مجله اپیدمیولوژی ایران
سال ششم شماره 1 (پیاپی 17، بهار 1389)

The significance of knowledge transfer and research utilization for health care decision makers in developed and developing countries have been paid more attention recently. Literature emphasizes that nursing practice should be based on utilizing of research. The aim of this study is to identify barriers of research utilization in Iranian clinical nurse’s practice. The Funk Research Utilization Barriers Questionnaire including 29 items in 4 domains (organization barriers and limitations, quality of research, nurses’ values, awareness and skills and communication of research) was employed in this study. Three main barriers to research utilization were identified: 1)"the nurse does not have time to read research", 2)"the nurse does not feel she/he has enough authority to change patient care procedures", and 3)"the facilities are inadequate for implementation". Considering the organizational barrier, it is recommended that academic organizations should support and adopt to utilize research findings particularly in nursing practice in Iran.

First aid education constitutes a major priority area for the Iranian Red Crescent. The present study assessed the student volunteer's knowledge of first aid procedures and their attitudes concerning strategies for community education. In this survey 5626 volunteers were selected based on a complex sampling design, in 5 different provinces of Iran. A total of 3581 students (63.7%) had attended the Red Crescent's first aid training courses. The mean knowledge score of the sample was 9.36 out of a maximum of 18 (CI 95%= 9.29-9.43), with only 674 subjects (11.9%) showing a high level of knowledge. Having training prior attending in this course and higher education were statistically significant related with their knowledge score (p<0.05). The mean score of their attitude was 33.60 out of a maximum of 45 (95% CI = 33.41-33.79), and only it was found to be related to previous training (p = 0.04). IRCS should expand its first aid training for young volunteers. This health educational programs should be supported by multidisciplinary work by governmental organizations such as ministry of education.

In clinical trials some of participants do not take assignment treatment. Intention-to-treat (ITT) is one of the strategies to analyze of clinical trials with control. ITT estimation will be invalid and incorrect to show of treatment effects in case of existing non-compliance in participants. In this study we adjusted noncompliance effect to compare of active treatment and placebo. To demonstrate efficiency of proposed model, a dataset of crossover clinical trial with 42 patients with knee osteoarthritis was used. To estimate the non-compliance’s effect adjusting at comparison of treatment effects, we use mean of compliance proportion at periods in sequences. The parameters were estimated by maximum likelihood method. (could you ask authors to have a look at what they wrote and compare with Farsi version) The results show that baseline variables distributions like duration of disease, severity of disease, age and sex, were not significant (p>0.05). The standard error estimation of treatment effects () based on adjusted model were less than standard model (0.09 and 0.12, respectively). In addition, likelihood ratio statistics based on adjusted model were less than standard model (1177.7 versus 1205.1). Based on estimation of standard errors and likelihood ratio statistics at adjusted and standard models, we observe that adjusted model is more efficient than standard model.

Because of uncertainty in interpretation of some tests for diagnosing TB, decision making for the tuberculosis treatment is based on multiple diagnostic tests. This study was conducted to assess the accuracy of Quanti FERON-TB Gold test in tuberculosis diagnosis.

The study was carried out on 30 cases and 46 controls. Statistical indices of sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios, odds ratio and Receiver Operating Characteristics (ROC) curve were estimated.

Sensitivity of QFT-G was 90.0% (95% CI=73.0-97.6), specificity 95.7% (95% CI=83.8-99.3), positive predictive value 93.1% (95% CI=76.3-98.9), negative predictive value 93.6% (95% CI=81.3-98.4). The area under ROC curve was 0.942 (95% CI=0.88-1.00), that significantly differed from chance diagonal area (P<0.0001). The optimum cut point for the Quanti FERON-TB Gold test was 0.35 IU/ml, with sensitivity of 0.90 and specificity of 0.957.

The Quanti FERON-TB Gold test displayed good validity indices in this study. Since the utility of this test has a high cost therefore this test would not be offered for routine tuberculosis detection. It suggested that this test are applicable for smear and culture negative tuberculosis, child tuberculosis, and assessment of TB contact tracing.

Increasing the rate of cesarean in recent decades is a noticeable sign which has been interested to look at some possible medical, psychological and social determinants. The aim of this study was to determine trend of cesarean during 1998-2007 and evaluation of some social factors in Damghan, Iran. We used a case-control study by direct interview with mothers in health centers of city. A total of 120 cases (delivered by cesarean method) and 90 controls (delivered by natural method) were selected. For estimating of trend we used all medical files in Damghan maternity hospital between 1998-2007.Statistical analysis was performed in SPSS (Ver16) by descriptive and analytical (Chi-square, ANOVA and logistic regression) methods. A total of 12200 deliveries were registered during 1998-2007 and 51.7 percent of them were cesarean. From 1999 to 2003 years there is an increasing trend and most frequency of cesarean was in 2006 year (53.5%). Mean age, education, occupation, number of delivery, husband occupation, number of children and residency area was not significant between two groups. But from social factors, mother's education from diploma and higher, recommendation by husband and his family and mother's family had a significant association with selection of cesarean (p<0.05). Recommendation of type of delivery by family member and relatives to be found an important factor so this issue should be taken into account for any health educational program in future.

According on surveys in Iran more than two million persons have non insulin diabetes mellitus. There are evidences that good glycemic control reduces the risk of diabetic complications. This study was designed to evaluat the glycemic control by using fasting blood sugar and hemoglobin A1C estimation and their relation with some variables. This cross sectional study carried out on 411 people with type 2 diabetes who referred to Tawhid diabetes center in Sanandaj. Demographic and other variables were gathered by a deigned questionnaire. Univariate analysis and multivariate analysis (logistic regression) were used. In Univariate analysis FBS showed a significant relationship with education, job and referral style and HgA1c was statistically significant with sex, age, education, and job. But logistic regression showed other in final model FBS and HgA1c were associated with body mass index and referral style and HgA1c had association with only body mass index and referral style. Correlation confidence between FBS and glycated hemoglobin was (r = 0.54). It is concluded that BMI and referral style have association with diabetes control.

statistical modeling explicates the observed changes in data by means of mathematics equations. In cases that dependent variable is count, Poisson model is applied. If Poisson model is not applicable in a specific situation, it is better to apply the generalized Poisson model. So, our emphasis in this study is to notice the data structure, introducing the generalized Poisson regression model and its application in estimates of effective factors coefficients on the number of children and comparing it with Poisson regression model results.

Besides introducing Poisson regression model, we introduced its application in fertility data analysis. A sample of 1019 women in rural areas of Fars was selected by cross sectional and stratified sampling methods. The number of children of family was determined as a count response variable for model validation.

The sample mean and sample variance of the response variable Y, the number of children, are respectively 4.3 and 8.3 (over-dispersion). Log-likelihood was -1950.93 for Poisson regression and -1946.93 for generalized Poisson regression model.

The results revealed that this data have over-dispersion. According to selection criteria, the suitable model for this data analysis was generalized Poisson regression model. It can estimate effective factors coefficients on the number of children exactly.

The popularity of qualitative research in the health sciences is steadily increasing. However individual qualitative research, alone, is unable to provide a comprehensive and broad understanding of the phenomenon under study. This may be the reason why the results of these studies are uncommonly used by health policy makers. Meta-synthesis is a method in which the results of a body of qualitative research are aggregated in order to produce a new and comprehensive interpretation of the studied phenomenon, in such a way that the final result still represents and includes the findings of the original studies. The lack of a comprehensive article in Farsi language in this field, encouraged the authors to write this paper to introduce this method and explain some of its essential components to familiarize health professionals, including researchers and students, with meta-synthesis. In this article, the following components of meta-synthesis are described: the definition, the necessity and the how-to of meta-synthesis; a determining research question, the selection and analysis of the original studies, and lastly, meta-synthesis conductors.