Zahra Hamidi, Mehdi Ranjbaran, Fateme Qotbi Nia, Akram Bahojb, Hamid Karyab,
Volume 18, Issue 3 (12-2022)
Abstract
Background and Objectives: Chromium is a heavy metal that toxic to humans in small concentrations. This study aimed to evaluate the cancer risk of exposure to chromium in drinking water in rural areas of Qazvin province.
Methods: Water sampling was performed according to the standard methods for water and wastewater examination and chromium analysis was performed with ICP-OES. Exposure factors were determined using a validated questionnaire. Finally, the risk assessment of oral and dermal exposure to chromium was performed using the risk assessment technique. Monte Carlo simulation was also used to determine the uncertainty caused by point risk estimation.
Results: The mean concentration of chromium in drinking water was 2.8±5.04 μg/l. The excess lifetime cancer estimated by the Monte Carlo simulation was 30.8 cases per 100,000 in the studied population, indicating 100 cases of cancer in the population living in rural areas of the Qazvin province.
Conclusion: Based on the obtained results, it can be concluded that although the concentration of chromium was lower than the maximum allowed in the national standard (0.05 mg/l), the risk of carcinogenesis was higher than the acceptable risk level of WHO (1 case per 100,000). Also, using the results obtained from the Monte Carlo simulation instead of point estimation provides higher confidence in risk management decisions.
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.
Abdolahad Nabiolahi, Najmeh Khammari, Nasser Keikha,
Volume 19, Issue 1 (6-2023)
Abstract
Background and Objectives: Mucormycosis is a severe fungal infection with high mortality, particularly affecting immunocompromised patients. COVID-19 patients, due to their compromised immunity, are also susceptible to mucormycosis. Given the rising prevalence of mucormycosis, this research aims to analyze highly cited articles focused on mucormycosis in COVID-19 patients.
Methods: This research employed a citation analysis approach using bibliometric analysis. The study's statistical population comprised articles related to mucormycosis and COVID-19 indexed in the Web of Science database between 1945 and 2023 that received a high number of citations. Histcite and VOS Viewer software were utilized to draw scientific and co-occurrence clusters of words.
Results: Analysis of highly cited articles revealed that among the 1,082 documents published, the top 100 works primarily focused on mucormycosis and COVID-19, histopathological findings, and fungal co-infections, garnering the highest citations. An article by Singh received the highest number of citations. The journal "Mycoses" was identified as an influential journal in the COVID-19 and mucormycosis domain, publishing 10 highly cited articles. Co-occurrence analysis of words highlighted four key thematic clusters related to COVID-19 and mucormycosis, as well as other types of fungal infections. Analysis of the top 100 articles indicated that mucormycosis and COVID-19 clusters had the highest frequency, focusing on histopathological areas and fungal coinfections.
Conclusion: The co-occurrence map of words and emerging topics in mucormycosis, COVID-19, and fungal infections can guide researchers in laboratory research, enhancing their understanding of the disease, related current issues and potential treatment methods. Moreover, it offers valuable insights for authors, journals, and researchers in selecting future research priorities.
Ali Jafari-Khounigh, Morteza Haghighi, Alireza Razzaghi, Shahram Habibzadeh, Seyed Taghi Heydari, Rasoul Entezarmahdi, Dr. Alireza Ansari Moghaddam, Hamid Sharifi, Mostafa Farahbakhsh, Mahdi Rezaei, Mina Golestani, Ehsan Sarbazi, Naser Nasiri, Homayoun Sadeghi-Bazargani,
Volume 19, Issue 3 (12-2023)
Abstract
Background and Objectives: Masks play a crucial role in preventing and controlling viral epidemics transmitted predominantly through the air. This study aimed to develop and validate a tool to measure people’s attitudes and behaviors related to mask usage during highly contagious viral epidemics.
Methods: In this psychometric study, the initial questionnaire was developed and face validity and content validity were assessed by 17 experts and three lay experts. Reliability was evaluated through internal consistency using Cronbach’s alpha and test-retest reliability using the Intraclass Correlation Coefficient (ICC). Construct validity was measured using exploratory factor analysis (EFA) with the principal component extraction method and Varimax rotation.
Results: Based on a review of previous studies, an initial 27-item questionnaire was crafted. During the face validity stage, two items were excluded. Through calculating the Content Validity Ratio (CVR) and the Content Validity Index (CVI), three and one items respectively removed. The average scale level content validity index (S-CVI/Ave) was 0.95. Cronbach's alpha coefficient was found to be 0.76 for attitude and 0.66 for practice sections; the ICC was equal to 0.873. EFA revealed two factors explaining 63.98% of the total variance.
Conclusion: This questionnaire demonstrated sound reliability and validity in Persian, providing an effective means to assess attitude and behavior related to mask usage during highly contagious viral epidemics. It stands as a valuable tool for use in Iran and other countries.
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.
Fatemeh Papiri, Sareh Shakerian,
Volume 19, Issue 4 (3-2024)
Abstract
Background and Objectives: Evidence suggests that one of the behaviors impacted by the quarantine measures enforced due to the COVID-19 pandemic is sexual activity. This study aims to investigate this phenomenon.
Methods: A descriptive-analytical study with before-after measurement was conducted during both the COVID-19 pandemic and post-pandemic periods in 2021-2022, utilizing the standard Sexual Performance Index questionnaire administered to 250 women in Ilam province. Inferential statistics including paired t tests, correlation and chi square analysis were performed by SPSS software.
Results: The findings revealed that the COVID-19 pandemic had an impact on all six components of sexual function in women of reproductive age, including sexual desire, sexual stimulation, lubrication, pleasure, satisfaction and pain. The average overall sexual performance during the COVID-19 period (2.01±1.25) and in the post-COVID-19 period (2.94±1.2) was lower than the cutoff point (3.8), indicating poor performance across the entire scale of sexual function. The results showed that there is an inverse and significant (P<0.05) relationship between age, duration of marriage and number of pregnancies with sexual function index and its subscales.
Conclusion: The study findings suggest that research population experienced weaker sexual performance during the COVID-19 pandemic compared to the post-pandemic period, highlighting the impact of the mental and physical burdens associated with the pandemic on sexual function.
Samaneh Dehghani, Masud Yunesian,
Volume 19, Issue 4 (3-2024)
Abstract
Microplastics refer to plastic particles and fragments smaller than 5 millimeters in various forms, derived from the breakdown of larger plastics or initially introduced into the environment from the primary constituent particles of plastic. The exact date of the emergence of microplastics in the environment is not precisely known, but it certainly predates the naming of these particles (2004). These particles can enter the bodies of living organisms, including humans, primarily through ingestion and inhalation. Their effects on the body depend on their size, chemical composition, and the composition of substances that later absorb these particles. In this article, we will first briefly examine the classification of these particles in terms of chemical composition and their origins, and then review some evidence of their presence in biological tissues and fluids. Given the increasing production and use of plastics in human life and the fact that most microplastics in nature derive from the breakdown of larger plastics, sometimes several years after their disposal, it is expected that even if plastic production decreases or stops, we will continue to see an increase in their presence in nature for years and decades, leading to human exposure to these compounds (whose effects and consequences of this exposure are not yet fully understood).
Ramin Farrokhi, Samaneh Hosseinzadeh, Abbas Habibelahi, Akbar Biglarian,
Volume 20, Issue 1 (6-2024)
Abstract
Background and Objectives: Identifying pregnant women who are at risk of premature birth and determining its risk factors is essential because it affects their health. This study aimed to use an interpretable machine-learning model to predict premature birth.
Methods: In this study, data from 149,350 births in Tehran in 2019 were utilized from the Iranian Mothers and Babies Network (IMaN) dataset. Various factors related to the mother and the fetus, such as the mother's demographic variables and health status, medical history, pregnancy conditions, childbirth, and associated risks, were considered. The machine learning models, including multilayer neural networks, random forest, and XGBoost, were employed to predict the occurrence of preterm birth after data preprocessing. The models were evaluated based on accuracy, sensitivity, specificity, and area under the ROC curve. The Python programming language version 3.10.0 was applied to analyze the data.
Results: About 8.67% of births were premature. The XGBoost algorithm achieved the highest prediction accuracy (90%). According to the model output, multiple births, which account for 46% of pregnant women's births, had the highest importance score. Delivery risk factors had a score of 41%, and other variables, including neurological and mental illness, preeclampsia, and cardiovascular disease, were subsequently ranked in order of importance for this particular individual.
Conclusion: Using an interpretable machine learning method could predict the occurrence of premature birth. Based on risk factors, the interpretable machine learning method can provide personalized preventive recommendations for every pregnant woman, aiming to reduce the risk of preterm birth.
Monireh Rahimkhani, Maryam Gilani,
Volume 20, Issue 1 (6-2024)
Abstract
Antibiotic resistance has increased significantly in recent years. On the other hand, machine learning (ML) algorithms are increasingly used in medical research and healthcare and are gradually improving clinical performance.
Using ML to fight antimicrobial resistance (AMR) is one of the most critical areas of interest among the various applications of these new methods. The rise of antibiotic resistance and managing multidrug-resistant infections that are difficult to treat are important challenges.
Both supervised and unsupervised machine learning tools have been successfully used to predict early antibiotic resistance and thus support clinicians in selecting the appropriate treatment. Machine learning and artificial intelligence (AI) in predicting antimicrobial resistance are among today's sciences. Therefore, an antimicrobial stewardship program (ASP) should be implemented to optimize antibiotic prescribing and limit AMR.
Kiumarss Nasseri,
Volume 20, Issue 1 (6-2024)
Abstract
Background and Objectives: Years of life lost (YLL) or “wasted life” is a measure based on early and untimely death based on the expectation of life at the time of birth. The objective of this study is to measure the YLL during the COVID-19 epidemic in Iran and compare it with a similar antecedent period by age, sex, and province.
Methods: Daily reports of the Ministry of Health and Medical Education on COVID-19 cases and attributed death in the country; Weekly statistics of death and birth, by age, sex, and province reported by the National Organization for Civil Registration; and population data from the Statistical Center of Iran were used in this study.
Results: During the COVID-19 (Corona) epidemic a 27 percent increase in crude death rate was observed compared to similar period before epidemic. During the epidemic period, 319,136 extra deaths was recorded of which 45% was registered as COVID-19 death by Ministry of Health and Medical Education. During this period, a total of 4,897,995 years of life were prematurely lost.
Conclusion: Although this study lacks some detailed analysis due to the limitation of the available data and, it provides a clear picture of the health and demographic impacts of this epidemic in Iran and we can use Information presented in this report in planning and advance preparation for control and management of similar significant epidemics in the future.
Elham Davtalab Esmaeil, Ali Hossein Zeinalzadeh, Leila R. Kalankesh, Alireza Ghaffari, Saeed Dastgiri,
Volume 20, Issue 2 (9-2024)
Abstract
Background and Objectives: The present study aimed to assess the prevalence and familial aggregation pattern of alcohol consumption among father-offspring, mother-offspring, siblings, and spouses in Tabriz city, and to investigate the associated risk factors.
Methods: This cross-sectional study was conducted in 2023 on 860 individuals in Tabriz city. The heads of households were selected as proband individuals. Conveniently, probands were recruited from daily visitors, and upon agreeing to participate, their first-degree relatives (spouse and children) were also invited to join in. Data were collected using standard self-reported questionnaires. Generalized Estimating Equations (GEE) were employed to assess family aggregation among father- offspring, mother-offspring, and siblings.
Results: No significant of familial aggregation alcohol consumption was observed between spouses (OR=0.54 (0.16-1.8)). Although familial aggregation was observed between mothers and children, this was not statistically significant (OR=1.54 (0.8-2.94)). There was a significant familial aggregation of alcohol consumption between fathers and children (OR=1.98 (1.08-2.5)). Among siblings, familial aggregation was not statistically significant (OR=1.38 (0.41-4.63)).
Conclusion: Based on the findings of this study, family members play an important role in influencing the alcohol consumption behaviors of other family members. Additionally, individuals with lower socioeconomic status, those who are divorced, and singles may be more appropriate targets for alcohol consumption screening programs.
Mahla Iranmanesh, Milad Ahmadi Gohari, Aliakbar Haghdoost, Maryam Yazdanpanah, Abbas Kamyabi, Simin Salehinejad, Vahid Yazdi-Feyzabadi,
Volume 20, Issue 4 (3-2025)
Abstract
Background and Objectives: In the field of medicine, job satisfaction holds significant importance, as it plays a vital role in the quality of healthcare services. This study aimed to assess physicians' job satisfaction levels and identify the related factors.
Methods: This cross-sectional survey study was conducted online in 2023 among 1,100 Iranian physicians using a respondent substitution method. Physicians answered the questions regarding themselves and their closest physician friend, with whom they maintain regular contact and interactions. Satisfaction was categorized using a Likert scale into two scales: sufficient satisfaction (very high and high) and insufficient satisfaction (very low, low, and moderate). Factors affecting job satisfaction among physicians were determined using multivariable logistic regression.
Results: Among the 2,200 physicians, 24.9% (547 individuals) of the physicians were satisfied with their profession, while 75.1% (1,653 individuals) had low or moderate (insufficient) satisfaction. The odds of male physicians being satisfied with their profession were 1.54 times higher than female physicians. Factors including interest in medicine, the amount of time spent practicing medicine, sufficient income, low occupational stress, high job stability, no reduction in professional autonomy compared to the past, migration status, time dedicated to practicing medicine in public and private sectors as well as in academic activities, pursuing further education, and the physician’s income were all positively and significantly correlated to job satisfaction (p<0.05).
Conclusion: Job satisfaction among Iranian physicians is significantly influenced by various factors such as interest in medicine, adequate income, job stability, and reduced job stress. The highest level of satisfaction was observed among male physicians. Improving working conditions and reducing job stress are essential to improving job satisfaction and the quality of healthcare services.
Farahnoosh Farnood, Elnaz Faramarzi, Aysouda Ghanizadegan, Seyyedeh Mina Hejazian, Sepideh Zununi Vahed, Mohammadreza Ardalan,
Volume 21, Issue 1 (6-2025)
Abstract
Background and Objectives: Sleep disorders are common issues in people's health and can be related to metabolic and kidney diseases. Studies have shown that the relationship between proteinuria and sleep disorders can be modified. Since this relationship has not been investigated in Iranian populations, this study examined the relationship between proteinuria and sleep in the Azar cohort population.
Methods: This cross-sectional study used data from the Azar cohort study with a population of 15,000. Based on the study's inclusion and exclusion criteria, 105 patients with proteinuria were selected. After age and sex matching, 420 patients without proteinuria were included in the control group. The patients' sleep patterns were assessed based on a designed questionnaire, and the results were compared between the two groups.
Results: None of the sleep factors significantly differed between the two groups with and without proteinuria (P>0.05). Moreover, the mean weight, waist circumference, systolic blood pressure, diastolic blood pressure, and body mass index (BMI) were significantly different in the two groups (P<0.001).
Conclusion: There was no significant relationship between proteinuria and sleep in the Azar cohort population. However, the weight, BMI, waist circumference, and systolic and diastolic blood pressure significantly differed between people with and without proteinuria.
Mohammad Heidari, Mohammad Saadati, Moradali Zareipour, Arezoo Qasemkhanloo, Mehrdad Karimi,
Volume 21, Issue 1 (6-2025)
Abstract
Background and Objectives: Earthquakes are among the most dangerous natural disasters and can significantly harm human life. Accordingly, public awareness and preparedness for earthquakes are essential. Therefore, this study aimed to evaluate earthquake safety behaviors, focusing on knowledge, attitudes, and protective behaviors in Khoy, Iran.
Methods: The present study is a cross-sectional study conducted on 412 people in Khoy city using cluster sampling method. The data collection tool was a researcher-designed questionnaire comprising demographic characteristics and assessments of awareness, attitudes, and protective behaviors against earthquakes. The data were analyzed using the t-test, ANOVA, and backward logistic regression method with Stata 15 software.
Results: The results of the present study indicated that over 66% of individuals had poor knowledge, 42% had an average attitude, and 46% exhibited moderate protective behaviors against earthquakes. The regression model demonstrated that high knowledge increased the likelihood of exhibiting protective behaviors by 1.92 times (OR = 1.92, p = 0.006), while a positive attitude increased this likelihood by 6.12 times (OR = 6.12, p < 0.0001). Also, university education level 2.92 times (p=2.92, OR=0.055) and having previous experience of earthquake 1.89 times (p=0.057, OR=1.89) increase the likelihood of these behaviors.
Conclusion: Considering the low levels of awareness and protective behaviors against earthquakes among the residents of Khoy, educational workshops, and simulation exercises should be organized. Additionally, developing educational content could enhance individuals' preparedness for earthquakes.
Bahar Haghdoost, Zhaleh Abdi, Iraj Harirchi, Elham Ahmadnezhad,
Volume 21, Issue 2 (9-2025)
Abstract
The COVID-19 pandemic has highly impacted health systems, and the limitations of the national reporting system have reduced the accuracy of estimating the burden of this disease. This study examined the underreporting of COVID-19 cases and hospitalizations using data from the National Survey on Risk Factors for Non-communicable Diseases (STEPS) in Iran in 2021. In this study, 25,425 individuals from the population aged 18 and above were randomly enrolled. In addition to information on non-communicable disease risk factors, participants were questioned about a history of COVID-19 infection, hospitalization, and intensive care unit admission. The frequency of these events was then compared with registry data at the time of data collection. According to the results, 9.3% (95% CI: 8.56 to 9.44) reported a history of COVID-19 infection. Furthermore, among those infected, 12.71% (11.25 to 14.20) reported a history of hospitalization due to COVID-19. Among those hospitalized, 13.74% (8.25 to 18.9) had been hospitalized in intensive care units. Based on this, it is estimated that the sensitivity of recording symptomatic cases was 61.7% (59% to 65%) and for hospitalized cases was 86% (77% to 97.1%).
As a conclusion, it can be stated that the registered incidence of symptomatic COVID-19 cases in Iran was underreported by nearly 40%, and hospitalizations due to COVID-19 were underreported by about 15%. Compared to data from many other countries, including developed nations, this situation can be considered as acceptable.
Masud Yunesian, Hosna Janjani, Zohreh Bahmani, Kamyar Yaghmaeian, Fatemeh Yousefian, Mina Aghaei,
Volume 21, Issue 2 (9-2025)
Abstract
Background and Objectives: The increased production of infectious and sharp waste in waste disposal centers has created significant health risks for staff in these facilities. This study aimed to evaluate the prevalence of serological markers of hepatitis B and C among staff of the Aradkuh Waste Processing and Disposal Complex in Tehran.
Methods: In this study, 89 staff from four different sections—administrative, pre-processing, post-processing (composting), and landfill were selected through convenience sampling, and their blood samples were tested for HBsAg, Anti-HBs, and Anti-HCV markers using the ELISA method. The anti-Hepatitis B antibody titer (Anti-HBs) was categorized into three levels: complete immunity (>100 IU/L), partial immunity (10-100 IU/L), and no immunity (<10 IU/L). The results were reported based on the staff in different sections.
Results: The results showed that 25% of the staff lacked protective immunity against hepatitis B, while 57% were completely immune, and 18% had partial immunity. The staff in the preprocessing unit were at the most significant risk, with 50% lacking protective immunity, whereas the administrative staff had the best immunity status, with 76% being fully immune. Regarding active hepatitis B infection (HBsAg positive), two individuals (11%) in the primary processing group and one individual (4%) in the post-processing (compost) group tested positive.
Conclusion: The results of the present study indicated that a significant percentage of staff lacked adequate immunity to hepatitis B. Additionally, positive cases of HBsAg and anti-HCV were identified. The staff involved in primary and final processing were at high risk of contracting hepatitis B and C due to frequent contact with urban waste containing used syringes, drug vials, sharp objects, and infectious waste. This highlights the importance of widespread vaccination, continuous monitoring of safety status, and implementation of occupational safety standards to reduce the risks of exposure to infectious waste and sharps. These findings can serve as a valuable basis for designing preventive interventions to promote occupational health among personnel in this field.
Fatemeh Gorji, Abolghasem Pourreza, Masud Yunesian, Simin Zahra Mohebi, Mahnaz Ashourkhani,
Volume 21, Issue 2 (9-2025)
Abstract
Background and Objectives: Timely use of dental services in early childhood plays an essential role in maintaining the health of primary teeth and preventing complications related to jaw development, nutrition, speech, and mental well-being. Regular dental visits help prevent early childhood caries and its consequences. This study aimed to evaluate factors influencing the use of dental services for primary teeth from parents’ perspectives, based on Andersen’s Behavioral Model.
Methods: This descriptive-analytical cross-sectional study was conducted in 2023 among 395 parents of children under six attending health centers in Semnan, Iran. Participants were selected using simple random sampling. Data were collected online via the Hackey questionnaire and analyzed using SPSS version 26 applying Chi-square tests and logistic regression.
Results: A minority of parents were aware of the appropriate timing for the first dental visit. Forty-five percent sought care only when problems occurred, while 36% attended regular check-ups. Overall, 62% reported moderate to good financial status, and 82% had basic insurance coverage. Key determinants of dental attendance included maternal education, service accessibility, insurance coverage, health information sources, and the characteristics of the healthcare providers as an educator. Larger family size and negative experiences with healthcare staff were associated with reduced utilization.
Conclusion: Interventions at individual and structural levels are needed to promote regular pediatric dental visits. Enhancing parental awareness, involving influential health personnel, expanding dental insurance, and fostering positive provider–parent interactions are recommended.
Ezzatolla Gharebagheri, Hojjat Zeraati, Saharnaz Nedjat, Habibeh Moradi, Akbar Fotouhi,
Volume 21, Issue 2 (9-2025)
Abstract
Background and Objectives: The removal of the free family planning program was implemented in Iran following the decrease in the fertility rate. This study evaluated the impact of this decision on couples' willingness to have children, the use of contraceptives, the increase in unwanted pregnancies and illegal abortions, especially in rural areas.
Methods: This was a cross-sectional study with a descriptive-analytical approach, conducted in 2021 on 592 married women aged 10–54 in Miyaneh. Data were collected using a researcher-designed questionnaire through a multi-stage random sampling method and analyzed using logistic and Poisson regression models.
Results: The mean (± standard deviation) of number of children of couples was 2.15 ± 1.01. The level of education and age at marriage of women were identified as the variables affecting the number of live children born. The desire for children was significantly related to the number of live-born female children (OR = 0.23, CI 95%: 0.12, 0.44) and current male children (OR = 0.12, CI 95%: 0.05, 0.25). Unwanted pregnancies in the first half of 2021 were 2.3 times higher than in the same period in 2020.
Conclusion: The results showed that education and age at marriage significantly affect fertility patterns. Most couples consider two children ideal and do not wish to have any more. The removal of the family planning program led to increased unwanted pregnancies and unsafe abortions. Thus, revisiting population policies and improving access to family planning services is essential.
Bahareh Yazdizadeh, Farid Najafi,
Volume 21, Issue 3 (12-2025)
Abstract
The World Health Organization has extended the roadmap for prevention and control of the Non-Communicable Diseases (NCDs) program, 2013–2020 until 2030. In the political declaration of the fourth meeting of the United Nations General Assembly held on September 25, 2025, the promotion of mental health and well-being has also been added to the agenda. The overarching goal of the program is to reduce premature mortality from non-communicable diseases by one-third by 2030 through prevention and control, as well as by promoting mental health and well-being. The program emphasizes the need to accelerate progress toward these goals through the implementation of a set of evidence-based, cost-effective, and affordable interventions. The role of national research systems is to generate the necessary evidence to identify best interventions, implement them, and monitor and evaluate their outcomes. This article identifies knowledge needs based on an evidence-informed policymaking approach. Within this framework, specific questions are defined for each stage of the policymaking cycle, which must be answered using evidence. Furthermore, the results of the mid-point evaluation of WHO’s 2013–2020 roadmap have been analyzed, and the identified research questions have been incorporated into those arising from the evidence-informed policymaking approach.
