Journal of School of Public Health and Institute of Public Health Research

The Situation of Sustainable Development in Iran

Behzad Damari

Background and Aim: Sustainable development to address the global economic, environmental and social issues has been introducedby prominent scientists and is widely used by governments, international organizationsand NGOs. This study aimed to assess the current sustainable development situation influencing health and the future of health in Iran.

Materials and Methods: This was a descriptive study. The sample size was determined using the targeted intentional method and data were collected through targeted search, semi-structured interviews and focus group discussions.

Results: Sustainable development situation in the country has improved in terms of quantitative indicators of child and maternal mortality and Human Development Index.Have However, badair quality, unemployment, inflation and other social harms have had undesirable trends.The most important causes of slow sustainable development have been reliance on oil revenues, unemployment, increased inflation, inequity in incomes, poverty, and insufficient intersectoral coordination due to lack of a multi-ministerial secretariat. The health sector should have a comprehensive approach to promoting health of the population.

Conclusion: Based on the findings, it is recommended to include training courses for managers based on sustainable development principles, as well as management techniques in academic training and in-service training of managers. It is essential to create a multi-ministerial infrastructure and, even, a infrastructural power, for cohesion and coordination in order to ensure sustainable development.

Exploring the Challenges of Group Therapy as a Selective Approach in Treatment of Addiction

Effat Sadat Merghati-khoei

Background and Aim: Group therapy is one of the selective approacheseffective in addiction treatment, although it is not used extensively.Therefore, it is essential to assessthe current group therapy situation and determine its barriers andreinforcing factors inaddiction treatment settings.

Materials and Methods: This qualitative study was a rapid assessment designed and conducted in 2014-2015. Formal and informal data were collectedfrom 6 selectedcenters (n=55) bya multi-disciplinaryresearch team,using a systematic and semi-structuredapproach. Data were analyzed using thematic analysis.

Results: Based on dataanalysis a descriptive model was obtained with two main items, namely, structure and implementation of group therapy and effectiveness process. These two main items were found to be composed of four descriptive sub-items, including structural determinants and effective determinants in group therapy, contextual features, content, acceptabilityand desirability of treatment.

Conclusion: The findings show that application and effectiveness of group therapy is desirable, but it is not used as a routine approach in addiction treatment centers. Barriers to expansion of group therapy include insufficient content, lack of a structured protocol, and lack of professionalcapacity building. The study also revealsthat group therapy is quite acceptableamong patients who have had the experience of being treated with this approach but less acceptable among those who are not familiar with it.

Comparison of Lipid Profile, Diet and Physical Activity Between Obese Women with a Normal and Those with a Low Resting Energy Expenditure

Hamideh Pishva

Background and Aim: Obesity is now recognized as the most prevalent metabolic disease worldwide.A decrease in resting energy expenditure (REE) may increase risk of obesity. This study was carried out to compare dietary, biochemical, anthropometric and body composition parameters and physical activity in obese women with a normal and those with a low REE.

Materials and Methods: A total of 49 subjects (women, 30-50 years old), were divided into three groups: group one (obese, n = 16) with a body mass index (BMI) of 28-39.9 and a normal REE, group 2 (obese, n = 17) with a BMI of 28-39.9 and a low REE, and group 3 (n = 16) with a normal BMI and a normal REE as the control group. Anthropometric measurements, body composition, REE and fasting blood lipid profile were determined in the 3 groups. In addition, dietary intakes and physical activity were assessed using valid questionnaires.

Results: There was no significant difference in body composition between the two obese groups. However, REE was significantly lower in the obese group with a lowREE than in the other 2 groups.Energy and macronutrient intakes and physical activity were not statistically different among the 3 groups. Neither was there any significant difference between the 2 obese groups (one with a normal and one with a low REE) as regards lipid profile.

Conclusion: The results of this study indicate that in some obese people the resting energy expenditure is much lower as compared to that in other obese people, although their body composition, age, sex, dietary intake, lipid profile and physical activity are not different.

Confirmatory Factor Analysis of Child Abuse Potential Inventory in Ahvazi Children

Hashem Mohammadian

Background and Aim: Children are one of the most vulnerable groups in the population. Child abuse is a complex phenomenon with multiple causes. The purpose of this study was to do a confirmatory factor analysis of child abuse potential inventory among Ahvazi children in Ahvaz, Iran.

Materials and Methods: This was a descriptive-analytical study, including all Ahvazi primary school pupils aged 8-13 years in the academic year 2015-2016.

The sample size for confirmatory factor analysis was determined based on the number of questions per parameter.The variance was extracted on the basis of mean scores and

composite reliability for structural equation modeling was determined based on the first-order and second-order confirmatory factor analysisusing the LISREL software.

Results: Confirmatory factor analysis revealed a short form of the child abuse's original 3-actor structure, including the psychological, physical and neglect scales. The outcomes indicated that the firstorder model was a better fit for the data than the second.

Conclusion: It can be concluded that the Ahvazi version of the child abuse potential inventory questionnaire is acceptable from a psychometric point of view. We think it is essential to take into consideration the diversity of perspectives between parents and children in future research in this area.

Health-Related Quality of Life of High School Students in Tehran, Iran

Gholam Reza Garmaroudi

Background and Aim: This study was conducted to assess the quality of life as an outcome of health services among high school students in Tehran, Iran.

Materials and Methods: This cross-sectional study included 1500 high school students in Tehran, Iran. Data were collected using the health-related quality of life questionnaire “KIDSCREEN-27” and analyzed using SPSS software version 23. The level of significance was set at p < 0.05.

Results: The quality of life amongst the participants was found to be moderate. The highest and lowest scores were for the parents’ relations and physical and psychological wellbeing dimensions, respectively. Based on multivariate linear regression, gender was a statistically significant predictor of the physical wellbeing dimension. Further analysis of the data showed gender and choosing a family to live with to be statistically significant predictors of psychological wellbeing dimension, while maternal education and choosing a family to live with were statistically significant predictors of parents’ relations and autonomy dimension. Finally, father’s job and choosing a family to live with were predictors of peer and social support and school environment dimensions, respectively.

Conclusion: The quality of life of the participants was moderate, which is not acceptable. It is recommended to design and implement intervention programs to improve the quality of life of high school students with an emphasis on physical and psychological wellbeing dimensions.

Physical Activity as a Popssible Predictor of Bone Mineral Density in the Hip and Lumbar Spine Areas in Women in Postmenopausal Years

Khadijeh Mirzaei

Background and Aim: The role of physical activity in prevention of non-communicable diseases is now well known. The purpose of the present study was to find any possible association between physical activity and bone mineral density (BMD) in the hip and lumbar spine areas in women in postmenopausal years.

Materials and Methods: This was a cross-sectional study including 254 postmenopausal women aged 46 to 78 years. Body composition and BMD were determined using the bioelectrical impedance analysis (BIA) and DEXA methods, respectively, and for physical activity measurement the International Physical Activity Questionnaire (IPAQ) was used.

Results: The distribution (%) of the subjects according to the level of physical activity ─ inactive, moderate and active ─ was 39.7%, 47.6% and 12.5% respectively. There was a positive association between physical activity level and lumbar spine BMD (P = 0.03) in the 55-year-old or younger women. No association was found between physical activity level and the hip BMD(P>0.05).

Conclusion: Based on the findings it may be concluded that physical activity level can be used as a predictor of bone mineral density in the lumbar spine area in women in postmenopausal years (≥55 years old).

Association Between Religiosity and Depression in Mothers of Children Hospitalized in Oncology Wards

Mir Masoud Fatemi

Background and Aim: This study aimed to investigate the association between religiosity and depression among mothers of children hospitalized in the oncology wards of affiliated hospitals of Kerman University of Medical Sciences (KUMS), Kerman, Iran.

Materials and Methods: Data were gathered using a religiosity questionnaire and a depression questionnaire. The sample consisted of 115 mothers of children admitted to the oncology ward, KUMS, among whom the questionnaires were distributed during a 6-month period.

Results: The findings showed that there was an inverse association between religiosity and depression. As regards demographic variables, a statistically significant association was observed only between depression and income. Further analysis of the data revealed significant associations between religiosity on the one hand and income and mothers’ occupation on the other.

Conclusion: Based on the findings it can be concluded that with an increase in the mothers’ religiosity level the rate of depression decreases in them. We recommend researchers to conduct similar studies to investigate possible associations between religiosity and such variables as anxiety and mental disorders related to it.

Cost-Benefit Analysis of Health Interventions: A Critical Review

Mahmood Zamandi

Background and Aim: Economic evaluation of health interventions is critical for efficient allocation of resources. The aim of this study was to critically review empirical studies on the cost-benefit of health interventions published over the last 40 years.

Materials and Methods: This study was carried out by searching seven databases (PubMed, Cochrane Database of Systematic Reviews, Web of science, Science Direct, Scopus, Springer Link, and SID) using appropriate keywords to find articles on the cost-benefit of health interventions published during 1975-2015. All the relatedretrieved articles were analyzed after quality assessment using a valid check list.

Results: A total of 33studies on the cost-benefit of health interventions during the last 40 years were included in the review; 39%, 37%, 21% and 3%of the studies had been conducted in Asia, America, Europe and Africa, respectively. The subjects dealt with in most ofthe studies (79%) were related to immunization, education, healthy nutrition and use of health technologies. Further analysis of the data showed mental health education, healthy nutrition, use of safety equipment while driving, vaccination, diagnostic and screening tests, and oral and dental healthto have considerable clinical and economic benefits.

Conclusion: The number of studies on the cost-benefit analysis of health interventions is increasing. Preventive and promotive interventions can help planners and policy-makers to better utilize the limited resources in the health sector aiming at promoting health of the people.