مجله تصویر سلامت
سال هشتم شماره 3 (پاییز 1396)

Achieving an appropriate policy needs an in-depth and comprehensive understanding of policy-making process. This study aimed to analyze HIV/AIDS policy-making process in Iran.
Material and This is a qualitative/exploratory study. Data were collected through document review and semi-structured interview. Non-probability sampling was used for selecting documents and research participants. We used framework analysis approach assisted by MAXQDA for analyzing qualitative data.
AIDS policy is formulated in two specific ways within national work group in the format of national strategic plan and drug damage reduction committee. The main problem of the policy process is fragmentation and lack of comprehensiveness. Country approach of the policy implementation is top-down. The main duty of country committee and its sub-committees facing with some challenges is generating interaction between the relevant organizations. Despite the specific structure of evaluation process, it suffers from challenges such as lack of required implementation power, lack of resource anticipation, weakness in systematic and comprehensiveness evaluation and not-enough cooperation among plan’s stakeholders.
It is obvious that policy-making in this area is completely governmental and the role of non-governmental organizations and civil servants is neglected. It seems that reform in AIDS policy-making structure and process can solve most of the problems of implementation, monitoring and evaluation.

As regards that suicidal ideation is a common problem in people with obsessive- compulsive tendencies, studying its components is of particular important. The aim of the present study was to investigate suicidal ideation based on perfectionism and positive and negative effects in people with obsessive tendencies.
Material and In a descriptive-correlational and cross-sectional research approach, 470 students from Tabriz University were selected using multistage random cluster sampling. From this sample, 163 people with an obsession score higher than the cut-off point were chosen and labeled as people with obsessive tendencies. In order to collect the data, Maudsley Obsessive-Compulsive Inventory, Five Facet Mindfulness Questionnaire, Responsivility Attitude Scale, and Beck Scale for Suicide Ideation were used. The data were analyzed using Pearson product-moment correlation and simultaneous multiple regression by SPSS v.21 software.
The correlation results showed that, among the components of mindfulness; observation components (r=0.15; p Based on these findings, it can be concluded that components, of consciousness-based act, non-judgment, and responsibility were the main determinants of suicidal ideation in people with obsessive tendencies.

Since 2014, the "health system transformation plan" was designed and implemented in order to solve some of the problems in Iranian health system. One of the goals of this plan is to reduce direct payments by inpatients. This study aimed to compare the direct payments by inpatients, before and after implementing the transformation plan.
Material and In this analytical-descriptive study, 1351 cases were selected (all cases). Direct costs paid by the inpatients were extracted from medical records and then analyzed using SPSS v.19 software and applying Uman-Whitney test.
The overall level of direct costs paid by inpatients before and after implementing the transformation plan has been decreased from 704 286 to 491815 Rials. A statistical relationship was observed between implementing the plan and the reduction of direct costs; but in detailed costs, there was no cange.
Health system transformation plan reduced the direct costs paid by inpatients; but in detailed costs, there was no reduction in some parts. Cooperation between hospitals is necessary to continue the plan.

Nowadays, electronic transactions and electronic health play a vital role in improving the health of patients. The purpose of this study was to determine the level of trust of hospitalized patients and factors affecting their trust in electronic health services.
Material and This was a cross-sectional study which was conducted through survey and questionnaire. A sample size of 60 people was randomly selected as a tool for collecting data in a Likert scale. Data were analyzed using descriptive and inferential statistics in SPSS software. The validity of the questionnaire was determined by content validity method and its reliability was confirmed by Cronbach's alpha coefficient test.
The overall trust of patients in electronic health was evaluated with a mean of 74.78% at a good level. Website's visibility factor with a mean of 8.99 point had the highest effect and the perceived risk of electronic health with a mean of 2.31 had the least effect on e-health.
The results showed that from the perspective of the participants, when deciding to apply electronic health, trust plays a key role and supporting factors, website and organizational factors are considered, respectively. So, for replacing e-health system, it is required to analyze discussed structures carefully.

The efficient and optimum application of antiseptics, disinfectants and sterile supplies plays a key role in controlling and extirpation of infections. Hospitals are considered as a source of infection transmitting center because of their special situation. The current study was conducted to investigate all kinds of disinfectants used in Tabriz hospitals.
Material and This was a cross-sectional study, conducted on seven important hospitals of Tabriz in March 2017. A questionnaire about disinfectants was filled. By visiting infection controlling units, environmental health, disinfectants and antisepsis warehouse and different parts of the hospitals, and performing interviews, the required information was collected and analyzed.
The results of this study demonstrated that each hospital used special kinds of antiseptics according to individual services; although there were some similarities. About 57% of the hospitals in this study used only domestic disinfectant products and others used both imported and domestic products. In the studied hospitals,Sodium Hypochlorite, Alcohol, Saya sept HP and Deconex 53 plus were the most common used disinfectants.
The results of this study showed that although holding environmental health training courses in hospitals is part of operational plans of the infection control committee, but since ward assistants and housekeepers perform disinfecting, increasing the awareness of the staff about the incidence and prevalence of nosocomial infections, the importance, dangers, human and financial losses related to these diseases and the effective role of these staff in proper removing of environmental pathogens and reducing nosocomial infections possibility are expected to be felt.

Breast cancer is one of the most common cancers in Iran, which neo-adjuvant chemotherapy used to treat in advanced types to reduce tumor burden. The aim of this study was to evaluate the ultrasound scales of patients with advanced disease, using two common treatment methods include TACs (Taxotere, Adriamycin, and Cyclophosphamide) and AC (Adriamycin, Cyclophosphamide).
Material and Clinical examination and Doppler ultrasound were performed before and after treatment. Before and after the treatment, the size of the primary tumor and tumor vascularization, and the ultrasound Resistivity Index (RI), Pulsality Index (PI), Peak Systolic Velocity (PSV) and the condition of the anterior lymph nodes, and the effect of two different therapies were investigated in response to treatment. The SPSS statistical software 17.0 was used to evaluate the relationship between the variables with 95% confidence interval, and P≤ 0.05.
The mean age of the patients was 48.90 (±10.58 SD) years. From these, 8 were postmenopausal and 9 were menopausal, and in 3 cases the situation was unknown. There was significant difference between the PSV levels of the main breast mass, pre and post chemotherapy (P=0.004). Changes in other indexes of breast mass and axillary mass were not statistical significant.
Color Doppler ultrasonography seems to be a promising alternative as an independent and complementary tool, to assess the response to treatment of breast masses to primary medical treatment in advanced breast cancers.

Evidence based librarianship (EBL) was defined as “use of best available evidence from qualitative and quantitative research results and rational experience and decisions acquired from the daily practice of library”. However there are controversies about if the nature of EBL deals with library services or professional practice and if it needs a formal education or informal continuing education is enough? To shed light on this ambiguity, the aim of this study was to find out the state-of-the-art of education of EBL in the world.
Material and The study utilized library and documentation methods to investigate the academic education of EBL through review of the available literature and websites.
The findings of the study revealed that evidence based librarianship does have formal curriculum for academic education in post graduate levels (post master and master). It also revealed that “Evidence Based Approach” (EBA) and “Evidence Based Medicine” (EBM) were also similar courses that are offered in Master and PhD levels.
Based on the history and revolution of EBA, it is time to develop formal curriculum and field of study for Evidence Based Information Practice. This study suggests establishment of the academic field of Evidence Based and Information Science to overcome the problems and limitations that library science faces in practice.