Evaluating the hospitalization costs for elderly patients in teaching hospitals of Kashan university of medical sciences during 2009-10

Background: Considering that hospital costs of the growing elderly population account for a significant share of the health care costs, this study aimed to investigate the elderly hospitalization cost in teaching hospitals of Kashan university of medical sciences. Materials and Methods: In this cross-sectional study, 2067 patients (age≥60) admitted to teaching hospitals of Kashan university of medical sciences during a one-year period (Sep. 2009–Sep. 2010) were randomly selected using stratified random sampling. Data related to hospitalization charges of cases were obtained from medical records and analyzed. Results: The mean hospitalization charge was 5533529 Rials. The highest cost share was for "bed-day" (26.4%). The highest average hospitalization cost for different diseases were for digestive, neoplastic and respiratory system, respectively. However, diseases of the eye and circulatory system accounted for the largest share of total hospital costs. Regarding the ward, the highest charges were paid for the elderly patients in ICU and CCU, but internal wards had the largest share of total hospital costs. In addition, a significant relation was seen between the cost for each elderly hospitalized and the ward/disease condition (P<0.001), and the comorbidities (P=0.001). Conclusion: To reduce the hospital costs, careful attention should be paid to disease services with the highest costs. Moreover, the preventive measures as well as alternative low-cost services (e.g. home care) and developing long-term care should be provided

A survey of neurobehavioral symptoms of welders exposed to manganese

Introduction: Occupational exposure to manganese can cause neurobehavioral symptoms. The aim of present study was to survey neurobehavioral symptoms of welders exposed to manganese- containing welding fumes and compare the frequency of these symptoms with unexposed group. .Material and Method: Twenty seven of welders as exposed group, and 30 administrative workers as unexposed controls, were participated in this study. Neurobehavioral symptoms data were gathered using Q16 questionnaire. Manganese concentrations were determined according to the NIOSH 7300 method. After preparing of blood samples using microwave assisted acid digestion method, all samples were analyzed to determine manganese by graphite furnace- atomic absorption spectroscopy (GF-AAS). .Result: The mean exposure to air manganese was 0.023± 0.012 mg/m3. Manganese concentrations in blood samples of welders (15.88± 7.11 µg/l) were significantly higher than unexposed workers (9.37± 8.70 µg/l), (P-V<0.05). The frequency of neurobehavioral symptoms of welders was significantly higher compared to unexposed workers (P-V<0.05). The correlation between neurobehavioral symptoms and blood manganese was significant for welders (P-V<0.05). . Conclusion: Welders’ exposure to manganese and its potential health effects should be evaluated periodically and effective control measures should be applied in order to to prevent neurobehavioral symptoms

SYSTEMIC COMPLICATIONS AND THEIR RISK FACTORS AMONG TEHRANIAN BLOOD DONOR, 2005

The systemic complications of blood donation are the first reasons why patients fail to return for further blood donation. This study was designed to determine the frequency of these complications and their associated risk factors among blood donors in Tehran. Also, we aimed to provide suitable methods to decrease the frequency of these adverse events, thereby eliminating the most important causes of withdrawal, while maintaining the health of the donors. This analytical descriptive cross-sectional study was performed on 554 blood donors who had donated blood from February 2005 through September 2005 in four fixed blood donation bases and four mobile blood collection buses. Each base was considered as a stratum, and a stratified random sampling proportional to size was done to select the donors. Results showed donor reaction rate to be 13.4%, the most common of which were blackout of vision (7%), dizziness (6.3%), fatigue (6.1%) and nausea (1.8%). There was no significant relationship between the incidence of these complications and type of base blood donation or fasting at the time of blood donation. Logistic Regression analysis showed that sex, condition of blood donor, exercise or walking, duration of donation, and practice to recommendation had significant effects on the odds ratio of systemic complication. Regarding the frequency values derived for the different systemic complications it can be concluded that attention to risk factors of these complications and their control can help encourage donors to become repeated donors as well as to prevent their withdrawal for further blood donation

Survival analysis of gastric cancer patients refering to Emam-Khomeini hospital using Weibull cure model

Background: Due to its high prevalence, the survey on gastric cancer survival in Iran seems too important. In the case of relative long-term survival of the cases, using standard models is not conventional. So cure models are used to estimate the proportion of the cured patients that will never experience the event of interest and also to evaluate the survival function of susceptible individuals who may experience the event and effective factors. This study was carried out to determine the five-year survival rate of gastric cancer patients who have undergone surgical treatment. Materials and Methods: Three hundred and thirty gastric cancer operated patients with a maximum 10-year survival were enrolled in the study. The patients’ life expectancy after surgery and cure fraction and their relationships with some variables were evaluated. Kaplan-Meier and Weibull Cure models were utilized for analyses. Results: The five-year survival rate and the median life expectancy were 24% and 19.9 months, respectively. Univariate analysis using the Weibull model showed that age, existence/site of metastasis and stage of disease influenced on the probability of curing (P0.05). Conclusion: Using the cure models is beneficial in situations which the population under study suggests the presence of subpopulation. The cure/immune model methodology may separeltery identify the sets of covariates related to the cured proportion and also the failure time distribution of uncured one

Sexual satisfaction after child birth: vaginal versus elective cesarean delivery

&quot;nBackground: The perception of impairment of sexual function after childbirth in vaginal delivery (as a complication) makes pregnant women to request elective cesarean section. But this conception is more related to culture. Therefore we studied women&apos;s sexual health after childbirth to assess whether women who underwent cesarean section experienced better sexual health in the postnatal period than women with vaginal births. &quot;nMethods: A cohort study was conducted on 303 primiparous women who had delivered vaginaly and 315 primiparous delivered by elective cesarean section in seven private hospitals in Tehran, employing data of demographic characteristics like age, education, BMI, obstetric history (weight gain in pregnancy, history of pelvic pain and vaginal discharge), stress incontinence history (prepregnancy and during pregnancy) and effect of delivery on sexual satisfaction in several follow-ups until 12 months after delivery. &quot;nResults: Sexual satisfaction after delivery in vaginal group was significantly more than cesarean group. (76% vs 60%, p&amp;lt;0.0001). There was no relation between pelvic pain &amp;amp; delivery type (in several follow- up). &quot;nConclusions: Instead of social conception of have more sexual satisfaction after cesarean delivery, outcomes from this study provide no basis for advocating cesarean section as a way to protect women&apos;s sexual function after childbirth. Therefore Request of cesarean section by mother for having more sexual satisfaction after childbirth is not logic

Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial

Fatemeh Estebsari,1 Maryam Dastoorpoor,2 Davoud Mostafaei,3 Narges Khanjani,4 Zahra Rahimi Khalifehkandi,5 Abbas Rahimi Foroushani,6 Hamidreza Aghababaeian,7 Mohammad Hossein Taghdisi8 1Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, 2Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 3Department of Nursing Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, 4Neurology Research Center, Kerman University of Medical Sciences, Kerman, 5Department of Health Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, 6Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, 7Nursing and Emergency Department, Dezful University of Medical Sciences, Dezful, 8Department of Health Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran Background: Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse.Methods: This parallel randomized controlled trial was conducted in 2014&ndash;2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using &chi;2 tests, multiple linear and logistic regression, and structural equation modeling (SEM).Results: The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher (P&lt;0.001) and the frequency of elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (S&beta;) showed that the intervention had the highest impact on increase social support (S&beta;=0.80, &beta;=48.64, SE=1.70, P&lt;0.05), self-efficacy (S&beta;=0.76, &beta;=13.32, SE=0.52, P&lt;0.05) and health promoting behaviors (S&beta;=0.48, &beta;=33.08, SE=2.26, P&lt;0.05), respectively. The effect of the intervention on decrease of elder abuse risk was indirect and significant (S&beta;=-0.406, &beta;=-0.340, SE=0.03, P&lt;0.05), and through social support, self-efficacy, and health promoting behaviors.Conclusion: Educational interventions can be effective in preventing elder abuse. Keywords: elder abuse, self-efficacy, social support, health promotion, health educatio

Prevention and control of health care–associated infections in Iran: A qualitative study to explore challenges and barriers

Background Globally, the health and economic burden posed by health care–associated infections (HAIs) remains wide and severe. To curb the burden associated with HAIs, countries, including Iran, aim at HAI prevention and control. This study explores the challenges faced by the Iranian health system in addressing the issues associated with the prevention and control of HAIs. Methods A qualitative research method was adopted in exploring the phenomenon. We used the purposive sampling approach in reaching 24 key informants at the national and subnational levels. The thematic framework analysis was conducted for analyzing the interviews. Results Five main themes emerged from our study demonstrating the obstacles toward the prevention and control of HAIs. They include governance and stewardship, resources, safety culture, monitoring and surveillance systems, and inappropriate prescription of antibiotics. Conclusions Strengthening of reporting and surveillance systems for HAIs coupled with proper governance and stewardship are crucial in order to improve the health and safety of patients. However, the availability of resources, through an intersectoral approach, is essential to achieve sustained output

Effect of daily consumption of probiotic yoghurt on insulin resistance in pregnant women: A randomized controlled trial

Background/objectives: Owing to excess body weight and increased secretion of inflammatory cytokines primarily during the third trimester, pregnancy is associated with elevated insulin resistance. To our knowledge, no report is available indicating the effects of probiotic yoghurt consumption on serum insulin levels in pregnant women. This study was designed to determine the effects of daily consumption of probiotic yoghurt on insulin resistance and serum insulin levels of Iranian pregnant women. Subjects/methods: In this randomized controlled clinical trial, 70 primigravida pregnant women with singleton pregnancy at their third trimester were participated. We randomly assigned participants to consume 200 g per day of conventional (n=33) or the probiotic group (n=37) for 9 weeks. The probiotic yoghurt was a commercially available product prepared with the starter cultures of Streptococcus thermophilus and Lactobacillus bulgaricus, enriched with probiotic culture of two strains of lactobacilli (Lactobacillus acidophilus LA5) and bifidobacteria (Bifidobacterium animalis BB12) with a total of min 1 � 10 7 colony-forming units. Fasting blood samples were taken at baseline and after 9-week intervention to measure fasting plasma glucose and serum insulin levels. Homeostatic model assessment of insulin resistance (HOMA-IR) was used to calculate insulin resistance score. Results: Although consumption of probiotic yogurt for 9 weeks did not affect serum insulin levels and HOMA-IR score, significant differences were found comparing changes in these variables between probiotic and conventional yogurts (changes from baseline in serum insulin levels: +1.2±1.2 vs +5.0±1.1 μIU/ml, respectively, P=0.02; and in HOMA-IR score: -0.2±0.3 vs 0.7±0.2, respectively, P=0.01). Conclusions: It is concluded that in contrast to conventional yogurt, daily consumption of probiotic yogurt for 9 weeks maintains serum insulin levels and might help pregnant women prevent developing insulin resistance. © 2013 Macmillan Publishers Limited

Plasma total antioxidant capacity and its related factors in Iranian pregnant women

Objectives: To determine the plasma total antioxidant capacity (TAC) and its related factors in pregnant Iranian women attending maternity clinics. Methods: In a cross-sectional study carried out in Naghavi Maternity Clinic, Shaheed Beheshti Specialty and Subspecialty Polyclinic and 10 antenatal centers, affiliated to Kashan University of Medical Sciences, Kashan, Iran, we determined the plasma TAC and its related factors including maternal age, weight, and body mass index (BMI) at the beginning, thirteenth, and twenty-first to twenty-fourth weeks of pregnancy, and gestational age at the twenty-first to twenty-fourth weeks of pregnancy in 137 primigravid pregnant women, 18-30 years old from October 2010 to March 2011. We used multiple linear regression to assess the relationship between TAC and its related factors. Results: Plasma TAC in the twenty-first to twentyfourth weeks of pregnancy was 0.75±0.11 mmol/l. The BMI at the beginning was 25.06±4, 25.72±4.13 at the thirteenth, and 26.95±4.19 kg/m 2 at the twenty-first to twenty-fourth weeks of pregnancy. Multiple regression analysis showed that gestational age was inversely associated with the plasma TAC (�: -0.234, p=0.007). Regression analysis also suggested a trend toward significant association between maternal age and plasma TAC (�: 0.150, p=0.080), but there was no association between other variables and plasma TAC. Conclusion: Gestational age was inversely correlated with plasma TAC and maternal age had a trend toward significant association with TAC in 18-30 year-old Iranian pregnant women in their sixth month of pregnancy