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Abstract Background Considering the increasing prevalence of fast food consumption among teenagers, providing the necessary training and self-awareness is the best solution for institutionalizing the prevention of fast food consumption by this group. Therefore, this issue should be taken seriously, as should the implementation of educational interventions to prevent the consumption of fast food. The theory of planned behavior (TPB) is one of the various health education styles and methods that works well. However, given that a number of local data points are crucial in establishing the efficacy of the model employed, this study looks into the impact of TPB-based education in preventing fast food intake among teenagers. Methods A total of 180 male students, ages 15 to 18, participated in this quasi-experimental study in Shiraz, Iran. Cluster sampling was used in the study, and participants were randomly assigned to two groups: the experimental group (n = 90) and the control group (n = 90). A theory-based questionnaire was used to gather data, and both the control and experimental groups had to complete it before and three months after the intervention. The data were examined using paired t, independent t, and chi-square statistical tests after being entered into SPSS-24. Results The results of the independent t-test showed that there was no significant difference between the two study groups before the intervention in terms of knowledge (P = 0.14), attitude (P = 0.57), subjective norms (P = 0.94), perceived behavioral control (P = 0.81), behavioral intention (P = 0.42), or behavior (P = 0.25). However, following the intervention, there was a significant difference between the two groups with regard to the noted variables (P = 0.001). Furthermore, the McNemar test results demonstrated that the experimental group’s consumption of fast food varied significantly before and after the intervention (P = 0.001), but not in the control group (P = 0.07). Conclusion The study’s findings demonstrated that TPB-based treatments are successful in helping male students change their habits of consuming fewer amounts of fast food. This study demonstrated that the instructional techniques employed improved the fast food consumption behavior of the intervention group as well as the TPB’s structure (attitude, subjective norms, behavioral intention, and perceived behavioral intention).

Abstract Background To the best of our knowledge, no population-based studies have provided insights into the prevalence of hysterectomy and its risk factors among northern Iranian females. Thus, the present study aimed to investigate the prevalence and sociodemographic determinants of hysterectomy in a large cohort of northern Iranian females. Methods This cross-sectional study included data from the enrollment phase of the Tabari cohort study (TCS). The TCS consists of 10,255 adults (4,149 males and 6,106 females) aged 35–70 years who reside in Sari, Mazandaran, Iran, of which 6103 females were included in the study. Multiple logistic regression analysis was used to search for hysterectomy determinants. Results Our results revealed that the prevalence of hysterectomy among northern Iranian females was 9.7% (595/6103). Additionally, 50–59 (OR: 4.63, 95% CI: 3.57–6.01) and 60–70 (OR: 5.83, 95% CI: 4.28–7.95) age groups, higher socioeconomic levels (OR: 1.66, 95% CI: 1.13–2.42), a history of tubectomy (OR: 1.27, 95% CI: 1.05–1.53), and more gravida (OR: 5.35, 95% CI: 1.62–17.63) were found to increase the odds of hysterectomy, whereas living in mountainous areas (OR: 0.57, 95% CI: 0.43–2.75) and having a job (OR: 0.62, 95% CI: 0.45–0.86) were found to decrease the odds of hysterectomy. Conclusion Older age groups, living in urban areas, higher socioeconomic levels, not having a job, a history of tubectomy, and more gravida were found to increase the odds of hysterectomy.

Abstract Introduction Suicidal ideations (SI), also known as suicidal thoughts, refer to impulses, desires, and obsessions related to death. Prevalence of suicidal ideation was 14 percent. The current study assumed that identifying the true predictors of SI would allow for a greater understanding of suicide risk. Methods In this cross-sectional population-based study, 17,644 residents aged from 15 to 90 years were selected through a multi-stage sampling method from 22 districts of Tehran. Using hypothesized causal models, the pathways through which various variables influenced the components of SI were identified. Also, the applicability of the compensatory and risk-protective models of resiliency for the prediction of SI was tested by using the interaction multiple regression analyses. Results SI was experienced by 13.44% of the study population. SI was more prevalent with individuals between the ages of 15 to 24. There are no differences between men and women when covariate analysis is used. The significant predictions by anxiety and physical activity (moderate) indicate support for the compensatory model for male and female, while the significant prediction by those indicates support for the risk-protective model for females. Conclusion PA would both lessen the detrimental impact of anxiety on suicidal thoughts and potentially reduce the probability of SI. It's important to develop and evaluate PA-enhancing treatments, especially for woman who are experiencing anxiety.

Abstract Background A significant number of referrals to the emergency departments is due to violence and conflict leading to serious injuries and death. The increasing number of such cases highlights the urgent need for investigating victimization of physical violence. Aim The purpose of this study was to determine the frequency of demographic and clinical characteristics in victims of violence and classify them based on penetrating or blunt trauma. Methods The data of the patients who had been the victims of violence in 2020 were extracted from the Trauma Registry System(TRS) of the Guilan Road Trauma Research Center(GTRC). All analyses were performed using SPSS software version 24. The significance level was considered less than 0.05. Results There was a significant difference in the type of violence-related trauma in different age groups (P

Abstract Background Underweight is a prevalent health issue in children. This study aimed to identify factors associated with underweight in children aged 1–2 years in Hamadan city. Unlike the studies conducted in this field, which are cross-sectional and do not provide information on the effect of age changes on underweight, our longitudinal approach provides insights into weight changes over time. On the other hand, this study focuses on the high-risk age group of 1 to 2 years, which has only been addressed in a few studies. Methods In this longitudinal study, 414 mothers with 1 to 2 year-old children referred to the health centers of Hamadan city, whose information is in the SIB system, a comprehensive electronic system, were examined to identify factors related to underweight. The response variable was weight-for-age criteria classified into three categories: underweight, normal weight, and overweight. A two-level longitudinal ordinal model was used to determine the factors associated with underweight. Results Of the children studied, 201 (48.6%) were girls and 213 (51.4%) were boys. Significant risk factors for underweight included low maternal education (AOR = 3.56, 95% CI: 1.10–11.47), maternal unemployment (AOR = 3.38, 95% CI: 1.05–10.91), maternal height (AOR = 0.85, 95% CI: 0.79–0.92), lack of health insurance (AOR = 2.85, 95% CI: 1.04–7.84), gestational age less than 24 years (AOR = 3.17, 95% CI: 16.28–0.97), child age 12–15 months (AOR = 2.27, 95% CI: 1.37–3.74), and child's birth weight (AOR = 0.63, 95% CI: 0.70–0.58). Conclusion Based on the results of the present study, it seems that the possibility of being underweight among children is more related to the characteristics of mothers; therefore, taking care of mothers can control some of the weight loss of children.

Background: Postbiotics comprise soluble compounds freed from the structure of destroyed bacteria or created by living bacteria. Such byproducts provide the host with enhanced biological function as well as specific physiological consequences. This research aims to examine the characteristics and possible health advantages of -derived postbiotics. Methods: The antibacterial effects of postbiotics derived from were examined in vitro against various infectious gastrointestinal agents, as well as pasteurized milk and minced beef. Postbiotic activity potential was evaluated using disc-diffusion agar, minimum inhibitory concentration, minimum bactericidal concentration, and well-diffusion agar methods. Postbiotics were tested for antioxidant activity against zinobis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) free radicals. Additionally, the total phenolic and flavonoid content of the postbiotics was determined. The colorimetric MTT was used to investigate the potential cytotoxicity of postbiotics. The chemical makeup of the postbiotics was also determined using gas chromatography/mass spectrometry. Results: The antibacterial capacity was mostly related to pyrrolo[1,2-a] pyrazine-1,4-dione, benzoic acid, and laurostearic acid. Gram-positive microbes were more influenced by microbial byproducts in vitro than Gram-negative bacteria (P

Background: Obesity and non-alcoholic fatty liver disease (NAFLD) are considered as the main causes of liver-associatedmorbidity and mortality. Antioxidant administration was proposed as a remedy for liver problems such as steatohepatitis. This systematic review aimed to examine the effects of supplementation with various forms of Vitamin E on liver enzymes.Methods: To find relevant articles, in our systematic review article, we searched PubMed, Scopus, Embase, Cochrane library, and Web of Science up to 20 MAY, 2021. Randomized controlled trials (RCTs) on the effects of vitamin E supplementation, in isolation or combined with other nutrients, on liver health were included. After excluding irrelevant records, 21 studies remained.Results: According to the results of the included studies, vitamin E, especially α-Tocopherol or its co-supplementation with other antioxidants, at specific dosage could possibly have positive effects on improving liver functions and levels of Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) enzymes.Conclusion: Vitamin E,could possibly have positive effects on improving the liver function and the levels of ALT and AST enzymes.

Background: Sarcopenia, an age-related decline in muscle mass, strength, and function, contributes to various adverse health outcomes and physical impairments. This study aimed to investigate the association between sarcopenia components and health-related quality of life (HRQoL) among communitydwelling older adults.Methods: In this cross-sectional study, 501 adults aged 65 years or older participated. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia (AWGS) guideline. Muscle mass was measured by bioelectrical impedance analysis (BIA), muscle strength by hand dynamometer, and physical function by 4-m gait speed. The HRQoL was assessed using 12 item shortform healthy survey (SF-12) questionnaire.Results: There was a significant relationship between the sarcopenia and demographic characteristics (educational levels and smoking habits). After adjustment for age, sex, Body Mass Index, education level, smoking habits, and number of comorbidities, a significant relationship was observed between sarcopenia and physical components of HRQoL. According to multivariate linear regression, low muscle mass was negatively related to physical aspects of HRQoL. Low handgrip strength (HGS) and gait speed (GS) were inversely correlated to both physical and mental components of HRQoL.Conclusion: Our study highlighted the adverse impact of sarcopenia on HRQoL in elderly population. Reduction in muscle strength and physical performance not only affected physical aspects but also were linked with mental components of HRQoL. Therefore, it seems HGS and GS might be good indicators affecting all aspects of HRQoL in the elderly groups.

Abstract Background Rape, as an adverse incidence, leads to irreparable complications and consequences in women. Provision of health services to women survivors of rape requires catering for their real needs and identifying current deficits as well as barriers. The present study aimed to explore health system-related needs in women survivors of rape. Methods In the present qualitative study, the participants consisted of 39 individuals, including 19 women survivors of rape and 20 individuals with work experience in providing services to women survivors of rape. The participants were selected using the purposive sampling method with a maximum variation in Isfahan, Iran. Data were collected through in-depth interviews as well as field notes and were concurrently analyzed via conventional qualitative content analysis method. Results After analyzing the interviews, the health system-related needs of women survivors of rape were classified into two main categories: 1- The need for efficient medical care services with three sub-categories, namely “receiving services with respect for privacy and confidentiality”, “non-judgmental behavior and approach”, and “the need to receive empathy and the feeling of not being alone”, and 2- The need for desirable conditions and structure to provide services with two sub-categories, namely “the need to receive comprehensive and integrated services”, and “establishing specialized centers for providing services to survivors”. Conclusions Overall, explaining and highlighting the health system-related needs of women survivors of rape could provide a suitable basis for policy-making and planning according to their real needs. Receiving continuous services in separate centers with confidentiality and empathy could reduce the worries and concerns of women survivors of rape and help improve their health.

BackgroundThe sensitivity of parasitological and molecular methods is unsatisfactory for the diagnosis of strongyloidiasis, and serological techniques are remaining as the most effective diagnostic approach. The present study aimed to design and produce a chimeric recombinant antigen from Strongyloides stercoralis immunoreactive antigen (SsIR) and Ss1a antigens, using immune-informatics approaches, and evaluated its diagnostic performance in an ELISA system for the diagnosis of human strongyloidiasis.Methodology/principal findingsThe coding sequences for SsIR and Ss1a were selected from GenBank and were gene-optimized. Using bioinformatics analysis, the regions with the highest antigenicity that did not overlap with other parasite antigens were selected. The chimeric recombinant antigen SsIR- Ss1a, was constructed. The solubility and physicochemical properties of the designed construct were analyzed and its tertiary structures were built and evaluated. The construct was expressed into the pET-23a (+) expression vector and the optimized DNA sequences of SsIR-Ss1a (873 bp) were cloned into competent E. coli DH5α cells. Diagnostic performances of the produced recombinant antigen, along with a commercial kit were evaluated in an indirect ELISA system, using a panel of sera from strongyloidiasis patients and controls. The physicochemical and bioinformatics evaluations revealed that the designed chimeric construct is soluble, has a molecular with of 35 KDa, and is antigenic. Western blotting confirmed the immunoreactivity of the produced chimeric recombinant antigen with the sera of strongyloidiasis patients. The sensitivity and specificity of the indirect ELISA system, using the produced SsIR-Ss1a chimeric antigen, were found to be 93.94% (95% CI, 0.803 to 0.989) and 97.22% (95% CI, 0.921 to 0.992) respectively.Conclusions/significanceThe preliminary findings of this study suggest that the produced SsIR-Ss1a chimeric antigen shows promise in the diagnosis of human strongyloidiasis. However, these results are based on a limited panel of samples, and further research with a larger sample size is necessary to confirm its accuracy. The construct has potential as an antigen in the ELISA system for the serological diagnosis of this neglected parasitic infection, but additional validation is required.

Objectives Local treatment for knee osteoarthritis (KO) is used to relieve pain, maintain or improve joint function, and reduce disability and patient dependence. This study aims to compare the effect of rosemary ointment and ginger ointment on pain and physical performance of elderly people with KO. Methods & Materials This is an open-label randomized controlled clinical trial. The study population consists of older adults with grade 1 or KO referred to a orthopedic clinic in Lorestan, Iran. Of these, 111 eligible elderly patients were selected and randomly divided into two intervention groups of ginger (n=37), and rosemary (n=37) and one control group (n=37). The intervention groups used ginger or rosemary ointments twice in the morning and evening for 14 days. The control group received standard drug treatments (ibuprofen). The pain and physical function of the elderly before and after the intervention were evaluated using the visual analogue scale and the WOMAC index, respectively. Data analysis was done using paired t-test, analysis of covariance and Tukey’s test. Results There was a significant difference in pain intensity and physical performance before and after the intervention in the intervention groups (P0.05). Conclusion Both ginger and rosemary ointments can improve physical performance and reduce pain in the elderly with KO.

Objectives: Understanding patterns of quality of life in people who inject drugs (PWID) can help healthcare providers plan and manage their health problems in a more focused manner. Therefore, the current study aimed to identify patterns of health-related quality of life in PWID in southeast Iran. Methods: This cross-sectional study was conducted in southeast Iran on men who had injected drugs at least once during the last year. We used convenience sampling in 2 drop-in centers and venue-based sampling at 85 venues. Demographic characteristics, high-risk behaviors, and health-related quality of life were evaluated using the 5-level EQ-5D version (EQ-5D-5L) questionnaire. Latent profile analysis was used to identify patterns of quality of life. Results: This study enrolled 398 PWID, who had a mean age of 34.1±11.4 years. About 47.9% reported a prison history in the last 10 years, 59.2% had injected drugs in the last month, and 31.6% had a history of sharing syringes. About 46.3% reported having 2 or more sexual partners in the last 6 months, and 14.7% had a history of sex with men. Out of the 5 EQ-5D-5L profiles, the fifth profile had the most people (36.6%). Most variations in quality of life were related to pain and discomfort. Conclusions: We showed that the pain and discomfort dimension of EQ-5D-5L had more variation in PWID. This finding will be useful for allocating appropriate interventions and resources to promote health-related quality of life in this population.

Abstract Background Cyclists are vulnerable traffic users and studying the cycling behavior of professional and elite cyclists, their previous history of traffic accidents combined with the current knowledge on high-risk behaviors of this group can be a useful basis for further studies on ordinary cyclists. This study aimed to determine the relationship between cycling behavior and the previous history of traffic accidents among members of the Cycling Federation of Guilan province in 2022. Methods A descriptive-analytical study was performed in which the Bicycle Rider Behavior Questionnaire (BRBQ) constructed in the Porsline platform was distributed using the WhatsApp social network. All participants were asked to self-report their cycling behavior. The final analysis was performed by using STATA software (version 14). Results The study subjects included a total of 109 cyclists with a mean age of 38.62 ± 10.94 years and a mean cycling experience of 13.75 ± 11.08 years. Using the logistic regression model, the relationship between gender (P = 0.039), years of cycling experience (P = 0.000), and education level (P ≤ 0.00), with previous traffic accidents, was found significant. There was also a significant relationship between stunts and distractions (P = 0.005), signaling violation (P = 0.000), and control error (P = 0.011) with previous traffic accidents. A significant association existed between stunts and distractions (P = 0.001) and signaling violation (P = 0.001) with a previous history of traffic injury within the last 3 years. Conclusions The findings of this study can be used to establish cyclist safety and preventative planning in society. In behavior change intervention programs, it is best to target male cyclists with higher-level education. In addition, the behavior of the cyclists whose predominant term of signaling violations must be corrected should be targeted. It is necessary to shape information campaigns and educational programs aimed for cyclists with common high-risk behaviors, especially signaling violations.

Abstract Background There has been lack of evidence on the association between healthy dietary patterns and metabolic health status of adolescents. The present study aimed to evaluate the association between alternative healthy eating index (AHEI) and metabolic health status among a relatively representative sample of Iranian adolescents with overweight/obesity. Methods Adolescents with extra body weight (n = 203, aged 12–18 y), were selected for this cross-sectional study by a multistage cluster random-sampling method. Habitual dietary intakes and diet quality of individuals were assessed using validated food frequency questionnaire and AHEI-2010, respectively. Data on other covariates were also gathered by pre-tested questionnaires. To determine fasting glucose, insulin and lipid profiles, fasting blood samples were collected. Participants were categorized as having metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO) phenotypes, based on two approaches (International Diabetes Federation (IDF) and combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR)). Results The overall prevalence of MUO was 38.9% (based on IDF criteria) and 33.0% (based on IDF/HOMA-IR criteria). After considering all potential confounders, participants in highest tertiles of AHEI-2010 had lower odds of MUO profile according to both IDF (OR = 0.05; 95% CI: 0.01–0.15) and IDF/HOMA-IR (OR = 0.05; 95% CI: 0.02–0.19) definitions. This association was stronger in adolescents with overweight compared with obese ones and also among girls than boys. Moreover, each unit increase in AHEI-2010 score was associated with lower risk of MUO based on both criteria. Conclusions Higher adherence to AHEI-2010 was inversely associated with odds of MUO in Iranian adolescents with overweight/obesity.

Background and Aim: The Hospital Information System is a complete one to provide high-quality patient care and enhance community health, so it must be designed and produced accordingly. In this regard, the current research was carried out with the aim of providing the document of standards for producing Hospital Information System software for Iran. Materials and Methods: In this study, following extraction of the features and services of the Hospital Information System from the texts, they were matched with the generalities of the document of standards compiled by the Statistical Data Management and Information Technology Office of the Ministry of Health, Treatment, and Medical Education (SDMITO). Also, the Hospital Information System was reviewed observationally, all defects of document of standards were identified, and the document was amended throughout. After providing the proposed document of standards, it was consulted by a group of experts, which included ten health information management professors, ten medical informatics professors (with at least seven years of experience as members of the academic staff), and five heads of the information technology field of the Ministry of Health. An agreement coefficient of 85% was considered to accept and approve the document of standards. After obtaining the agreement coefficient, The Hospital Information System software production document of standards was provided. Results: The document of standards provided for the production of Hospital Information System software includes the Hospital Information System design meta model, Hospital Information System subtypes, standards for the structure and content of Electronic Health Record, information terminology standards, data classification standards, security data standards, data exchange standards, clinical services, and management services, which were placed in the four areas of “features”, “services”, “documentation requirements” and “rules and policies”. Conclusion: The application of this document of standards leads to the production of a higher quality, efficient, and standard Hospital Information System software, which is effective in improving the health level of society and provides the conditions for the implementation of Electronic Health Record.

Objective: To explore the impacts of parental deportation on the health and well-being of U.S. citizen children of Mexican immigrants. Methods: From 2019–2020, this ambi-directional cohort study recruited U.S.-based families with an undocumented Mexican immigrant parent and U.S.-citizen childrens (ages 13–17) recently exposed to parental deportation (N = 61), and similar families without a history of parental deportation (N = 51). Children health, behavioral, economic, and academic outcomes were measured via phone surveys upon enrollment and six months later. A subsample of “exposed” caregivers (N = 14) also completed in-depth semi-structured interviews. Data were analyzed using fixed-effects regression models and thematic analyses. Results: Childrens exposed to parental deportation had significantly worse health status, behavioral problems, material hardship, and academic outcomes than children in the control arm (p

Abstract Background and aim Understanding the characteristics of global policy actors and the political context in which they address diplomatic issues in the field of NCDs can play an important role in advancing NCD-related goals. The purpose of this study was to identify and analyze the network of global health actors in the field of NCDs in Iran. Methods This study was conducted in 2020 using a qualitative methodology and framework analysis. In-depth semi-structured interviews were conducted with subject-matter experts from all levels of diplomacy, including global, regional, and national, who had managerial, administrative, and academic experience. Findings A total of 21 interviews were conducted with individuals who met the inclusion criteria. Following the framework of the World Health Network, the findings were divided into three general areas: the features of the network and the actors; the policy environment; and the characteristics of the issue. Conclusion A successful and sustainable program to combat NCDs requires the participation of multiple actors from governments, the private sector, and civil society at international, national, and local levels. The Global Network for Prevention and Control of NCDs should enhance the effectiveness of NCDs policies by highlighting the need to simultaneously improve the internal factors of the network, including relationships among the actors; external factors, including the policy environment; and the complex nature of NCDs.

Background: Spread of COVID-19 worldwide created anxiety, stress. In the meantime, healthcare workers have been suffering from significant psychological distress due to providing direct care to the patient, side injuries and quarantine. The present research aims to investigate and identify the factors involved in reduction of psychological effects of COVID-19 by interpretive structural modeling. Methods: This study was a mixed study (quantitative and qualitative). The study population included doctors, supervisors and nurses of the clinical departments of Khatam-ul-AnbiyaAbarkoh Hospital in Yazd. The participants were selected using the snowball sampling method. Semi-structured interviews were used to collect data. In the qualitative part of the research, mainly library studies and expert opinions were used. In the quantitative part of the research, the structural self-interaction matrix was used. The final analysis was performed by MATLAB2018. Results: The results show that the most psychological effects of Covid-19 are related to "appropriate measures to reduce the disease such as environmental ventilation" and "financial support of personnel" and "sufficient provision of personal protective equipment" and "dedicated sufficient manpower to the involved departments" (with a power of 8). And the lowest influence is related to "continuous training of stress management and constant presence of a psychologist" (with an influence of influence 5) Conclusion: The basic factors in the research model include continuous stress management training, the presence of a psychologist, and inspection of infected areas. By the management team and providing adequate personal protective equipment.

Abstract Background Non-communicable diseases behavioral risk factors can be improved if effective interventions are designed considering the health system’s capabilities and local resources. This study evaluated the effectiveness of interventions that aimed at increasing non-physician community health workers’ motivation in reducing non-communicable diseases behavioral risk factors in the community. Methods A randomized field trial study was conducted in 32 community health centers in 4 Iranian districts after a baseline population survey on the status of NCDs of 30–70-year-old individuals (n = 1225). The interventions were performed to improve insufficient physical activity, insufficient fruit consumption, insufficient vegetable consumption, high salt intake, and tobacco use. Four intervention packages were implemented in 24 community health centers; the other 8 centers were used as control groups. The non-physician community health workers performed the interventions. The packages additively included goal-setting, evidence-based education, operational planning, and incentive payments. A second survey was conducted 1 year after the start of the interventions to identify the effects on an independent random sample of 30–70-year-old individuals (n = 1221). Difference-in-difference method was used to quantify the interventions’ effects. Results The average age of participants in both surveys was about 49 years. Also, about half of the participants were female, and about 43% were illiterate or had a primary school education. The interventions had statistically significant effects only on decreasing the prevalence of insufficient physical activity. The package with all the intervention components decreased the odds of insufficient physical activity to 0.24 (95% CI, 0.08, 0.72). The package with operational planning but no performance-based financing did not change the odds of insufficient physical activity. Conclusions This study highlighted the importance of components, design, and implementation details of interventions intended to reduce NCDs behavioral risk factors. Some risk factors, such as insufficient physical activity, seem more easily modifiable with limited low-cost interventions in a one-year horizon. However, risk factors related to healthy food consumption and tobacco use need more extensive interventions. Trial registration This trial was registered on the Iranian Registry of Clinical Trials (IRCT20081205001488N2) on 3 June 2018 ( https://en.irct.ir/trial/774 ).

Abstract Background The main objective of this study was to construct and validate a composite socioeconomic status indicator containing material capital, human capital, and social capital (CAPSES scale) and also appropriate it for CVDs in a large population-based study. Methods This cross-sectional study, the Urban HEART-2 project, was conducted in Tehran, Iran, in 2011. A total of 34,116 households covering 118,542 individuals were assessed in this study. A 14-parts questionnaire was completed for all selected households. All the gathered data were based on the participants’ self-reports. Literacy, wealth index, expenditure, skill level, and Townsend index were used as SES indexes. CVDs, including Hypertension, Myocardial infarction, and stroke, were considered the main outcomes. A structural equation model (SEM) was used to construct a CAPSES scale and a composition index of SES. Criterion validity and Construct validity were used to assess this scale. Results A total of 91,830 subjects consisting of 33,884 (49%) men were included in this analysis. The mean age of the participants was 41.5 ± 11.37 years. Among the assessed participants, 5904(6.4%) reported hypertension, 1507(1.6%) myocardial infarction, and 407(0.4%) strokes. The overall weighted prevalence of self-reported cardiovascular events (hypertension, stroke, and MI) was 8.03% (95%CI: 7.8–8.2). Inverse associations were seen between the CAPSES scale and its domains with CVDs, adjusted for sex, age, BMI, smoking, and diabetes by a multiple logistic regression model. Conclusion The CAPSES scale was significantly associated with stroke and hypertension. Our findings showed that the CAPSES index could be useful for public health research.

Introduction and purpose: Covid-19 is an infectious disease caused by the novel Coronavirus, and its pandemic has resulted in numerous deaths and losses worldwide. This study aimed to predict Corona-preventive behaviors in adults aged 30 to 50 admitted to Ardabil health centers based on their health literacy. Methods: The present study was a correlational descriptive-analytical study. The statistical population consisted of 30 to 50-year-old patients admitted to Ardabil health centers (Iran) in 2019, from which 232 were randomly selected using cluster sampling. Data were collected through administering a health literacy and preventative behavior questionnaire online. The data were then analyzed using inferential (Pearson correlation and linear regression) statistics by the SPSS software (version 26) with a significance threshold of 0.05. Results: The results of this investigation revealed a statistically significant relationship (P

Acquiring information about groundwater quality is essential in developing management strategies. In this article, spatio-temporal variations of cations in groundwater in Esfarayen plain were investigated using data monitored in 134 groundwater wells, active in 1988, and 47 wells, active in 2019. To evaluate groundwater quality, interpolation methods have been used to interpolate existing limited spatial data. The performance of 8 current interpolation methods on the data for the two selected years (1988 and 2019) was compared. Finding the optimum interpolation method for the considered groundwater quality parameters is essential. Cross-validation and three indexes of R2, mean absolute error (MAE), and root mean square error (RMSE) were used to compare the performance of the methods. By identifying universal kriging (UK) and global polynomial interpolation (GPI) methods as the optimum methods and using those for the selected years (1988 and 2019), spatial variation of the concentration of cations in groundwater across the plain has been presented. In 1988, the maximum concentration of the cations occurred in the southwest of the plain (about 80 mg/L), and the minimum concentration of the cations was observed in the northwest of the plain (approximately 8 mg/L). Similarly, in 2019, the highest concentration of the cations was found in the southwest of the plain (almost 64 mg/L), and its lowest concentration was observed in the northeast of the plain (roughly 13 mg/L). Moreover, temporal variations of the concentration of cations in groundwater from 1988 to 2019 have also been presented. The concentration of the cations increased by approximately 23 mg/L in the northwest and decreased to about 37 mg/L in the southwest of the study area from 1988 through 2019. According to the results, changes in the quality of groundwater are a complex problem and it is necessary to adopt proper strategies to reduce its adverse effects.

Abstract Background During epidemics, supports are limited and individual and collective vulnerabilities as well as domestic violence are increased. Therefore, various groups in society, especially children and their mothers, are extremely vulnerable. This study aimed to assess the relationship between aggressive behaviors of preschool children and the violence against Iranian women during the COVID-19 pandemic. Methods This descriptive-correlational study was conducted in October–November 2020. Stratified random sampling was performed among preschool children in Kerman. Data were collected using the Violence toward Women Inventory and the Aggression scale for preschoolers Scale. Data were analyzed using SPSS25, ANOVA, independent t-test, and Pearson correlation test. Results The results showed that the total mean scores of violence against women and preschoolers’ aggression were 54.43 ± 10.6 and 88.44 ± 6.5, respectively. The results showed a statistically significant difference in aggressive behaviors of preschool children, mother's job, number of children, mother's education, income, and age. A positive and significant relationship was also found between the subscales of violence against women and aggression in preschool children. Conclusions The results showed a positive and significant relationship between violence against women and aggression of preschool children. Therefore, it is recommended that parents identify and eliminate the risk factors for domestic violence during the COVID-19 in order to protect their children. Parents also must learn coping strategies for stress and resilience in the epidemic crises.

Abstract Background Human milk composition varies over time within an individual mother as well as between lactating mothers due to several factors including maternal health, diet, and nutritional status. Therefore, improving nutrition status during gestation and breastfeeding is crucial for improving the health of both mothers and infants. Diet can enhance the oxidant-antioxidant balance of human milk. This study aimed to investigate the association between human milk oxidant-antioxidant balance with dietary patterns of lactating mothers identified by using principal component analysis. Method This cross-sectional study included 350 breastfeeding women between the ages of 20 to 35 years. The dietary intakes of the women in the study were estimated using a validated food frequency questionnaire, which included 65 food items. The oxidant-antioxidant balance of milk samples was assessed using the ferric reducing antioxidant power (FRAP), 2, 2′-diphenyl-1-picrylhydrazyl (DPPH), thiobarbituric acid reactive substances (TBARs), and Ellman’s assay. The milk concentration of total protein, calcium, and triglyceride was also measured using commercial kits. Result Two predominant dietary patterns were recognized that we defined as a healthy and unhealthy pattern. There were higher levels of DPPH and thiol in the milk from mothers in the third tertile (highest adherence) of a healthy dietary pattern compared to the first tertile (lowest adherence; p

Background & Objectives: Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS). Clostridium perfringens ε-toxin (ETX) can cause emerging complications of MS due to its tendency to the blood-brain barrier. This study aimed to determine the presence of toxin-producing genes in intestinal C.perfringens in patients with multiple sclerosis. Materials & Methods: Stool samples were taken from 70 MS patients and 70 without MS individuals. The samples were enriched in cooked meat media, and cultural and biochemical methods separated Clostridium isolates. PCR tested these isolates to identify C. perfringens species. In addition, the presence of alpha, beta, epsilon and iota toxin-producing genes was evaluated in all isolates by Multiplex PCR. Results: Isolates containing the etx gene were observed in 10 patients, while no itxA gene was identified in any isolates. The results showed that isolates in 8 patients were type D. Also, the gene encoding toxin type D was identified in 2 isolates obtained from the control group. Conclusion: Our findings indicated the high frequency of C. Perfringens in MS patients. In the studied samples with clinical presentations, most of these organisms were type D bacteria that produce ε-toxin.

Background: Based on diversified intergenerational living in urban Iran, this study was conducted to determine the role of intergenerational family in family functions and cultural values in Aligudarz. Methods: This study was analytical cross-sectional based on questionnaire. The population were included over 18 years of age in Aligudarz, 376 people were selected as a sample using Cochran sampling by simple random sampling method. Library and survey methods were used to collect data. One-way analysis of variance and Pearson correlation tests were used to test the hypotheses. Results: Elderly people have better family functions than others (P=0.011) and adhere more to cultural values. Elderly people have more management in family crises with f value of 3.140 (p=0.019). The correlation coefficient between family cohesion and family functions is 0.152 with a direct correlation (P=0.003). As the level of family cohesion increases, family functions also increase. There is a direct correlation between kinship relations and family functions (P=0.777, -0.015). There is no relationship between the level of kinship and family functioning. Conclusion: It is possible to improve the current status given the level of adherence to cultural values, crisis management, and family cohesion, Kinship relationships among different generations, and the relationship between the variables of adherence to cultural values, crisis management and cohesion, and family functions.

BackgroundMexican migrants traveling across the Mexico-United States (U.S.) border region represent a large, highly mobile, and socially vulnerable subset of Mexican nationals. Population-level health data for this group is hard to obtain given their geographic dispersion, mobility, and largely unauthorized status in the U.S. Over the last 14 years, the Migrante Project has implemented a unique migration framework and novel methodological approach to generate population-level estimates of disease burden and healthcare access for migrants traversing the Mexico-U.S. border. This paper describes the rationale and history of the Migrante Project and the protocol for the next phases of the project.Methods/designIn the next phases, two probability, face-to-face surveys of Mexican migrant flows will be conducted at key crossing points in Tijuana, Ciudad Juarez, and Matamoros (N = 1,200 each). Both survey waves will obtain data on demographics, migration history, health status, health care access, COVID-19 history, and from biometric tests. In addition, the first survey will focus on non-communicable disease (NCD), while the second will dive deeper into mental health and substance use. The project will also pilot test the feasibility of a longitudinal dimension with 90 survey respondents that will be re-interviewed by phone 6 months after completing the face-to-face baseline survey.DiscussionInterview and biometric data from the Migrante project will help to characterize health care access and health status and identify variations in NCD-related outcomes, mental health, and substance use across migration phases. The results will also set the basis for a future longitudinal extension of this migrant health observatory. Analyses of previous Migrante data, paired with data from these upcoming phases, can shed light on the impact of health care and immigration policies on migrants’ health and inform policy and programmatic responses to improve migrant health in sending, transit, and receiving communities.

Abstract Background Diabetes as a leading cause of death imposes a heavy burden on health systems worldwide. This study investigated the trends in prevalence, awareness, treatment and control of diabetes among Iranian population aged 25 to 65 years over 12 years (2004-2016). Methods Secondary data analysis was performed using data from a national population-based survey, STEPwise approach to surveillance (STEPS) for non-communicable diseases (NCDs) in four rounds (2004, 2007, 2011, 2016). The sample sizes were 89,404, 29,991, 12,103 and 30,541 individuals, respectively across the country in both rural and urban areas. Data were analyzed using descriptive statistics and a logistic regression model with odds ratio at a significance level of less than 5% with no adjustment for age and sex. Logistic regression was used to identify socio-demographic factors associated with the levels of awareness, treatment and control of diabetes mellitus. Results The prevalence of diabetes in four rounds was 8.4, 9, 11.1 and 13.2%, respectively. Among people with diabetes, 53.5, 65.6, 70.5 and 82.2% were aware of their condition and 35.9, 42, 46 and 39.6% were treated for this condition, respectively. In four rounds of study, 14.5, 20.8, 20.4 and 18.5% of all diabetic patients had adequate glycemic control, respectively. In the multivariable logistic regression analysis, there was a significant relationship between female gender, age over 40, living in the urban area, being in the third wealth quintile and having health insurance with diabetes prevalence. Female participants were more likely to be aware of the disease. Older participants were more likely to receive treatment and had adequate glycemic control. Conclusion The prevalence of diabetes in Iran has been increasing and despite the great awareness of the disease, receiving treatment and effective control of the disease are suboptimal. While several national policies to improve diabetes screening and care have been passed in recent years, it seems large gaps remain in disease detection and treatment. It is suggested that more attention be paid to the treatment and control of diabetes by NCDs national policies to prevent the growing burden associated with the disease.

Abstract Background The prevalence of vitamin D deficiency is increasing globally and is associated with an increased risk of metabolic syndrome, autoimmune disease, and cardiovascular disease. Vit D deficiency is also associated with increased systemic inflammation. The current study aimed to determine the efficacy of low-fat milk and yogurt fortified with 1500 IU nano-encapsulated vitamin D, on systemic inflammation in abdominal obese participants. Method This multi-center study was conducted using a 2.5-month parallel total-blind randomized clinical trial design. Two hundred and eighty nine subjects were allocated to four groups: low-fat milk fortified by 1500 IU nano-encapsulated vitamin D3 (200 mL/day). Simple milk (200 mL/day), low-fat yogurt fortified by 1500 IU nano-encapsulated vitamin D3 (150 g/day), and simple yogurt (150 g/day). Results The results showed that serum levels of neutrophils, lymphocytes, platelets and red blood cell distribution width (RDW) were significantly lower before and after the intervention in fortified dairy groups. The results showed that serum levels of neutrophils, lymphocytes, platelets, and RDW before and after intervention in the fortified dairy groups were significantly lower (p

Objectives Social network in older adults refers to interpersonal relationships and the perception of these relationships. Given the importance of the social network, the current study was conducted to answer three pivotal questions. First, do personal and regional factors affect the social network of the elderly? Second, how much share do the individual and regional factors have in the social network of the elderly? And third, which of these factors affect the social network of the elderly at each level of the personal and regional relationships. Methods & Materials The study was conducted based on the second round of the Tehran city health equity and response tool (Urban-Heart 2). Thus, 5760 individuals (age

Objectives: Frailty is characterized by an increased vulnerability to stressors. Frail older patients are at increased risk of Emergency Department (ED) visits, hospitalization, and disability. The aim of this study was to determine the relationship between frailty syndrome and polypharmacy in the elderly referred to the emergency department of Ardabil teaching hospitals. Methods & Materials: In this cross-sectional descriptive study, 505 elderly people referred to the hospital emergency department were selected by convenience sampling method. Frailty syndrome was measured using the five-item criteria of fried which include: 1) slow walking, 2) muscular weakness, 3) exhaustion, 4) low physical activity and 5) unintentional weight loss. Polypharmacy considered the use of 5 or more drugs. Data were analyzed using descriptive statistics including mean and standard deviation and inferential analysis including analysis of variance, independent t-test, correlation, and multiple regression using spss v. 22 statistical software. Results: The mean age of participants was 70.91‌±‌7.49 and 255 (50.5%) were male, 318 (63%) were married and 271 (53.7%) were illiterate. the results of the study showed that 204 (40.4%) of the elderly who referred to the emergency department had frailty and 177 (35%) had pre frailty. In this population, we identified a 42.2% (n=98) of frail with polypharmacy, 37.1% (n=86) of prefrail with polypharmacy. The correlation test showed that there is a significant relationship between fertility and polypharmacy (P˂0.001). Linear regression analysis showed the variables of age, education, living arrangement, hospitalization, and the number of medications used by the patient as predictors of frailty syndrome in the elderly referred to the emergency department. Conclusion: Number of drugs used, age, education, living arrangement and number of hospitalizations were predictors of frailty syndrome in the elderly. Considering the living conditions of the elderly and the prevention of unnecessary hospitalizations can reduce polypharmacy and ultimately a preventive strategy to prevent and manage frailty. Of course, further research is needed to confirm the possible benefits of reducing polypharmacy in the development, reversion, or delay of frailty.

COVID-19 crisis has placed medical systems over the world under unprecedented and growing pressure. Medical imaging processing can help in the diagnosis, treatment, and early detection of diseases. It has been considered as one of the modern technologies applied to fight against the COVID-19 crisis. Although several artificial intelligence, machine learning, and deep learning techniques have been deployed in medical image processing in the context of COVID-19 disease, there is a lack of research considering systematic literature review and categorization of published studies in this field. A systematic review locates, assesses, and interprets research outcomes to address a predetermined research goal to present evidence-based practical and theoretical insights. The main goal of this study is to present a literature review of the deployed methods of medical image processing in the context of the COVID-19 crisis. With this in mind, the studies available in reliable databases were retrieved, studied, evaluated, and synthesized. Based on the in-depth review of literature, this study structured a conceptual map that outlined three multi-layered folds: data gathering and description, main steps of image processing, and evaluation metrics. The main research themes were elaborated in each fold, allowing the authors to recommend upcoming research paths for scholars. The outcomes of this review highlighted that several methods have been adopted to classify the images related to the diagnosis and detection of COVID-19. The adopted methods have presented promising outcomes in terms of accuracy, cost, and detection speed.

Abstract Introduction Self-care behaviors in diabetic patients is considered an important factor for controlling the diabetes. Therefore, diabetic patients need training the self-care behaviors to control this disease. This study aims to investigate the reasons for diabetic patients’ non-participation in a self-care training program. Method This qualitative study was carried out between 1 April to 1 July 2019. We used in-depth semi-structured interviews with 30 diabetic patients who did not participate in the self-care training program. Data analysis was conducted using content analysis with MAXQDA software. Findings The results of this study showed that there are 5 themes and 14 sub-themes for patients’ non-participation in self-care training program. Themes included access; individual, familial and social factors; attitude and awareness; motivator factors and need Factors. Also sub-themes were physical access, time access, physical abilities, social-familial responsibilities, attitude to disease, attitude to education, attitude to health, awareness, incentive, communication, teaching methods, perceived risk, access to other educational resources and self-efficacy. Conclusion According to the results of this study, simple physical and time access, offering high-quality education, providing virtual and distant training, organizing and designing modern training methods can lead to increase participation in self-care training programs.

BackgroundBreast cancer is the most common cancer among women and is the second leading cause of cancer death. This disease affects all aspects of the patient's life and family, especially the patient's spouse, which confirms the need to adapt to these changes. The common instruments used for the investigation of adaptation among husbands of women with breast cancer are mainly outdated, one-dimensional, or non-concordant with the Iranian culture. Therefore, the present study aimed to design and validate an adaptation scale among the husbands of Iranian Muslim women suffering from breast cancer.MethodsThis exploratory sequential mixed study was conducted in two qualitative and quantitative stages. In the qualitative stage, semi-structured interviews were performed with 21 participants. Then, items were developed through content analysis using the approach proposed by Elo and Kyngas on the basis of Roy's adaptation model. In the quantitative stage, the extracted items were reduced and psychometric properties such as face, content, and construct validity as well as reliability were explored. To investigate the construct validity, a cross-sectional descriptive study was conducted on 300 husbands of women with breast cancer selected via cluster sampling.ResultsThe initial questionnaire contained 79 items. After the assessment of face and content validity, 59 items were evaluated regarding construct validity using exploratory factor analysis. At this stage, six adaptation dimensions were observed among the women's husbands, with the variance of 51.71. The Cronbach's alpha and correlation coefficient of the questionnaire were 0.912 and 0.701, respectively.ConclusionThe developed 51-item adaptation scale had an appropriate validity and reliability and could be used for the assessment of adaptation in the target group.

Introduction: Socio-economic inequalities in the use of dental services are a major challenge to health policies in many countries. This cross-sectional study was conducted to investigate socio-economic inequalities in utilization of dental services in households of Lorestan province and comparing it with neighboring provinces. Methods: Data required for the study were collected from the household expenditure and income survey (HIES). The study population included 5547 households in the western provinces of the country. Logistic regression method was used to determine the most important factors affecting the use of dental services, and the focus index was used to measure inequality between income groups. Data analysis was performed using Stata software version 14. Results: The highest and lowest percentages of dental services among households were related to Hamedan (7.02%) and Lorestan (3.19%) provinces, respectively. The results of the focus index showed that the benefits and costs of dental services were concentrated among households with higher socio-economic status. In other words, inequality benefits the rich. Being a female head of household and increased size of the household leads to a decrease in the use of these services. The higher education level of the head of the household and the increase in the number of employed and literate household members showed a positive relationship with the utilization of dental services. Conclusion: Benefiting from dental services was significantly higher among higher socio-economic groups. These inequalities can be avoided by introducing and implementing targeted policies. Low-income households, lower education levels, and the unemployed should be the focus of health policies to address unmet dental care needs.

Abstract Background The steady rise in noncommunicable diseases (NCDs) worldwide has been a key global health challenge. Governments have the primary responsibility for taking action to prevent and control NCDs. Given the growing importance of globalization of healthcare as well as the increasing use of soft power, governments need to identify challenges and opportunities to enhance global health diplomacy (GHD) for NCD prevention and control. The purpose of this qualitative research was to explain the challenges and opportunities of GHD for NCDs in Iran. Methods This study was conducted in 2020 using a qualitative approach and through in-depth, semi-structured interviews with 21 experts and specialists in related fields such as health policy, healthcare management, epidemiology and other related specialties. The participants were selected from all levels of diplomacy, including global, regional and national levels, with at least 3 years of experience in managerial, executive and scientific activities. Data analysis was performed by content analysis with an inductive approach. Data were analysed using inductive content analysis. Results The identified challenges were categorized into five main themes, including content challenges, structural challenges, process challenges, governance challenges and cultural challenges. Opportunities extracted from the interviews were also categorized into four main themes, including strong political will, utilizing the capacity of nongovernmental organizations (NGOs), multisectoral collaborations and a well-developed health system. Conclusions NCD prevention and control requires a multilateral collaboration-based solution. Recognition of the challenges and opportunities in GHD can help draw significant lessons for building the necessary capacities and implementing more effective policies to prevent and control NCDs.

Abstract Background and aim The growing globalization has changed the goals and methods of diplomacy. Due to the challenges and complexities of dealing with noncommunicable diseases (NCDs) at the national and international levels, policy makers require global health diplomacy (GHD) to achieve the goals of prevention and control of NCDs. The purpose of this systematic review was to identify the challenges and opportunities in GHD for NCDs. Methods A systematic review of articles was conducted by searching MEDLINE via PubMed, Web of Science, Scopus, and Embase and by using Google and Google Scholar search engines. Additional articles were identified by reviewing reference lists and a number of special journals. The inclusion criteria include literature published in English from 2007 to 2020, and the exclusion criteria are literature published in any language other than English, absence of full text, dissertations, and duplicates. Overall, 32 articles met the requirements for inclusion in this review and were analyzed using content analysis in MAXQDA 10. Findings There are 32 published articles on GHD for NCDs. Identified challenges were classified into three levels: global (global health governance), national (Governance at the state level, health sector, and civil society), and industry. The progress on global health issues has created opportunities for the development of GHD for the prevention and control of NCDs. These opportunities were divided into three levels: international, national, and individual level. Conclusion Various challenges at the global level, national level, and industry led to less engagement of policymakers in GHD for prevention and control of NCDs and, as a consequence, a less coordinated approach to address prevention and control of NCDs worldwide. So, there is a need for more efforts of collective action and negotiation for tackling NCDs. Policymakers and managers of the health system should increase the advocacy, building a coalition with civil society, use negotiation and diplomacy to engage with other sectors and organizations, manage industry conflicts, and leverage foreign policy to promote health and welfare.

Background: Academic buoyancy can be a major factor in the psychological-educational perspective and can contribute to solving students’ problems in their school life. The present study aimed to investigate the association of academic buoyancy with school-related anxiety and social participation among students educated via the educational approaches of Mizan and regular schools in Tehran, Iran. Methods: The current study was descriptive-correlational. The study population comprised of all elementary-school students in Tehran in the 2018-2019 academic year. A sample of 606 students was selected from regular and guided discovery schools (300 students from regular and 306 from Mizan guided discovery schools). The research instruments included the Academic Buoyancy Scale, the School Anxiety Scale, and School Bonding Questionnaire. Data were analyzed using the Pearson correlation coefficient and structural equation modeling was applied to predict the relationships among variables. Results: The results showed that the scores of academic buoyancy and social participation were significantly higher among students receiving guided discovery than that of those receiving traditional education (P=0.014). The scores of school-related anxiety were significantly lower among students receiving guided discovery than that of those receiving traditional education (p

Background: Anxiety and depression (A&D) are common among patients with diabetes (DM). We assessed the mediatory effect of obesity on the pathway between past and current mental health (as measured by A&D) on self-care DM treatment adherence and DM treatment failure. Methods: We used data collected in two rounds (2009-12, 2014-2018) of a population-based cohort study in Kerman, Iran (KERCADRS). By a random cluster sampling approach, 5900 residents of Kerman aged 15 to 75 yr were recruited to the study to measure demographic characteristics, body measures (to calculate BMI), adherence to DM treatment, and symptoms for A&D (Beck questionnaires). Fasting blood also collected for biochemical tests and glycemic control (as an indicator for treatment failure). We used path analysis and Structural Equation Modeling (SEM) for analysis. Results: We analyzed data for 264 patients with diabetes who attended in both study rounds. While only 5.7% reported not adherence to DM treatment, 67.9% had diabetes treatment failure. Past mental health had a significant positive association with HbA1c (standard beta coefficient for total effect =0.148, P=0.044), of which 42% was indirect effect through obesity. Current mental health had a positive association with current no adherence to diabetes treatment (standard beta coefficient for total effect=0.077, P=0.001). Conclusion: Our study showed an important indirect path from A&D to diabetes treatment failure outcome which mediated by obesity. Screening for A&D symptoms and treating those as well as obesity among patients with diabetes may improve glycemic control.

BackgroundMigrants detained and held in immigration and other detention settings in the U.S. have faced increased risk of COVID-19 infection, but data on this population is scarce. This study sought to estimate rates of COVID-19 testing, infection, care seeking, and vaccination among Mexican migrants detained by U.S. immigration authorities and forcibly returned to Mexico.MethodsWe conducted a cross-sectional probability survey of Mexican migrants deported from the U.S. to three Mexican border cities: Tijuana, Ciudad Juárez, and Matamoros (N = 306). Deported migrants were recruited at Mexican migration facilities after being processed and cleared for departure. A two-stage sampling strategy was used. Within each city, a selection of days and shifts were selected during the operating hours of these deportation facilities. The probability of selection was proportional to the volume of migrants deported on each day of the month and during each time period. During the selected survey shifts, migrants were consecutively approached, screened for eligibility, and invited to participate in the survey. Survey measures included self-reported history of COVID-19 testing, infection, care seeking, vaccination, intentions to vaccinate, and other prevention and risk factors. Weighted data were used to estimate population-level prevalence rates. Bivariate tests and adjusted logistic regression models were estimated to identify associations between these COVID-19 outcomes and demographic, migration, and contextual factors.ResultsAbout 84.1% of migrants were tested for COVID-19, close to a third were estimated to have been infected, and, among them, 63% had sought care for COVID-19. An estimated 70.1% had been vaccinated against COVID-19 and, among those not yet vaccinated, 32.5% intended to get vaccinated. Close to half (44.3%) of respondents had experienced crowdedness while in detention in the U.S. Socio-demographic (e.g. age, education, English fluency) and migration-related (e.g. type of detention facility and time in detention) variables were significantly associated with COVID-19 testing, infection, care seeking, and vaccination history. Age, English fluency, and length of detention were positively associated with testing and vaccination history, whereas detention in an immigration center and length of time living in the U.S. were negatively related to testing, infection, and vaccination history. Survey city and survey quarter also showed adjusted associations with testing, infection, and vaccination history, reflecting potential variations in access to services across geographic regions and over time as the pandemic unfolded.ConclusionThese findings are evidence of increased risk of COVID-19 infection, insufficient access to testing and treatment, and missed opportunities for vaccination among Mexican migrants detained in and deported from the U.S. Deportee receiving stations can be leveraged to reduce disparities in testing and vaccination for deported migrants. In addition, decarceration of migrants and other measures informed by public health principles must be implemented to reduce COVID-19 risk and increase access to prevention, diagnostic, and treatment services among this underserved population.

This descriptive, cross-sectional study aimed to assess the correlations between the knowledge, attitude, and performance of the students of Hamadan University of Medical Sciences, Iran, regarding waste recycling in 2020-2021. A questionnaire was used for data collection, and the sample population consisted of 70 male and female students. Data were analyzed using SPSS version 21 by Mann-Whitney and Kruskal-Wallis (α=0.05). The sample population included 87.1% women and 12.9% men. In total, 22.9% of students received special training to recognize the adverse effects and management of waste while 77.1% of them received no training. In addition, 22.9% of students reported the contraction of infectious diseases in themselves or others around them due to contact with garbage or contaminated equipment. The marital status had a significant difference with the amount of knowledge of the studied students for determining the type of awareness regarding the importance of recycle waste while gender represented no substantial difference in this regard. Based on the results, a positive correlation was observed between attitude and awareness, as well as the performance with knowledge and attitude. Knowledge, attitude, and performance are meaningful predictors of waste management. According to the results, the importance of waste management should be emphasized to student in the community in terms of the current health conditions. It also seems that the influential factors in waste management should be fully identified in interventional programs, and appropriate interventions should be planned and implemented accordingly.

Background: To end the COVID-19 pandemic, a large part of the world must be immune to the virus by vaccination. Therefore, this study aimed to gauge intent to be vaccinated against COVID-19 among ordinary people and to identify attitudes towards vaccines and barriers for vaccine acceptance. Methods: The study population comprises 1880 people residing in different countries that answer a prepared questionnaire. The questionnaire topics are demographics, historical issues, participants’ attitudes and beliefs regarding vaccines, concerns, and vaccine hesitancy. Results: Attitudes and beliefs relating to vaccines in general, and the COVID-19 vaccine, were ascertained. Overall, 66.81% of the contributors would like to be vaccinated against COVID-19, while %33.19 did not intend to be vaccinated. Reasons for COVID-19 vaccine hesitancy included concern regarding vaccine side effects, fear of getting sick from the uptake of the vaccine, and the absence of accurate vaccine promotion news. Individuals with higher education believe that India (68.6%) produces the best vaccine (P

Abstract Background COVID19 is a respiratory disease caused by a novel coronavirus. As there has been no definitive treatment for the disease so far, the only way to control the spread is to break the chain of infection. Our study aimed to analyze the preventive behaviors and influencing factors in the Iranian population. Methods This cross-sectional study was a web-based survey in the Iranian population. We performed the study during the first peak of COVID-19 outbreak (from March 25th, 2020 to April 5th). We used demographic and Preventive behaviors questionnaires to collect the data. This web-based survey was publicized on the internet through the common platforms used by the Iranian population. This survey was released on the website “ Porsline.com ”. A total of 2097 acceptable questionnaires were filled. All data were analyzed, using Statistical Package for Social Sciences (SPSS) version 19. Results 61.9% of the participants checked the hand-washing question as “Always”. 55.7 and 58.2% checked the wearing masks and gloves as “Always”, respectively. We found a significant relationship between gender and hand washing behavior (P = 0.006) and the use of masks and gloves (P

Abstract Introduction: Proper assessment of the employees’ ability to work from an economic point of view is important for employers since it is one of the ways to increase human resource productivity. The purpose of this study was to investigate the relationship between job stress and ability to work in nurses of hospitals affiliated to Ahwaz University of Medical Sciences. Methods: The present study was analytic and cross-sectional. The participants were 250 nurses with at least one year of work experience selected from all 8 hospitals affiliated to Ahwaz University of Medical Sciences using proportional sampling method. The dimensions of job stress and work ability were measured through the JCQ and WAI Questionnaires. For data analysis, descriptive statistics, Mann-Whitney U, Spearman correlation coefficient­, and Kruskal-Wallis were used by SPSS20. Results: Work ability had a significant and direct correlation with and the decision making authority ( r= 0.161, p-value = 0.011) and physical isometric load (r= 0.136, p-value = 0.032). In contrast, a significant and inverse relationship was found between job ability and psychological needs (r=-0.177, p-value =0.005). No significant difference was observed between the ability to work and other dimensions of occupational stres. Conclusion: In most nurses, moderate to high levels of job stress and moderate levels of job ability were observed. To reduce their job stress and increase their ability to work, free decision making and social support should be increased, physical and psychological stresses should be adjusted, and job security should be enhanced.

Introduction and purpose: The competence of healthcare and treatment staff, including health network staff, is increasingly being paid attention to. Therefore, this study aimed to investigate the relationship of hardiness with self-efficacy and job stress among healthcare network staff at Baft city, Kerman Province, Iran. Methods: This descriptive cross-sectional correlational study was conducted on 255 employees working in the healthcare network of Baft city, 2019, who were selected using a random sampling method. The instruments utilized to collect data included questionnaires, namely the Hardiness Scale, General Self-Efficacy Scale, and Job Stress Questionnaire. The gathered data were analyzed in SPSS software (version 22) and LISREL software (version 8.8) using descriptive statistics (mean and standard deviation) and structural equation modeling. Results: The results showed that hardiness and its components, including commitment, control, and challenge could have a positive and significant effect on self-efficacy (P=0.186, P=0.48, P=0.37, and P=0.42, respectively). Moreover, it was revealed that job stress had an inverse relationship with hardiness and its components, namely commitment, control, and challenge (P=-0.143, P=-0.39, P=-0.31, and P=-0.34, respectively ). Conclusion: Based on the results, hardiness and its components could predict self-efficacy and job stress and be effective in increasing and decreasing it, respectively. Consequently, it is suggested to improve the performance of the healthcare network staff by holding hardiness training courses as a personality-acquired trait.

Background: We aimed to elucidate the pathogenic bacterial and fungal profiles of specimens obtained from suspected ocular infections at Farabi Eye Tertiary Referral Hospital, Tehran, Iran. Methods: In this cross-sectional study, we collected data from ocular specimens taken during the seven-year period of 2011 to 2018, and the results were then retrospectively analyzed. Samples had been obtained from patients who were investigated for ocular infections. Results: Overall, 16,656 ocular samples were evaluated. The mean patient age was 48.31 ± 26.62 years. Most patients were men (60.33%), and men in the 7th decade of life were the largest represented group. The seasonal distributions of specimen collection sites followed the overall distribution of collection sites by year. Specimens obtained from the cornea were the most common (49.24%), also representing the largest number of specimens in all seasons. The most commonly isolated fungal microorganisms were Fusarium spp., followed by Aspergillus spp. and Candida albicans. Of the 6,556 specimens with positive bacterial cultures, 59% produced gram-positive bacteria, while the remainder produced gram-negative pathogens. The most commonly isolated bacteria were Pseudomonas aeruginosa (17.77%), Staphylococcus epidermidis (13.80%), Streptococcus pneumoniae (13.27%), S. viridans (12.23%), and S. aureus (11.18%). Conclusion: Most submitted specimens were obtained from the cornea. The most commonly isolated fungal microorganisms were Fusarium spp., followed by Aspergillus spp. and C. albicans. The most commonly isolated bacteria were P. aeruginosa, followed by S. epidermidis and S. pneumoniae.

Background: Identification of freshwater snails and possible trematodes transmission sites are essential to continue monitoring the potential for disease outbreaks in areas with a history of parasitic infections. We aimed to search some areas in the margin of the Caspian Sea, northern Iran to identify the snail fauna of this area and verify the contamination of vector snails. Methods: More than 5,308 snails from 51 diverse and permanent habitats were studied from April 2019 to October 2021. Snails were collected randomly and identified using shell morphology. Trematode infection in snails was investigated by the release of cercariae and dissection methods. Results: Five families of freshwater snails including Lymnaeidae, Physidae, Planorbidae, Bithyniidae, and Viviparidae were investigated in the Caspian Sae Litoral of Iran. Physidae were found as the most prevalent snails (55.1%) followed by Lymnaeidae (29.4%). The parasitize rate was observed as 20% using releasing cercaria technique. Echinostomatoidea (31%), Schistosomatoidea (8%), and Diplostomoidea (21%), and Plagiorchioidea (40%) were seen as detected parasites. Meanwhile, 60% of the studied snails illustrated the other stages of trematodes. Conclusion: The rate of infection of snails with different cercaria in northern Iran is significant. It needs further deep studies to clarify the situation of zoonoses transmitted by snails in the region. Policy makers should pay attention more to this area in terms of monitoring the snail-transmitted diseases.

Objectives The aim of the present study was to investigate the relationships among hospital safety climate, patient safety climate, and safety outcomes among nurses. Methods In the current cross-sectional study, the occupational safety climate, patient safety climate, and safety performance of nurses were measured using several questionnaires. Structural equation modeling was applied to test the relationships among occupational safety climate, patient safety climate, and safety performance. Results A total of 211 nurses participated in this study. Over half of them were female (57.0%). The age of the participants tended to be between 20 years and 30 years old (55.5%), and slightly more than half had less than 5 years of work experience (51.5%). The maximum and minimum scores of occupational safety climate dimensions were found for reporting of errors and cumulative fatigue, respectively. Among the dimensions of patient safety climate, non-punitive response to errors had the highest mean score, and manager expectations and actions promoting patient safety had the lowest mean score. The correlation coefficient for the relationship between occupational safety climate and patient safety climate was 0.63 (p

Introduction and purpose: Nowadays, traffic-induced air pollution factors are classified as destructive to the environment. Regarding an increase in urbanization and the number of cars, transportation, and movement of passengers and citizens between cities, transportation systems should utilize mathematics scientifically and intelligent systems practically to move towards sustainable development and benefit from healthy air and transportation. This study aimed to investigate the effect of traffic parameters on air pollution of the suburban route of Sari-Qaemshahr road in Mazandaran province, Iran, regarding the atmospheric variables and ozone pollutants. Methods: This study analyzed and modeled the ozone pollutant concentrations in the suburban route of Sari-Qaemshahr road. Moreover, the factors affecting the concentration of pollutants based on traffic and climate statistics were determined in this study. Additionally, it was attempted to investigate the relationship of air pollution with traffic variables, average speed, rainfall, temperature, humidity, and wind speed. Subsequently, SPSS software (version 16) and regression method were used to present a model that will be able to estimate the concentration of ozone pollutants on suburban roads with appropriate accuracy for the coming years. Results: According to the proposed model for ozone pollutants, among the available variables, temperature, traffic volume, and wind speed had the greatest impact on ozone pollutants. Moreover, the results obtained from the validation showed the success rate of the proposed model in estimating pollution. In this study, the level of regression significance was above 95%. In addition, the 90% data contribution rate for ozone pollutants in the model has been satisfying. Conclusion: According to the results, the modeling by a regression method and SPSS software is a suitable method for estimating ozone pollutants. The proposed model can control and manage pollution emissions in road design and construction.