فهرست مطالب hamed fattahi

Dangerous behavior adversely affects the health of adolescents and young adults. The purpose of this study was to identify subgroups of college students based on the parameters of risky behavior and to analyze the impact of demographic factors and Internet gaming disorder belonging to each class. Study design: A cross sectional study.

The study was conducted in 2020 on 1355 students through a multi-stage random sampling method. A survey questionnaire was used to collect data and all students completed 1294 sets of questionnaires. We analyzed the data using T-test and latent class analysis.

Three latent classes have been identified. a) low-risk (75%), b) tobacco smoker (8%), and c) high-risk (17%). There was a high possibility of risky behavior in the third class. Being single (OR=2.28), Not having a job along with education (OR=1.54), and internet gaming disorder (OR=1.06) increased the risk of inclusion in the tobacco smoker class. Also not having a job along with education (OR=1.43) increased being in the high-risk class.

According to the findings of this study, 25% of the students were tobacco smokers or were at high risk. The results of this study may help develop and evaluate preventive strategies that simultaneously take into account different behaviors.

The purpose of this study was determination of the prevalence of post-traumatic hydrocephalus (PTH) in patients who had traumatic brain injury (TBI) worldwide.

Four electronic databases including Scopus, PubMed, Embase, and Web of Science were searched in this meta-analysis. The random-effects model was appliedfor the pooled effect size of I2> 50%. Subgroup analysis was done to evaluate the heterogeneity, and the Egger’s test was used to test the asymmetry of the funnel plots in order to assess the publication bias.

A total of 48 studies with 11624 patients were evaluated. The pooled prevalence of PTH was 13% [95% confidence interval (CI): 11.0-15.0] and according to decompressive craniectomy (DC) surgery was 22.0% (95% CI: 18.0-26.0). This result among patients with severe TBI (sTBI) was 16.0% (95% CI: 13.0-19.0) and it was higher in the developed countries. The prevalence of PTH was generally higher in studies with a sample size lower than 100 (21.0%) and was generally lower in studies conducted between 1990 to1999 (4.0%). These results were not toodifferent according to the study design.

It is recommended to design a prospective clinical study in order to explain the true dynamics and circulation of the cerebrospinal fluid (CSF) after DC. Moreover, there is a need to evaluate the cost-effectiveness of DC in reducing the intracranial pressure in comparison with other available options. In fact, performing the clinical studies with higher quality in less developed countries could provide more reliable related results to achieve a true global conclusion.

The outbreak of COVID-19 in Iran in February 2019 prompted the Iran’s health system to plan for pandemic prevention and control. The national mobilization program (NMP) against COVID-19 was devised to support the sick and vulnerable and promote community awareness and skills regarding the crisis. This study aimed to investigate the role of community health workers (CHWs) in preventing and controlling the COVID-19 pandemic.

The present study is a descriptive cross-sectional study. The census method was used to study 30,034 rural health workers (RHW) and 22,573 urban health workers (UHW) working in medical universities. The required data were extracted using the integrated health system and the portal of the Ministry of Health and Medical Education's Primary Health Network Management Center and were analyzed using descriptive and analytical statistical methods.

More than 78 million people were screened during the first phase of the NMP , more than 42 million during the second phase, and more than 59 million during the third phase. In addition, by the end of the fourth phase of the NMP, 4,278,899 highly vulnerable individuals were screened. According to the health system's report, CHWs administered 28,073,777 vaccines since the implementation of the fifth step (until 04.09.2021)

Considering the facilities and capabilities of primary health care networks in providing prevention, diagnostic, and treatment services, the activity of the primary health network management center and all affiliated units in the implementation of the NMP has been significant since the beginning of this pandemic. Inadequacies in human resources, financial resources, and training planning should all be considered.

Cancers seldom happen in childhood age and awareness of accurate cancer incidence is essential in order to preventive programs. This study aimed to estimate the childhood cancer incidence in Iran using the three-source capture -recapture method.

Total new cases of childhood cancer reported by three national data sources of MAHAK charity database, pathology reports and clinical records in Iran were enrolled in this study. The common cases among three sources were determined using data linkage method. The childhood incidence rate per 1 million popula-tions was estimated based on three-source capture-recapture method. We used BIC, G2 and AIC statistics to select the best-fit model. Arch GIS was used to determine geographic distribution.

Overall, 2567 childhood cancer was included by three sources of registries. The total estimated num-ber of childhood cancer was 5388 (95% CI: 4742.15-6228,14). The higher estimated incidence rate was Leuke-mia, Lymphoma by 94.91 and 24.80 per 1 million populations and the lower incidence was liver and retinoblas-toma with 2.35 and 7.01 per 1 million populations. Provinces of Ardabil and Kohgiluyeh with an incidence rate of 420.01 and 404.61per 1 million populations had a higher incidence rate and Mazandaran and Ilam with an incidence rate of 60.87 and 66.88 per 1 million populations had the lowest incidence. The overall completeness of the childhood cancer registry based on three-source was48%.

The low-quality childhood cancer registration system highlights the needs for urgent screening programs for early detection in the high prevalent area in Iran

We evaluated the accuracy of two‑dimensional speckle‑tracking echocardiography (2DSTE) and 3DSTE to identify early cardiac dysfunction in comparison with cardiac T2* magnetic resonance imaging (MRI) in patients with blood transfusion-dependent β-Thalassemia.

A total of 48 consecutive patients (36 males) successfully underwent 2DSTE, 3DSTE, and MRI on the same day. We calculated left ventricular segmental global longitudinal strain (GLS) (%) and segmental global circumferential strain (GCS) (%) from strain curves. Cardiovascular MRI was performed with the relevant protocols to measure the T2*.

In this study, we found that the GLS and GCS derived from 3DSTE correlated with cardiac T2* (r = −0.50, r = −0.49, respectively), whereas no correlation was detected between 2DSTE parameters and cardiac T2*. We calculated the area under the receiver operating characteristic area under the curve to determine the capability of 3DSTE parameters including GLS (<−23.5%) and GCS (<−33.4%) to discriminate between patients with (cardiac magnetic resonance T2* <20 ms) and those without myocardial iron overload.

The study will clarify GLS and GCS’s superiority derived from 3DSTE over the 2DSTE parameters in the detection of myocardial iron overload in patients with blood transfusion-dependent β-Thalassemia.

To assess prevalence and predictive factors for Nosocomial Infection (NI) in the military hospitals.

PubMed, Scopus, Cochrane and PreQuest databases were systematically searched for studies published between Jan 1991 and Oct 2017 that reported the prevalence of NI and predictive factors among military hospitals. We performed the meta-analysis using a random effects model. Subgroup analysis was done for heterogeneity and the Egger test to funnel plots was used to assess publication bias.

Twenty-eight studies with 250,374 patients were evaluated in meta-analysis. The overall pooled estimate of the prevalence of NI was 8% (95% 6.0–9.0). The pooled prevalence was 2% (95% CI: 2.0–3.0) when we did sensitivity analysis and excluding a study. The prevalence was highest in burn unit (32%) and ICU (15%). Reported risk factors for NI included gender (male vs female, OR: 1.45), age (Age≥65, OR: 2.4), diabetes mellitus (OR: 2.32), inappropriate use of antibiotics (OR: 2.35), received mechanical support (OR: 2.81), co-morbidities (OR: 2.97), admitted into the ICU (OR: 2.26), smoking (OR: 1.36) and BMI (OR: 1.09)

The review revealed a difference of prevalence in military hospitals with other hospitals and shows a high prevalence of NI in burn units. Therefore careful disinfection and strict procedures of infection control are necessary in places that serve immunosuppressed individuals such as burn patient. Moreover, a vision for the improvement of reports and studies in military hospitals to report the rate of these infections are necessary.

Estimation of health workforce supply becomes problematic when there is no knowledge about the number of active specialists. The aim of this study is to estimate active specialists and their geographic accessibility in Iran.

We enrolled all medical specialists from the Iranian Ministry of Health database (14 151), national hospitals survey (28 898) and Continuing Medical Education registries (13 159) in 2015. Duplicate records across the three registries were identified based on the similarity of national ID codes and medical council codes. The number of active medical specialists was estimated by three-source capture-recapture method using Stata 12 software.

A total of 33,416 specialists were identified from three sources. We estimated the number of specialists at 39 127 (95% CI: 38823.6-39448.4) in 2015. Of these, 45.4% pertained to the province of Tehran while only less than 1.8% of specialists were in the provinces of Ilam (0.50%), South Khorasan (0.56%) and Kohgiloye and Boyerahmad (0.59%). The estimated ratio for specialists was 4.9 per 10 000 population and ranged from 9.2 per 10 000 in Tehran to 1.5 per 10 000 population in Sistan and Balochestan. The overall completeness of data registries by three sources was 85.4%.

The current distribution of specialists appears to be imbalanced. It is suggested to adopt appropriate policies to improve the distribution and maintenance of medical specialists in different parts of Iran.

No one can deny the importance of educational services and the role it plays in attaining social goals. Proper training and students’ satisfaction leads to system promotion and finally social development. This study aimed to evaluate the educational service quality in Qazvin University of Medical Sciences (QUMS).
This cross - sectional study was conducted in 2014 among 327 students of QUMS who were selected through simple random sampling. The most significant variables were tangibility, assurance, empathy, reliability, and accountability of the educational service quality. The data were collected using the 27 - item SERVQUAL questionnaire. Cronbach’s alpha score (α = 0.88) and test - retest (R = 0.83) method were used to determine the reliability of the questionnaire.
The average age of the students was 22.2 ± 3.1 years. The quality gap of the educational services was -1.62, -1.70, -1.52, -1.31, and -1.15 for assurance, accountability, empathy, reliability, and tangibility, respectively, which was statistically significant (P 0.05).
There are significant gaps in the educational service quality regarding accountability and assurance. More attention from policymakers seems to improve the educational service quality.

Hospitals are as the most expensive health care centers, and they take most of the health budget, on the other hand they have largest number of educated personnel. Therefore, considering variables that affecting the performance of the hospitals employees is important. This study has been designed and implemented to determine The Relationship between "strategic alignment and "employee engagement" of HashemiNejad Hospital in Tehran.
Material and This Research is a correlation study. Population included 424 staff of nursing, administrative (human resource and finance) as well as auxiliary and paramedical, which a sample size of 202 was calculated. Samples selected randomly in proportion to the number of people in each class. A questionnaire was applied to collect data. Finally Data were analyzed using descriptive statistics including tables, comparative analysis, Pearson correlation, and Multiple Regression.
Based on results Mean ± SD scores for the strategic alignment 31.90±4.47 from 40 and Mean ± SD score for employee engagement 54.19±7.34 of 70 was calculated. The findings of liner regression analysis indicated that strategic alignment can be a predictor of employee engagement (P-value=0.01, r=0.64).
Strategic alignment is one of the effective factors in Employee engagement. Goal setting according to demographic and environmental conditions, prepare strategies to guide employees for achieve the goals, collaborative goal setting and accurate and clear information to employees are as effective methods for improving strategic alignment and then employee engagement.

Quality of care has become increasingly critical in the evaluation of healthcare and healthcare services. The aim of this study was to assess quality of delivered care among patients with rheumatoid arthritis using a model of Comprehensive Quality Measurement in Health Care (CQMH). This cross-sectional study was conducted on 172 patients with rheumatoid arthritis (RA) who were received care from private clinics of Isfahan University of medical sciences in 2013. CQMH questionnaires were used for assessing the quality of care. Data were analyzed using SPSS for Windows. The mean scores of Quality Index, Service Quality (SQ), Technical Quality (TQ), and Costumer Quality (CQ) were 72.70, 79.09, 68.54 and 70.25 out of 100, respectively. For CQ only 19.8% of participations staying the course of action even under stress and financial constraints, there is a significant gap between what RA care they received with what was recommended in the guideline for TQ. Scores of service quality was low in majority of aspects especially in "availability of support group" section. Study shows paradoxical findings and expresses that quality scores of service delivery for patients with arthritis rheumatoid from patient's perspective is relatively low. Therefore, for fixing this paradoxical problem, improving the participation of patients and their family and empowering them for self-management and decision should be regarded by health systems.

Context: Rheumatoid Arthritis (RA) is a chronic disease accompanied by physical disabilities and a number of co-morbidities; it leads to remarkable economic burden, reduced productivity, and deteriorated quality of life (QOL).. The current study aimed to provide a clear view of quality of life among the Iranian patients with Rheumatoid Arthritis through a systematic review..Data Sources: The current study was conducted as a systematic literature review on the articles published from 2000 to 2013 in data bases such as: Google scholar, Science Direct, PubMed, IRANDOC, SID and Medlib and by keywords: quality of life, Rheumatoid Arthritis, Iran and, their Persian equivalents..Study Selection: Finally, 10 articles were selected out of the 2065 assessed ones..Data Extraction: In the first step, the extracted results were summarized in the extraction table, and then analyzed using the Forest plot.. Based on the Forest plot, six studies on the quality-of-life, met the inclusion criteria. Total QOL score was 47.5. In the reviewed articles (n = 10), different variables and factors were reported to affect the QOL in patients with RA. The most important factors affecting QOL were demographic factors, depression, and complications of RA, etc.. Due to the chronic nature of RA, promoting the QOL and adherence to therapies could be achieved through convincing the patients. Therefore, identification of weak points and planning for them at all levels; from individual to the community level is suggested..