Competence in Evidence-Based Medicine among Residents of Kerman University of Medical Sciences, Iran

Background & Objective: Evidence-based medicine (EBM) is a systematic review process for evaluating and using results of the best clinical trials for diagnosis and treatment of diseases. It must comply with the values and specific circumstances of each patient in need of treatment. Since very few studies have examined the competence of different groups of medical professionals in this area, this study was conducted to assess the competence of residents in EBM. Methods: This descriptive cross-sectional study was conducted on 90 residents from 4 main clinical departments in Kerman University of Medical Sciences, Iran, in 2013. The data collection tool was the Berlin Standard Questionnaire. The samples were selected using census method and data were analyzed using SPSS software. Results: Among the participants in the study 42.2% were male and 57.8% female with the mean age of 31.17 ± 3.32 years. Based on the results of the study, residents had little competence in the field of evidence-based medicine their scores ranged from 0 to 8 and their mean score was 2.54 ± 1.43 of a total of 15. Conclusion: Considering the mean score and low competence of residents in evidence-based medicine, short-term programs by the relevant departments seem essential to rapidly promote knowledge of evidence-based medicine. Keywords Competence Evidence-based medicine Resident

Operational Strategies for Establishing Disaster-Resilient Schools: A Qualitative Study

Introduction: Resilient schools can warranty students’ health and survival at disasters. It is obligatory that schools be prepared for natural challenges through local programs. Considering the great population of students, disaster-resilient schools can be a safe and suitable environment for students at the time of disaster. Objective: This study aims to identify certain operational strategies for establishing schools resilient to natural disasters. Method: This qualitative study was based on conventional content analysis. Using purposive sampling method, 24 experts in the fields of health in disasters, construction engineering, psychology, teaching, and administrative management participated in the study. Maximum variation sampling continued until data saturation was achieved. The data collected via unstructured interviews were analyzed with Graneheim and Lundmen’s conventional content analysis. Results: Content analysis resulted in four main categories as operational strategies for establishing disaster-resilient schools including: 1) “construction and non-construction optimization”, with four subcategories of construct risk management, optimization of construct architecture and physical structure, correct construct localization, and promotion of non-construct safety, 2) “promotion of organizational coordination and interactions” with two subcategories, namely improvement  in intra-organizational communication and improvement  in extra-organizational communication, 3) “improvement  in education” with three subcategories of holding educational courses for families and students, holding educational courses for managers and personnel, and holding simulated exercises, and 4) “process promotion” with four subcategories of increased preparedness, correct planning, creation of organizational structure, and rehabilitation facilitation. Conclusion: Various factors affecting schools’ response to disasters form operational strategies to establish disaster-resilient schools. These strategies influence pre- and post-disaster preparedness. Awareness of these components followed by preparedness prior to disasters can save students’ lives, improve school performance after disasters, and aid in establishing disaster-resilient schools as safe lodgings

Operational Strategies for Establishing Disaster-Resilient Schools: A Qualitative Study

Introduction: Resilient schools can warranty students’ health and survival at disasters. It is obligatory that schools be prepared for natural challenges through local programs. Considering the great population of students, disaster-resilient schools can be a safe and suitable environment for students at the time of disaster. Objective: This study aims to identify certain operational strategies for establishing schools resilient to natural disasters. Method: This qualitative study was based on conventional content analysis. Using purposive sampling method, 24 experts in the fields of health in disasters, construction engineering, psychology, teaching, and administrative management participated in the study. Maximum variation sampling continued until data saturation was achieved. The data collected via unstructured interviews were analyzed with Graneheim and Lundmen’s conventional content analysis. Results: Content analysis resulted in four main categories as operational strategies for establishing disaster-resilient schools including: 1) “construction and non-construction optimization”, with four subcategories of construct risk management, optimization of construct architecture and physical structure, correct construct localization, and promotion of non-construct safety, 2) “promotion of organizational coordination and interactions” with two subcategories, namely improvement  in intra-organizational communication and improvement  in extra-organizational communication, 3) “improvement  in education” with three subcategories of holding educational courses for families and students, holding educational courses for managers and personnel, and holding simulated exercises, and 4) “process promotion” with four subcategories of increased preparedness, correct planning, creation of organizational structure, and rehabilitation facilitation. Conclusion: Various factors affecting schools’ response to disasters form operational strategies to establish disaster-resilient schools. These strategies influence pre- and post-disaster preparedness. Awareness of these components followed by preparedness prior to disasters can save students’ lives, improve school performance after disasters, and aid in establishing disaster-resilient schools as safe lodgings

The Effect of Education on Formula and Bottle Feeding Behaviors of Nursing Mothers Based on PRECEDE Model

Objective: Although a lot of interventional studies may be found which have investigated the effects of education on nursing mothers regarding advantages of breast-feeding behavior, but very few studies in developing countries have examined whether mothers are conscious of the risks associated with formula and bottle-feeding on children. Knowing that Breast-feeding Index has decreased in Iran and feeding behaviors are not suitable and adequate in nursing mothers, we studied the effect of education based on PRECEDE Model on improving mothers’ breast-feeding behaviors in Yazd, Iran. Methods: Cluster stage sampling was employed to recruit 60 pregnant mothers who had one month to the time of their delivery. Before and 3 months after implementing the educational program through group discussion, lectures and pamphlets , a self-prepared questionnaire was completed by the respondents. Validity and reliability of the scales were approved. SPSS software was used for the purpose of data entry, manipulation, and analysis. Findings: Mean age was 25.9 (±5.8) years; 96.6% were housewives. After implementing the educational program, mothers' knowledge (38%) and attitude (12.3%) were significantly increased (P=0.001). After implementing the program, 85% of the mothers fed their children exclusively with mother's milk and 15%, breast-fed together with formula. The children, who were formula-fed, were breast-fed 4-5 times daily as well. Moreover, none of them was formula-fed from the time of birth and formula-feeding was used as a result of improper weight getting in these children. Conclusion: In order to design effective educational programs, healthcare professionals should better understand the determinants of feeding behaviors in nursing mothers and develop stage-specific interventions, within which, promoting predisposing factors like knowledge and attitude are priorities of the program. The PRECEDE Model, as a basic model for programming, was found to be helpful in addressing the effects of education on formula and bottle-feeding behaviors and their predisposing factors in nursing mothers

Determinants of Cancer Early Detection Behaviors:Application of Protection Motivation Theory

Background: Cancer is account for 13% of all deaths around the world and is the third cause of mortality in Iran. More than one third of these cases are pre-ventable and about 33% are curable with early detection. The aim of this study was to determine the predictors of cancer early detection (CED) behaviors ap-plying Protection Motivation Theory (PMT). Methods: In this cross-sectional study, cluster sampling method was employed to recruit 260 individuals of above 20 years old in Yazd, Iran and a researcher designed questionnaire was completed through interviews for each of the respondents. PMT theoretical variables and CED behaviors were the basis of data collection procedure. Results: Participants acquired 64.47% of the protection motivation, 30.97% of the passive and 45.64% of the active behaviors‟ possible scores. Theory con-structs predicted 19.8%, 15.6% and 9.6% of the variations for protection moti-vation, passive and active behavior respectively. Protection motivation was re-sponsible for 3.6% of passive and 8% of active behaviors‟ variations. Conclusion: Considering the scarceness of CED behaviors and the applicability of PMT in predicting these behaviors, utilization of the PMT‟s constructs in any interventional programs to accelerate CED behaviors could be an alternate methodological choice in the cancer control initiatives

Is Life Expectancy Associated with Depression in the Elderly?

Introduction: Depression is one of the most common psychiatric disorders and risk factors for suicide in aging that often underdiagnosed and those who are more hopeful, suffer from less depression. The present study was conducted to determine the relationship between life expectancy and depression among older people in Yazd, Iran.   Methods: This descriptive cross-sectional study was conducted on 250 community-dwelling elderlies over 60 years of age, Yazd city. Eligible older people were selected using cluster sampling method. The data collection instrument included geriatric depression scale and The adult hope scale. Data analysis was carried out using descriptive frequency distribution, independent t-test, ANOVA and Pearson correlation.   Results: The mean score of depression and life expectancy in the elderly was 6.77 ± 3.17 and 39.52 ± 6.27, respectively. There was a significant negative correlation between life expectancy and depression (r = -0.594 and p = 0.005), and a significant positive correlation between age and depression (r = 0.258 and p = 0.005).   Conclusion: Considering that the depression score in the elderly was at a moderate level, and also considering that with decreasing life expectancy, depression increased in the elderly, psychological interventions focusing on preventing and reducing depression, and increasing the life expectancy, are recommended

Relationship between Abuse Experience and General Health among Older Adults in Yazd City- Iran

Introduction: Elder abuse may increase the vulnerability of ageing people to disease and decrease their general health status, so addressing the issue is essential for promoting elderly quality of life. The study aimed to examine the relation between abuse experience and general health among elderly people in Yazd city- Iran. Methods: The cross-sectional study carried out on 250 community-dwelling seniors in the city of Yazd who were selected with cluster random sampling. Data collection tools included, Iranian Domestic Elder Abuse Questionnaire and Persian version of the General Health Questionnaire 28. Data were analyzed using Spearman correlation coefficient and linear regression tests. Results: Mean scores of abuse experience and general health among the elders were 11.84±12.70 (range 0-100) and 21.82±10.84 (range 0-84) respectively. General health status was more undesirable among elders who had experienced abuse than those who had not. Elder abuse subscales accounted for 17.2 % changes in general health, which had only care neglect and physical abuse subscales with significant prediction effect. Conclusion: Abuse experience has negative effects on older adults' general health. care neglect and physical abuse play a more important role

The Relationship between Demographic Variables with General Health and Quality of Life in Students of Islamic Azad University, Sabzevar Branch, Iran

Background and Objectives: Community mental health is one of the pillars of health assessment in communities, which is influenced by the quality of life, and is of great importance among students due to stressful education period. The purpose of this research was to determine the relationship between demographic variables with general health and quality of life among the male and female students. Methods: This study was conducted as a descriptive cross-sectional study on 209 students of the Islamic Azad University, Sabzevar Branch in 2013. The samples were selected using stratified sampling method. Data collection tools were demographic questionnaire, World Health Organization's Quality of Life-BREF (WHOQoL-BREF), and 28-item General Health Questionnaire (GHQ-28). Data analysis was performed by Pearson&rsquo;s correlation, analysis of variance, and independent t- tests. Results: In this study, the mean overall quality of life among female students (8.32&plusmn;1.91) was lower than male students (8.91&plusmn;1.62). Also, the total general health score was poorer in the female students (32.64&plusmn;12.91) compared to the male students (16.41&plusmn;7.63). The students with depression disorder (r=-0.178, p<0.01) and low general health (r=-0.152, p<0.029) had lower quality of life in mental health domain. Conclusion: Given the results of this research and undesirable level of general health and quality of life among the students, especially female ones, the need for comprehensive programs in universities is necessary to promote quality of life and general health and to reduce health disorders, and more attention should be paid to mental health and quality of life in students during education period

Determination of preventive behaviors for pandemic influenza A/H1N1 based on protection motivation theory among female high school students in Isfahan, Iran.

INTRODUCTION Influenza A/H1N1 pandemic has recently threatened the health of world's population more than ever. Non-pharmaceutical measures are important to prevent the spread of influenza A/H1N1 and to prevent a pandemic. Effective influenza pandemic management requires understanding of the factors influencing preventive behavioral. This study reports on predictors of students' preventive behaviors for pandemic influenza A/H1N1 using variables based on the protection motivation theory (PMT). MATERIALS AND METHODS In a cross-sectional study, multiple-stage randomized sampling was used to select 300 female students in Isfahan who completed a questionnaire in December 2009. Data were collected using a self-report questionnaire based on PMT. The statistical analysis of the data included bivariate correlations, Mann-Whitney, Kruskal-Wallis, and linear regression. RESULTS The mean age of participants was 15.62 (SE = 1.1) years old. Majority of participants were aware regarding pandemic influenza A/H1N1 (87.3%, 262 out of 300). Results showed that, protection motivation was highly significant relationship with preventive behavior and predicted 34% of its variance. We found all of the variables with the exception of perceived susceptibility, perceived severity, and response cost were related with protection motivation and explained 22% of its variance. CONCLUSION Promotion of students' self-efficacy, and intention to protect themselves from a health threat should be priorities of any programs aimed at promoting preventive behaviors among students. It is also concluded that the protection motivation theory may be used in developing countries, like Iran, as a framework for prevention interventions in an attempt to improve the preventive behaviors of students

Disability and Self-Care among Elders in Yazd

Introduction: Geriatric syndromes lead to a number of disabilities which dramatically affect the quality of life in ageing. Facilitating the process of self-care can improve the elder's health to a great extent which has received less attention in previous studies. This study aimed at investigating the relationship between the disability and self-care in the elderly of Yazd. Methods: This cross-sectional study was conducted in Yazd; 234 elderly participants were selected through cluster random sampling. WHODAS-II questionnaire and a researcher-designed self-care questionnaire were utilized and collected data analyzed using Mann-Whitney U, Kruskal-Wallis H, chi-square and Spearman correlation coefficient tests. Results: The mean score of disability was 38.55 &plusmn;13.71 (ranging from 0 to 92) and the mean score of self-care was 61.57&plusmn; 15.94 (ranging from 0 to 118). There was no statistically significant correlation between total score of disability and self-care, however, correlation was detected between the subscales. Conclusion: Given the high level of disability in a majority of elders and low level of their self-care, self-care promotion programs and prevention of disabilities in collaboration with their families and health centers are recommended