مجله دانش و تندرستی در علوم پایه پزشکی
سال سوم شماره 4 (پاییز و زمستان1387)

Regarding the importance of health economics in education, it is a bear necessity to justify and organize the process of resource allocation in health allied faculties in all medical universities. Applying the "Principal–Agent Theory", researchers sought to determine indicators for resource allocation in faculties in a university of medical sciences, based on principles of scientific management and economics. In this qualitative study, using expert panel discussion and Delphi technique, researchers investigated many recourse allocation methods in universities all over the world and did their best to establish localized indicators for resource allocation in the university. Based on the findings of this study, resource allocation in a selected medical university was not in accordance with their performance, number of faculty members, number of students and the types (undergraduate & postgraduate) and costs of their programs. In this study, indicators for resource allocation were, mostly, based on last year costs of faculties and authorities. bargaining abilities in each faculty, but not based on their performance. This research showed that bargaining and verbal justifications were replaced by documentation and improved performance in order to receive proper resources in the process of resource allocation. Moreover, this research showed that the best indicator to proportionate the financial resources among faculties in a university is to multiply the number of student by program cost weight in under and postgraduate curriculums. In this study, localized programs cost weights in the selected university were identified.

This research was performed in 2008 in order to design an operational planning model for Iranian primary health care systems at level one.

In this applied study, which was done in a descriptive and cross-sectional manner, some countries and international organizations which had comprehensive planning systems and some local organizations were studied. The required data from the selected countries were collected through data collection forms, and for local organizations, the data were collected through interview, and the initial model was presented accordingly. The model was tested via Delphi technique and taking the authorities’ views into account, the required changes were made and the ultimate model was prepared.

All the studied overseas and indigenous organizations had programming systems. However, none of the level-one Iranian primary health care units had a coherent planning system, and they did not follow any specific models. Since 2008, the model of operational planning has also been utilized by Iranian Ministry of Health, Care and Medical Education at headquarters levels; however, there was no model at lower levels especially in rural and urban health care centers. In all selected countries, the model of programs included title, objectives or expected results, schedule, activities, budget system and evaluation and monitoring indexes. Though these parts existed in the common models in Iran, no scientific basis could be observed in compiling the operational programs. The mechanism of designing the initial suggested operational planning had eight stages, but after three stages of reviewing by authorities, seven stages were ratified.

Utilizing the suggested operational planning model can enhance the level-one performance indicators of health care networks in Iran.

Kidney stone is a common urologic complaint. In this study, bone density in stone formers was compared with that of a control group; bone density of stone formers was also analyzed based on age, sex and stone configuration.

In a group of 85 patients with upper urinary calcium stones and 85 healthy people, variables such as age, height, weight, BMI, T-score and Z-score results of bone densitometry of lumbar vertebrae (L2-L4) and femoral neck were recorded. The serum levels of uric acid, calcium, potassium, sodium, phosphor, alkaline phosphates and parathyroid hormone were also analyzed and recorded. Furthermore, all patients, 24-hour urine was studied for levels of cr, oxalate, citrate, uric acid calcium, urea and the total volume.

Lumbar and femoral bone mineral density (BMD) was significantly lower in patients suffering from renal stone. This difference was also significant when the study and control groups were classified into hypercalciuric and normocalciuric ones. Based on the densimetric results of lumbar vertebrae and femoral neck, BMD reduction among menopause women was significantly greater.

Noting the lack of relationship between hypercalciuria and bone loss, and noting that a low-calcium diet not only has no proved role in renal stone prevention, but also it leads to calcium imbalance and finally bone loss, low-calcium diets are not suggested for renal stone formers.

MMP-9 (matrix metalloproteinase-9) is an enzyme with protease activity the performance of which in creating several cancers has been reported up to now. With respect to the relationship between the active form of this enzyme and occurrence of cancer, in the present study, we decided to assay the plasma level of this enzyme in recuperating or aggravating and metastasis of the breast cancer. In this study, MMP-9 activity was measured by gelatin quantitative zymography in the euglobulin plasma of 98 patients in two steps of diagnosis and after treatment of cancer. From the 80 patients with positive response to treatment, in 76 persons, the MMP-9 significantly decreased after treatment compared to the time of diagnosis. Whereas in 4 patients, the MMP-9 plasma level did not show any change before and after the treatment. Also in 18 patients with recurrence, (6 persons with early breast cancer and 12 persons with metastasis to other tissues) this enzyme level increased, compared with the time of diagnosis. Our results show a positive correlation between plasma MMP-9 activity and the treatment or metastasis to the other tissues. According to our findings, plasma MMP-9 level can be used as a useful factor for investigating the reaction status of breast cancer patients to the treatment.

Test anxiety, a common phenomenon among college students, is one of the problems of educational systems. Because test anxiety affects academic performance, this study was performed to determine test anxiety and its relationship with academic performance among nursing students. In this descriptive- analytical study, 150 students of Abadan Nursing College were selected in 2007. Data were collected via a two-component questionnaire including demographic data and the test anxiety inventory that were completed self-directedly during the final exams. The data were analyzed by SPSS (13.0) software, using some measures of central tendency and variability, Mann Whitney test and Spearman correlation coefficient. The mean score of test anxiety in students was 30.9± 23.2. Fourteen percent of participants did not have any test anxiety, 48.67% had low test anxiety, 34% had moderate test anxiety and 3.33% had severe test anxiety. In sum, 86% had some degrees of test anxiety. In this study, no significant relationship was found between test anxiety and academic performance (r= -0.12, p= 0.13), nor between test anxiety and age (P= 0.84,), nor between test anxiety and marital status (P=0.053), nor between test anxiety and level of education (P=0.057). Regarding the high prevalence of test anxiety in students, far further research is recommended to identify factors relevant to this phenomenon and to present strategies to reduce it.

Educational materials which are based on psychological effects should develop the power of imagination, reinforce the senses and be motivating, in terms of both the separate elements and their combination. This study aimed at investigating the effect of color in educational films on the amount of learning. In this study, using random cluster sampling method, from among 1777 fourth-graders in state elementary schools in Shahroud, eight classes, and from the practical sciences textbook, four chapters were selected. Eight content-relevant black and white, and color films were also produced. Administering the post test with 10 questions, the results were analyzed using an independent t-test procedure. After one month, 30 students were selected and were evaluated for consistency of learning with color films. : The results showed that the mean of students who had seen color films was 3.68 and that of students who had seen black and white films was 3.39 which show a significant difference. In an investigation performed after a month of displaying color films, no significant difference was observed between the means of groups in the two temporal periods. Nowadays, regarding the growing needs of educational, technical, and academic centers for educational media, and also the easy and inexpensive availability of film producing devices which can even be installed on PCs, it seems necessary to take into account the specifications of educational films. So, it is recommended that in producing educational media, the use of various colors be scientifically taken into account by authorities.

Noise is one of the most important sources of life pressure so that results of scholarly research show that troublesome noise, in addition to physical harms such as hearing decrease, hypertension and increased vulnerability, is a stressful environmental agent impacting cognition and cognitive performance and causing precision decrease in brain activities and inconsistency in mental work and comprehension. This inconsistency and carelessness is especially more evident in task performance strategies and distraction than any other aspects. 36 undergraduate students in Az-zahra University with the age range of 19 – 24 took part in this experimental study. Students’ scores on Eysenc logical test when they were exposed to Tehran traffic noise were obtained and analyzed through one-way ANOVA. Results showed a significant difference between the means of groups in complicated task performance. That is, compared to others, the students exposed to continuous noise had poorer performance in complicated tasks. Results of the study show that complicated cognitive tasks are influenced by unpredictable noise; hence some strategies should be worked out to control the noise in working, thinking and educational environments where people are exposed to this kind of noise while performing cognitive tasks.

This study was conducted to determine the prevalence of hypertension and its associated risk factors in a rural population with ethnic variation. This was a cross sectional study conducted in rural areas of Agh- Ghola in Golestan province. 1500 thirty-plus- year-old participants were selected by cluster sampling method. Due to the nature of the variables, the data were collected through interview, measurement and observation, and they were analyzed through logistic regression. The prevalence of hypertension was 18.4% and women suffered more from the disease than men did. Hypertension prevalence in Turkmen was greater than that in Baluchi and Sistani ethnic groups. There was also a significant relationship between hypertension and lack of physical activity, and with the age increase, the hypertension prevalence also showed an increasing trend. Major risk factors were: age over 60, high BMI, lack of physical activity and high proportion of abdominal to hip circumference. The higher prevalence of hypertension among Turkmen was firstly because of the weight-gain and higher BMI, and secondly due to lack of physical activity. The higher susceptibility of women to hypertension was due to the higher frequency of risk factors among them, no the effect of their gender.

Though not impeding it, malnutrition during childhood delays the menarche age. This study aimed at investigating the relationship between anthropometric parameters with menarche age of adolescent (11-14- year old) girls. In this cross-sectional study, 418 middle school girls in Shahroud were randomly selected and studied. To demonstrate the participants, nutritional status, BMI was used for age, weight and stature, and then it was compared with NCHS standard. It was revealed that the mean of BMI (body mass Index) of menstruated girls was 19.8±3/1 and that of the non-menstruated participants was 17.6±3. The average menarche age turned to be 12.9±0.8. A significant relationship (P<0.0001) was found between age and incidence of menstruation. 47% of the participants experienced their menses in summer. The weight and height means of the menstruated participants were 48.7±8.5 kg and 156.9±6.7 cm respectively. A significant relationship (P=0.0001) was also found between weight, height, BMI and anthropometric parameters of the students, and their menstrual conditions. Statistical analysis also showed a significant relationship between menarche status and socioeconomic condition. The results of this study indicate a significant relationship between nutritional status and menarche age. Due to the importance of menarche age, its decline and creation of sexual desire, and noting the important effects of BMI and anthropometric parameters on menarche age, special attention should be paid to ideal weight, proper nutrition and sufficient physical activities in this high-risk group.