[ effect of PRECEDE model-based educational program on depression level in patients with coronary artery bypass grafting]

Depression is among the most important barriers to proper treatment of cardiac patients causing failure in accepting their conditions, decreasing their motivation in following the therapeutic recommendations and thus negatively affects the patients' function and their quality of life. To investigate the effect of PRECEDE Model-based educational program on depression level in coronary artery bypass grafting surgery [CABGS] patients. This was a quasi-experimental study in which 54 post-bypass surgery patients of Isfahan Cardiovascular Research Center were investigated. The patients were randomly divided into two groups marked as intervention and control groups. The data were collected using two questionnaires. Primarily, the Cardiac Depression Scale Inventory questionnaire was used to measure the degree of depression followed by PRCEDE Model-based educational questionnaire to identify the role of educational intervention on patients. The PRECEDE Model-based intervention composed of nine educational sessions per week [60 to 90 min each]. The patients were followed up for two months post-intervention. Following the educational intervention, the mean score of Predisposing factors, Enabling factors, Reinforcing factors, and self-helping behaviors was significantly increased in intervention group compared to control group [p<0.001]. Also, a significant difference associated with the mean score of depression level in patients was demonstrated between two groups following the educational intervention [p<0.001] The findings of current study confirmed the practicability and effectiveness of the PRECEDE Model-based educational program on preventing or declining the depression level in CABGS patients

[Measurment and ranking of social capital in the townships of Isfahan province]

Social capital is one of the concepts in social sciences which during the short time, less than two decades, not only has been populared in academic environments as a scientific term, but also it could arrive into the level of policy-making. The importance of the concept is up to high level that there is a special act about social capital in the fourth program of economic, social and cultural development. Also, social capital is called as an desired characteristic in the document of Iranian development for the year of 2025. But, how is the situation of social capital in the Iranian society? This article, that is extracted from a survey research with a provincial approach and carried out in 2006, try to answer the question. The main target of the study is measuring and ranking of social capital in 20 townships of Isfahan province. The data are gathered by interview based on a standardized questionnaire. The sample size are 4739 cases who have been selected on the basis of a quota method by sex, age group and region. The results have revealed that in some subdimensions such as institutional trust, trust towards family members, friends and acquintances, security feeling, social participation and social mediation are in better situation than the others that consist generalized trust, the new pattern of participation and civil engaging of citizens in social life. The most important result shows that Isfahan city, as the center of the province, accompanied by city of Khomeinishahr are located in the lowest rank of the social capital hierarchy in comparison with other townships

Pharmacological treatment, lifestyle modification and awareness in coronary artery and cerebrovascular disease patients

Cardiovascular diseases [CVD] and cerebrovascular diseases [CeVD] are a large and growing problem in low- and middle-income populations. Secondary prevention which can reduce the risk of recurrent CVD includes changes in lifestyle, pharmacological interventions and revascularization procedures. The aim of the first phase of this project was to perform situation analysis and identify gaps in secondary prevention of major cardiovascular diseases. This study estimated the physicians' awareness and the patients' knowledge and behavior towards CVD and CeVD complications. It also assessed the efficacy of methods for decreasing recurrent events. A sample of consecutive patients was selected from the outpatient units of the health care facilities selected for the study. Stratified random sampling of primary and secondary private and public health care facilities in cities and villages was performed to select 449 eligible cases. We selected 257 men and 192 women. The inclusion criteria were as follows: Age above 21 years, established diagnosis of cardiovascular and/or cerebrovascular disease defined as any of the following alone or in combination with others: previous myocardial infarction, stable/unstable angina, percutaneous transluminal coronary angioplasty [PTCA], coronary artery bypass graft [CABG], stroke, transient ischemic attack [TIA] or carotid arterectomy. The patients were included if their first event had occurred more than a month, but no earlier than three years ago. The prevalence of high systolic and diastolic blood pressure was 40.1% and 26.9% respectively in MI patients, and 70.1% and 51.2% respectively in CeVD patients. In most of the patients fasting blood sugar and total cholesterol were within the normal range. Among MI patients, 93.9%, 68.5% and 48.2% were already taking aspirin, beta-blockers and statins respectively. Among CeVD patients, 79.9%, 61.1% and 23.2% were taking aspirin, beta-blockers and statins, respectively. Blood pressure had been managed in 94.9% and 93.7% of MI and CeVD patients, respectively. Among MI patients, 85.8% and 83.2% had correct behavior towards blood sugar and cholesterol control and 68% had adequate knowledge of the risk of recurrent events. Secondary prevention of vascular disease should be regarded as a key component of public health strategies to reduce the rising burden of CVD and CeVD in Iran

Outcomes of cardiac rehabilitation after angioplasty [PTCA], bypass surgery [CABG] and myocardial infarction [MI]

Cardiac rehabilitation [CR] reduces cardiovascular mortality and improves cardiovascular and mental status of cardiac patients. Evaluation of the effects of CR in different groups according to sex, age and cause of disease would help the CR program to be special and individual and reduces the cost of treatment. The aim of this study was to evaluate the outcomes of CR in patients referring to CR program with different reasons. We studied 310 cardiac patients including 150 CABG, 44 PTCA and 110 persons with any other cause like Ml, angina, etc. without revascularization. All patients were subjected to a 24 sessions of CR including aerobic exercise, education and diet therapy. Exercise capacity, ejection fraction [EF], lipid profile and body mass index [BMl] were measured before and after the CR program. The data were analyzed using Chi-square, independent pair t-test and ANOVA. Results of this study showed that lipid profile, exercise capacity, EF and BMl were improved after CR in all groups. Changes of the variables were the same in all groups and the differences were not statistically significant. all the male and female patients attending CR program equally benefited from cr. we concluded that patients under medical treatment could improve their cardiovascular status before revascularization and sometimes postpone the intensive procedures