Comparison of quality of work life in rural family physicians and other general physicians in Iran

Background: Job satisfaction of physicians in family physician team is considered as one of the important factors for health system. The aim of the preent study was to compare the quality of work life (QoWL) in rural family physicians and general physicians with private clinics in Kurdistan province.Methods: A cross-sectional study was conducted among 103 general physicians including 50 rural family physicians and 53 general physicians with private clinics in Kurdistan province in 2016. The data were collected using QoWL questionnaire and analyzed using SPSS, v. 16. Descriptive statistics including frequency, percentage, mean, and standard deviation (SD) were used to describe the data and to examine the relationship between the variables, T-test was run.Results: The QoWL of rural family physicians with a mean of 55 (SD = 7.6) was higher than average scores. But QoWL of other general physicians with a mean of 47.7 (SD = 13.5) was lower than average scores. The results of t-test showed that there was a significant difference between QoWL of family physicians and other general physicians (t = 82.3, p = 0.001). In rural family physicians, there is a significant association between the QoWL and gender (t=2.7, P = 0.009) as well as native status (t=2.53, P = 0.004). In general physicians with private clinics, the QoWL of native physicians was higher than that of non-native physicians (t = 4.3, P = 0.001).Conclusion: The QoWL of rural family physicians is better than that of others general physicians, even though it is unsatisfactory in both studied groups. Therefore, improving the QoWL of rural family physicians, especially female and non-native rural family physicians, is recommended because promoting the rural family physicians' satisfaction can decrease the likelihood of turnover, and thus increase service quality and responsiveness, as a goal of the health system

Effects of cell phone waves on granular cells migration of cerebellum in neonatal rat

زمینه و هدف: استفاده روز افزون از تلفن های همراه باعث افزایش نگرانی ها در مورد آثار بیولوژیک امواج این دستگاه بر بافت های بدن، بخصوص سیستم عصبی مرکزی شده است. این مطالعه با هدف بررسی اثر امواج تلفن همراه بر مهاجرت سلول‌های گرانولار مخچه در رت انجام شده است. روش بررسی: در این مطالعه تجربی 40 سر نوزاد رت به طور تصادفی به 4 گروه ده تایی تقسیم شدند. یک گروه شاهد و سه گروه آزمایشی I، II و III که در روزهای 7 تا 13 بعد از تولدشان روزانه بترتیب 5/0، 2 و 8 ساعت از فاصله cm10 مورد تابش امواج تلفن همراه قرار ‌گرفتند. در روز چهاردهم، پس از کشتن رت ها و تهیه مقاطع بافتی، با استفاده از نرم‌افزار موتیک سلول های گرانولار مخچه شمارش شدند؛ همچنین ضخامت لایه گرانولار با نرم‌افزار Nikon اندازه‌گیری شد. یافته‌ها: جمعیت سلولی ناحیه گرانولار داخلی مخچه در گروه آزمایشی III نسبت به گروه شاهد، به طور معنی ‌داری کاهش یافت (05/0

Effects of cell phone radiation on migration of granule cells in rat cerebellum

Introduction: There are a growing number of cell phone devices and they are one of the most popular sources for electromagnetic waves. However, there are many concerns regarding their biological effects on the body, especially the central nervous system. Therefore, the aim of this study was to evaluate the effects of cell phone radiation on histology of the cerebellar granular cells in the neonatal rat. Materials and methods: We selected some Wistar rats. Then, we randomly divided their newborns into four groups. One of the groups was control and the other three were experimental groups. Groups I, II, and III were exposed to radiation from cell phone (with a distance of 10 cm from the rats) for a duration of 30 minutes, 2 hoursand 8 hours, respectively. After killing of the rats and preparing histological sections, we counted the granular cells of the cerebellum using Motic software. We measured the thickness of granular layers with Nickon software. Then, after data collection, statistical analysis was conducted using Tukey and Anova tests. Results: Results showed that cell population in internal granular region significantly decreased in group III. Also, results indicated a reduction in the external granular layer thickness in group III. Furthermore, cerebellar weight to body weight ratio in group III was significantly reduced as compared with the other groups. Conclusion: Results of this study showed that cell phone electromagnetic radiation can reduce the number of internal granular cells of the cerebellum and the external granular layer thickness is reduced

Analysis of vaginal delivery promotion package in the National Health System Reform Plan in Iran: a qualitative study

Background: The Vaginal Delivery Promotion Package was a part of the National Health System Reform Plan in Iran, which was implemented to reduce the rate of cesarean sections. The aim of the present study was to examine the views of the beneficiaries on the implementation of the promotion of natural vaginal delivery in the hospitals affiliated to Tehran University of Medical Sciences.  Methods: A qualitative study conducted in 2016 using semi-structured interviews for data collection. The sampling method was purposeful with maximum variation of the beneficiaries. After doing 35 interviews, the data reached a saturation point. Data analysis was done through content analysis method using MAXQDA 10 software.   Results: The package beneficiaries believed that it was successful in achieving its goal to reduce cesarean sections. Their perspectives were classified into two categories (strengths and weaknesses), eight themes (package design, achieving the goals, education and persuasion, package comprehensiveness, monitoring, infrastructures, plan implementation, and service quality), and 24 sub-themes. The most important weaknesses of this package were the payments and supervisions.  Conclusion: Officials and policymakers can improve the package by continuous monitoring, providing necessary feedback to the staff, and modifying the payments. Besides, paying attention to midwives and health workers, the first contact point for pregnant mothers with service providers, can increase the effectiveness of this package

Relationship between Quality of Work Life of Medical Staff and Quality of Patient Care

Background: Nowadays, quality of patient care is one of the major and important concerns of health care delivery which is extremely dependent on the medical staff. Objectives: The purpose of this study was to investigate the relationship between Quality of Work Life (QWL) and quality of patient care. Methods: This study was a descriptive-analytic study based on correlation which was conducted in the educational hospitals of Kermanshah. A total of 320 medical staffs were selected for the study. Quality of Work Life and Quality of Patient Care questionnaires were used to collect the data. For data analysis, descriptive statistics, person correlation coefficient, t-test and multivariate regression were used by using SPSS16 Results: Data analysis showed that the Quality of Work Life of medical staffs was in a medium level. Our findings indicate that there is a significant, negative relationship between stress at work and quality of patient care (P-value=0.001 & r=-0.247) and there is a significant, positive relationship between control & job satisfaction and quality of patient care (P-value=0.001 & r=0.217). Results of multivariate regression analysis showed that stress at work net account for 6% of the variance of the quality of patient care. Conclusion: Focusing on improving the working conditions of medical staffs can be incredibly useful in increasing the quality of health care

Burden of pediatric asthma in Kurdistan Province, West of Iran

BACKGROUND: Asthma is the most common chronic respiratory disease (CRD) and one of the most serious and important pediatric diseases in developing countries. The present study aims to estimate the burden of asthma among children in Kurdistan Province, Iran.METHODS: Disability-adjusted life year (DALY) was used in order to estimate the burden of asthma. In a cross-sectional study, with a sample size of 4000, and using the multi-stage sampling method and Asthma and Allergies in Childhood (ISAAC) questionnaire, the prevalence of asthma was estimated for two 6-7 and 13-14 age groups in Kurdistan Province in 2013. In addition, some necessary data were extracted from the death registration system in Kurdistan Provincial Health Center and Statistical Center of Iran (SCI).RESULTS: Burden of asthma for 6-7 age group was 71.6 DALYs in boys (2.77 DALYs per 1000 population) and 48 in girls (2.22 DALYs per 1000 population) with a total burden of 119.6 DALYs (2.52 DALYs per 1000 population). Moreover, its burden for 13-14 age group was 121.1 DALYs in boys (4.86 DALYs per 1000 population) and 82.3 in girls (3.98 DALYs per 1000 population) with a total burden of 203.4 DALYs (4.46 DALYs per 1000 population).CONCLUSION: Considering the significant prevalence of asthma and its burden among children in Kurdistan Province, it is suggested that prevention and management of this disease be considered as a priority by policy makers and in health programs, in addition to attempting to prevent and reduce its burden by setting out effective interventions

Systematic review and meta-analysis of global prevalence of HBsAG and HIV and HCV antibodies among people who inject drugs and female sex workers

The main objective of this study was to evaluate the prevalence of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), hepatitis C virus (HCV) and hepatitis B virus (HBV) and their co-infections among people who inject drugs (PWID) and female sex workers (FSWs). Data sources were searched from January 2008 to October 2018 in different databases. Data were analyzed in Stata 16 software using the Metaprop command. The results showed that the prevalence of HIV, HCV and HBV among PWID was 15, 60 and 6, respectively. The prevalence of HIV, HCV and HBV among FSWs was 5, 1 and 3, respectively. The prevalence of HIV/HCV, HIV/HBV, HCV/HBV and HIV/HCV/HBV co-infections among PWID was 13, 2, 3 and 2, respectively. The prevalence of HIV/HCV and HIV/HBV co-infections among FSWs was 3 and 1, respectively. The results show that the prevalence of HCV and HIV infections in PWID and the prevalence of HIV in FSWs is higher than their prevalence in the general population. Interventions for the prevention of HIV and HCV in PWID appear to be poor, and may not be sufficient to effectively prevent HIV and HCV transmission. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

Estimating utility value for female genital mutilation

Background: Female genital mutilation/cutting (FGM/C) is a clear violation of women's rights and can have adverse and irreversible health effects as well. Worldwide, more than 200 million women and girls have undergone FGM/C. Utility value of FGM/C has not been estimated yet, so we designed this study to extract the health utility value of FGM/C for the first time in the world. Methods: In a cross-sectional study in Iran, 125 girls and women who underwent FGM/C procedure were examined by the trained midwives in order to determine its type. In addition, a questionnaire was completed for identifying the socio-demographic factors and extracting the health utility of these individuals. Health utility was measured using Time Trade-off method and also to determine the effects of the socio-demographic factors on the health utility a two-limit censored regression model was applied. Results: The mean and median of the health utility of women with FGM/C were 0.971 (SE: 0.003) and 0.968 (IQR: 1-0.95), respectively. Number of non-Traders was 58 (46.4) who reported perfect health utility. However, the mean of health utility among traders was 0.946 (SE: 0.002). Only type 1 (Clitoridectomy) and type 2 (Excision) FGM/C were seen in this study. Women with Type 1 FGM/C had significantly lower health utility value (Mean: 0.968, Median: 0.957) than their type 2 counterparts (Mean: 0.987, Median: 1.00). Moreover, women in the age group of 31-45 years (Mean: 0.962, Median: 0.956), single (Mean: 0.950, Median: 0.954), divorced (Mean: 0.951, Median: 0.950), employed (Mean: 0.959, Median: 0.956), and with supplementary insurance (Mean: 0.962, Median: 0.950) had significantly lower health utility than their counterparts. Conclusion: FGM/C affects physical and psychological well-being of these individuals, resulting in a lack of personal and marital satisfaction, which ultimately leads to a 3 reduction in their health related quality of life. Therefore, preventing from this practice is very important and should be considered by health system policy makers more than before. © 2020 The Author(s)

Incidence, mortality, and burden of crimean congo hemorrhagic fever and its geographical distribution in Iran during 2009-2015

Background: This study aimed at estimating the incidence, mortality, burden, and geographical distribution of Crimean Congo Hemorrhagic Fever (CCHF) using Disability Adjusted Life Years (DALYs) in Iran 2009-2015. Methods: CCHF-related DALYs was calculated using a method developed by WHO for the investigation of Global Burden of Diseases (GBD). DALYs was calculated through adding years of life lost due to premature death (YLLs) to years lived with disability (YLDs). To calculate YLD, the average duration of the disease and its disability weight were set at 25 d and 0.613, respectively. The data on the incidence and mortality were collected from the CCHF surveillance system from the governmental section. Results: The highest and the lowest incidence rates of CCHF were observed in 2009 (122 cases) and 2010 (254 cases), respectively. Moreover, the lowest and highest mortality rates were reported in 2009 (20 cases) and 2012 (52 cases), respectively. The mean rate of fatality from CCHF observed between 2009 and 2015 was about 21.1. In addition, the lowest and highest DALYs were observed in 2009 (483 cases) and 2010 (1156 cases), respectively. CCHF incidence, DALYs, and mortality rate over the studied period were higher among males than females. CCHF-related DALYs did not have an equal distribution in all provinces of Iran; some provinces were suffering from a higher burden of the disease. Conclusion: It is recommended to improve the CCHF surveillance system, identify high-risk areas, practice early diagnosis and intervention, develop vaccines, control, and fight tick, and screen livestock to control and prevent the spread of this disease. © 2019, Iranian Journal of Public Health. All rights reserved