[ prevalence of the alpha-1 antitrypsin deficiency in patients with chronic obstructive pulmonary disease]

Alpha 1-antitrypsin deficiency [AATD] is one of the genetic risk factors in the patients suffering from chronic obstructive pulmonary disease [COPD]. The exact number of Iranians suffering from this disease is yet not known. Therefore, the aim of this study was to determine the prevalence of the deficiency of AAT enzyme in patients suffering from COPD. The topical test of AAT serum was conducted on 125 patients affected by COPD who had referred to Ekbatan Hospital of Hamadan in 2007. The diagnoses of COPD in these patients dad been confirmed through history and spirometerty test before and after bronchodilator inhalation and the outcomes had been confirmed based on GOLD regulations. In other words, after separation of serum from blood, the specific antibody of AAT was added to the sample. The AAT serum level was read according to nephelometry measurement and the results were given in g/L. The gathered data were then analyzed using SPSS software program and statistical tests such as T-test and chi[2] [p<0.05]. Out of 125 patients, 91 were male and 34 patients were female [2.7/1]. The mean age was 63 +/- 12 years and the mean AAT serum in the patients was between 0.710g/L and 2.696g/L [mean 1.311 +/- 0.364g/L]. Almost all of the male patients had history of smoking [91%] and this smoking and its dose [Pack/Year] were significantly related to the severity of COPD. There was no significant relation between plasma levels of AAT and smoking, age or sex. The average age of patients suffering from COPD in rational AAT deficiency was significantly lower. However, the severity of symptoms had no significant difference between patients with normal levels of AAT. Based on the findings of this study, no case of exact deficiency of AAT was found in patients suffering from COPD admitted to Ekbatan Hospital of Hamadan. Regarding geographical location and number of the samples, the possibility of prevalence of this disease in Hamadan is much lower than that of European countries. However, the relative deficiency of AAT [20% in this study] was higher than the amounts obtained from similar studies in European countries

Barriers to and facilitators of empowerment in people with diabetes

Empowerment in individuals with people diabetes is well researched. However, few researchers have focused specifically on the barriers to and facilitators of empowerment in Iranians with diabetes. Understanding the barriers and facilitators that affect the empowerment process could help health professionals to more effectively facilitate self-empowerment. A grounded theory research design was used with in-depth interviews to collect the data from a purposive sample of males and females aged 21-73 years. Data were collected between February and July 2007. Themes were identified using the early steps of the grounded theory data analysis. Common barriers to empowerment were similar to other chronic diseases viZ prolonged stress, negative view about diabetes, ineffective healthcare systems, poverty and illiteracy. Diabetes education, fear of diabetes' complications, and hope for a better future also emerged as being crucial to empowerment. Facilitators specific to Iranians were the concept of the doctor as a holy man, accepting diabetes as God's will and the body as God's gift and support from peers and especially from daughters. Iranians with diabetes describe similar facilitators and barriers to empowerment quite similar to those as people from other countries as well as some specific to Iran. Empowerment is strongly affected by cultural and religious beliefs in Iran. Health professionals with deeper understanding of information about diabetics' lives and sources of strength could facilitate the process

Research tool translation and cross-cultural adaptation

Data collection is one of the important stages of research requiring valid and reliable instruments. Most of the time, researchers try to design questionnaires or translate valid and reliable instruments. In medical studies, researchers need to use translated instruments. The important issue in this regard is to consider some facts and the process that keeps the original concept and meaning of a questionnaire. In this way using questionnaires at different societies with different cultures would be useful There are different methods to translate questionnaires with cross-cultural adaptation but, in Iran little evidence exists in this regard. In this article, a guideline for translation is presented. Stages of translation with cross-cultural adaptation include preparation, forward translation, reconciliation of forward translation, back translation of reconciliation, back translation review, cognitive debriefing and finalization, proofreading and final report, each discussed in detail