Showing 96 results for Health
L Shams, Gh , T Nasiri, M Meskarpour Amiri,
Volume 17, Issue 4 (3-2022)
Abstract
Background and Objectives: The aim of this study was to investigate the relationship between socioeconomic status and non-communicable diseases (NCD) risk factors in one of the northern counties of Iran.
Methods: A descriptive-analytical cross-sectional study was conducted in Langrud County in 2019. In this study, 906 rural and urban households were surveyed using mixed sampling. The data collection tool was the standard questionnaire of "NCD disease care system". Households’ exposure to NCD behavioral risk factors (including unhealthy diet, sedentary lifestyle and smoking) in different socio-economic groups was examined and compared with logistic regression models using the STATA software.
Results: The probability of smoking in illiterate subjects and those with unfinished high school education and high school diploma was 5.1, 7.5 and 4.2 times higher than those with university education (OR = 5.1,7.5,4.2; P <0.05). The probability of unhealthy diets in the first and second quartiles of income (very low and low income) was 3.4 and 2.6 times higher compared to the people in the fourth quartile of income (high income) (P <0.05; OR = 3.4, 2.6).
Conclusion: The micro-level socioeconomic inequalities (within the county) have a significant relationship with households’ exposure to NCD risk factors. Reducing socio-economic inequalities at the micro level should be considered as an appropriate tool to reduce health inequality at the macro level.
A Bagheri, M Saadati, N Zanjari, A Shabak,
Volume 18, Issue 1 (5-2022)
Abstract
Background and Objectives: Considering the growing trend of aging in Iran, it is necessary to study the factors affecting the health of elderly people. The main purpose of this study was to investigate demographic, social, and economic determinants of self-assessed health of elderly people in Tehran using generalized structural equation model (GSEM).
Methods: The data of the present study was obtained from a cross-sectional study in which 598 elderly people aged 60 years and over were selected from 22 districts of Tehran in 20151394 using stratified multi-stage sampling method and a researcher-made questionnaire was completed for them. The reliability of the questionnaire was also confirmed using and time consistency. To study the determinants of self-assessed health of elderly people, WLSMV and ULSMV estimators of GSEM were compared in Mplus (7.3).
Results: Based on the goodness-of-fit indices, the ULSMV estimator was selected to evaluate factors affecting the self-assessed health of elderly people (RMSEA=0.02, CFI=0.951 and TLI=0.962). The self-assessed health ranks of married and employed elderly people were higher than single (P-value=0.022) and unemployed (P-value=0.048) ones, respectively. An increase in spirituality (P-value=0.016), physical and mental health (P-value=0.001), and health-oriented behavior (P-value=0.016) increased the standard score of self-assessed health of elderly people. Physical and mental health played a complete mediating role in relationships of gender (P-value=0.014), marital status (P-value=0.040), education level (P-value=0.039), self-reported socio-economic status (good/ P-value=0.013 and middle/P-value=0.017) and number of diseases (P-value=0.001) with self-assessed health of elderly people.
Conclusion: According to the results, for policy-making in the field of geritrics, special attention should be paid to structural variables like gender, marital status, education level, and self-reported socio-economic status in addition to physical and mental health.
Aliakbar Haghdoost, Alireza Alikhani, Mostafa Hosseini Golkar, Reza Dehnavieh, Samira Seifi,
Volume 18, Issue 2 (9-2022)
Abstract
Background and Objectives: The COVID-19 epidemic and its subsequent effects have become a significant global challenge. In addition to being affected by this crisis, Iran is also facing many other problems, including sanctions and economic problems. So, there is a concern that it will suffer more severe consequences.
Methods: Scenario planning is one of the ways to recognize future changes and environmental uncertainties. This study used the so-called global business network (GBN) method, also known as the scenario matrix method. This method is based on two key uncertainties and six steps have been taken to examine variables related to health and socio-economic factors and use the opinions of relevant experts.
Results: To be expected, Iran's health system will be able to manage the epidemic in the face of various conditions with severity and weakness, and only in the pessimistic scenario or in Worst-case scenario with the default assumption of the continuation of sanctions and the spread of the epidemic. It leads to global restrictions, loss of foreign exchange reserves, loss of performance or collapse of the health system, increasing the number of deaths and diminishing the quality of life.
Conclusion: Regarding the COVID-19 epidemic and the existing background factors, scenarios of Iran’s health and economic conditions were narrated. Given the ability of the scenarios to understand the complexity and help in decision-making, it is considered a useful tool for policy makers to have a broader, comprehensive and reasonable look to achieve a correct consensus. This situation leads to the preservation and continuation of society health and conventional economic decisions.
Hamid Choobineh, Zeinab Parisay, Fatemeh Shahbazi, Gazaleh Danesh, Mahdi Nasri, Sayed-Saeed Hashemi-Nazari,
Volume 18, Issue 2 (9-2022)
Abstract
Background and Objectives: Human resources are the center of sustainable development in advanced management. Health, Safety and Environment (HSE) is a system that consistently and by means of human resources, facilities and equipment and tries to create a healthy, pleasant, fresh environment away from accident, damage and waste. This study was conducted to assess the health performance, Safety and Environmental Indicators (HSE) in the field of human resources development of Tehran Municipality.
Methods: This study was conducted as a descriptive cross-sectional and, the study base was all 22 districts of Tehran municipality. After designing and validating of HSE performance evaluation protocol, HSE status was evaluated in 22 districts of Tehran. The aforementioned protocol contained seven sections: leadership and commitment, policy and strategic goals, organization and documentation, risk management, planning, implementation and monitoring, audit and review). Its validity and reliability were determined by obtaining corrective opinions from specialists and experts inside and outside the municipal organization.
Results: In most areas of Tehran municipality, the inter-organizational communication index was the highest score. The highest score (68%) is related to this index. The mean overall score for performance evaluation was 46.6.
Conclusion: The HSE situation was undesirable (less than 70%) in more than half of Tehran's municipalities. Regions 4 and 7 were in desirable status (above 70%). Thus, for current situation improvement, we should use long-term strategy planning in the field of HSE.
Mohammad Meskarpour-Amiri, Sayyed-Morteza Hosseini-Shokouh,
Volume 18, Issue 2 (9-2022)
Abstract
Background and Objectives: The socioeconomic factors affecting health include various variables that are not clearly and consistently classified in the studies. This study aimed to identify and classify the main socioeconomic variables affecting household health.
Methods: This applied study was conducted with a quantitative approach and a systematic review method in 2019. A systematic review of the studies with PRISMA protocol was used to search and identify the main socioeconomic variables affecting household health in international and national scientific databases. The inclusion criteria included focusing on socioeconomic variables affecting health at the household level, providing a specific model for influencing socioeconomic variables on health, publishing in English or Persian, and accessing the full text of the study. The qualitative evaluation of the studies as well as their conformity with the inclusion and exclusion criteria, were performed by peer review. All socioeconomic variables were extracted in researcher-made form, classified using MAXQDA 2018 software and finally synthesized narratively.
Results: Twenty-one conceptual models were identified to influence socioeconomic factors on household health. Researchers and international organizations provided all models, and no native models were found in Persian regarding socioeconomic factors affecting household health. Content analysis of the studies showed that the three main variables of education, income and employment in all models (100%) were used as socioeconomic factors affecting health. After that, household health behaviors (81%), age (71%), family support (71%), housing area per capita (67%), place of residence (67%), social capital (62%) and gender (57%) were the most commonly used socioeconomic variables affecting household health respectively.
Conclusion: In addition to vital socioeconomic variables (education, income, and employment), other contextual variables such as household health behaviors, family support, per capita housing area, and social capital need to be considered for policy interventions. In addition, it is suggested that a native model of socioeconomic factors affecting health be designed for Iranian households' socioeconomic conditions.
Saeed Ghavi, Rafat Asarzadeh, Somayeh Derakhshan, Simin Poursaman, Fereshteh Sohrabivafa,
Volume 18, Issue 4 (3-2023)
Abstract
Background and Objectives: In December 2019, a novel coronavirus was discovered in Wuhan, China, leading to the global outbreak of COVID-19. The rapid transmission of the virus, the emergence of various strains, disparities in community vaccination, and the high mortality rate have presented significant health challenges to countries worldwide. Against this backdrop, this study aimed to assess the mental health status of women in the workforce during the COVID-19 pandemic.
Methods: The study employed a systematic review approach, conducting keyword searches on databases such as PubMed, Science Direct, Scopus, and Google Scholar. The search terms included "Covid-19 Virus Infection," "Covid-19 Pandemic," "Coronavirus," "Alphacoronavirus," "Bat Coronavirus," "Mental health," "Psychological," "Working women," "Working woman," and "Employee women." Articles published between 2019 and 2021 were collected and evaluated. A total of 11 articles met the inclusion criteria for data extraction and were analyzed.
Results: The reviewed studies identified several significant psychological consequences, with anxiety being reported in 82% of the articles, followed by stress (73%) and depression (64%). The COVID-19 pandemic has exacerbated negative psychological effects among working women, including those in hospital settings and those working remotely.
Conclusion: A multitude of factors contribute to the experience of COVID-19-related stress among women. These include health disparities, lower professional status, worries about personal health, family and community well-being, financial uncertainties, childcare responsibilities, and decreased social connections. As a result, stress-related disorders such as anxiety, depression, sleep disorders, insomnia, and burnout tend to manifest more severely in working women compared to men in comparable positions.
Yaser Mesri, Mina Pakkhesal, Aliakbar Naghavialhosseini, Fatemeh Mirzaei, Abdolhalim Rajabi,
Volume 18, Issue 4 (3-2023)
Abstract
Background and Objectives: Considering the impact of the COVID-19 pandemic on health and the significance of oral health, this study aims to investigate the effects of the COVID-19 pandemic on dental care utilization among children.
Methods: This retrospective study utilized available data from the archives of the dental clinic at Gorgan Pediatric Hospital in 2022. Information regarding demographic characteristics and the types of received services were collected and entered to SPSS version 26 statistical analysis software. The chi-square test was used to compare the annual differences in the frequency of different service types, and the Cochrane-Armitage test was employed to examine the linear trend of changes in each service.
Results: A total of 24,185 different dental services were received by children aged between 2 and 14 years old referred to dental clinic of Taleghani Children Hospital from March 2020 to February 2022. Comparing the frequency of dental services in 2021 to that of 2020 revealed a 31% decrease in the total number of services. The types of services utilized during the first year of the pandemic exhibited significant changes compared to the pre-pandemic year. This included an increase in tooth extraction (P = 0.001) and a reduction in restorations (P = 0.000). Additionally, a noticeable increase in pulp treatment (P = 0.003) was observed, particularly in the second year of the pandemic.
Conclusion: The frequency of dental care utilization, types of services received, and insurance utilization underwent significant changes during the pandemic. It is crucial to plan for future required treatments and establish infrastructures to address similar pandemics.
Maliheh Dadgar Moghadam, Majid Khadem Rezaian, Zainab Shateri Amiri,
Volume 18, Issue 4 (3-2023)
Abstract
Background and Objectives: The novel and rapidly spreading nature of COVID-19 surpasses the capacity and capabilities of the healthcare system, necessitating comprehensive management. This study aims to explore the role and relationship of social determinants of health with the ultimate outcome of patients.
Methods: In this cross-sectional study, the information of COVID-19 patients within the coverage area of Mashhad University of Medical Sciences was examined from three sources (outpatient or inpatient) between March 2018 and March 2019, utilizing the census method. The logistic regression model was employed to assess the predictability of social determinants of health.
Results: Out of 182,602 patients, 100,407 (55%) were men, and 82,195 (45%) were women. Logistic regression analysis revealed that the odds of mortality due to corona infection increased by 1.075 (1.073-1.077) times for each year of age. Additionally, the odds were 2.37 (2.06-2.73) times higher in men compared to women and displayed an inverse relationship with educational level (PV<0.001). Job status did not demonstrate a significant effect. The presence of diabetes (OR=1.28, 95% CI: 1.19-1.38), underlying diseases (OR=1.16, 95% CI: 1.09-1.22), and immune system weakness (OR=7.94, 95% CI: 6.44-9.80) were associated with an increased likelihood of death. Conversely, pregnancy (OR=0.90, 95% CI: 0.57-1.42) and high blood pressure (OR=0.95, 95% CI: 0.89-1.02) exhibited no significant association.
Conclusion: Considering the relationship between social determinants of health and COVID-19 mortality, it is recommended that policymakers involve sectors outside the healthcare system in addressing health matters.
Nafiseh Salehnia, Abbas Assari Arani, Hossein Sadeghi Saghdel, Alireza Olyaeemanesh,
Volume 18, Issue 4 (3-2023)
Abstract
Background and Objectives: Health promotion is a crucial task for policymakers. Therefore, this study aims to identify the key factors that determine population health in Iran and illustrate the causal relationships between these factors.
Methods: The research was conducted using a mixed-method approach in three stages. First, macro social determinants of health were identified by analyzing available resources from 2000 to 2019. Screening of factors was carried out through the fuzzy Delphi method and a survey involving 15 experts. Finally, the causal relationships between the social determinants of health were depicted using a fuzzy cognitive map.
Results: Initially, 96 health determinants were identified at the national and global levels. After the screening, 8 factors that had less significance in population health were excluded. In terms of causal relationships, the economic system emerged as the most important and influential factor, with a centrality degree of 21.06 and an out-degree of 10.91. Following that, governance and policy-making, as well as national policies, were ranked with centrality degrees of 20.25 and 20.19, respectively.
Conclusion: Irrespective of the causal relationships, the health system holds the utmost importance in population health. However, when considering the causal relationships, the economic system takes precedence as the most critical factor, while the health system does not rank among the top three factors. Therefore, the analysis of fuzzy cognitive maps assists policymakers in understanding priorities and the interconnectedness between sectors in developing and implementing health-oriented policies across all sectors, enabling the adoption of the most effective policies.
Sahar Najafizadeh, Seyed Vahid Ahmadi Tabatabaei, Fatemeh Dehnavieh Tijang, Somayeh Noori Hekmat,
Volume 19, Issue 1 (6-2023)
Abstract
Background and Objectives: Human resources play a crucial role in delivering optimal healthcare services to the population. Expanding primary healthcare coverage requires a heightened focus on the healthcare workforce due to their pivotal role in service delivery. This study aims to evaluate the current workload and staffing requirements for primary health workers and midwives in Kerman, Iran, employing the Workload Indicators of Staffing Need (WISN) methodology.
Methods: A descriptive cross-sectional study was conducted in four selected health centers in Kerman, Iran, to estimate staffing requirements across two categories. A total of 118 activities for primary health workers and 89 activities for midwives were identified through the collaboration of expert panels and a comprehensive review of the Iran’s integrated health system. Subsequently, all activities were meticulously timed in each of the four health centers using stopwatches, and WISN ratios and proportions were calculated using Microsoft Excel 2010.
Results: The WISN calculations revealed a surplus in the number of primary health workers in three of the centers: B, C, and D. However, in center A, the workforce in this category is deemed sufficient. Conversely, a deficiency of midwives was noted in two centers, A and B, with WISN ratios of 0.67 and 0.50, respectively, while center C demonstrated an excess of the workforce with a WISN ratio of 2.00. Notably, an average of 50% of the staff workload in both categories comprises supportive and additional activities.
Conclusion: Interestingly, despite 75% of the cases indicating an excess or sufficiency of employees, staff members continue to grapple with high work pressures. This anomaly appears to be linked to the substantial volume of support and additional activities. Furthermore, the intense workload during specific days and hours translates into a pervasive sense of pressure throughout the week. As a potential remedy, introducing a queuing system into the primary healthcare sector could alleviate this issue.
Alireza Didarloo, Behrouz Fathi, Raana Hosseini, Habibollah Pirnejad, Sima Ghorbanzadeh, Kajal Yasamani,
Volume 19, Issue 1 (6-2023)
Abstract
Background and Objectives: Vaccination stands as a paramount achievement in global public health and a key strategy to control COVID-19. Vaccine acceptance is a pivotal determinant of the success or failure of vaccination programs. Leveraging health education models and theories to predict behavioral intention, this study aimed to investigate the determinants of the intention to receive the COVID-19 vaccine among the general population of Urmia using the Health Belief Model (HBM).
Methods: This descriptive-analytical study employed a cross-sectional approach among 575 individuals aged over 18 residing in Urmia. Sampling was conducted through the snowball and convenience sampling methods. Data was collected using a valid and reliable electronic researcher-made questionnaire comprising four sections: demographic characteristics, knowledge, HBM constructs, and intention to receive the COVID-19 vaccine. Data were analyzed using descriptive and inferential statistics in SPSS version 16.
Results: The HBM effectively explained 67% of the variance in the intention to vaccinate against COVID-19. Within the model's constructs, individuals' perceived self-efficacy (β = 0.505, P = 0.001) emerged as the strongest predictor of the intention to receive the COVID-19 vaccination. Other influencing factors included perceived susceptibility (β = 0.158, P = 0.001) and perceived barriers (β = -0.109, P = 0.001).
Conclusion: Given the robust predictive ability of the HBM for the intention to vaccinate against COVID-19, this model can be utilized in educational and behavioral programs and interventions. Special emphasis should be placed on effective constructs, particularly self-efficacy, to enhance citizens' willingness to receive the COVID-19 vaccine.
Mohammad Sasanipour, Saeedeh Shahbazin,
Volume 19, Issue 1 (6-2023)
Abstract
Background and Objectives: This research aims to investigate the components of Rowe and Kahn's successful aging model, encompassing the absence of disease and disability, high cognitive and physical performance, and active participation in life among the elderly population in Tehran in 2020, considering both genders.
Methods: This study utilized a survey approach, involving a sample of 637 individuals aged 60 years and above in Tehran. The sample was selected using a multi-stage cluster sampling method from 22 districts of Tehran, considering the elderly population in each district. Confirmatory structural equation modeling (SEM) was employed to assess whether Rowe and Kahn's model aligns with the collected data.
Results: The study's findings demonstrated that Rowe and Kahn's model exhibited a strong statistical fit (p<0.01). Factor loadings in the overall population model and among the two genders were statistically significant and varied. Across the three dimensions of successful aging (avoiding disease and disability, maintaining physical and cognitive functioning, and continuing engagement with life), avoiding disease and disability was the most strongly associated with successful aging, regardless of gender. However, in the other two dimensions, the significance and strength of participation in life and physical and cognitive function varied based on gender.
Conclusion: Programs to support the physical health of the elderly, especially in chronic diseases resulting from lifestyle choice should be developed, and increasing active participation should be a priority, which requires interventions in youth and middle age.
Fatemeh Hajivalizadeh, Mahnaz Sanjari, Noushin Fahimfar, Kazem Khalagi, Mohammad Javad Mansourzadeh, Elahe Hesari, Bagher Larijani, Hadis Ghajari, Mahboobeh Darman, Afshin Ostovar,
Volume 19, Issue 2 (9-2023)
Abstract
Background and Objectives: In Iran, a substantial number of individuals at risk of osteoporosis lack access to osteoporosis diagnostic services, highlighting a significant gap in the diagnosis and subsequent treatment of osteoporosis. This study aims to investigate the distribution of bone densitometer devices in Iran.
Methods: Bone densitometry devices across the country in 2018 were assessed through a comprehensive census. Information regarding these devices was gathered based on their location (urban or rural), ownership (government or private), adherence to standards, and years of operation. To calculate the inequality index in the distribution of devices among cities within a province, the frequency of devices in the provincial center was compared to those outside the center. To assess the inequality in the distribution of devices among the provinces of the country, the Lorenz curve and concentration index were utilized. All values were calculated per one million people over 50 years of age.
Results: Of the total 492 bone density measurement devices in the country, 399 devices (81.0%) were located in provincial centers. Out of these, 103 (20.9%) devices were in government-owned centers, while 389 (79.0%) devices were in privately-owned centers. For every one million individuals over 50 years old, the total number of devices, standard devices, standard devices with less than 10 years of operation, and devices in government-owned centers were calculated as 33.4, 20.3, 9.9, and 7, respectively. The inequality index in the distribution of devices in the cities was found to be 4.7. Furthermore, the inequality index in the distribution of devices between provinces was estimated as 0.13 (95%CI: 0.005-0.25) (P value=0.05).
Conclusion: There exists a significant disparity in the distribution of bone densitometry devices across the provinces and cities within the country.
Fatemeh Ershadinia, Elham Rahimi, Bushra Zareie, Hadi Pashapoor, Manoochehr Karami,
Volume 19, Issue 2 (9-2023)
Abstract
Background and Objectives: The disease surveillance system provides essential information about the population at risk and the disease pattern. This review aimed to describe the experiences of countries in establishing COVID-19 school-based surveillance systems.
Methods: We conducted a systematic review. Four databases were searched between January 2019 and December 2022 using relevant keywords. The studies were screened by two people according to the inclusion and exclusion criteria. The findings were extracted using a standard form and aligned to the objectives of the review.
Results: The data from 12 studies were extracted using the standard form. All studies related to the school-based surveillance system of COVID-19. Most of studies were conducted in the United States of America and England. The reports did not conform to the standard. The number of schools covered in surveillance systems ranged from 2 to more than 6000 schools. The age group in these studies was 0 to 19 years. Schools submitted data daily or weekly.
Conclusion: The results of the COVID-19 surveillance systems in schools should be reported according to standard Instructions. This is considered a necessity to monitor and evaluate the surveillance system. It also allows other countries and researchers to share and use the results. In addition, sensitivity, timeliness, and positive predictive value were not reported in implemented surveillance systems.
Asal Aghadavodian Jolfaee, Maryam Jahanbakhsh, Mohamad Sattari, Roya Kelishadi,
Volume 19, Issue 3 (12-2023)
Abstract
Background and Objectives: The present research was conducted to predict mental health based on three factors: nutrition, activity, and leisure time, among students in the adolescent age group, using data mining techniques.
Methods: The present analytical study was conducted on 14274 data available in the Caspian 5 database. According to the CRISP-DM method, data mining was done in 6 steps using decision trees, k nearest neighbors, simple Bayesian and random forest techniques in Rapidminer software.
Results: Among the four data mining techniques used to predict the mental health of adolescents based on nutrition, physical activity and leisure time, the random forest technique has the highest accuracy (91.72) and specificity (82.73) and the k-nearest neighbors technique has the highest sensitivity (96.30). In addition, based on random forest techniques, the rule with the highest level of support showed that an adolescent who is in high school, eats breakfast, lunch, and dinner every day, drinks tea and coffee weekly, exercises 2 hours a week at school,also, he has 4 days of physical activity for 30 minutes in the last week, and he goes to school with the service, with 100% confidence has good mental health.
Conclusion: Based on the random forest technique, which has showen the best performance, nutrition has the greatest impact on the mental health of Iranian adolescents. So, it is necessary to think about providing a suitable platform for training parents and adolescents regarding proper nutrition and increasing awareness in the field of adolescent mental health.
Faezeh Joghataei, Payam Roshanfekr, Meroe Vameghi, Zahra Jorjoran Shushtari, Neda Soleimanvandiazar, Peimaneh Shirin Bayan, Gholamreza Ghaedamini Harouni,
Volume 19, Issue 4 (3-2024)
Abstract
Background and Objectives: Rapid Assessment and Response (RAR) is an approach that has been used in health research since the 1990s, and several guidelines have been designed for it. This study examines and compares different guidelines in this field.
Methods: This review study was conducted on the 6 guidelines published in PubMed and Scopus databases. After the initial review, the main dimensions of these guidelines, including the definition and target group, methods used, steps to conduct the research, and time planning were extracted in the form of a comparative table.
Results: In six guidelines, the RAR approach has been defined in relation to the comprehensive and rapid investigation of a health-related problem. There are differences in terms of the number of 'steps' of rapid assessment and response, as well as in 'time planning'; a period of 12 to 16 weeks is considered. Among the methods used in the reviewed guides, the following can be mentioned: reviewing available information, conducting interviews (open, structured, and semi-structured), focused group discussions, and other methods such as observation, surveys, narrative methods, and mapping.
Conclusion: The rapid assessment and response (RAR) can be used as an approach, with high flexibility and consideration of scientific and practical aspects, to assess health problems and high-risk behaviors in hard-to-reach groups.
