Journal of Health Scope
Volume:13 Issue: 1, Feb 2024

 The health transformation plan (HTP) in Iran started in May 2013 with 3 financial support approaches for people, creating justice in access to health services and improving the quality of services in hospitals in 2 health and treatment sectors. In the first phase, this program was divided into 8 separate packages in the treatment section, reducing the amount of payment for hospitalized patients, supporting the longevity of doctors in disadvantaged areas, the presence of resident specialist doctors in hospitals, improving the quality of visiting services in hospitals, improving the quality of hoteling in hospitals, and financial support of incurable, special and low-income patients. It refers to promoting natural childbirth and launching an air emergency service.

 This study aims to investigate the effect of HTP on bed occupancy rate, average length of stay, and bed rotation distance in one of the most deprived areas.

 This study was a semi-experimental and retrospective descriptive-analytical study before and after the health system transformation plan based on the information collected from March 2012 to March 2019 in all Sistan and Baluchistan province hospitals. The data of indicators of monthly bed occupancy rate, average length of stay, and bed rotation interval in 83 months in the years before and after the implementation of the transformation plan were collected from the Vice-Chancellor of Treatment of Universities or the statistical units of hospitals and compared. The data were analyzed by Stata software using the interrupted time series (ITS) model, and split regression analysis was used to evaluate the short-term and long-term effects of HTP on the studied indicators.

 This study showed that the bed occupancy rate increased, and the average length of stay and bed turnover interval decreased immediately after HTP in Sistan and Baluchistan province hospitals. Also, the reform had a long effect on these indicators.

 Possibly due to underdeveloped hospitalization services in the past, the bed occupancy rate increased, and the average length of stay and bed turnover interval decreased in the hospitals after this province's major health system reform.

Context: 

Today, the emergence of fungal infections in public places has become a focus, especially in developing countries.

 The present study aimed to study the literature on fungal infections in public places in Iran to find a variety of fungal infections.

Study Selection: 

A search was performed to identify relevant studies in PubMed, Web of Science, Scopus, Scientific Information Database (SID), and Magiran databases from 2010 to 2022 using special keywords and equivalents. Overall, 25 studies met the inclusion criteria. Finally, the required information was extracted and discussed.

 The research findings indicate that the research design of most of the papers was cross-sectional. Most of the studies in the field of fungal infections in public environments in Iran have been carried out in places such as swimming pools, schools, some health-related environments, cultivation environments, and soil. Different species of Aspergillus, Penicillium, Mucor, and Mucormycosis were identified in the environments.

 Examination of different species showed a combination of superficial, skin, mucosal, and visceral fungal infections observed in public places. Prevention and environmental analysis should be given more attention by health policy-makers in order to reinforce public health.

 Recycling is proposed as an economic model for saving raw material and energy costs, pollution reduction, reducing waste, resource depletion, and situation improvement in a range of environmental pollution issues.

 The present study aimed to investigate the effect of educational interventions based on an integrated social cognition model (ISCM) on waste recycling at the source among housewives in Lahijan City, Iran.

 In this quasi-experimental study, a total of 144 women who sought health care services in Lahijan were selected using a multistage random sampling method. The participants were then evenly divided into intervention and control groups, with each group consisting of 72 women. The study was conducted between 2021 and 2022. Data collection tools included demographic information questionnaires, awareness questions, and ISCM constructs about waste recycling at the source. The total mean scores for the content validity ratio (CVR; 0.84) and content validity index (CVI; 0.83), Cronbach's alpha coefficient (0.85), and internal consistency (0.84) were measured to evaluate the validity and reliability of the questionnaire. Educational content based on ISCM constructs was prepared and carried out in the intervention group in six 60-90-minute sessions virtually via mobile phone using WhatsApp messenger over 6 consecutive weeks. The data were collected before and 1 month after the educational intervention and analyzed using descriptive statistics, Chi-square, independent t-test, paired t-test, and analysis of covariance (ANCOVA) using SPSS version 25.

 The mean age of the participants was 38.9 ± 12.1 years. Before the study, the 2 groups had no statistically significant difference regarding all demographic variables, awareness, and ISCM constructs (P > 0.05). The 2 groups showed a statistically significant difference in the mean scores of awareness, attitude, subjective norms, perceived behavioral control, self-efficacy, behavioral intention, and action and coping planning after the intervention (P < 0.001). The mean ± SD of the behavior score increased from 17.25 ± 4.96 before the intervention to 25.78 ± 4.95 after the intervention (P < 0.001).

 The design and implementation of educational interventions based on ISCM have the potential to enhance housewives' performance in waste management and recycling while also increasing their awareness levels.

 Traffic injuries are one of the top ten leading causes of mortality worldwide that impose a substantial burden on the health and economy of nations. Among all traffic users, pedestrians are the most vulnerable, accounting for a significant share of injuries and fatalities resulting from traffic accidents. Numerous factors contribute to pedestrian traffic accidents, with unsafe pedestrian behavior being one of the most critical factors.

 Various factors can influence the traffic behavior of pedestrians. Therefore, this study aimed to examine the relationship between demographic characteristics, the general health status of pedestrians, and their traffic behavior.

 In this cross-sectional study, after obtaining ethical approval and participants’ consent, data were collected from eligible individuals. The data included participants’ demographic information and their responses to the 28-question General Health Questionnaire (GHQ-28) and the Pedestrian Behavior Questionnaire (PBQ). Linear regression analysis was performed to assess the relationships between demographic variables, general health domains, and the total score obtained from the PBQ.

 Among the 1 421 participants in the study, 720 (50.7%) were female and 1 310 (92.2%) were under the age of 60. In terms of marital status, 979 individuals were married (69.5%), and 368 (26.2%) were single. The overall score of the general health of the participants was high in 623 individuals (43.8%), moderate in 666 individuals (46.9%), low in 122 individuals (8.6%), and very low in 10 individuals (0.7%). The mean (standard deviation) score of pedestrian behavior was also 57.89 (±11.9). There was a significant relationship between female gender, age of 15-29 years, being single, and domains of general health (somatic symptoms, anxiety assessment, social dysfunction assessment, and depression assessment) with the overall score of pedestrian behavior. Additionally, a significant relationship was found between the overall score of the participants’ general health and the overall score of their pedestrian behavior.

 There is a significant relationship between demographic characteristics and various domains of the general health of pedestrians and their behavior. Paying attention to this issue in policymaking and conducting further studies to identify other factors affecting pedestrian traffic behavior to prevent traffic injuries seems necessary.

Context:

 Health, in all its aspects, is an important human right. There are various factors for the health of individuals with complex relationships with other cultural and social characteristics of a society that lead to inequality in health. Social determinants of health have a critical role in health matters; their impact on women's fertility and childbearing must be viewed as an important field to macrolevel and microlevel health scope decision-making and policy development.

 This study aims to extract and determine the social determinants that affect women's reproductive health based on existing studies and strong evidence.

 This study was a systematic review that searched reputable medical databases and sites, including PubMed, Scopus, ISI, IranDoc, and SID, utilizing keywords like "social," "reproductive health/fertility/childbearing," and "women/female/woman". The scope of the study was limited to articles published between 2010 and 2019 due to the large volume of data available, and articles written in languages other than English or Persian were excluded from the review. The segregated articles concerning the abstract content were screened by two independent individuals to match the research objectives and keywords. The relevant abstracts were separated for review in the next step, and the full text of the obtained articles was read separately by two independent individuals to ensure their alignment with the research objectives. The articles were reviewed for quality and accuracy using the CASP tool, and those scoring above 75% entered the final stage of the study.

 In the initial database search, 1731 articles were found, and after removing duplicates, 1516 remained. Of these, 1313 were removed for not meeting the research objectives, leaving 203 articles for the next stage. After further review, 92 articles were excluded, resulting in 107 articles for further review. Out of these, 84 articles were evaluated for compliance with research objectives, with 26 articles entering the critical evaluation stage. All articles scored above 75% on evaluation tools and entered the final stage of information extraction.

 The social determinants that impact women's reproductive health and childbearing, based on studies worldwide, include racial, ethnic, and national discrimination (for immigrants and minorities), micro and macroeconomic factors (income, costs of living, and healthcare), socio-cultural factors (education, employment, family norms), and socio-geographical factors (residence and urban status).

 Agricultural pesticide poisoning is a common and serious occupational hazard for farmers in developing countries.

 In this study, we try to explain the pattern of agricultural pesticide use and its hazards in Iran.

 In this qualitative study, purposeful sampling was performed, and 8 farmers and 2 agriculture engineers participated.

 Information collected about pesticide use in Iran was categorized into 4 themes. First, “no supervision for the use and distribution of pesticides”. Second, “farmers” knowledge is inadequate about the hazards of pesticides, and no organization is responsible for educating them”. Third, “safety instructions are not obeyed, and the hazardous effects of pesticides are frequently observed among farmers”. Fourth, “the use of pesticides is irrationally high in Iran”.

 Serious action should be taken to prevent pesticide human health hazards in Iran, including comprehensive training programs about proper preparation, storage, and use of agricultural pesticides for farmers and pesticide retailers. Also, it is necessary to continuously supervise pesticide sales, distribution, and use in the country.

 Sleep disorders are one of the most common complications in patients undergoing open-heart surgery. Cognitive-behavioral therapy (CBT-I) is used as a way to improve sleep quality.

 This study aimed to determine the effect of a nurse-led CBT-I on sleep quality among patients undergoing open-heart surgery.

 This prospective randomized clinical trial was conducted on 90 patients undergoing open-heart surgery in both intervention and control groups (N = 45). The control group received routine care. The intervention group received 10-12 sessions of nurse-led CBT-I. The demographic questionnaire and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data. The data was analyzed in SPSS v. 22 software using X2, independent sample t test, analysis of covariance (ANCOVA), and paired t test.

 The majority of samples were in the age range of 31 - 40 years (33.33%) and male (53.33%). The results of the independent t test showed that the mean total PSQI score in the 2 groups before the intervention was not significantly different (P = 0.245). Also, the results of ANCOVA showed that the mean total PSQI score after the intervention has a significant difference in the 2 groups (P = 0.0001).

 Nurse-led CBT-I intervention helps to improve the sleep quality of patients after open-heart surgery by reducing their automatic thoughts that affect behavior. Thus, it is recommended that training in nurse-led CBT-I be included in the nurses' academic training program, as well as in continuing education programs for nurses working in heart surgery wards.

 Currently, physical activity serves as a preventive approach to reduce the side effects of medical conditions and mental disorders, as well as to enhance public health.

 This study aims to explore the impact of physical activities on depression, anxiety, quality of life (QoL), and the severity of clinical symptoms in patients with pemphigus vulgaris (PV).

 This study was conducted as an experimental investigation on patients with PV who were referred to Razi Hospital in Tehran. A total of 76 patients were selected as the statistical sample and were randomly divided into 2 equal groups: an intervention group and a control group. The intervention involved engaging in recreational walking in a park for 60 minutes every other day, for three sessions a week, over a period of 8 weeks.

 The intervention group showed improved QoL compared to the control group after 8 weeks (P-value = 0.045, 5.2 ± 2.97 vs. 7.5 ± 6.45); (P-value = 0.066, 4.97 ± 1.89 vs. 6.1 ± 4). Additionally, there was a noticeable reduction in anxiety levels in the intervention group compared to the control group after 8 weeks (6.92 ± 4.7 vs. 9.31 ± 4.97, P-value = 0.03). However, there was no significant difference in depression and the severity of symptoms between the 2 groups over the two-month period (4.6 ± 6.03 vs. 4.3 ± 7.78, P-value = 0.067). Nonetheless, significant improvements in anxiety were observed in the intervention group.

 Inadequate mattresses can pose risks to users, and the routine inspection of mattresses often falls short in various healthcare settings.

 To evaluate the physical condition of mattresses in hospitals and long-term care facilities and to explore the association with management practices regarding procurement, handling, and maintenance.

 This analytical descriptive cross-sectional study was conducted in 13 hospitals and 5 long-term care facilities, examining a total of 278 mattresses through proportional stratified sampling. The Mann-Whitney U test, Kruskal-Wallis test, and Multiple Regression Analysis were utilized for data analysis.

 Only 9.9% of the mattresses met the physical evaluation criteria, highlighting a significant gap in mattress management standardization. The highest compliance was noted in the utilization of waterproof coverings, whereas the lowest was in mattress labeling. Factors significantly influencing the scores included the involvement of nurses in the evaluation process, periodic replacement of coverings, type of administration, assessment of mattress and covering integrity during bed making, and the nature of the institution.

 Due to inadequate physical conditions in both hospital and long-term care settings, the low approval rate of mattresses underscores the urgent need for standardized mattress management practices. Descriptors: Beds, Hospital Infection, Disinfection, Long-Term Care Facilities for the Elderly, Patient Safety.

 Nowadays, hospitals are increasingly facing a shortage of resources, posing a significant challenge. This situation has led to competition, where a successful organization is defined by its ability to cut costs while upholding the quality of services.

 This study aimed to identify cost reduction strategies from the viewpoint of hospital managers in Tehran Province, Iran.

 This qualitative study was performed between April and September 2021 in Tehran Province, Iran. The data were collected using in-depth semi-structured interviews with 24 managers of public and private hospitals affiliated with Iran University of Medical Sciences. The participants were selected using purposive sampling. The obtained data were analyzed using the content analysis method in NVivo 10 software.

 Through analyzing the interviews conducted with aware key participants, cost reduction strategies were presented in 3 themes, 10 categories, and 42 subcategories. Key themes for cost reduction strategies include human resources in 4 categories, management and organization in 4 subcategories, and building equipment and facilities in 2 subcategories.

 Policymakers, especially hospital managers, can cut costs by adding economic insight into health services and providing a platform to increase efficiency and optimal use of available resources. Formulation of strategies in the field of human resources management, equipment and construction facilities, and organization of hospitals can play a significant role in reducing hospital costs and achieving the goals of the health system.

 The COVID-19 pandemic led to significant concerns and public panic. Due to the ambiguous and deadly nature of this virus, it triggers anxiety related to COVID-19 and a fear of death. On the other hand, early maladaptive schemas (EMSs) can impact anxiety.

 The current research aimed to determine the relationship between EMSs, COVID-19 anxiety, and death anxiety during the COVID-19 pandemic among Zahedan University of Medical Sciences (ZAUMS) students in Iran.

 The present descriptive-analytical cross-sectional study was conducted on 120 ZAUMS students selected through a purposive and convenience sampling technique from May 2022 to December 2022. The data were collected using the COVID-19 Anxiety Scale, the short version of the Young Schema Questionnaire (YSQ), and the Templer Death Anxiety Scale (DAS). The data were analyzed in SPSS 22 using various statistical methods, including frequency analysis, mean calculation, standard deviation calculation, descriptive indices, and multiple regression analysis.

 The disconnection and rejection schema predicted COVID-19 anxiety without a moderator or with a history of contact with a COVID-19 patient as a moderator (B = 0.10, t = 2.69, P < 0.05, R2 = 0.09). Impaired autonomy and performance could predict death anxiety with the moderating role of a history of contact with a COVID-19 patient (B = 0.31 t = 2.14, P < 0.05), history of contracting COVID-19 (B = 0.24; t = 2.12, P < 0.05), discipline, and study period or without any moderator. Over-vigilance could predict death anxiety with the moderating role of discipline or without a moderator (B = 0.41, t = 2.93, P < 0.05).

 Disconnection and rejection with or without a moderator predict COVID-19 anxiety. Over-vigilance, impaired autonomy, and performance schema domain predict death anxiety. Effective moderators in predicting variables are contact with a COVID-19 patient, history of contracting COVID-19, discipline, and study period.