[Use of Single Index Model for estimation of survival of the patients with acute myocardial infarction]

The Cox proportional hazard model is the standard approach for analyzing survival data in many cases. One restriction of this method, however, is that it assumes that the log of the hazard function relates to the covariates through a linear function. As a consequence, it fails to estimate efficiently the effect of the non-linear terms. But we can estimate the survival rate by using spline functions. Our goal is to investigate the appropriateness of an alternative method, the so-called single index model, for estimation of the survival rate of the patients with acute myocardial infarction. This was a descriptive analytical cohort study which included 650 subjects with acute myocardial infarction. The patients were followed up for one year to ensure survival or detect death events. Data were recorded in a pre-defined check list. In this study the relationship between the log of the hazard function and covariates were considered unknown. We estimated the coefficients of the model by using the polynomial spline and penalized partial likelihood. Data analysis was carried out by using R version 2.12 software and significant levels were considered 0.05. We found the Cox model with unknown link function to have larger log likelihood than the standard Cox model. The effects of estimated parameters in both models were relatively different. Effects of diabetes and arrhythmia in Cox model with unknown link function were significant [P<0.05]. In standard Cox model unlike Cox model with unknown link function the age was significant [P<0.05]. Considering the results of this study Cox model with unknown link function could estimate the effect of factors such as diabetes and arrhythmia in the survival of the patients, in addition to the effects of streptokinase and ejection fraction

[Patients' satisfaction of dental care provided in Shiraz dental school]

Evaluation of patients' satisfaction could be a good index for assessing and improving the future dental care and it has a positive role in elimination of defaults. This study was designed to measure satisfaction rate of those patients who referred to Shiraz Dental School with a hope to solve some of the problems in this school. In this cross-sectional study, 300 patients with different age ranges, filled in a questionnaire containing demographic information such as age, sex, career and education and also some questions about the students' behaviors toward patients and their ability in handling dental care, personnel's behavior, hygiene conditions of different departments and guide signs helping patients in finding related departments. The results were analyzed statistically using ANOVA. 21 graphs in relation to 21 questions were prepared. Comparison of satisfaction rate among different departments was shown by 7 graphs. 87.5% of the patients were completely satisfied with the health care provided.%84.5 noted that they would prefer to choose this center for further dental care, if needed. Thirty seven percent were satisfied with the appointments procedures. 44.5% were satisfied since all their dental needs were performed in dental school. Fitly five percent were satisfied with the student's clinical capabilities. Pediatric department gained the first rank among other departments in this satisfaction evaluation. Most of the patients were satisfied with their dental care provided in Shiraz dental school, but in some instances such as student's clinical capabilities, pain control and students- patient relationship, there were some deficits that should be considered in course plans

[Comparison of depression, anxiety, stress and quality of life in dormitories students of Tarbiat Modares university]

Students are the future managers of each country and in our country because of having a young population pyramid; the importance of them in managing country future is more outstanding. Therefore physical health especially their psychic condition is directly related to the community health in future. The purpose of this study was to compare depression, anxiety, stress and quality of life [QOL] of female and male students resident in Tarbiat Modares University dormitories. This study was a cross-sectional descriptive study which used DASS21 and SF-8 questionnaires completed by subjects to measure the mentioned variables in 223 female and male dormitory students of Tarbiat Modares University. The subjects were selected using cluster sampling method. The results of this study showed that 51.6% of students suffer from depression, 39.5% from anxiety and 71.7% from stress. The level of depression, anxiety, and stress in male students showed to be higher than females. Student's QOL was moderate in 33.2% and poor in 4.9% of them. The relation between education level [MSc vs. PhD] and the main variables was not significant. Stress, anxiety and depression had a direct relation together and an inverse relation with QOL. Regarding to the results of this study, it is concluded that academic study is accompanied by a high level of depression and anxiety and lower level of QOL because of the presence of high levels of stress. So every society which thinks about its health and its future generations is expected to investigate on predisposing factors of stress, depression, as well as anxiety and remove them in order to ensure its future goals

Needlestick injuries reporting among clinical nurses

Exposure to blood-borne pathogens by needlestick injuries [NSIs] continues to pose significant risks to healthcare workers [HCW]. The number of contaminated NSIs sustained by HCW primarily due to underreporting, is still unclear. Therefore the objective of this study was to investigate the Needlestick Injuries and the rate of reporting among Clinical Nurses. This cross-sectional study was conducted among nurses in one teaching hospital and one nonteaching hospital in Tehran. To investigate the causes of these injuries 111 nurses with using purposive sampling method, were contributed and voluntarily and anonymously filled in a questionnaire on the demographic and professional characteristics. In this study, data regarding the frequency of contaminated needlestick and the rate of reporting the injuries and the reasons for not reporting such injuries, were collected. According to the findings, 54.1% [n = 60] of the subjects had no contaminated injuries and 45.9% [n = 51] had experienced at least one contaminated NSI in their period of clinical practices. Thirty-four percent of the nurses experienced 58 contaminated needlestick injuries in the past 12 months [Crude Incidence Rate: 0.52 NSI/nurse/year]. Only 36.8% [n=14] of the nurses who had experienced NSIs in the previous year, were reported all exposures to the needlestiks. The reasons for not reporting injuries consisted of dissatisfaction with follow up [33.3%], low probabilities of the infection risk of the injury source [29.2%], to be busy [12.5%], not familiar with reporting process [16.7%] and low perception of risks [8.3%]. This study suggests that the ferequency of NSIs and the rate of underreporting among Iranian nurses are considerable and it needs to be further investigated. Interventions such as continous training of nursing staff about standard reporting protocols and precautions of the post-exposure procedures might improve reporting of such injuries among nurses

Barriers to and support for physical activity in overweight and obese compared with normal weight adolescents

As the prevalence of overweight increases among adolescents, thus factors that may influence children's participation in weight-related health behaviors need to be examied. This study examined barriers to and support for physical activity in overweight and obese adolescents compared with normal weight adolescents. In this cross-sectional study, sample included 279 male students studying in two secondary schools in Tehran. Of all students, 179 [64.2%] were within normal weight range, 49[17.6%] were obese and 51[18.3%] were overweight. A questionnaire comprising demographic characteristics, and barriers to and support for physical activity, and also, a checklist of physical activity within current week were distributed to be filled out by students. Data were analyzed using One-Way ANOVA and Tukey's test. According to finding, adolescents with normal weight had significantly higher moderate and vigorous physical activity than obese adolescents and the time of TV watching were significantly more among overweight and obese adolescents than adolescents with normal weight. Body-related, social and fitness barriers were the most predominant ones among obese adolescents. There was no statistically significant difference between mean score of convenience and resource barriers among different weight groups. Obese adolescents also reported significantly lower levels of adult and peer support for physical activity. Obese adolescents may be particularly vulnerable to body-related, social and fitness barriers to physical activity. Reducing these barriers may be helpful, as physical activity intervention is most relevant for overweight youth. Interventions should be implemented for reducing barriers to physical activity and also enhancing parents and peers support for physical activity among obese adolescents