Journal of School of Public Health and

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Background and Aim: In 2020 the rank of Iran in happiness index and gender inequality were reported to be rather low, they being, among 153 countries, 118 and 113, respectively. This study aimed to investigate the relationship between gender inequality and happiness in Iran's provinces.
Materials and Methods: This ecological study was conducted based on secondary analysis of data on happiness index, as the dependent variable, and gender inequality, as the main independent variable, in 31 Iranian provinces, the statistical population being people over 10 years old. The sources of data on other background variables were previous national studies and the national statistical yearbook. Analysis of the data was done using descriptive statistics, Pearson correlation coefficient and multiple linear regression.
Results: No significant relationship was found between gender inequality and happiness (p<0.05) in the provinces. Neither was found any relationship between the background variables and happiness. However, the mean age of the population and gender inequality were inversely associated (p<0.05), meaning that with an increase in the mean age gender inequality would decrease.
Conclusion: The fact that no statistically significant association was found between the various variables and happiness in Iran’s provinces could be due to the small sample size.
We would recommend to investigate further this topic at the individual level and with a larger sample size.

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Background and Aim: Breast cancer is one of the most common cancers in Iran. The aim of this study was to assess the effectiveness of existential-humanistic therapy in self-acceptance and marital satisfaction in women with breast cancer.
Materials and Methods: This was a quasi-experimental study with a pre-test, post-test and follow-up design with a control group. The statistical population was the women with breast cancer referring to Shahid-Rahimi Hospital in Khorramabad, Iran in 2020, from among whom two groups (experimental and control) of 15 women each were randomly selected and asked to complete the self-acceptance (USAQ) and marital satisfaction (ENRICH) questionnaires. Then the experimental group attended eight 90-minute intervention sessions. After the intervention, both groups took a post-test and followed up further after two more months. The data were analyzed using the repeated measures ANOVA test.
Results: The repeated measures ANOVA test showed that the interaction between group and time was statistically significant. Therefore, the self-acceptance and marital satisfaction variables increased significantly (F=5/77, P<0/01 and F=13/97, P<0/01, respectively).
Conclusion: According to the results of this study, existential-humanistic therapy has a significant effect on self-acceptance and marital satisfaction in breast cancer patients. It is, therefore, recommended to pay attention, in addition to the physical problems of such patients, also to their psychological problems and, along with pharmacotherapy consider psychotherapy, including existential-humanistic therapy as well.                                                                                                                                          

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Background and Aim: Occupational injuries are an important human resource management challenge with negative effects on employees and organizations. A knowledge of the prevalence of occupational injuries is the first step in eliminating or reducing them. The aim of this study was to determine the prevalence of occupational injuries among financial employees of hospitals affiliated to Tehran University of Medical Sciences.
Materials and Methods: This was a cross-sectional questionnaire survey conducted in 2019 in 13 hospitals of Tehran University of Medical Sciences using a valid questionnaire to gather data. A total of 162 questionnaires were randomly distributed among the financial staff of the hospitals, but only 147 subjects completed the questionnaires. Data were analyzed using the SPSS statistical software.
Result: Analysis of the data showed that 52.6% and 50.2% of the financial staff of the hospitals were suffering from physical and mental occupational injuries, respectively. Most of the occupational physical injuries were related to headache, neck pain, back pain and visual impairment, and most of the occupational psychiatric injuries were stress and anxiety. Female and single employees experienced significantly more occupational injuries. Working in a sitting position for a long time, lack of proper equipment operation, lack of safety and health facilities, insufficient training and carelessness of staff were the causes of musculoskeletal injuries.
Conclusion: About half of the hospital financial staff were found to suffer from occupational injuries. Occupational injuries had had direct and indirect costs for the employees and the hospitals. Hospital managers should plan and implement measures to eliminate or reduce occupational injuries at an individual, group, and organizational level.
 

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Background and Aim: The objective of this study was to determine the seroepidemiological history of SARS-CoV-2 infection among asymptomatic children in Tehran.
Materials and Methods: Blood samples of children younger than 14 years old were collected during the period autumn-winter 2020 and spring 2021 and tested for SARS-CoV-2 IgG antibody using the EUROIMMUN ELISA kit. In addition, questionnaires were used to collect demographic and infection status information in the participants. Data were analyzed using the SPSS software.
Results: Out of the 1142 children collected from the children with no COVID-19 symptoms, 33.3% (381/1142) were found to have had a history of SARS-CoV-2. The positive samples in girls and boys were 34.1% and 33.03%, respectively. Analysis of the data showed no statistically significant differences between the infection rate on the one hand and age, family size, underlying diseases, gender or occupations of the family members on the other hand. In addition, the infection rate was significantly lower in autumn 2020 than in winter 2020 and spring 2021.
Conclusion: SARS-CoV-2 infection can occur in children with no clinical symptoms. In addition, the infection rate is in direct correlation with an increase in age of the children.
 

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Background and Aim: Cardiovascular diseases are the most common cause of death in most countries of the world, hypertension being the most important cause of disability. The aim of this study conducted in 2020-2021 was to determine the effect of educational intervention on the nutritional knowledge, illness perception and dietary adherence in hypertensive middle aged women based on the transtheoretical model (TTM).
Materials and Methods: This was a quasi-experimental study on middle-aged women (30-59 years old) suffering from hypertension referred to the  health centers and health bases in the 21st district of Tehran in 2020-2021. A total of 164 subjects were randomly assigned to the intervention (n=82) or control (n=82) group by randomized quadruple blocks. A multifaceted questionnaire was completed for both the control and intervention groups and their blood pressure measured. This was followed by  a one-month virtual education for the intervention group in the form of a WhatsApp group and designing and developing fifty-six podcasts and educational clips with a maximum duration of four minutes based on the transtheoretical model constructs. After a lapse of one and six months both groups completed the questionnaire again and their blood pressure was measured. Descriptive statistics and general linear model were used for data analysis using the SPSS version 25 (p<0.05).
Results: Before the intervention the mean age of the subjects was 50.16 years and their systolic and diastolic blood pressures were 1.35 and 1.84 mmHg, respectively, and there were no statistically significantly differences between the two groups as regards contextual variables, constructs of nutritional awareness, disease perception, diet adherence, systolic and diastolic blood pressures and body mass index (as an ananthropometric index) and transtheoretical model constructs. Data one month after the intervention revealed significant differences (p<0/001) between the two groups (p <0/001) as regards the constructs of nutritional awareness, disease perception, self-sufficiency construct of the transtheoretical model and systolic blood pressure. Six months after the intervention significant differences were observed between the two groups as regatds  nutritional awareness constructs, disease perception (p<0.007), diet adherence (p<0.001), stages of change constructs (p<0.001) and self-sufficiency (p<0.001) of the transtheoretical model.
Conclusion: The results of this study show that educational intervention based on the transtheoretical model in middle-aged women with hypertension can increase their nutritional knowledge, illness perception, self-sufficiency, self-adequacy and diet adherence.
 

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Background and Aim: The District Health Network is based on the principles of equity, appropriate technology, inter-sectoral collaboration and public participation. Measuring patient satisfaction is one of the basic criteria in determining the quality of care services. The purpose of this study was to compare the level of satisfaction of service recipients between government and non-government health posts in the south of Tehran in 2021.
Materials and Methods: This was a cross-sectional, descriptive and analytical study. A two-part researcher-developed questionnaire was used to collect data. The first part included items related to demographic characteristics of the clients, insurance status, geographical location and type of health post, appointment system and frequency of visits, and the second part contained questions on the type and level of satisfaction with the services provided.
Results: In the governmental health posts, the clients were mostly satisfied with, in a decreasing order, vaccination services, post-vaccination education, waiting time and physical space. In the outsourced posts, post-vaccination care education, under-one year old child care, vaccination and a sense of responsibility obtained, in an increasing order, the highest scores of satisfaction. Further analysis of the data showed the clients’ least satisfaction with youth and middle-aged care in governmental posts and youth care in outsourced posts.
Conclusion: Continuous and frequent measurement of satisfaction and developing timely interventions based on the results obtained will help greatly promotion of the quality of health services.
 

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correlation coefficient, and multiple regression analysis were performed using SPSS 27.
Results: The results of multiple regression analysis showed the effect of nutritional knowledge variables on nutritional behavior (p <0.001, β = 0.159) and physical activity knowledge on nutritional behavior (p = 0.008, β = 0.120) if the Physical activity knowledge variable was not effective on physical activity behavior and also nutritional knowledge variable had no effect on physical activity behavior.
Conclusion: Increasing knowledge of nutrition and physical activity improves students' nutritional behavior, but this increase in knowledge does not affect physical activity behavior. The sedentary lifestyle and the presence of the Covid-19 pandemic appear to have significantly reduced physical activity. By increasing knowledge, nutritional behavior and physical activity can be improved to some extent
 

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Background and Aim: The objective of this research was to identify the components of electronic foundation data theory teaching and learning in the workplace.
Materials and Methods:  This research was conducted using qualitative content analysis with a conventional content analysis approach. The statistical population was comprised of two groups: 1.Three sources of information (a sample of 26 out of 317 textbooks, scientific articles and theses/dissertations) selected by judgment sampling; 2. Relevant specialists and experts (a sample of 22) selected according to the theoretical saturation technic. The methods and tools used to collect data and information included archival surveys and field studies (interviews and questionnaires).
Results: For the primary coding, 644 categories were identified and converted into 45 secondary categories based on common conceptual aspects, which were finally became nine (9) main themes in the axial coding phase; these themes were used to build the thematic network.
Conclusion: The research model shows that the following nine categories are involved in electronic teaching and learning in the workplace: 1). organization and management; 2). information and contents; 3). interaction and communication; 4). characteristics of the person who teaches; 5). effectiveness; 6). technical quality; 7). learning objectives; 8). learning requirements, and 9). electronic education dimensions.
 

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Background and Aim: The health system is trying to prevent unnecessary referrals to higher levels by providing tiered services and thus reduce the cost of health care. Therefore, this study was conducted in Zahedan City, Iran with the aim of finding the causes of referrals from level 1 to higher tiers in rural areas.
Materials and methods: This cross-sectional study was conducted on 458 rural patients referred to the second level in the rural areas of Zahedan City, Iran. Data were collected from the family health files available in the Sib system and analyzed using the SPSS-16 statistical software, the statistical tests being descriptive statistics (percentage, frequency) and Chi-square test.
Results: The highest (57.6%) and lowest (4.1%) proportions of referrals to the second level of service provision were found to have been in 2018 and 2016, respectively. From among the referred patients nearly 50% had been referred due to the need for a higher expertise, thus most referrals (67.2%) were to specialists. Further analysis of the data showed that only in 23.6% of the cases there was a feedback from the higher level to the first level.
Conclusion: The findings show that referrals from family physicians to higher levels in the health system requires higher medical expertise and patient insistence. In addition, feedback to the first level of service provision has not received proper attention. Establishing interactions between physicians and other health service levels, refresher training of physicians, emphasizing the importance of providing feedback and promoting the awareness of patients can reduce to a large extent inappropriate referrals.
 

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Background and Aim: Kidney transplantation is the treatment of choice in most patients with kidney disease. It is a surgical operation in which a person’s kidney with chronic failure is replaced with a healthy kidney. The present study was conducted with the aim of estimating the survival probability of a transplanted kidney in patients with chronic kidney failure in Zahedan city, Iran.
Materials and Methods: This was a descriptive-analytical retrospective cohort study using the survival analysis method carried out in 2020. The sample size was estimated to be 211 patients.
Data were analyzed with SPSS.VER22 software using descriptive tests, the Kaplan-Meier method and the Cox proportional hazards model of survival.
Results: The data obtained showed that in general 45 (21.3%) clients had been rejected. In the multiple logistic regression model of kidney transplantation several variables, including survival time, patient survival variables, marital status, donor status, blood pressure and diabetes remained in the model (P<0.05). Further analysis of the data revealed that in the kidney disease patients with transplant survival in Zahedan city, only donor status variables, high blood pressure and diabetes remained in the final multiple Cox regression model.
Conclusion: Based on the results, it can be said that the probability of survival of kidney disease patients is independent of the type of donor and the characteristics of the recipient, which indicates the evolution of kidney transplant management over the past few years; dialysis before kidney transplantation also has an effect on the probability of survival. These factors can help to increase the probability of kidney transplant survival.