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Controlling and prevention of novel coronavirus through health and safety protocols in food: review article
Zahra Esfandiari, Fatemeh Amani, Meraj Pourhossein, Hedayat Hosseini,
Volume 78, Issue 12 (3-2021)
Abstract
The development of industry and technology, changes in agriculture, trade and global travel, and the adaptation of microorganisms are important factors in the occurrence of emerging diseases. Currently, the world is facing a pandemic caused by an emerging virus called the novel coronavirus (Covid 19) in 2020. This disease led to infect more than one million people worldwide and the death of more than five hundred thousand people during six months. Covid 19 causes death in patients with respiratory problems of varying severity. Fever, soreness, dry coughs, shortness of breath, runny nose, and nasal congestion were observed in coronavirus-infected individuals. Fever was one of its common symptoms. Other unusual signs such as diarrhea and nausea were reported for this disease. For the first time, the bat was introduced as the host of the novel coronavirus in China. Therefore, identifying the initial route of transmission of the novel coronavirus is necessary to prevent the occurrence and its widespread distribution. The virus enters into a human through respiratory particles as well as touching the surfaces contaminated by nasal, mouth and eye secretions. Viruses are obligate intracellular pathogens needing host cells to survive. These microorganisms cannot proliferate in foods and require live cells for existence. Food is introduced as a carrier of viruses to the consumer. There have been no reports of novel coronavirus transmission through food. However, it is important to observe the principles of health and safety by assuming the spread of the virus due to food contamination. Regarding the presence and proliferation of novel coronavirus in the gastrointestinal tract and aerosol formation of this microorganism in the feces and the possibility of re-transmitting it to people from various environmental sources, the most important priority is to remove the virus from food environments. It is also important to update the methods of disinfecting surfaces, especially areas with high contact of hand as well as personal hygiene. Therefore, it is recommended to educate the staff about managing the novel coronavirus and improving health guidelines. Furthermore, keeping distance and washing hands is in priority in different food-related environments.

A comparative study of the quality of life in patients undergoing hemodialysis and kidney transplant recipients: systematic review and meta-analysis
Mohammad Hossein Kamaloddini, Khadije Saravani,
Volume 78, Issue 12 (3-2021)
Abstract
Background: Given the huge mental, psychological, and economic impact imposed on patients with chronic renal failure, it seems quite necessary to study life satisfaction in such individuals in to order to provide the necessary information and plan for appropriate services. In form of a systematic review and meta-analysis, the present study was conducted in to order to compare the quality of life in two groups of patients, one undergoing hemodialysis and the other recipients of a kidney transplant.
Methods: In order to fulfill the objective of the present study, among innumerable researches carried out in this field, through the implementation of a meta-analysis checklist nine researches were found to be qualified for the final meta-analysis (specific consideration was given to the following criteria: hypothesis, research method, statistical population, sample size, sampling method, measurement tool, and statistical analysis method). All related studies conducted from June 1995 to July 2016 in Iran.
Results: Out of 310 articles that had been selected initially, 262 were removed after reviewing their full text, then, 39 more articles were removed due to over-similarity of titles or exact repetition of the same topic. Finally, 9 studies Were found to be for the meta-analysis process. The sample size included 1736 subjects. The results of the analysis of total quality of life scores in renal transplant patients and hemodialysis patients showed that the mean overall quality of life of transplanted patients was 42.26±42.2 and the mean score for patients with hemodialysis was 42.9±36.36. The difference in the mean quality of life in renal transplant patients and hemodialysis patients was statistically significant (P<0.05), and renal transplant patients had a better quality of life in comparison with patients undergoing hemodialysis.
Conclusion: Patients undergoing hemodialysis experience more severe suffering due to their specific circumstances. Recognizing and applying the predictive factors for the quality of life of these patients can help to design more suitable care and treatment programs. It is also desirable to take effective steps to improve the quality of life of these patients in planning health-care services; the final hope is to provide considerable enhancement within the quality of life for patients with renal failure.

Equity of hospital bed distribution in Tehran city: brief report
Ali Mohammad Mosadeghrad, Hamed Dehnavi, Alireza Darrudi,
Volume 79, Issue 2 (5-2021)
Abstract
Background: Health equity is “having fair access to healthcare, utilizing it according to actual needs, paying for it based on financial capacity and finally, having an acceptable level of health”. Health equity is an underlying principle of the universal declaration of human rights. Equitable distribution of hospital beds increases people’s access to healthcare services and as a result, improves their health status. This study aimed to examine the equity in the geographic distribution of hospital beds in Tehran city, Iran.
Methods: The data for this descriptive and cross-sectional study were obtained from the Ministry of Health and the Iranian statistics center in April 2019. All hospitals in Tehran city were included in this study. Lorenz curve and the Gini coefficient were used to measure the equity in the geographic distribution of hospital beds. Excel software was used for data analysis.
Results: Tehran city had a population of 8,693,706, and 142 hospitals with 24,535 beds in 2016. There was 1.6 hospitals per 100,000 people and 2.8 hospital beds per 1000 people in this city. Nearly half of the hospitals were private (49%) and the remaining were public or semi-public. About 77% and 23% of hospitals were general and specialized respectively. Almost half of the hospitals are more than 40 years old.  The average number of beds in hospitals was 173. The Gini coefficient was 0.619 for hospital bed distribution among Tehran districts. Districts 6, 12 and 3 have had the highest hospital beds per 1000 people. Districts 6 had 23% of the total hospitals and 24% of the hospital beds.
Conclusion: The geographic distribution of hospital beds in Tehran city is not equitable. Hospital services should be accessible based on actual need rather than on the ability to pay. Achieving health equity is a prerequisite of universal health coverage. Hence, healthcare policymakers should reduce or eliminate the existing disparities and inequalities in access to hospital beds.

Methodology of conceptual review in the health system
Ali Mohammad Mosadeghrad, Mahnaz Afshari, Fereshteh Karimi ,
Volume 80, Issue 1 (4-2022)
Abstract
Background: Conceptual review is a creative research method for generating new knowledge in the context of a vague and complex concept that helps to explain and clarify the concept, its components and its relation to related concepts. This study aimed to explain the methodology of conceptual review in the health system.
Methods: Articles related to the conceptual research method were searched and collected in four databases (i.e., PubMed, Scopus, Embase, Science Direct) and two search engines (e.g., Google and Google Scholar) between January 1950 and September 2021. Finally, 83 articles were selected for final review and analyzed through narrative analysis.
Results: This study was conducted using scoping review between October and December 2021. The conceptual review study is a systematic, scientific and objective inquiry that helps to identify and explain the dimensions, components, features and applications of a particular concept by defining, synthesizing and interpreting the findings of studies. It results in clarification of the meaning of concepts. An eight- steps protocol was introduced for conceptual review including concept selection, entry and exit criteria definition; selection of databases and search strategies; selection and reporting of studies using flowcharts; evaluating the validity of selected studies; extracting information about the definition, components, antecedents, consequences and evaluation criteria of the concept from selected studies, synthesizing data and developing a conceptual model and drawing conclusions from the synthesized findings. In addition, the structure of a conceptual review article was described and a checklist for evaluation of a conceptual review study was introduced.
Conclusion: A conceptual review study is a method that defines the concept by searching for scientific sources about a concept and their comprehensive review, explaining their characteristics, antecedents, consequences and applications to determine the position of the concept beyond their vocabulary definition. The conceptual review helps to develop existing theories by identifying the components of a complex concept and its antecedents and consequences and establishing a logical connection between them.

Identifying the dimensions and components affecting paraclinical services in the social security organization
Maryam Noohi , Seyed Hesam Seyedin, Rouhollah Zaboli, Samaneh Ghods, Leila Najafi,
Volume 80, Issue 2 (5-2022)
Abstract
Background: Health & Well-being is one of the most important fundamental human requirements and the main indicators of development and social welfare. However, with rising health costs and unlimited needs and dwindling health system resources, it is necessary to rethink new remedial behavior. Paraclinical services are an important and costly part of health services, it appears crucial to understand the elements that influence them.
Methods: This is a qualitative study that has been designed & performed from 23rd September 2019 to 23rd September 2021 through face-to-face interviews with selected experts. The project has been approved by the institutional review board of Islamic Azad University, Semnan branch through ethical registration codes as IR.IAU.SEMNAN.REC.1399.014. The first stage was to identify the dimensions and components affecting paraclinic services offered at Iran Social Security Organization (SSO) clinics & hospitals. A semi-structured questionnaire was prepared. The interview has been arranged with SSO managers, experts and officials and finally analyzed through the thematic analysis method.
Results: Doing qualitative research and conducting thematic analysis, paraclinical services were classified into three categories: input, process, and outcome. The inputs  category had 5 organizing themes including paraclinical structure, human resource empowerment, cost management, social responsibility and service purchasing. The processes consisted of four themes: organizing the acceptance and delivery of services, monitoring and evaluating implementation, interdisciplinary coordination, applying innovation, and creativity in service delivery. Finally, outputs included three themes: organizing disease prevention and health promotion, gaining a competitive advantage, and reducing health costs.
Conclusion: According to the study's findings, to purchase or rationally use paraclinical services, it is necessary to know the dimensions and components that affect them. Managers of the social security organization are urged to lay a greater focus on employee empowerment, the employment of innovative approaches, and interdepartmental collaboration to enhance paraclinical service supply. Additionally, they may better fulfill their social duties and enhance their workers' health services by monitoring and evaluating executive actions.

Costs of services covered by the global payment system in Tehran University of Medical Sciences
Jalal Saeedpour , Mehdi Rezaei , Shamsi Ekhteyar, Sara Akhavan Rezayat , Soheila Damiri , Faezeh Fartaj, Maryam Radin Manesh ,
Volume 80, Issue 4 (7-2022)
Abstract
Background: In Iran, a combination of three methods of budget payment, fee for service and case-based payment (known as the global payment system) is used to reimburse the cost of hospital services. The aim of this study was to investigate the costs of 90 services of the Global Hospital Reimbursement System at Tehran University of Medical Sciences.
Methods: This descriptive cross-sectional applied study was performed from March  2017 to March 2019 in the hospitals of Tehran University of Medical Sciences. The billing and record data of all patients whose services were reimbursed on a global payment system basis were extracted from hospital information systems. Data were analyzed using descriptive statistics (frequency mean. std deviation, maximum & minimum) in SPSS 21 and Excel 2016.
Results: During two years in TUMS, the costs of services provided to 143,866 patients have been reimbursed based on the global payment system., which had a cost of 2300 billion rials. 80% of the total services and costs were related to 10 services. 78.46% of the cases were related to two specialized groups of ophthalmology and obstetrics and gynecology. 83.17% of the total costs of services reimbursed globally at the TUMS were related to these two specialized groups. The average cost per service was about 16 million Rials, but varied greatly for different services, ranging from about 1.8 million Rials to 67 million Rials. On average, for a global service, the share of each of the cost subgroups of diagnostic services, hoteling and nursing services, medicine and consumables, operating room and surgery, physician's visit and consultation, respectively 3.1%, 11.6%, 21.4%, 49.9% and 13.9%.
Conclusion: Managers need to focus on high-frequency and high-cost services to reduce the cost and financial losses for services that are under the global payment system. Depending on the specific cost pattern of each service, the strategies adopted to control the costs of that service should also be different.

Methodology of pharmacoeconomic evaluation studies in Iran: a brief report
Sara Emamgholipour, Rajabali Darroudi , Abdoreza Mousavi, Samira Alipour , Fakhraddin Daastari,
Volume 80, Issue 11 (2-2023)
Abstract
Background: Given the limited resources of health system, economic evaluations studies can provide appropriate evidences for resource allocation by clarifying the possible consequences of a decision. Present study aimed to evaluate the implemented approaches for economic evaluation studies of pharmacoeconomic in Iran.
Methods: This study was carried out using the critical review method. All studies related to economic evaluation studies of pharmacoeconomic in Iran, indexed in PubMed and SID databases and Google Scholar search engine, were searched by using appropriate keywords and search strategies until 2021. Further, published papers from Iranian researchers in the field of health economics and pharmacoeconomics and pharmaceutical administration were extracted with the scientometric system of the Health Ministry. Then, retrieved papers were screened by title, abstract, and the whole text. Finally, papers were evaluated by applying the Drummond quality assessment checklist, and finally appropriate ones were selected. Finally, 29 papers were selected and analyzed.
Results: Out of total available papers (n=1324), 29 papers had inclusion criteria to evaluate. The selected papers were analyzed based on 10 parameters, including type of analysis, type of comparator, source of clinical effectiveness, time horizon, used model, perspective of the analysis, measured expected outcomes, discounting of costs and outcomes, sensitivity analysis, and subgroup analysis. Most studies have used cost utility analysis. Shortcomings were found in some aspects as follows: some studies did not mention the applied model, or the time horizon. Moreover, some studies had time horizon more than one year, while the cost and consequences were not discounted.
Conclusion: In recent years, economic evaluation studies in the field of pharmacoeconomic in Iran have been center attention in line with global trend. In order to make a decision regarding the allocation of resources based on the findings of economic evaluation studies, these studies should be conducted with the systematic and transparent approach. Therefore, it is necessary to develop a standard framework for implementing and reporting the results of economic evaluation studies in Iran.
Keywords: cost-benefit analysis, cost-effectiveness analysis,

Management of cosmetic surgery in iran: challenges and solutions
Maryam Tajvar, Parisa Pourfarokh, Najmeh Bahmanziari, Ebrahim Jaafaripooyan, Maryam Nazari , Haniye Sadat Sajadi ,
Volume 81, Issue 1 (4-2023)
Abstract
Background: Nowadays, beauty practices have attracted the attention of people following the change in lifestyle and social values. Therefore, the present study was conducted with the aim of examining the opinion of experts regarding the challenges and management solutions of the aforementioned practices in Iran.
Methods: This qualitative study was conducted through interviews with 26 policymakers and cosmetic surgery service providers in Tehran from April to September 2022. Sampling was purposeful and snowball. The interviews were semi-structured and thematic analysis was used to analyze the data obtained from the interviews. The inclusion criteria for the interviewees' entry were knowledge and experience in the subject and willingness to participate.
Results: Challenges under the four categories of service providers (improper education, non-specialist providers, moral hazards, deficiencies in the way laws are written, and the ineffectiveness of the complaint handling process), service receivers (being influenced by deceptive advertisements, low level of public health literacy and lack of mental health), the place of providing services (performing surgeries in non-standard places and non-integrated information system) and medicines, products and medical equipment (insufficient control over supply, distribution and use and price fluctuations) were categorized. Experts considered the major part of the challenges to be related to the service providers. In the category of service recipients, "being influenced by deceptive advertisements" was the main problem mentioned by the experts. Performing surgeries in non-standard places, including limited surgery centers, non-sterile places, and unauthorized places, is among the unsolved problems regarding the place of providing services. In relation to medicines, products, and medical equipment, the main problem was insufficient supply, distribution, and use supervision.
Conclusion: The main effective measure to solve the challenges is to strengthen the supervision of the health system administrator with internal and external coordination and cooperation. In this regard, it is recommended to develop educational, ethical, and legal frameworks, regulate regulatory laws, public awareness, clinical interviews and psychological counseling, especially before cosmetic surgery, and the establishment of an integrated electronic health record system.

Investigating the results of breastfeeding counseling in mothers referred to the breastfeeding counseling clinic of the health centers
Zeinab Khazaeeshir , Kobra Mirzakhani, Golnaz Sadat Ahmadinezhad, Fatemeh Sadat Naderi, Nahid Jahani Shoorab ,
Volume 81, Issue 1 (4-2023)
Abstract
Background: The rate of exclusive breastfeeding in Iran at the ages of 3 and 6 months is estimated to be 44% and 27%, respectively, which is still far from the optimal index of the World Health Organization until 2030 (70% in the first six months). In order to monitor breastfeeding counseling centers, which have been set up with the aim of promoting breastfeeding and supporting mothers who have problems with breastfeeding.
Methods: This is a descriptive-retrospective study and all the mothers who were referred to the Health and Treatment Center No. 2 in Mashhad between April 2019 and March 2019 were examined. This health center has two active counseling clinics and the collection of information is based on documents registered in offices and computers. The inclusion criteria for study were not having breast diseases, having an infant child, being able to read and write and living in Mashhad city. The exclusion criteria were also the unwillingness to participate in the study and the newborn suffering from diseases that are incompatible with breastfeeding. Therefore, census sampling was done. The data were analyzed using SPSS 16 software and the significance level was less than 0.05.
Results: In 42.8% of cases, mothers had started feeding combined formula with breast milk before visiting, and in 28.1% of cases, when referring to counseling milk clinics, it was reported that the baby was fed only with formula. After breastfeeding consultations and follow-ups at the end of six months, the rate of exclusive breastfeeding is 34.1% (12% increase compared to the initial reference) and combined formula feeding with breastmilk is 27.8% (a 22% decrease compared to the first visit). And feeding with powdered milk alone was calculated to be 36.5% (an increase of 8.4% compared to the first visit).
Conclusion: The positive role of breastfeeding counseling center in reducing the cases of artificial feeding is clear, and it is recommended to prepare written instructions based on the challenges in breastfeeding for breastfeeding counseling in the first month after delivery.

Awareness, attitude and behavior toward using microwave in health care workers of shahid beheshti university
Zainab Moradi, Tayebeh Marashi, Ali Ramezankhani,
Volume 81, Issue 10 (1-2024)
Abstract
Background: In the last decade, the use of microwave ovens throughout the world, including Iran, has increased significantly. Therefore, it is important to understand the knowledge, attitude, and behavior of microwave oven use among employees of the Eastern Health Center to promote safe and responsible practices in the workplace. Assessing their familiarity and attitudes with microwave ovens, this study aims to identify potential areas for improvement and training. This, in turn, can create a safer and more efficient work environment for all involved.
Methods: In this cross-sectional study in 2022, the study population was all employees working in the health center and comprehensive health service centers affiliated with the East of Shahid Beheshti University of Medical Sciences, numbering 162 people. The research tool was a questionnaire adapted from Nadiri's thesis (2015). After collecting the questionnaires, the data was obtained by SPSS 26 software and were analyzed using Pearson's correlation coefficient, multiple regression, independent t-test, and one-way ANOVA.
Results: Although the attitude (36.35±3.579) and the behavior (61.16±6.402) towards using microwave ovens are favorable, there is still room for improvement of knowledge and awareness. Knowledge has a positive and significant effect on behavior (P=0.002, B=0.245) and attitude (P=0.001, B=0.263), which shows that improving knowledge about the safe and responsible use of microwave devices can lead to behavior. and a more favorable attitude among employees. In addition, the attitude has a strong positive and significant effect on behavior (P=0.001, B=0.417), and promoting a positive attitude toward using microwave devices can also lead to more favorable behavior. However, the relatively weak effect of awareness on attitude indicates that other factors may also play a role in determining the attitude toward using microwave devices.
Conclusion: These findings highlight the importance of educational and awareness campaigns to promote the safe and responsible use of microwave devices among healthcare workers.

Mobile applications as a new way to health: a systematic review
Negar Heidari , Fatemeh Rajati , Mojgan Rajati, Paria Heidari,
Volume 81, Issue 11 (1-2024)
Abstract

                                                                  
Background: Management of chronic diseases, such as hypertension and diabetes, requires a comprehensive long-term care plan. Adherence to self-management behaviours is crucial in improving health outcomes and quality of life for individuals living with these conditions. The research highlighted in this review study aimed to explore the potential of mobile health technology in enhancing primary and secondary prevention of chronic diseases. By providing personalized interventions, mobile applications can play a significant role in supporting individuals in the self-management of their hypertension and diabetes, ultimately leading to better disease control and improved overall well-being.
Methods: The present study is a systematic review of research examining the impact of mobile application interventions on the self-management of hypertension and diabetes. The review analyzes studies published between July 2013 to March 2023, retrieved from the PubMed and Scopus international databases using keywords such as Mobile Health, mHealth, adherence, Hypertension, High Blood Pressure, and Diabetes.
Results: A total of 1398 abstracts were found, of which 12 articles met the inclusion and exclusion criteria for this study. The research indicates that mobile health (mHealth) applications have significant potential to optimize healthcare processes and facilitate improved access to health information. These digital tools can combine various treatment methods with attractive, user-friendly solutions that allow patients to actively monitor a range of health indicators, such as diet, body weight, blood pressure, mood, and sleep patterns. By enabling this type of continuous self-monitoring, mHealth apps can empower individuals to take a more active role in managing their well-being. Additionally, these applications can facilitate greater collaboration between healthcare providers, patients, and their families, thereby enhancing the overall coordination and accessibility of care. As such, mHealth technologies can be effectively leveraged in conjunction with traditional medical services to improve health outcomes and expand access to critical health information.
Conclusion: The present study found a significant increase in mobile health app usage. To understand the real, long-term impact of this technology on health, further longitudinal studies are needed. Comprehensive research is crucial to guide the development of effective digital health interventions that can improve individual and population outcomes over time.


Available and future of digital health solutions for body weight management in diabetic patients
Marziyeh Najafi, Sima Marzban, Roya Rajaee, Behrooz Pouragha,
Volume 81, Issue 12 (2-2024)
Abstract
Managing overweight and obesity is associated with lower risks of chronic diseases like diabetes. Digital health, particularly smartphones or m-health, effectively manages body weight. Technologies such as telemedicine services, mobile health (mHealth) or the use of mobile phones or portable digital devices in healthcare services and wearable devices can be used in this field. Therefore, this study was conducted to understand the impact of digital health technologies on weight management in diabetic patients.
Methods: The present study is a systematic review study that was initially searched using a systematic review of published studies in the field of digital health for weight management in diabetic patients from October 1401 to October 1402. Our study was conducted in two rigorous steps. Firstly, we performed a systematic review by searching for publications on Digital Health Solutions for Body Weight Management in Diabetic Patients until 12 October 2022. We meticulously combed through two comprehensive databases, PubMed and Web of Science, using a set of specific and relevant keywords. After a thorough screening and full-text assessment, we handpicked eight documents for this study. We cross-referenced with the companies' websites producing the identified applications to enrich our findings further.
Results: In the initial search, 223 documents were identified and after screening and qualitative evaluation, eight documents were selected for this study. Our research uncovered a range of mHealth apps that have shown promise in weight management for diabetic patients. These apps have demonstrated potential efficacy, high acceptability, and favorable user experiences. Importantly, they have also improved diabetes management and quality of life for the users.
Conclusion: Our review of digital health solutions has not only illuminated their potential in weight management for diabetic patients but also opened up new avenues for a more personalized, engaging, and practical approach to this issue. As technology continues to advance, these interventions hold the potential to revolutionize diabetes self-management, significantly enhance the quality of life, and contribute to better health outcomes for individuals living with diabetes.

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