M Shami, P Azodi, M Mahmodi, S Najafipour Boushehri, F Jahanpour ,
Volume 17, Issue 1 (5-2021)
Abstract
Background and Objectives: Physical activity is one of the most important components of life. The aim of this study was to evaluate the physical activity level of primary school students in Bushehr in 1398.
Methods: In this cross-sectional descriptive-analytical study, the research population included all elementary school students in Bushehr. Four hundred and six students were selected using multi-stage random sampling. The Physical Activity Questionnaire for Children, which is a valid and reliable scale, was used to collect the data. Independent t test, one-way analysis of variance, Pearson correlation coefficient and multiple linear regression model were used for data analysis. Data was analyzed using the SPSS software version 20.
Results: The mean score of physical activity was 3.27±0.84. There was a significant relationship between demographic factors (parents’ education level, participant’s education level and BMI) and physical activity. Students whose parents had higher levels of education were more likely to engage in physical activity and people who were obese had less physical activity.
Conclusion: The students' physical activity was moderate. Given that there is a direct link between physical inactivity and increased prevalence of overweight and obesity, it is important to pay attention to the lifestyle of people, especially children and adolescents who are in the learning age. Therefore, more attention should be paid to improving the level of physical activity in students through education and building a culture.
Mh Rabiee, H Akbarin, S Bokaie, Mh Fallah Mehrabadi , A Sadrzadeh, F Tehrani,
Volume 17, Issue 1 (5-2021)
Abstract
Background and Objectives: The commercial layer chicken farming is one of the most important sectors of the poultry industry. This study was conducted to evaluate the status of biosecurity of commercial layer chicken farms in 9 Iranian provinces with the highest layer chicken population.
Methods: In this cross-sectional study, 202 commercial layer chicken farms were selected from nine Iranian provinces in 2019 using stratified random sampling. Then, the required data were collected using a questionnaire by presenting to the farms in person. The results are expressed as mean, standard variation, sum and adoption rate index.
Results: The results showed that the adoption level of total biosecurity measures was 68.18% in the commercial layer chicken farms in Iran. This figure was 72.11%, 75% and 60.82% for conceptual, structural and operational biosecurity measures, respectively. Among conceptual biosecurity measures, the lowest adoption level (29.20%) was for distance to the nearest garden and agriculture land. Among structural biosecurity measures, the lowest adoption level (28.96%) was for a hand disinfection spot before shed. Among the operational biosecurity measures, the lowest adoption level was for water filtrations (31.18%) and microbial testing of water (33.91%).
Conclusion: This study investigated the biosecurity status of commercial layer chicken farms in nine Iranian provinces with the highest layer chicken population and revealed some weaknesses in the implementation of these measures at conceptual, structural and operational levels.
Sara Jalali-Farahani, Parisa Amiri, Zeinab Shayeghian, Parnian Parvin, Leila Cheraghi, Fereidoun Azizi,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: The Covid-19 prevalence can threaten self-care behaviors and disease control in people with type 2 diabetes (T2D) through increasing anxiety and stress levels and limited access to medical services. This study was conducted to investigate the association of the Covid-19 pandemic with self-care behaviors in patients with T2D.
Methods: The present study was conducted on 318 adults with T2D who participated in the Tehran Lipid and Glucose Study (TLGS) between 1397 and 1399 and completed the summary of diabetes self-care activities (SDSCA) questionnaire. Data on self-care activities during the Covid-19 pandemic were collected 3-4 months after the announcement of the epidemic in the country via telephone calls. For data analysis, a multiple linear regression model and paired t-test were used.
Results: The mean total scores of self-care behaviors were 49.7±14.8 and 56.1±13.1 before and after the Covid-19 pandemic, respectively (P<0.001). After the Covid-19 pandemic, women's total self-care score increased with an increase in the diabetes duration (β= 0.31, P= 0.020) after adjusting for the aforementioned related conditions. This score showed a significant decrease in women with a high school education compared to those with higher education (β= -6.57, P= 0.024). Moreover, the diet and foot care subscales in both sexes and the blood glucose testing score in women were significantly higher after versus before the pandemic.
Conclusion: Following the Covid-19 pandemic, self-care behaviors, especially those related to diet, foot care, and blood glucose testing, improved in the short term
Sadegh Kargarian-Marvasti , Malihe Hasannezhad , Jamile Abolghasemi,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: This study aimed to investigate the effective factors in the survival/hazard time of Covid-19 patients in three waves of epidemic.
Methods: All 880 Covid-19 patients were included in this prospective cohort study using the census method. Polymerase chain reaction was used to diagnose Covid-19. The survival status of these patients was followed up for 4 months. The analysis of this study was based on the time of infection in three epidemic waves in IRAN. To analyze the data, the Kaplan-Meier nonparametric approach and Cox proportional hazards regression model were used. Survival distributions were compared in three epidemic waves using the R software (version 3.6.2) (P<0.05).
Results: We diagnosed 880 positive case of Covid-19 using PCR test on 2269 susspected people who had respiratory symptomps. At the end of 1-year follow-up, cumulative incidence (risk) of Covid-19 was estimated 7%. Effective factors in the survival time of patients with Covid-19 based on Cox multivariate regression model were: 1- Age 2- Intensity of infection (Hospitalization) 3- Heart disease 4- Epidemic Wave and 5- Transmission mode of the disease (P <0.05). The Kaplan-Meier approach and log rank test (Mantel-Cox) showed a significant difference in the survival rate in three epidemic waves (P = 0.018).
Conclusion: Elderly patients, especially those with a history of heart disease, are at higher risk of death than other groups. In addition to regular screening, these patients will need active monitoring, especially at the time of hospitalization.
K Holakoui-Naeini, Ma Mansournia, Sh Naderian, R Beiranvand, M Bidkhori, Kh Maajani, Sh Nematollahi,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: Pre-natal mental health problems are major causes of disease burden, especially in lower socio-economic groups of population. The present study used data of a prospective cohort study to estimate the risk of mental health problems, including depression, anxiety, and stress, on birth weight.
Materials and Methods: This study used data of 398 pregnant women who were participants of the Bandar Abbas Pregnancy Cohort Study (BAPC) during 2017-2020. Data of depression, anxiety, and stress were collected using DASS-21items questionnaire in pregnancy. Low Birth Weight (LBW), as birthwieght below 2500 grams, was calculated according to infant`s vaccination log. Modified Poisson regression models with logarithm link function and significance level of 5% were applied to estimate the effect of depression, anxiety and stress on LBW.
Results: Compared to the subjects without mental health problems, the risk of LBW increased by 8.03 times in the severe depression (95% CIs: 5.55-11.62), by 8.06 times in the moderate stress (95% CIs: 5.64-11.51), by 3.13 times in the severe anxiety (95% CIs: 1.18-8.31), and by 8.43 in the highly severe anxiety (95% CIs: 5.80-12.25).
Conclusions: Severe and moderate levels of depression, anxiety, and stress all had statistically significant effects on LBW. Pre-natal screening services can help mitigate the burden of mental health by timely detection and referral. Moreover, designing and implementing consultation programs for pregnant women and their fsmilies, expecially their spouses, to provide emotional support and to improve marital relationship are amongst the suggestions.
Zahra Hosseinkhani, Mozhgan Abbasi, Amaneh Khaleghi, Elham Kakavand, Nahid Yazdi, Hassan Reza Mohammadi Moein,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: The spread of COVID-19 in the world has had adverse effects on all aspects of people´ life and social and economic development of the communities. The current study was conducted to determine the knowledge, attitudes, and practices toward COVID-19 in the general population of Qazvin province.
Methods: This cross-sectional study conducted on 1223 people above 15 years in Qazvin province between December and January 2020. We used multistage stratified random sampling to select the participants from urban and rural health centers. The questionnaires were completed by the patients as well as through phone interviews. The questions included demographic information and knowledge, attitude, and practice toward COVID-19.
Results: In total, 1223 subjects with a mean (standard deviation) age of 35.6 ± 12.2 years participated in this study. The scores of knowledge, attitudes, and practice were 68%, 72% and 91%, respectively. The lowest score of knowledge was related to awareness of common symptoms of the disease (6%). Forty-two subjects believed they observed the principles of disease prevention. A distance of 2 meters was observed by 50.3%. The scores of knowledge (P=0.007) and practice (P=0.028) increased with age, and the scores of knowledge (P<0.001) and attitude (P=0.001) increased and decreased with an increase in the education level, respectively. Males had significantly lower knowledge (P=0.002) and practice (P<0.001) scores. Moreover, rural residents had higher attitude scores compared to urban residents (P=0.002).
Conclusion: The results suggest that the general population of Qazvin province had desirable knowledge, attitude and practice towards COVID-19 at the time of the epidemic.
Mohammad Ali Derik, Mohammad Kakavand, Shahram Mamdohi, Mojgan Navabi, Elham Goodarzi, Hamid Mokhayeri, Zaher Khazaei,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: Viral hepatitis is one of the most prevalent diseases and an important underlying cause of death and disability in the world. This case-control study was conducted to investigate the outbreak of hepatitis A in Boroujerd in 2019.
Methods: This case-control study was conducted to investigate the epidemic of hepatitis A in Boroujerd in 2019. Fifty hepatitis A patients were recruited. For each patient diagnosed, two controls with no history of the disease were selected from a neighboring village. Data were collected using a demographic questionnaire as well as the results of experiments. To investigate the association between the disease and risk factors, odds ratio and 95% confidence interval were used.
Results: In this study, the odds ratios were significant for a number of risk factors including washing fruits and vegetables with a source other than tap water [OR = 3.2], washing dishes with a source other than tap water [OR = 3.7], non-sanitary toilets [OR = 8.3], using sources other than tap water when there is no tap water [OR = 4.4], being unaware of the disease and its transmission methods [OR = 4.8] and water well dug less than 15 m from the sewage well (OR = 4.1).
Conclusion: Increased public awareness and improved health status of the environment and rural sewage can preclude similar epidemics in the study area and other regions.
Mohammad Zare, Zahra Tagharrobi, Khadijeh Sharifi, Zahra Sooki, Javad Abolhasani,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: Valid, reliable, short, sensitive and accurate tool is needed to diagnose pain in dementia patients. This study aimed to determine the psychometric properties and diagnostic accuracy of short-form Persian version of Doloplus-2 (P-Doloshort) in pain assessment in elderly with dementia.
Methods: In this cross-sectional study, 100 elderly were selected using convenient sampling from private clinics and nursing homes in Kashan in 2018-19. Construct validity was determined by exploratory factor analysis, known-groups approach and convergent validity. Also, reliability was evaluated by internal consistency, equivalence, and stability. P-Doloplus-2 and P-Doloshort were used as the reference standard and the index test, respectively. Data were analyzed by SPSS-v16 using independent T-Test, linear regression, Pearson and intra-class correlation coefficients (ICC), Cronbach's alpha, ROC curve, and diagnostic test parameters.
Results: Factor analysis identified the tool as a single-factor; it was able to explain 65.851% of total variance. P-Doloshort was able to differentiate between two groups with and without painful underlying diseases (P<0.0001). There was a positive and significant correlation between P-Doloshort score with P-Doloplus-2 score (r=0.975, P<0.0001) and PACSLAC-II-IR score (r=0.0001, P<0.0001). Cronbach's alpha, ICC and standard error of measurement were 0.898, 0.891 and ±1.183, respectively. The relative frequency of minimum and maximum possible score was less than 15%. At the cut-off point of 2.5, area under ROC curve, sensitivity, specificity, and overall diagnostic accuracy were estimated 0.985, 0.956, 1.000 and 0.970, respectively.
Conclusion: P-Doloshort can be used as a valid, reliable, sensitive and accurate tool for pain assessment in elderly with dementia.
Malihe Safari, Salman Khazaei, , Mohammad Abbasi, Ghodratollah Roshanaei,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: The incidence of rectal cancer is increasing in developing societies, especially in younger age groups. The aim of this study was to evaluate the factors affecting the survival of patients with rectal cancer in the presence of competing risks.
Methods: In this retrospective cohort study, the data of 121 patients with rectal cancer during 2001-2017 were studied. Death related to cancer progression was considered as the interest outcome and other causes of death were considered as competing risks. Cause-specific and sub-distribution hazard models were used to investigate the factors affecting patient survival in the presence of competing risk.
Results: The mean (SD) age of the patients was 53.4 (13.9) years and 68 patients (56.2%) were male. The results of log-rank test showed that sex, age, metastasis, type of first treatment, rate of penetration into intestinal wall, tumor location, number of lymphomas involved and tumor size had significant effects on the patient survival (P<0.05). Based on cause-specific and sub-distribution hazard models, tumor stage, lymph node metastasis, and tumor grade had significant effects on death hazard due to the cancer progression (P<0.05).
Conclusion: Due to the need to consider competing risks, the results of both competing risk methods showed that tumor grade, lymph node metastasis and stage increased the instantaneous hazard and hazard of cancer death. Therefore, to determine the specific risk factors for each cause of death in the survival analysis, competing risk methods should be used if there is more than one cause of death.
Sedighe Sadat Tabatabaei Far, Taha Kushki, Mohammad Jamshidi, Sajad Delavari,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: The health sector will face a shortage of manpower during crises. The sustainability and retention of human resources during these conditions are vital. The purpose of this study was to explain possible policies and strategies to strengthen health workers during the crisis and prevent them from leaving the organizations and hospitals.
Methods: This was a scoping review research to find strategies for retention of human resources during epidemics. English and Persian databases were searched and relevant studies were selected and reviewed. The key pieces of information obtained were then categorized. Finally, suggested efficient policies and strategies were summarized and reported.
Results: A total of 168 different articles were collected. After excluding irrelevant studies, 21 articles were selected and fully reviewed. The results were classified into six main categories of policy-making as well as strategies to implement them.
Conclusion: Considering the epidemic situations, in order to strengthen and support human resources in times of crisis, it is recommended that policymakers and decision-makers of the health sector focus their attention on six major topics including education reform, financial support, psychological support, social and welfare support, professional support, and development of infrastructures in deprived and crisis-stricken areas. The important point about suggested strategies is that they need to be in accordance with the ongoing situation of their target societies, as we know that underdeveloped, developing and developed countries have a different set of circumstances and therefore require different priorities and policies.
Sara Najibi, Shadab Shahali, Kh Hekmat, Bahman Cheraghian,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: Child growth health is one of the most important issues that determines the community health. Considering the importance of mothers in family and healthy society, the aim of this study was to evaluate the correlation between maternal employment status and infant growth during the 9-12 months in Ahwaz.
Methods: In this prospective cohort study, 345 nine-month infants of three groups of mothers including full time employees, part-time employees, and homemakers were selected using non-probability quotas sampling method. Data was collected using a researcher-made questionnaire and analyzed with the SPSS software version 22 using statistical tests such as chi-square, anova.
Results: In the full-time job group, 54.2% of the infants had favorable weights and 45.8% had unfavorable weights. In the part-time group, 69.6% of the infants had favorable weights and 30.4% had unfavorable weights. In the homemaker group, 68.7% of the infants had favorable weights and 31.3% had unfavorable weights. There was a significant difference in the infant’s weight between full-time and part-time job groups
(P= 0.01) and the full-time job and homemaker group (P= 0.04) but there was no significant deference in the infant’s weight between the part-time job and homemaker group (P= 0.87). No significant association was found between maternal employment status and infant’s height (P= 0.11) and head circumference as well (0.08).
Conclusion: The growth status of infants with full-time working mothers was lower than that of infants with homemaker and part-time working mothers. It is recommended to reduce the working time of the mothers who have full-time jobs as long as they breastfeed their babies.
Zahra Jaafari, Zahra Abdolahinia, Hajar Ghasemi, Ali Esmaeilpour, Saeideh Mahmoodzadeh, Ali Bahaodini, Seyed Vahid Ahmadi Tabatabaei, Najmeh Safa, Hamid Reza Tohidinik, Ali Akbar Haghdoost, Ali Sharifi, Vahid Yazdi-Feyzabadi, Hamid Safari,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: low utility of health care services is one of the main determinants of not achieving desired health indicators in urban areas. This study aimed to investigate the barriers and facilitators of receiving health services from health centers in Kerman city, Iran.
Methods: This study was a qualitative study with a content analysis approach conducted in 2020. After selecting health centers with the experience of desirable or low utility services, purposive sampling continued until information saturation. A total of 78 staff members, recipients, and non-recipients of services citizens were interviewed semi-structured and face-to-face at health centers. All interviews were recorded and coded manually and then reviewed and analyzed using directional content analysis.
Results: The essential services for children and mothers, free services, and service providers' behavior were mentioned as facilitators of referral. Distance and physical factors, knowledge of different types of services, preference of private centers, time access, view of people on regular visits to centers, addresses and telephone numbers registered in the system, responsiveness to health needs, fear of disease disclosure, lack of human resources in the centers, and service providers' behavior, were among the barriers of visiting the centers.
Conclusion: According to the results of this study, an accurate understanding of the under-coverage people's views and perceptions can help national and local planners and policymakers design the necessary strategies to increase the use of health services in urban health centers.
Mahbube Shali, Azam Ghorbani, Pegah Matourypour , Ehsan Salehi Morkani, Mohammad Salehpoor Emran, Alireza Nikbakht Nasr Aadi,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: It is necessary to apply appropriate coping methods to reduce destructive physical and psychological effects of stress during Covid-19 pandemics. This study was conducted to explore nurses' experiences of stress coping techniques during the Covid-19 pandemic.
Methods: The present study used a qualitative methodology with interpretive phenomenology method. Purposive sampling was used. The participants, including nurses working in hospitals affiliated to Tehran University of Medical Sciences, shared their experiences through in-depth, individual and semi-structured interviews. The transcripts of interviews were analyzed based on the Dickelmann's approach using the MAXQDA 12 software.
Results: The participants included nine nurses (six females and three males) with a mean age of 45 ± 5.3 years. The results of data analysis showed four main categories and fifteen subcategories conceptually named based on their nature. The main categories were self-support, family shelter, hospital support umbrella, and community support on both extremes.
Conclusion: The participants practiced different coping strategies to deal with stress and anxiety. In addition to individual mechanisms, nurses sought help from other sources of support, such as family, workplace, and community. Based on the experiences of nurses participating in the study, it is recommended to teach nursing staffs coping methods with stress, especially in times of crisis such as the Covid-19 pandemic.
Mohsen Mahdinia, Seyyed Hassan Adeli, Hamidreza Heidari, Abolfazl Mohammadbeigi, Mohammadreza Khaksar, Ahmad Soltanzadeh,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: Pulmonary consequences of exposure to low concentrations of ammonia have been less studied. The purpose of this study was to model the pulmonary consequences of exposure to low concentrations of ammonia.
Methods: This historical cohort study was conducted in the fertilizer industries in 2019. The participants were divided into two groups of exposed (n=98) and non-exposed (n=105). The exposure level, pulmonary symptoms, and pulmonary function parameters were assessed using the NMAM 6016 and American Thoracic Society and European Respiratory society (ATS&ERS) protocols. Data analysis was performed using the IBM SPSS v. 22.0, and multivariate linear and logistic regression models.
Results: The ammonia exposure level was 4.80±1.54 ppm in the exposed group. There was no significant difference in most of the individual variables between the two groups (P>0.05). The frequency of all pulmonary symptoms was significantly higher in the exposed group compared to the non-exposed group (P<0.05). The highest prevalence of pulmonary symptoms in the exposed group was for cough (25.51%), wheezing (19.39%) and shortness of breath (18.37%). All lung function parameters were significantly lower in the exposed group versus the non-exposed group (P<0.05). The values of lung function parameters in the exposed group including FVC, FEV1 and FEV1 / FVC were 86.0%, 82.47% and 81.97%, respectively. Regression modeling results showed that ammonia exposure had a significant relationship with all pulmonary symptoms and lung function parameters (P<0.05).
Conclusion: The findings indicated that exposure to low concentrations of ammonia should be considered as a major risk factor in the prevalence of pulmonary symptoms and reduced lung function parameters.
Sa Hashemi, K Holakoui-Naeini, Ma Mansournia, R Akrami, M Nomali, T Valadbeigi, V Mennati, Ha Adineh, Mr Taghavi, M Ghafouri, S Poorbarat, A Hoseinzadeh, M Farahdel, Mr Armat, M Haresabadi,
Volume 17, Issue 3 (12-2021)
Abstract
Background and Objectives: COVID-19 is a new disease and little information is available on its risk factors. The aim of this study was to determine the mortality risk factors in patients with COVID-19 in the northeast of Iran.
Materials and Methods: A case-control study was conducted. Patients of both sexes with a confirmed diagnosis of Covid-19 infection who died during the study were studied as the case group and patients who were in good general health and ready for discharge were studied as the control group. Data analysis was performed with the STATA software version 14 using descriptive statistics and univariate and multiple logistic regression tests.
Results: Six hundred and eleven patients were studied (27% cases and 73% controls). Multiple logistic regression analysis showed that the odds of death were 2.8 times higher in patients over 80 years compared to patients aged 50-60 years. In addition, age under 40 years reduced the odds of mortality by 85% and living in rural areas increased odds of death by 2.2 times. Cough, general fatigue, pain, nausea and vomiting increased the odds of COVID19 survival.
Conclusion: The odds of mortality were higher in elder patients with COVID-19. In addition, living in rural areas increased the odds of mortality in patients. Cough and fatigue reduced mortality; however, it is needed to address other hidden factors for sound judgment.
Y Salimi, Ma Mansournia, I Abdollahpour, S Nedjat,
Volume 17, Issue 3 (12-2021)
Abstract
Background and Objectives: Using a random sample of women aged 15 to 50 years in Tehran, this study sought to estimate the lifetime prevalence of abortion (intentional and unintentional) and to identify its associated factors.
Materials and Methods: The control data of a population-based case-control study conducted in 2014 in Tehran was used in the present study. Data from 544 randomly selected women aged 15-50 living in municipality areas of Tehran were included in this study. A multiple logistic regression model was used to investigate factors associated with abortion and to estimate the adjusted odds ratios (ORs) and 95% confidence intervals.
Results: Overall, 102 women (18.8%, 95% CI (22.4% -15.8%)) reported a lifetime history of abortion. In the logistics regression model, being single (OR =3.46, 95% CI: 1.42-8.47) older age (OR = 1.07, 95% CI: 1.04-1.11) increased the odds of a positive lifetime history of abortion. However, having a child (OR = 0.27, 95% CI: 0.11-0.65)), more education years (OR = 0.89, 95% CI: 0.82-0.96)) and higher religious beliefs (OR = 0.65, 95% CI: (0.45-0.93)) decreased the odds of a positive lifetime history of abortion..
Conclusion: High reported lifetime prevalence of abortion in the present study and its subsequent risks to maternal health highlight the need for educational interventional programs taking into account the level of education and knowledge of mothers along with their religious.
M Karami, S Khazaei, F Shahbazi, M Mirzaei, A Biglarkhani, A Ataei, Seyed Jalalodin Bathaei, A Zahiri, M Shojaeyan, R Zamani, Ae Karshenas, F Heeders-Moghis, K Hamelmann, R Heidari Moghadam, I Khodadadi-Kahlan, S Bashirian, F Keramat, Sh Hashemi, E Jalili, F Azizi-Jalilian,
Volume 17, Issue 3 (12-2021)
Abstract
Background and Objectives: The aim of this study was to investigate the epidemiological characteristics of patients with Covid-19 in Hamadan Province.
Materials and Methods: In this descriptive cross-sectional study, demographic and epidemiological data of all people who presented to hospitals in Hamadan Province from February 2019 to December 2020 were extracted using two checklists. Data were then analyzed using the Stata software.
Results: In this study, 9674 covid-19 positive patients were examined. According to results, 49.11% of the cases occurred in the elderly over 60 years. The rate of involvement was higher in females than males (51.57% vs. 48.43%). Moreover, 72.05% of the definitive patients lived in the city and 0.76% reported traveling to areas with a high prevalence of the disease two weeks before the onset of symptoms. The highest incidence of this disease per one hundred thousand population was in Malayer, Hamedan and Nahavand counties and the highest fetality was in Razan and Dargazin, Tuyserkan and Asadabad counties, respectively. The data of suspected, probable, and definite outpatients with Covid-19 presenting to medical centers were not evaluated in this study.
Conclusion: Due to the high death rate in the elderly, males, those with underlying diseases, and people living in rural areas, it is necessary to design and apply precautionary measures in these groups. Attention should be paid to these high-risk groups in the shortest possible time to reduce the burden of this disease on individuals as well as the health care system.
M Faghir Gangi, Ali Mirzazadeh, H Rastad, S Nedjat, A Rahimi-Movaghar, K Yazdani,
Volume 17, Issue 3 (12-2021)
Abstract
Background and Objectives: This qualitative study was conducted to identify reasons for not using condoms by people who inject drugs (PWID) in Iran.
Materials and Methods: Purposeful sampling was applied to recruit four groups [male PWID (n = 14), female PWID (n=6), service providers (n=8), and HIV/Addiction experts (n = 9)] into a qualitative study. Data were collected through focus group discussions (FGDs) or individual in-depth interviews. Data were analyzed using conventional content analysis.
Results: The mean age was 44.0 years for male and 38.2 for female PWID. Qualitative analysis showed 16 themes for not using a condom, which were grouped in three main categories, including knowledge (3 themes), accessibility (4 themes), and individual barriers to use condoms (9 themes). Poor knowledge included low perceived level of risk, insufficient training, and misconceptions. Lack of access to condoms resulted from the country's new policy for population growth control and decrease in the number of pharmacies and harm reduction centers and prisons where condoms were previously distributed free of charge. Common reported individual barriers to condom use were poverty, homelessness, depression, low self-care, and low self-esteem, less pleasure, having sex under the influence of drugs, and stigma.
Conclusion: Both structural and individual factors may play a role as barriers to condom use among PWID.
S Heidari, M Karami, Sm Zahraei, I Sedighi, F Azimian Zavareh,
Volume 17, Issue 3 (12-2021)
Abstract
Background and Objectives: Given the importance of the early detection of any outbreak or change in the trend of meningitis, this study was conducted to estimate the fixed and dynamic alarm threshold levels of meningitis and its outbreak in Iran.
Materials and Methods: In this study, the data of all patients from 20¬ March 2016 to 20 March 2019 were extracted from the National Meningitis Disease Surveillance System. Alarm threshold levels were calculated separately for different seasons and provinces. To determine the alarm threshold levels, four methods of Upper Control Limit (UCL), relative increase, statistical cut off points, and recommendations provided by the World Health Organization were used.
Results: The alarm threshold levels for confirmed cases were determined for Iran according to the upper limits of cumulative sum (CUSUM) algorithm and the statistical cut off points based on the 90th percentile, 2 cases per day for Iran. The fixed amount was 3 to 5 cases per week in populations under 30,000 and 5 to 7 per week in populations between 30,000 and 100,000. According to the relative increase method, a 30% increase in one week compared to previous weeks was considered as the threshold level.
Conclusion: The use of alarm threshold levels reported in this study can be a basis for detecting meningitis outbreaks.
H Soori, T Yousefinezhadi, E Haghighat Manesh,
Volume 17, Issue 3 (12-2021)
Abstract
Background and Objectives: Road accidents are a major public health problem and one of the leading causes of death in the world. Some survivors of traffic accidents experience acute stress disorder and post-traumatic stress disorder during weeks to months following the accident. These disorders can have disastrous effects on victims and their inability to return to normal living conditions.
Materials and Methods: This was a cross-sectional descriptive study. The Post-Traumatic Stress Disorder checklist (PCL5) was used to assess acute stress disorder and post-traumatic stress disorder. The sample size was 384 people and the data were collected one week and two months after the trauma in the orthopedic, emergency and inpatient wards of Taleghani, Shohadaye Tajrish and Haftom Tir hospitals. This study was conducted between October and January 2016.
Results: This study was conducted on 350 participants. About 49% of the participants (n = 172) met the diagnostic criteria for acute stress disorder and 40.6% (n = 142) met the diagnostic criteria for post-traumatic stress disorder. There was a relationship between demographic variables of age and death of a close family or friend and the severity of post-traumatic stress disorder.
Conclusion: According to the results, about half of the participants had acute stress disorder and met the diagnostic criteria of post-traumatic stress disorder. This result highlights the high prevalence of this disorder in traffic accident victims and the importance of its follow-up and control.
