Health Technology Assessment in Action
Volume:8 Issue: 1, Nov 2024

The presence of accompanying midwives (doulas) in the delivery room always entails many challenges. This study was carried out to determine the challenges of attendance with training from the point of view of midwives and expectant mothers in selected hospitals of Chaharmahal and Bakhtiari province, Iran.

The present study was a descriptive study on 70 midwives working in the delivery block, 120 pregnant mothers, and 20 trained attendants. The sampling of midwives and doulas was performed using the census method, and the sampling of pregnant mothers was conducted using the convenience method. The study tool included questionnaires made by the researcher about demographics and socioeconomics, therapeutics, and psychological challenges for the group of mothers and midwives. The face validity and content validity of the questionnaires were confirmed by midwifery professors and reproductive health specialists, and their reliability was confirmed by internal consistency. The data were analyzed using descriptive statistics with SPSS software (version 21).

In this study, 70 midwives working in selected hospitals of Chaharmahal and Bakhtiari province, 120 pregnant mothers, and 20 trained attendants were examined. Most of the pregnant women (n = 39, 32.5%) mentioned that the most important motivation for requesting a doula during pregnancy and labor was to overcome the fear of childbirth. Most of them (n = 101, 84.9%) also stated that they used doula services at the right time. Meanwhile, 54 women (45%) were familiar with doula services during pregnancy, and most of them (n= 67, 56.3%) stated that doula services can be useful and effective in all three stages of pregnancy, labor, and delivery.

There are dissatisfactions and challenges regarding the support of doulas during pregnancy and childbirth. Therefore, it is recommended to provide the necessary training to healthcare providers, especially obstetricians, midwives, and mothers, regarding the importance and place of doula’s supportive care in this era. Additionally, doula activities should be integrated and promoted in the care of the health team.

In the context of Persian traditional medicine, there are several therapeutic strategies for managing diseases, ranging from lifestyle changes to herbal remedies.

Given the application of Persian traditional medicine in the management of chronic diseases, the burden of chronic illnesses, and the public’s recourse to traditional medicine specialists, this study aimed to assess the cost-effectiveness of traditional medicine dietary regimens for the treatment of non-alcoholic fatty liver disease from the perspective of the payer.

In this study, we investigated the cost-effectiveness of providing nutrition counseling for lifestyle modification (changes in the aforementioned Setteh-e-Zarurieah) by a traditional medicine specialist compared to receiving counseling from a nutritionist for nonalcoholic fatty liver disease from the payer’s perspective. The outcomes measured were changes in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes, body mass index (BMI), and the grade of fatty liver. Cost and effectiveness data were entered into Excel software, and the ICER ratio was calculated.

The results indicated that the dietary regimen prescribed by Persian traditional medicine when compared to the nutritionist’s recommended diet, resulted in a lower decrease in AST and ALT enzymes but led to a greater decrease in BMI (mean change = 0.42) and a significant change in the grade of fatty liver (OR = 9.75). Since the costs of tests, ultrasounds, and visits were equal in both groups, the cost difference was zero. In the first scenario, where traditional medicine is considered an alternative therapy and liver enzymes are the
primary focus, providing nutritional counseling services by Persian traditional medicine may not be cost effective. However, if we consider the grade of fatty liver and BMI as the primary variables, providing nutritional counseling services by Persian traditional medicine may be cost-effective.

Based on the available evidence, the treatment of fatty liver using Persian traditional medicine can be considered an effective and cost-effective complementary (or alternative) intervention. Considering the long-term costs imposed by the health system and insurance organizations, it is predicted that adding visits to Persian traditional medicine specialists may reduce overall healthcare system costs.

Currently, health indicators are considered an important factor in the development of countries and can be effective in raising the level of developmental indicators.

In this regard, the present study aimed to analyze the relationship between the effect of health indicators on the developmental indices of the provinces of Iran.

The current study of an applied type was descriptive, cross-sectional, and retrospective. The data were prepared through forms designed based on experts’ opinions and classified information in statistical yearbooks for the provinces of the country during 2016 - 2020. Data analysis was carried out using Stata 17 software. Moreover, panel data was used to estimate the model, and the Xtpcse test was used to obtain the results of the hypotheses.

The results of the model estimation show the positive and meaningful impact of health indicators on educational indicators such as the ratio of students to teachers, the ratio of students to staff and management, the ratio of higher education students to the population of the provinces and the distribution of students in the province.

The country’s authorities can improve and develop health by identifying and optimizing the use of effective indicators in the field of Health and education indicators such as increasing the number of medical and health students and developing educational programs in the field of Health and health and informing the community about these programs, as well as encouraging higher education in low-income areas.

Acceptance and commitment therapy (ACT) is an emerging form of cognitive-behavioral treatment that is based on functional context.

The purpose of this study was to investigate the effectiveness of ACT in individual and social adaptation in adolescents with disabled parents.

The research design was a quasi-experimental, pre-test and post-test, with the control and experimental groups. The study population included all female adolescents with disabled parents in Mobarakeh, Isfahan, Iran, in 2017. The sample included 30 female adolescents with disabled parents selected using the purposive sampling method. The participants were randomly assigned to both experimental and control groups. The experimental group received ACT tests in 8 sessions, and each session lasted 90 minutes. The participants were assigned to each group before the intervention and at the end of the intervention using the California Psychological Inventory (CPI). Statistical analysis for this study was performed using SPSS-22 software for statistical calculations, and descriptive and inferential statistics were used for data analysis.

According to the results, the mean ± standard deviation (SD) of the individual adaptation and social adaptation variables in the experimental and control groups during the post-test period (130.58 ± 7.88 and 128.50 ± 7.79, respectively), compared to the pre-test (44.8 ± 0.7128 and 45.5 ± 0.5128, respectively), did not increase significantly. Moreover, the results indicated that there was no significant difference in the post-test period between individual adaptation scores (F = 1.191; P = 0.288; η2 = 0.054) and social adaptation scores (F = 0.727; P = 0.403; η2 = 0.033) of the experimental group and the control group.

The results showed that there was no significant difference between individual and social adaptation scores in the post-test stage. This study suggests that treatment attempts were not very effective.

Chronic kidney disease (CKD) is an irreversible condition that demands hemodialysis treatment until a kidney transplant is carried out. If dialysis is not sufficient, the patient might experience numerous physical and psychological consequences. This study aimed to examine the relationship between depression and anxiety and dialysis adequacy in patients receiving hemodialysis in Birjand, Iran.

In this cross-sectional study, 100 patients undergoing hemodialysis treatment at Shahid Beheshti Hemodialysis Center in Birjand were examined. The state of depression and anxiety in them was evaluated according to the Hospital Anxiety and Depression Scale (HADS), and the adequacy of the patients’ dialysis was extracted from their medical records. In this study, scores ≤ 11 on the HADS scale were considered healthy. Moreover, dialysis adequacy was calculated with the KT/V formula, and cases ≥ 1.2 were considered adequate. Data analysis was performed using SPSS 19 software, independent samples t-test, and Pearson correlation coefficient.

The results showed that 18% and 82% of the participants had depression and anxiety, respectively. The patients’ depression and anxiety scores did not significantly correlate with the adequacy of dialysis (P = 0.82 and P = 0.86, respectively). The prevalence of depression and anxiety was not significantly influenced by gender or marriage; however, the results indicated that as patients aged, the prevalence of depression increased (P = 0.009) and anxiety decreased (P = 0.003).

The adequacy of dialysis in patients undergoing hemodialysis treatment remains unaffected by mental disorders, such as anxiety and depression. Age has a significant impact on depression and anxiety levels in patients receiving hemodialysis treatment. To reduce anxiety and depression in younger and older patients, it is recommended to initiate support and educational programs.

The process of entrepreneurship and creativity are the main current principles in human life at the beginning of the third millennium AD; therefore, it is considered one of the most important goals of educational organizations. Preparing students to enter society effectively will not be provided unless creativity is cultivated among them. Therefore, the present study was conducted to use the effect of the constructivist teaching method on students’ creative thinking and entrepreneurship.

In this interventional study, 40 female students in sixth grade were selected by available sampling and randomly divided into two groups of 20 (20 in the intervention group and 20 in the control group). Then, the intervention group was given the necessary training for 5 one-hour sessions. The investigated variables were collected from demographic questionnaires, Abedi’s creativity , and Lumpkin and Dess’s  tendency to entrepreneurship through pre-test and post-test. Data analysis was performed using SPSS software (version 25) and descriptive statistical methods of covariance test.

In terms of parents’ education level and household income, no difference was observed between the two groups (P > 0.05). The average score of creative thinking in the intervention group increased from 67.55 before the intervention to 75.75 after the intervention; however, in the control group, the average score decreased from 20.68 in the pre-test to 55.61 in the post-test. Additionally, the average score of entrepreneurial tendency in the intervention group increased from 43.75 before the intervention to 54.50 after the intervention; however, in the control group, the average score increased from 40.10 to 42.50.

The constructivist teaching method plays a significant role in the learning approach. In addition, the use of this method can be effective in increasing the tendency to entrepreneurship. Considering the importance of entrepreneurship, teaching constructivist courses in universities and schools is appropriate.