Showing 342 results for SH
A Bagheri, M Saadati, N Zanjari, A Shabak,
Volume 18, Issue 1 (Vol.18, No.1, Spring 2022 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.
F Heydari, A Shahesmaeili, M Eslami Shahrbabaki,
Volume 18, Issue 1 (Vol.18, No.1, Spring 2022 2022)
Abstract
Background and Objectives: This study was conducted to compare the personality type and alexithymia between opiates dependents, concurrent opiates and methamphetamine users and control groups presenting to drug abuse treatment centers in Kerman in 2020.
Methods: In this cross-sectional analytical study, three groups with a sample size of 130 participants were recruited through convenience sampling from six drug abuse treatment centers (two governmental and four private centers) in Kerman, 2020. The first group comprised opiates-only users. The second group included concurrent opiates and methamphetamine users. The third group included never-drug users. The data were collected using three questionnaires including a demographic questionnaire, the Friedman and Rosenman personality types questionnaire and Toronto Alexithymia Scale. Comparison of variables between the three groups was done using multivariable multinomial logistic regression.
Results: The research outcomes indicated a higher chance of type A personality in the opiates with methamphetamine dependents (adjusted odds ratio (AOR):1.97; 95% confidence interval (95% CI): 3.64, 1.06) compared to the control group. The chance of severe alexithymia was higher among opiates dependents (AOR: 1.86; 95% CI: 3.27, 1.06) and concurrent opiates and methamphetamine users (AOR: 2.7; 95% CI: 4.83, 1.51) compared to the control group. The concurrent opiates and methamphetamine users were more likely to be male (AOR: 3.1; 95% CI: 6.25, 1.53), single (AOR: 2.6; 95% CI: 4.72, 1.43) and unemployed (AOR: 4.01; 95% CI: 9.09, 1.77) compared to the control group. Compared to the control group, the opiates dependents (AOR: 4.14; 95% CI: 7.71, 2.22) and the opiates with methamphetamine dependents (AOR: 1.95; 95% CI: 3.69, 1.03) were more likely to have education levels lower than secondary school diploma.
Conclusion: Considering the relationship between the personality type and alexithymia with opiates and methamphetamine use, early screening, continuous care, and necessary trainings are required to prevent drug dependency in high-risk people, especially at younger ages.
Hamid Choobineh, Zeinab Parisay, Fatemeh Shahbazi, Gazaleh Danesh, Mahdi Nasri, Sayed-Saeed Hashemi-Nazari,
Volume 18, Issue 2 (Vol.18, No.2, Summer 2022 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.
Mahdieh Shojaei Baghini, Tahereh Naseribooriabadi, Mansooreh Rastgoo, Mahdieh Poornakhaei, Ali Mohammadpour,
Volume 18, Issue 2 (Vol.18, No.2, Summer 2022 2022)
Abstract
Background and Objectives: Poisoning is one of the most common causes of hospitalization. The external causes of poisoning and toxic agents differ in age, gender, and occupational groups. It is essential to understand the epidemiological pattern of poisoning in each region to prevent it. This study was conducted to determine the epidemiological characteristics of poisoning in patients referred to the Kerman University of Medical Sciences teaching hospital.
Methods: This descriptive cross-sectional study was performed retrospectively. Medical records of poisoning patients were reviewed from October 2016 to October 2017. Data was gathered using a researcher-made checklist based on the minimum data elements needed to record the diagnostic expression of poisoning accurately. Data analysis was performed using descriptive and inferential statistics using SPSS software 24.
Results: Poisoning was higher in males (52.1%), the 20-30 years-old age group (28.5%), single (52.8%), urban regions (80.6%), and self-employed (29.8%). The mean age of the subjects was 26.9±17.21. The external causes of poisoning were associated with marital status, age, gender, occupation, addiction, season, a personal history of suicide attempts, a family history of suicide attempts, and a personal history of poisoning. The toxic agent was also associated with age, gender, occupation, location, and external poisoning causes.
Conclusion: According to the result, poisoning often happens intentionally, so providing a suitable and stress-free family environment might be useful to reduce the amount of intentional poisoning. Educating parents with young children more about child care and how to store chemicals is also necessary.
Mohammad Meskarpour-Amiri, Sayyed-Morteza Hosseini-Shokouh,
Volume 18, Issue 2 (Vol.18, No.2, Summer 2022 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.
Maryam Aghajarinezhad, Yahya Salimi, Shahab Rezaeian, Ghobad Moradi, Fatemeh Khosravi Shadmani, Roya Safari Faramani, Ebrahim Shakiba, Yahya Pasdar, Behrooz Hamzeh, Nayebali Rezvani, Mitra Darbandi, Farid Najafi,
Volume 18, Issue 2 (Vol.18, No.2, Summer 2022 2022)
Abstract
Background and Objectives: Serological studies are based on the detection of antibodies. However, the produced antibodies decrease over time; therefore, such methods cannot provide a valid estimate of prevalence and incidence. The present study aimed to determine the serum prevalence and cumulative incidence in the Ravansar cohort population (Youth and RaNCD Cohort) in October 2020.
Methods: A random sample of 716 people aged > 18 years old were selected from the participants in the Ravansar cohort study in October 2020. Euroimmun anti-SARS COV-2 IgG ELISA kits (Lübeck, Germany) were used to measure antibody levels. Seroprevalence was estimated with considering of cut-off = 1, and cumulative incidence (modified and modified based on test specificity) was determined using modeling.
Results: In the present study, the serum prevalence of COVID-19 viral infection in the Ravansar cohort population from 22 October 2020 to 18 November 2020 was estimated to be %35.16 (95%CI: %31.64, %38.79). Modified Cumulative incidence and modified based on test characteristics from 20 February to 18 November 2020 were estimated to be %68.85 and %67.71, respectively.
Conclusion: Although very high cumulative incidence may be a sign of approaching herd immunity, adherence to health protocols is still recommended due to the potential role of asymptomatic cases in transmitting the disease to other members of the community; and the presence of new variants of the virus and reduced antibody levels should be considered.
Fereshteh Eidy, Hoosein Fallahzadeh, Rahman Panahi, Jamshid Jamali,
Volume 18, Issue 3 (Vol.18, No.3, Autumn 2022)
Abstract
Background and Objectives: Today, overweight and obesity are among the significant challenges in the world. They can have adverse effects on quality of life. Quality of life is determined by social and physical environment. The present study investigated the construct validity of the Persian version of the Impact of Weight on Quality of Life (IWQOL-lite) questionnaire using multilevel confirmatory factor analysis.
Methods: The present study was conducted on 310 people over 18 years old living in Yazd city. The data were analyzed using m-plus6.2 software.
Results: The mean age of the participants in this study was 33.97± 4.70 years. Sixty percent (N=183) of subjects were male. The indices of the one-level model were more appropriate than those of the two-level model, and the one-level confirmatory factor analysis model had a good fitting to the data (CLI: 0.98, TLI: 0.98, RMSEA: 0.038).
Conclusion: The results of this study indicated the need for more effectiveness of urban areas on quality of life. The one-level confirmatory factor analysis model confirmed the construct validity of the IWQOL-lite questionnaire. This questionnaire can be used in the Iranian population.
Ali Hasanabadi, Shirin Nasri, Elaheh Salarpour, Naser Nasiri, Hamid Sharifi,
Volume 18, Issue 3 (Vol.18, No.3, Autumn 2022)
Abstract
Background and Objectives: Screening for home contact with TB patients is essential to identify new infections. This study aimed to evaluate the tuberculosis status in family members of patients with pulmonary tuberculosis in Bam.
Methods: This cross-sectional study was conducted as a census of patients' family members whose records are registered during 2013-2019 in Bam Health Center. Patients' information was collected based on a checklist, and then sputum smear-positive patients were identified using tuberculin and sputum smear tests.
Results: Ninety-seven of the patients had a positive sputum smear test result. Based on the records of these patients, 237 members of their families were examined as contact persons. Most of the patients were female and in the age group of 40-50 years; 76.8% of them had unprotected close contact, and 78.9% had a history of permanent contact with patients. Five (2.1%; 95% confidence intervals: 0.7-4.9) sputum-positive smear pulmonary tuberculosis cases were found in contacts of patients, most of them were over 50 years old and primarily women. 40% of these people had unprotected close contact, and 80% had a house with less than 70 square meters.
Conclusion: in this study, 2.0% of the family members of patients were sputum smear-positive. Identifying patients and following them up is essential to prevent the spread of tuberculosis in those people around them. Therefore, screening the patient's family members can significantly help ease the disease burden in Iran.
Nasrin Talkhi, Nooshin Akbari Sharak, Zahra Rajabzadeh, Maryam Salari, Seyed Masoud Sadati, Mohammad Taghi Shakeri,
Volume 18, Issue 3 (Vol.18, No.3, Autumn 2022)
Abstract
Background and Objectives: Due to the high prevalence of COVID-19 disease and its high mortality rate, it is necessary to identify the symptoms, demographic information and underlying diseases that effectively predict COVID-19 death. Therefore, in this study, we aimed to predict the mortality behavior due to COVID-19 in Khorasan Razavi province.
Methods: This study collected data from 51, 460 patients admitted to the hospitals of Khorasan Razavi province from 25 March 2017 to 12 September 2014. Logistic regression and Neural network methods, including machine learning methods, were used to identify survivors and non-survivors caused by COVID-19.
Results: Decreased consciousness, cough, PO2 level less than 93%, age, cancer, chronic kidney diseases, fever, headache, smoking status, and chronic blood diseases are the most important predictors of death. The accuracy of the artificial neural network model was 89.90% in the test phase. Also, the sensitivity, specificity and area under the rock curve in this model are equal to 76.14%, 91.99% and 77.65%, respectively.
Conclusion: Our findings highlight the importance of some demographic information, underlying diseases, and clinical signs in predicting survivors and non-survivors of COVID-19. Also, the neural network model provided high accuracy in prediction. However, medical research in this field will lead to complementary results by using other methods of machine learning and their high power.
Farnoosh Zarabadi Poor, Fatemeh Mohammai, Zahra Hosseinkhani, Seyedeh Ameneh Motalebi,
Volume 18, Issue 3 (Vol.18, No.3, Autumn 2022)
Abstract
Background and Objectives: Fear of COVID-19 is common among older adults and negatively impacts on their physical and mental health. Self-regulation is an essential factor for controlling or managing excitement and anxiety. So, this study aimed to determine the relationship between fear of COVID-19 and death anxiety with the moderator role of self-regulation among the elderly residing in Qazvin.
Methods: This descriptive and cross-sectional study was performed on 430 elderly aged 60 and over living in Qazvin in 2021. Samples were selected by cluster sampling method. The demographic checklist, Templer death anxiety scale, fear of COVID-19 questionnaire, and Self-Regulation Inventory were used for collecting the data. The data were analyzed using the Path Analyze test.
Results: The mean age of the elder participants in the study was 66.88 ± 6.40 years old. The results showed a significant and positive relationship between fear of COVID-19 and death anxiety (β=0.60, P<0.001) and an inverse association between fear of COVID-19 (β=-0.24, P=0.021) and death anxiety (β=-0.10, P=0.021) with self-regulation. Furthermore, the results of the Path analysis confirmed the moderator role of self-regulation in the association between fear of Covid-19 and death anxiety among the elderly residing in Qazvin, Iran.
Conclusion: Given the mediator role of self-regulation in the relationship between fear of COVID-19 and death anxiety, it is suggested to use teaching strategies to the older adults to improve self-regulation to control and mitigate the negative impacts of the fear of COVID-19 in this vulnerable population.
Layla Halimi, Eshagh Dortaj Rabari, Reza Majdzadeh, Aliakbar Haghdoost,
Volume 18, Issue 4 (Vol.18, No.4, Winter 2023)
Abstract
Background and Objectives: In adolescence, there is a heightened inclination to cultivate stronger social networks within schools, resulting in the exchange of information. This study investigates the influential factors that shape the exchange of information among students within their classrooms.
Methods: The study involved 350 male and female middle and high school students in Hamadan. Two types of networks were constructed within each class: the communication network, representing ordinary students’ interactions, and the specific network, which focused on the exchange of sensitive information about puberty. The network centrality index was calculated, and factors influencing information transfer were evaluated through a questionnaire.
Results: The degree of centrality in the social network of boys exceeded that of girls, with values of 55.4% versus 47.6% in the communication network, and 33.4% versus 20.1% in the specific network, respectively. The degree of centrality of students had significant positive association with the length of time that they spent with their friends. Moreover, we found the degree of centrality of students in both networks, particularly in special network, was stronger in high schools.
Conclusion: During adolescence, boys tend to possess a broader communication network within their classrooms, enabling them to effectively exchange information about puberty. Factors such as effective communication skills, knowledge about puberty, and spending time with their classmates play crucial roles in facilitating the exchange of information among adolescents in schools.
Fatemeh Shahbazi, Salman Khazaei, Mohammad Mirzaei, Seyed Jalalodin Bathaei, Ali Zahiri, Manoochehr Karami,
Volume 18, Issue 4 (Vol.18, No.4, Winter 2023)
Abstract
Background and Objectives: The purpose of this study was to ascertain the mortality rate and years of life lost (YLL) resulting from COVID-19 infection in Hamadan Province.
Methods: In this cross-sectional study, information regarding the number of deaths caused by COVID-19 infection was obtained from the Vice-Chancellor of Health at Hamadan University of Medical Sciences. The research period spanned from February 2020 to February 2021. The deaths recorded by the deputy health department encompassed both outpatients and inpatients. The calculation of Years of Life Lost (YLL) was based on the guidelines outlined in the Global Burden of Disease (GBD) 2010. All data analysis was performed using Excel software.
Results: During the study period, a total of 1556 deaths occurred due to COVID-19 infection in Hamadan Province. The years of life lost (YLL) due to premature death were 15783 years (49.99 per thousand) in men, 12794 years (38.43 per thousand) in women, and 28577 years (44.08 per thousand) in both sexes. Specifically, urban areas accounted for 19824 YLL, while rural areas accounted for 8753 YLL.
Conclusion: Based on the findings of this study, COVID-19 infection resulted in a significant loss of potential years of life, particularly among men, those over 60 years of age, and in urban areas. As a result, intervention programs should prioritize the importance of early detection of the disease, reducing its severity, and subsequently mitigating the number of fatalities. Additionally, better control of the disease in elderly populations, who represent the highest proportion of years of life lost, should be a focal point.
Batoul Rabbani, Ardeshir Khosravi, Mahinsadat Azimi, Jafar Sadegh Tabrizi, Azizallh Atefi, Amin Ataey, Hossien Kazemeini, Elham Rashidin,
Volume 18, Issue 4 (Vol.18, No.4, Winter 2023)
Abstract
Background and Objectives: Overall, the four categories of non-communicable diseases (NCDs) (Cardiovascular disease (CVD), Cancer, Diabetes and chronic respiratory diseases) contribute to over 80% of annual premature deaths, with more than 85% of these occurrences transpiring in low- and middle-income countries. This study seeks to assess the likelihood of premature mortality attributable to these diseases across the provinces of Iran.
Methods: Data on causes of death from 2016 to 2019 was extracted from the death registration system of the Ministry of Health and Medical Education. To assess the completeness of the death registration system on a provincial level, we employed a novel method introduced by Adair and Lopez.
Results: From 2016 to 2019, non-communicable diseases, specifically the four primary diseases, constituted 68.98%, 69.44%, 69.17%, and 67.94% of all causes of death in Iran, respectively. During the same period, the probabilities of premature mortality attributed to major non-communicable diseases were 14.95%, 15.15%, 15.25%, and 16.63%, respectively. Notably, Golestan province exhibited the highest probability of premature death.
Conclusion: The percentage of probability of death resulting from non-communicable diseases is a crucial indicator for the prevention and control of NCDs at both the international and national levels. This indicator requires ongoing monitoring to effectively address the issue. Given the diverse socioeconomic and epidemiological circumstances across the provinces of Iran, acquiring a comprehensive understanding of the current situation regarding these diseases becomes imperative. Such knowledge facilitates the development of well-informed planning and policy-making strategies aimed at managing the increasing burden of NCDs and ensuring equitable healthcare provision.
Saeed Ghavi, Rafat Asarzadeh, Somayeh Derakhshan, Simin Poursaman, Fereshteh Sohrabivafa,
Volume 18, Issue 4 (Vol.18, No.4, Winter 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.
Mohammad Khajedaluee, Maliheh Dadgar Moghaddam, Amir-Reza Khajedaluee, Hiva Sharebiani, Hamidreza Bahrami Taghanaki, Maryam Ziadi Lotfabadi, Zeinab Shateri Amiri,
Volume 18, Issue 4 (Vol.18, No.4, Winter 2023)
Abstract
Background and Objectives: Cardiovascular diseases are the leading cause of adult mortality in many developing countries. This study aims to compare the estimation of the ten-year relative risk of cardiovascular events using the Framingham criteria with a native model.
Methods: This population-based cross-sectional study was conducted in 2014, focusing on the adult population (≥16 years) of Mashhad. Stratified random cluster sampling was employed to gather participants' information based on Framingham's criteria. Data mining, utilizing the decision tree algorithm design, was evaluated using Rapidminer v5.3 software and the cross-validation method.
Results: Out of 2978 individuals, 1930 (64.9%) were women and 1041 (35.1%) were men, with a mean age of 43.5±14.7. Applying the Framingham criteria, the ten-year risk levels of cardiovascular disease were estimated as follows: 77.8% at a low-risk level, 13.4% at a medium-risk level, and 8.8% at a high-risk level.
Regarding data mining, model number (1) achieved an accuracy of 79.56%, indicating that the predicted risk levels using the Framingham algorithm matched the observed values at 95.24% for the low-risk level, 90.8% for the medium-risk level, and 33.13% for the high-risk level. As for model number (2), an accuracy of 82.78% was obtained, with the matching values being 98.20% for the low-risk level, 0.42% for the medium-risk level, and 53.01% for the high-risk level.
Conclusion: The Framingham criteria demonstrate limited effectiveness in predicting medium and high-risk levels in the Mashhad population. According to the local model, smoking and high blood pressure in adulthood are the most significant factors in predicting the risk of cardiovascular diseases in young individuals.
Nafiseh Salehnia, Abbas Assari Arani, Hossein Sadeghi Saghdel, Alireza Olyaeemanesh,
Volume 18, Issue 4 (Vol.18, No.4, Winter 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.
Maliheh Dadgar Moghadam, Majid Khadem Rezaian, Zainab Shateri Amiri,
Volume 18, Issue 4 (Vol.18, No.4, Winter 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.
Mohammad Sasanipour, Saeedeh Shahbazin,
Volume 19, Issue 1 (Vol.19, No.1, Spring 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 Rangraz Jeddi, Ehsan Nabovati, Afsaneh Vazin, Azar Houshmand, Reza Abbasi,
Volume 19, Issue 1 (Vol.19, No.1, Spring 2023)
Abstract
Background and Objectives: Antibiotics are extensively utilized and constitute a significant portion of hospital drug expenses, posing challenges due to their overuse. Among hospital wards, the intensive care unit (ICU) is a major consumer of antibiotics. This study aimed to assess the antibiotic prescription rates within the ICU wards of Namazi Hospital in Shiraz.
Methods: We retrieved and analyzed electronic prescriptions from all 16 ICU wards at Namazi Hospital in 2020. The data were collected using a checklist that included patient demographics, prescription date, and the number of prescribed antibiotics. The relationship between antibiotic groups and patient demographics was assessed using Chi-square test.
Results: Out of 381,003 electronic prescriptions, 67,002 (17.6%) included at least one antibiotic. Additionally, 5,056 patients (98.9%) received antibiotics. Analysis of the prescriptions revealed that most antibiotics were prescribed for male patients and those under 15 years old (P<0.05). Patients admitted during the winter also received the highest rate of antibiotics (P<0.05). The most commonly prescribed antibiotic groups were beta-lactam and chloramphenicols (32.89%), cephalosporins (19.28%), and glycopeptides (18%).
Conclusion: While less than one-fifth of prescriptions included antibiotics, nearly all patients received them. It is advisable for future studies to evaluate antibiotic prescribing based on prescriptions to provide hospital managers with more precise statistics, enabling appropriate actions for antibiotic stewardship.
Ali Khorshidi, Mehdi Moradi Nazar, Mansour Masoumi, Mohammad Reza Karami Ghezeli, Zahra Mohammadi,
Volume 19, Issue 2 (Vol.19, No.2, Summer 2023)
Abstract
Background and Objectives: The World Health Organization estimates that over a million people contract sexually transmitted diseases daily. Given the significant impact of these diseases on public health in developing countries, this study aims to investigate the epidemiology and burden of sexually transmitted diseases in the Eastern Mediterranean countries.
Methods: This study utilized global disease burden data from The Institute for Health Metrics and Evaluation to examine sexually transmitted disease indicators in the Eastern Mediterranean region, encompassing 22 countries from 1990 to 2019. Analyses related to the lost years index, considering premature death and disability (DALY), incidence rate, prevalence rate, mortality rate, and standardized age rates, were conducted. All estimates are reported with 95% uncertainly interval due to various sources of error, including measurement bias and modeling. Microsoft Office Excel 2016 was employed for all analyses.
Results: The age-standardized incidence and prevalence of sexually transmitted diseases in the Eastern Mediterranean region decreased from 9053 and 13424 in 1990 to 8658 and 13143 in 2019, respectively, and the age-standardized death rate increased from 2 to 4 per 100,000 people.
Conclusion: Considering the economic burden caused by these diseases in the Eastern Mediterranean region, it is necessary for the health policy makers to develop intervention strategies for prevention and health planning.
