Determinants of Early Marriage from Married Girls' Perspectives in Iranian Setting: A Qualitative Study

Early marriage is a worldwide problem associated with a range of health and social consequences for teenage girls. Designing effective health interventions for managing early marriage needs to apply the community-based approaches. However, it has received less attention from policymakers and health researchers in Iran. Therefore, the current study aimed to explore determinants of early marriage from married girls' perspectives. The study was conducted from May 2013 to January 2015 in Ahvaz, Iran. A purposeful sampling method was used to select fifteen eligible participants. Data were collected through face-to-face, semistructured interviews and were analyzed using the conventional content analysis approach. Three categories emerged from the qualitative data including "family structure," "Low autonomy in decision-making," and "response to needs." According to the results, although the participants were not ready to get married and intended to postpone their marriage, multiple factors such as individual and contextual factors propelled them to early marriage. Given that early marriage is a multifactorial problem, health care providers should consider a multidimensional approach to support and empower these vulnerable girls. � 2016 Simin Montazeri et al

Attitudes and knowledge of HIV positive persons and high risk behaviors groups in Golestan, Iran

Background & Objectives: The epidemic of HIV has been become worldwide. Infected people with HIV which are most intravenous drug users (IDUs) and/or people who have unsafe sex are important source of transmission of infection to other persons in a community. Since there is little known about the knowledge and attitudes of HIV positives about HIV in Iran, therefore we decided to measure the level of knowledge and attitudes of this group in Golestan province in compare with individuals with risky behavior.Methods: This cross-sectional study was conducted on 54 HIV+ persons and 134 people with high risk behavior individuals in 2007 year.Results: Our study showed that HIV- (High risk group) cases had higher education level (P=0.034). Rate of jobless was higher in HIV+ persons (P<0.001). HIV+ cases had lower income (P=0.037). Both groups had moderate knowledge and poor attitude on HIV/AIDS. Level of attitude in HIV+ positive persons was lower than high risk group (P=0.05).Conclusion: It is concluded that these susceptible persons and also infected individuals with HIV regardless of their socio-economic levels need more continuous education in structured programs

Developing appropriate criteria for Benign Prostatic Hyperplasia Surgery Using RAND Appropriateness Method (RAM)

ABSTRACT: Introduction & Objective: Results of different studies show that a relatively large number of healthcare services offered are inappropriate or unnecessary. Benign prostatic hyperplasia is a benign enlargement of the prostate gland. Clinical features of this disease are one of the most common problems encountered by elderly males. The aim of this study was to assess the appropriateness of benign prostatic hyperplasia surgery. Materials & Methods: In this qualitative study which was conducted in 2008-9, in Tehran University of Medical Sciences, the RAN/UCLA method was used, which was designed in 1980 by the RAND institute and the University of California in Los Angeles. Regarding the stages of our method, scenarios and indications for benign prostatic hyperplasia surgery were chosen from the latest approved scientific resources and subsequently sent to urology specialists, who were chosen as members of the specialized panel. Panel members gave scores ranging from 1 to 9 to each indication and scenario based on scientific resources, clinical experiences and patient’s condition in two separate panel sessions. After compilation, the indications were finally grouped as appropriate, equivocal, and inappropriate so that they could be used to determine appropriateness of benign prostatic hyperplasia surgery in hospitals. In this study, the most suitable and most approved clinical guidelines related to benign prostatic hyperplasia, the Guidelines Evaluation and Research Appraisal (AGREE) were used.The selected guidelines were used as scientific resources for choosing the indications of benign prostatic hyperplasia surgery. SPSS version 16 and kappa weighted value were used in analysis process of the study. Results: Out of 282 scenarios grouped as 9 conditions related to benign prostatic hyperplasia surgery, which were extracted from scientific sources, 73 cases (25.9%) were considered as appropriate, 14 cases (5%) as equivocal and 7 cases (2.5%) were considered as inappropriate. Also 22 cases (7.8%) were considered as appropriate indications for drug therapy and none were found to be suitable for waiting and watching. There were 94 scenarios related to surgery that 75 scenarios (80%) were grouped in appropriate and 8 scenarios (8.5%) identified inappropriate. Conclusion: At the present time, due to the lack of scientific evidence for suitable decision-making in providing health services, methods based upon agreement, including the one used in the present study, and the use of treatment standards derived from similar studies, are amongst the most important measures taken to improve the standard of health, provide suitable health services, and to reduce unnecessary costs. In addition, RAM appropriateness method could be an ideal method in determining the appropriateness of health care and in reducing the rate of inappropriate services provided. The similarity of results derived from other studies performed by the RAND method in determining the appropriateness of benign prostatic hyperplasia treatment with the current study shows the validity and reliability of this method. Keywords: Appropriate criteria, Benign Prostatic Hyperplasia (BPH), Appraisal of Guidelines for Research and Evaluation (AGREE)

Knowledge and attitude levels in high risk groups about HIV/AIDS and relation with socioeconomic level indicators in Golestan province (2007)

Background and Objective: Acquired immunodeficiency syndrome (AIDS) is a definition of dysfunction of immune system in human that is induced by infection with a virus named human immunodeficiency virus (HIV). The most high risk group in HIV infected people are intravenous drug users (IDUs) with unsafe sex. This study was conducted to evaluate knowledge and attitude of IDUs with unsafe sex about AIDS and relation with socioeconomic levels in Golestan province in North of Iran. Materials and Methods: This Cross-Sectional study was conducted on 134 IDUs in Golestan province during 2007. Samples were chosen by a random systematic method. Data was collected with interview by standard questionnaire. Data was analyzed by SPSS-16 and One-way ANOVA,T-test student, Kruskal-wallis, Mann-Whitney U and Kendall tests. Results: This study showed that 36.6% of samples had moderate knowledge about AIDS and 49.3% of them had negative attitude about AIDS. 67% of subjects had education between 6-12 years, 44.8% were married and 53% were jobless and without income. Level of knowledge had a significant relation with age (P<0.05) and education level (P<0.05). Older subjects had better knowledge. Level of knowledge in 25-34 years group was higher than other age. Well educated people had higher knowledge compared with low educated and illitrate subjects. Level of knowledge had a significant relation with attitude (P<0.05). Conclusion: The findings of this study showed that 65% of subjects with high risk behavior on HIV/AIDS had a appropriate knowledge about transmission of HIV, but half of these population have a poor HIV/AIDS attitude