Survey of educational drop-out indexes and its related factors in alumni of paramedical faculty of Kashan Medical University

BACKGROUND AND OBJECTIVE: Educational dropout is one of the problems of educational system. The educational drop-out prevention and its complications require recognition of the probability risk factors. So, this study is carried out in order to assess the indexes of educational drop-out and its related factors in alunmi of paramedical faculty of Kashan medical University, Iran. METHODS: This cross-sectional study was performed on the entire alunmi from 1990-2003 (n=1439). The questionnaire including probability related factors and the indexes of educational drop-out (probation, unacceptable total average, lesson repeating, major changing, withdrawing, ejection from university, education leaving and delay in graduating) was used. FINDINGS: Prevalence of probation, unacceptable total average and delay in graduating were 9.2 (n=133), 14.5 (n=209), and 14.1 (n=203), respectively. The utmost probation frequency was related to first and then second semester. Delay duration was only one semester in 152 (10.56). 413 (28.7) had repeated lesson that 227 (15.8) had repeated only one lesson. Prevalence of major changing, withdrawing, ejection from university and education leaving were 2 (n=29), 0.9 (n=13), 0.4 (n=6), and 0.6 (n=9), respectively. There was an association between demographic data, prior educational status, and admission criteria with academic drop-out. CONCLUSION: With attention to the considerable prevalence of educational drop-out and its risk factors, diagnosing and supporting of the vulnerable students is a must

Referral patterns in Kashan's hospitals, 1996

History and Objectives: Due to the important role of the referral system in utilization of medical and educational resources, the current study was performed in 1996 to determine referral patterns in Kashan hospitals. Materials and Methods: In this descriptive study, 614 patients were selected through sequential sampling. The sample size was calculated based on the 10 error. These 614 patients were distributed in Kashan's hospitals according to the number of beds. In each case care variables including age, sex, occupation, educational level, chief complaint, number of visits, method of payment and referral pattern were recorded. Results: Of the patients studied, 350 (57) were female and the remaining male. The mean age was 37.9 years and 75.2 were married, 20.2 had infectious diseases and the remaining had other afflictions. Self-referral was seen in 47.2 of the cases. Conclusion: Based on these referral patterns and its effect of function of the health and treatment system, we suggest the shortcomings of the referral system be identified as soon as possible and step be taken to alleviate the problem

Surveying the knowledge, attitude and practice of Kashan faculty member towards educational media

Background: Educational media have utmost importance however, their proper application is not clarified for faculty members. The present study was performed to determine the role of educational media on knowledge, attitude and practice of Kashan faculty members. Materials and methods : All Kashan faculty members have enrolled. Their knowledge was assessed based on subjects' knowledge towards educational media, while their attitude was evaluated by Likert test. Meanwhile, their practice was evaluated by direct observation of their usage of media. Finally, subjects were assigned in 3 groups of poor, moderate, and good. Results : The study population included 38 clinicians and 59 basic scientists. Good knowledge, attitude, and practice was reported in 12, 11.3, and 25.3 of faculty members, respectively. However, 34, 40.2, and 44.3 revealed to have poor knowledge, attitude and practice, respectively. Conclusion : Results have revealed that Kashan faculty members have poor knowledge, attitude and practice of educational media. Thus, they are strongly candidated for educational program

A study of self-referral in public and private health care delivery system, Kashan, 2000

Background: Appropriate utilization of primary physician and specially care has stimulated substantial debate, but the portion of discussion focused on policies that restrict or discourage direct access to specialist. We examined the self-referral incidence rate and the association of health care delivery system structure with utilization of primary physician and specialist. Materials and Methods: Office visit for patients in private sector and outpatients in public clinic care, stratified by insurance status (Rural Health Insurance, Imam Khomeini Welfare Committee, private insured patients and non insured patients or self-pay patients). 1306 subjects were randomly selected for the study purpose. 39.9% were covered by Imam Khomeini Welfare Committee, 14% Rural Health Insurance, while 46.1% were open for direct referral to specially services. Results: In Imam Khomeini Welfare Committee closed loop referral system, 6.8% of patients were direct self-referral. In rural health insurance 29.7% of patients were direct self-referral, while in open referral system 75.5% of the patients were direct self-referral to specialist. Significant association was detected between the structure of health care delivery system and patient self-referral of specially cares. The incidence rate of self-referral in public sector was 60.5 and in private sector was 36.4%. Significant association was detected between public and private sector self-referral (P<0.001). Patients’ reasons for skipping the general practitioner were high specialist competency as those problems were specific for the specialist waste of time, friends’ recommendation and weakness information about referral system. Conclusion: The results suggest greater utilization of specialist in open referral system. Closed loop referral system like Imam Khomeini Welfare Committee may reduce some of these disparities

A study of patient seeking care behavior

Background: Patient seeking care behaviors are affected by many factors including socio-cultural and financial affaires, therapeutic costs, etc. This study was conducted to investigate patient seeking care behavior in Kashan, in 2004. Materials and Methods: This was a descriptive study in which a random sample of 414 individuals was selected from people attending public outpatient health clinics. Multi stage sampling was used to select the subjects. For data collection a trained expert health worker interviewed the subjects individually in the health centre waiting room. Identity variables and study specific objectives (contact with GP or health clinics as optimistic behavior and direct contact with specialty or subspecialty as non relevance behavior) were assessed. Then the data were analyzed using Chi-square statistical test. Results: Of participants, 49.3 were men and 51.7 were women. Rate of having a visit to a physician in four recent weeks were X= 0.96 ± 1.29 in women and X= 0.49 ±0.93 in men. Seeking care optimistic behavior were 21 and 15.7 respectively. There was a significant association between the sex and physician seeking care behavior (X 2 =18, P=0.5). Of subjects  83.3 were covered by a health insurance plan and 16.6 were not covered by any insurance plan. Overall patient optimistic behavior in insured and uninsured subjects were 19.1 and 14.5 respectively. Conclusion: The findings of this study demonstrated the high degree of difference in patient seeking care behavior rates according to the healthcare delivery system structure (insurance type and care givers), patient characteristics and many influencing variables. We recommend findings of this study for reorganization of healthcare delivery systems. The findings may be regarded as preliminary to further research into this area of health system structure

A study of nonthyroid illness (NTI) in patients admitted at intensive Care units at Hospitals of Kashan University of Medical Sciences

Background: Since there are many controversies about the incidence and prevalence of thyroid hormone abnormalities in critically-ill patients, and because of lack of such information in our patients, this study was performed to determine the frequency of these abnormalities in patients admitted to Intensive Care Unit of Kashan Medical University hospitals in the second half of 2003. Materials and Methods: This descriptive study (with new data)was conducted on patients with severe illness admitted in Intensive Care Unit. The information on age, sex, primary diagnosis, vital signs was obtained. A sample of blood to assess thyroid hormone was taken too. Another sample to assess thyroid hormone was taken 8 weeks later. Results: The population under study included 99 cases with mean age of 58.04 ± 21 years, 61.6% of which were males and 49.5% of patients died in the course of admission. The prevalence of reduction in T4-T3-TSH-T3Ru on the beginning of admission was 22.2%, 31.3%, 29.3% and 22.2% respectively. The most common abnormality was decreased in T3 level and 71% of patients with this reduction died. Decrease related to T4 was 81.8% and related to simultaneous decreased of both hormones was 91.7%. The mean level of T4 was 76.10 ± 37.60 (nmol/lit) in died patients and 100.48 ± 37.84 (nmol/lit) in recovered patients (p<0.002). The measurement about T3 in died and recovered patients was 0.96 ± 0.58 (ng/ml) and 1.33 ± 0.65 (ng/ml) respectively (p<0.004). The mean of hormonal level in 50 recovered patients was 0.96 ± 0.58 (ng/ml) and 1.33 ± 0.65 (ng/ml) respectively (p<0.004). The prevalence of NTI according to hormonal assessment 8 week after discharge-related to T3,T4,T3RU and TSH was 88.9, 66.7, 100, 0 percents respectively. Conclusion: Our research showed that hormonal change in Nonthyroid illness (NTI) in intensive care unit is common, and has prognostic value. Therefore, recognition of this abnormality in critically-ill patients is needed. Experimental clinical trials are recommended to choose the appropriate approach