Journal of Research in Health Sciences
Volume:10 Issue: 2, Summer-Fall 2010

Quality in health care can be seen as having three principal dimensions: service, technical and customer quality. This study aimed to measure Customer Quality in relation to self-management of Type 2 diabetes. A cross-sectional survey of 577 Type 2 diabetes people was carried out in Australia. The 13-item Patient Activation Measure was used to evaluate Customer Quality based on self-reported knowledge, skills and confidence in four stages of self-management. All statistical analyses were conducted using SPSS 13.0. All participants achieved scores at the level of stage 1, but ten percent did not achieve score levels consistent with stage 2 and a further 16% did not reach the actual action stage. Seventy-four percent reported capacity for taking action for self-management and 38% reported the highest Customer Quality score and ability to change the action by changing health and environment. Participants with a higher education attainment, better diabetes control status and those who maintain continuity of care reported a higher Customer Quality score, reflecting higher capacity for self-management. Specific capacity building programs for health care providers and people with Type 2 diabetes are needed to increase their knowledge and skills; and improve their confidence to self-management, to achieve improved quality of delivered care and better health outcomes.

Helicobacter pylori infection is the most common gastrointestinal bacterial disease worldwide. Although using culture is considered as the golden standard method for diagnosis of H. pylori infection, urea breath test is a notable alternative method because it is an easy, quick, and non-invasive approach. The aim of this study was to estimate the prevalence of H. pylori infection in patients with digestive discomforts using urea breath test in Mashhad County, northeast of Iran.

The study involved 814 patients, 467 women and 347 men, aged 17-80 years, with gastrointestinal symptom from January 2007 to November 2008. The urea breath test was performed and the patients ingested a solution of isotope labeled urea. The expired air was collected and was analyzed using the Heliprobe breath card (Noster System, Stockholm, Sweden).

The results of the test were positive for 698 out of 814 (85.75%) patients including 403 (86.30%) of women and 295 (85.01%) of men. However, the difference between the two groups was not statistically significant. Positive cases were classified by age. The highest prevalence rate of H. pylori infection was observed among 50-60 years old patients.

The infection of H. pylori is very common among patients who have gastric complain and can be easily diagnosed by noninvasive urea breath test. Since H. pylori infection is related to poor prognosis outcomes such as gastric cancer. Therefore, screening and treatment of infected people especially symptomatic cases using urea breath test is a priority.

The purpose of this study was to determine the effects of educational program based on the BASNEF (Belief, Attitude, Subjective Norm, and Enabling Factors) Model on eye care among patients with insulin independent diabetes mellitus in Shiraz City, Fars Province, Iran. We enrolled 100 patients with non-insulin independent diabetes mellitus (Type II) fulfilling the inclusion criteria of this experimental study. The participants were randomly divided into two groups, one experimental, and one control group. All groups completed the questionnaires based on the BASNEF Model, a checklist related to patient's practice including patient's HbA1c and FBS levels, the pre-test results of an ophthalmologist's eyes examination and the results of three months follow-up. The experimental group participated in eight educational sessions during the interventional. The data analysis used including chi square-test, t-test, and ANOVA. The knowledge and all BASNEF Model components were significantly increased in the experimental group compared to the control group after intervention. In addition, behavioral eye care, such as physical activities, regular taking medicine, having eye examination, FBS checking, having appropriate diet, HbA1c level, and fasting blood sugar levels improved significantly among the experimental group compared to the control group. Applying the BASNEF Model is very effective for developing an educational program for diabetic patients, in order to control their blood sugar and enhancing behavioral eye care. Besides such programs, follow up education on controlling and monitoring is highly recommended.

A laboratory study was conducted to investigate the ability of a special type of strongly basic resin MP500WS for the removal of nitrate from different waters. Two different types of Point-of-Use (POU) devices containing an identical resin were used. MP500WS known as macro porous was used in POU devices for removal of high concentrations of nitrate and sulfate ions from water. Sulfate and chloride ions are considered the most important interferences in the treatment process of nitrate by most anion exchange resins. The results obtained by treatment of water samples having different ranges of nitrate (20 to150 mg/L), sulfate (50, 100 and 800 mg/L) and chloride (50 and 500 mg/L) have shown that the method was suitable for delivering water with NO3 concentrations in less than its maximum contaminant level (MCL=45 mg/L) as long as the initial NO3, SO4 and Cl concentration has remained in less than 150, 100 and 500 mg/L, respectively. For this purpose, POU systems that utilize a suitable tested resin may be considered as an economical and effective alternative to conventional systems. This study shows this strategy very effective for nitrate reduction to acceptable levels when macro porous type strongly basic resin is used as the resin.

The study was developed in order to find a subset of potential factors, which affect birth distance pattern, regarding consideration on correlation of events of birth in a family and correlation within clusters/centers which other studies omit these correlations. Referring to documents that were registered for family in the health care centers on socio-economical zone, we consider the families with at least one successful birth. Data were drawn from four health care centers, which selected via 27-health center in Hamedan City, western Iran, each from a socio-economic zone. It was expected, same socio-economic status family have same specific birth distance and a family follows a specific pattern. The multilevel recurrent approach was conducted to analyze the sample. The sample was 480 families and 1115 birth events occurred in these families. The final step model shows that significant factors on the birth distance time were mothers job (P=0.018). The random effect of second level (clusters/centers) was significant (P=0.038). In other words, the socio-economic of family affects on the birth distance patterns. Other potential variables were not significantly affected birth distances and were deleted from the final model. There are many potential factors, which may affect to birth distance, but multilevel recurrent event model has a better fit to data because of frailty and center effects. Application of other model such as Cox and frailty models may result in misleading reports.

This study aimed at determining the drug abuse pattern and the frequency of high-risk behaviors among the clients of Methadone Maintenance Treatment Centers and Drop-in Centers in Shahroud County of Semnan Province. In this cross-sectional study, the data collection tool was a questionnaire including 10 general and 32 specific items about drug abuse pattern and high-risk behaviors. The data were collected via interview. The mean age of the subjects was 34.8 year. The patterns of opium consumption among the subjects before coming to treatment center were inhalation (44.4%), ingestion (25.7%), and injection (12.7%). The subjects abused different types of opium before referring to the treatment centers including opium 88.42%, opium extract 65.5%, crack 48.0%, alcohol 30.3%, cannabis 19.8%, heroin 16.7%, and other substances 6.5%. Almost 42.4% of subjects had positive family history of drug abuse. There was not statistically significant correlation between the form of substance abuse and gender, education level, occupation and marital status. However the correlation between form of substance abuse and place of residence (P=0.014), income (P=0.03) and tobacco smoking (P=0.001) was statistically significant. The most prevalent pattern of drug consumption was inhalation. Opium and crack were the most frequent kind of drugs among study subjects. These results need serious attention in providing services through Methadone Maintenance Treatment Centers as well as Drop-in Centers. In addition, due to highly positive family history among addicts, family participation will play an important role in prevention.

So far, several studies were conducted to estimate the prevalence of cigarette smoking in Iran, but none of them used a statistical model to deal with unobserved smokers. The present study planned to estimate the accurate prevalence of cigarette smoking using mixture of truncated Poisson distribution. A cross-sectional study was conducted in Hamadan, west of Iran in 2009, using cluster sampling and 1146 men and women aged ≥18 years were enrolled. The data collection was done by an expert group of psychologists and sociologists. A truncated mixture Poisson distribution was fitted to the daily number of cigarettes smoked by smokers. The number of components of the mixture model and related mean and weight were specified using Bayesian information criteria. Accordingly, the number of cigarette smokers who answered incorrectly to the relevant question was estimated. To investigate the validity of the results, a simulation study was conducted using CAMCR software. Mixture Poisson distribution with four components was the most appropriate model fitted to the count data. After correction for underestimation, the prevalence rate of cigarette smoking in the population was 20.6%, including 36.2% for men and 3.3% for women. According to the simulation study, the bias of estimated prevalence was about zero and the root mean square error was estimated 2.5. The number of unobserved data can be estimated by fitting model to truncated count data. The mixture of truncated Poisson distribution is particularly useful to estimate population size when the main objective of the study is to investigate negative traits to which the participants may answer incorrectly.

This was a population-based cross-sectional study that enrolled 2495 subjects (1247 males and 1248 females) using stratified cluster sampling. Interviewers recorded the data using a multidimensional questionnaire including anthropometric indexes. Body mass index equal to or greater than 25 was considered as overweight and that of 30 and 40 as obese and pathologic obese respectively. SPSS 16.0 software was used for statistical data analysis. Mean age of the subjects was 39.2 [95% CI: 38.6, 39.8] yr. Mean body mass index was 25.3 [95% CI: 25.0, 25.6] kg/m2 for men and 27.5 [95% CI: 27.2, 27.9] kg/m2 for women. The prevalence rates of overweight, obesity and pathologic obesity were 29.9% (745/2495), 22.5% (561/2495) and 1.8% (44/2495) respectively. The prevalence of obesity was higher in urban residents than rural ones, 27.3% versus 18.9% respectively (P<0.001). The prevalence rates of obesity and pathologic obesity were much higher in women than men were, 30.3% versus 15.4% and 3.0% versus 0.6% respectively (P=0.001). The odds ratio estimate was 1.68 [95% CI: 1.40, 2.02] for urban area compared to rural area; 2.60 [95% CI: 2.14, 3.15] for females compared to males; 5.95 [95% CI: 3.54, 9.99] for married people compared to single people; 1.89 [95% CI: 1.44, 2.84] for age group of 55-65 years compared to age group of 15-24 years; 1.76 [95% CI: 1.17, 2.64] for illiterate people compared to those who had academic education; 1.98 [95% CI: 1.13, 2.49] for poor people compared to people with high economic level. The prevalence of obesity and overweight is very high in the north of Iran, hence is a signal of serious health problem, and should be the focus of special attention.