فهرست مطالب roya hasanzadeh

Given the shift in biological challenges model in the central province in Iran during the last three decades and the priority of environmental crisis management, utilizing NGOs potential as a non-expensive and universal approach has become a necessity. The present research, based on this fact, aimed at semantical reconstruction of the effectiveness of NGOs in environmental sustainable development of the central province in Iran and its results by survey research.

Statistical population includes all active environmental NGOs in the central province with 30 of which semi-structured interviews were carried out. Systematic Struss and Corbin method was used to analyze data.

From data coding, 114 primary codes, 28 subcategories and 11 major categories were extracted and provided in a survey-paradigm model including causal, intervening, background conditions, approaches and results. Causal conditions including structural factors and agency factors; background conditions including unpleasant lived experiences in NGOs and environmental protection network; and, intervening conditions including knowledge and technological management, training and experience exchange were classified. Activists in environmental NGOs try to influence environmental sustainable development through organizational strategies and interactions with the government.

The results showed that organizational strategies in the form of innovation, encouraging green economy activities and symbolic activities and strategies for interaction with government including desecuritizing the activities of NGOs, intervening in decision-making governmental institutions, seeking support from governmental and public institutions help environmental NGOs in achieving their objectives in environmental sustainable development.

 Hysterosalpingography (HSG) is a common diagnostic method that has therapeutic effects on fertility success.

 The purpose of this study was to investigate the effect of HSG on the biochemical pregnancy rate of women with primary and secondary infertility in patients referring to Ali-ibn Abitalib Hospital in Zahedan.

 A descriptive-analytical study was performed on 100 women with primary and secondary infertility referred to Ali-ibn Abitalib Hospital of Zahedan for performing HSG. Following performing the examinations, initial tests, and procedures, as well as ruling out acute pelvic infection by the expert gynecologist, the patients were referred to the radiologist for HSG. All patients in the study underwent HSG. Data were analyzed by SPSS version 21 software.

 The mean age of patients in the study was 30.36 ± 5.25 years, and the mean duration of infertility was 4.81 ± 2.31 years. There was no significant relationship between the type of pregnancy and the outcome of pregnancy. There was no statistical relationship between age, abdominal surgery history, and HSG in both groups of women with spontaneous pregnancy or ovulation induction. There was a significant relationship between the mean duration of infertility and spontaneous pregnancy.

 The use of HSG as a therapeutic approach is not effective, but it could have therapeutic effects as a diagnostic method in women with early infertility.

For overcoming the existing problems and finding a pathway for realization of universal health care, health complexes were implemented in the form of a pilot project in Tabriz suburban area. Tabriz Health Complex Project was designed in 2013 in the provincial health center of East Azer-baijan. In terms of execution schedule, this intervention had 4 phases including 1) study phase, 2) planning phase, 3) pilot phase, and 4) implementation phase. Each health complex covers a population of 40,000 to 120,000 in a defined geographic area and consists of a Comprehensive Health Center (CHC) including health centers and a management center, which usually located in CHC. The important features of this project are as follows: people-centered primary health care, special attention to health promotion and prevention and estab-lishment of a referral system within the region (organic connection between the first and second levels). An accountable and responsive health care system has been established to deliver integrated care ser-vices to people in a defined catchment area against identified per capita payment, under district health centre policies and regulations. Each health team consisted of a general practitioner and a family health nurse who covered around 4000 people to deliver prevention, promotion, and treatment services especially in and NCDs field. Health complex as a model of public-private participation and practical solution to address many of the problems in the primary care system of the country􀀑 The project can organize the PHC system and fami-ly medicine program.

Technical quality of health care, compared with whatever is presented on the basis of scientific evidence as a standard service, is an important aspect of the quality in health services and everything that customer receives. The purpose of this study was to assess the technical quality of prenatal care according to the standards of the Ministry of Health from the perspective of pregnant women at Shahid Chamran Health Centers in Tabriz.

This was a cross-sectional study based on CQMH model. Forty pregnant women were selected randomly from the women who referred to Shahid Chamran Health Centers. We used standard questionnaire for collecting data which its validity has been tested and its reliability was confirmed. (Cronbach's alpha,. 952)

The findings of the study showed that the highest level of compliance with the standard was the examining of women and listening to fetal heartbeat (16.7%) in the clinical examination. Regarding the prenatal care standard, the highest level of compliance was in oral health education (6.8%) which is 80% lower than the standard and 13.3% higher than the standard. These findings also indicated that education about bleeding and spotting is 90% lower than standard. Prescribing pharmaceutical supplements was higher than standard. In part of paraclinical services, the highest level of compliance with standard was the number of blood tests (50%) that was 6.7% lower than standard and 43.3% higher than standard.

A significant proportion of pregnant women statements indicated the underuse and overuse of the standard which leads to a need for indispensable changes in order to improve the quality of prenatal care according to the standards of the Ministry of Health. Standards were in poor condition at the clinical examinations and prenatal care educations fields which require appropriate intervention based on the results of this study.

Customer Quality is one of the most important dimensions of quality in health care which refers to service receiver''s knowledge، attitude and skills that play effective role in treatment process. This study is aimed at assessing customer quality score in patients with Inflammatory Bowel Disease in Tabriz city in 2012.

This is a cross-sectional study which was conducted with the participation of 94 Inflammatory Bowel Disease patients who referred to Tabriz Imam Reza Hospital and Golgasht clinic. Customer Quality was measured using a questionnaire with 19 items which its validity was confirmed by 10 experts and its reliability was reviewed using Cronbach''s alpha index (α =0. 78). Obtained data were analyzed using SPSS17.

The results illustrated that average score of customer quality among patients with inflammatory bowel disease is 70. 63 (±9. 67). All the participants achieved stage 1 scores of Customer Quality in self-management but only 11. 7% reported highest customer quality score and were able to continue their self-care in high pressure circumstances such as stress and financial problems. Also، there was a significant relation between customer quality score and patient’s education (P-value=0. 05)، so that by having higher education level، the customer quality score was increased as well.

The results of this study indicate that customer quality status in assessed patients with Inflammatory Bowel Disease is partially acceptable، but major problems in some areas are evident and require more attention of health care managers and policy makers.

Customer Quality refers to customers’ capabilities to be effectively participating in service delivery and correct care processes. The aim of this study was to evaluate the validity and reliability of customer quality questionnaire in services related to patients with Inflammatory Bowel Disease.

This is a qualitative study with the aim of assessment of customer quality questionnaire with 16 questions. This questionnaire was distributed among 11 experts to determine the validity of the questionnaire. Finally, 10 of them expressed their own opinions based on the criteria of validity and in the face validity section, they expressed their opinions qualitatively. Also, reliability of questionnaire was reviewed with 30 samples, according to the internal consistency.

In determining the content validity, all the questionnaire items were confirmed by CVR (1) and CVI (0.89) indicators. Also, reliability of the questionnaire was confirmed by Cronbach’s alpha (α=0.78).The final questionnaire was changed according to the experts’ recommendations and their qualitative comments on the 19 questions in four stages of customer quality, including: a) the patient’s belief that his/her role in care process is important, b) having knowledge, skill and confidence to take action in the care process, c) taking action to protect and improve the health or active involvement, d) continuity of care, even in critical situations and under stress.

Confirmation of the questionnaire with statistical scientific methods showed that this questionnaire is a very strong tool that using it in research can be an effective step in order to improve the quality of health services.