Six-fold difference in the stomach cancer mortality rate between northern and southern Iran

Stomach cancer is the most common cancer in Iran. A multi-ethnic population and wide variation in the environmental risk factors may lead to variations in cancer risk within this country. We have designed an ecological study and evaluated geographical variation regarding mortality from stomach cancer and its established risk factors in Iran. We used the Iranian National Causes of Death Registry and estimated the age-standardized mortality rates [ASMR] of stomach cancer in 29 Iranian provinces, stratified by sex and area of residence [rural/urban]. The average ASMR of stomach cancer among Iranian males was 15 per 100, 000 and females it was 8.1 per 100, 000. The highest and lowest mortality rates were observed in Kurdistan with an ASMR of 29.1 per 100, 000 in northwestern Iran and Hormozgan that had and ASMR of 5.0 per 100, 000 in southern Iran. Males had approximately a two-fold higher ASMR compared to females, as did rural residents when compared with urban residents. The prevalence of H.pylori infection was about 90% in the province of Ardabil [a high-risk area] and 27% in the province of Sistan-Baluchistan [a low-risk area]. The wide geographical variation and high mortality rate of stomach cancer in Iran is likely due to differences in the exposure to the environmental risk factors among people living in the high-and low-risk areas, particularly H. pylori infection, a well-established risk factor of stomach cancer

[ rate of general and managerial educations among managers and chief experts in iran universities of medical sciences/ vice chancellors for health]

Background and Objective: Education and improvement of human resources is a kind of investment in organizations and have a key role in improving their performance and productivity. This study was conducted to determine the rate of managerial trainings among managers and chief experts in health deputies of Iran Medical Sciences Universities and its relation to demographic and institutional factors

Methods: This cross-sectional study was conducted in spring 2011. Sample population was managers and experts of Health Deputies of Medical Sciences Universities in Iran. Thirteen universities were selected by random systematic and stratified sampling and their managers and chief experts were interviewed by using a questionnaire consisted of demographic and organizational variables as well as 40 management-related topics

Results: A total of 293 managers and chief experts were studied. Among 40 studied management topics, only in 8 topics over than 40% had been trained and in 32 remained topics the rate of trained individuals varied from 1% to 40%. The rate of education showed significant relationship with the grade of university and subjects' sex, age , work experience, educational level and field, taking MPH courses and current work location and position [p<0.05]. The grade of university [77.5%] and work experience [12.5%] had respectively the highest and lowest relationships with the rate of education

Conclusion: Low rate of managerial and general trainings among managers and chief experts requires designing and implementing more educational programs?