soodabeh hoveidamanesh

Improper use of antibiotics is one of health care problems that can lead to side effects or antibiotic resistance without benefit. This study aimed to evaluate the association between health literacy and knowledge on appropriate use of antibiotics in a population sample from Tehran.

This was a cross-sectional, descriptive-analytic study on adults aged between 18 and 65 years. Health literacy was measured by the Health literacy for Iranian Adults (HELIA: Health Literacy for Iranian Adults) questionnaire, and awareness about proper antibiotic use was evaluated by a checklist designed based on a literature review and expert’s opinion in domains of knowledge and attitude. Both an online Google Forms questionnaire and a paper questionnaire completed by outpatients from particular clinics in Tehran's north, west, or center were used to collect the data. SPSS Version 22 was used to analyze the data.

Out of 359 participants, 59.6% were women, and 66.8% had a university education level. Internet and health care workers were the main sources of health information. The mean score of health literacy was 71.4 out of 100, and 67.4% of the respondents had excellent or sufficient health literacy. The mean antibiotic awareness score was 10.5 out of 13, and the score in the domain of attitude was higher than knowledge. There was a significant relationship between health literacy and awareness about proper antibiotic use (P < 0.001). Health literacy was significantly higher in women (P = 0.001), people with higher education levels (P = 0.001), and financial sufficiency (P = 0.0038). Also, there was a significant relationship between awareness about proper antibiotic usage and age (P = 0.007) and financial sufficiency (P < 0.001) of the respondents. The online questionnaire users were not different in terms of their health literacy, but they were more educated and aware of antibiotics.

The level of health literacy and awareness about the proper use of antibiotics in this study was good. level of health literacy was closely related to knowledge about the proper use of antibiotics, thus, it seems that promoting health literacy may increase awareness about proper antibiotic use.

One of the main parts of the early treatment of Acute Ischemic Stroke (AIS) is the attitude and knowledge of Emergency Medicine (EM) specialists. This study aimed to investigate the knowledge and attitude of emergency physicians working in Iran about the prescription of tissue Plasminogen Activator (tPA) in AIS. This was a cross-sectional questionnaire-based study including EM physicians working in different cities of Iran in 2020. A previously used English questionnaire was translated into Persian. After face validity and reliability assessment, the final questionnaire was designed as a Google form and sent to 400 EM professionals. 128 physicians filled in the forms. 64.8% of participants had sufficient attitude and 68% had sufficient knowledge about tPA treatment in AIS. The knowledge regarding tPA treatment was higher in the age>40 years, male gender and physicians with up-to-date information (P<0.05), but no significant association was found for the attitude. Logistic regression analysis showed that the amount of information about tPA administration in AIS (OR=3.475, 95% CI =1.242-9.723, p=0.018) and age (OR=0.336, 95% CI = 0.130-0.865, p=0.024) had the greatest impact on the level of knowledge for tPA treatment. About two-thirds of EM professionals in Iran had sufficient knowledge and attitude about tPA administration in AIS. Having up-to-date information and age>40 years were the major predictors of higher knowledge of AIS treatment. Holding some training workshops together with strengthening infrastructures such as establishing intensive stroke units would help to increase the use of tPA in AIS in Iran.

Workplace physical activity plays an important role in employees’ health. As university employees are a population at risk for a sedentary working pattern, this study aimed to investigate the physical activity status of employees of Iran University of Medical Sciences (IUMS) and its subsequent effects on their well-being.  

This cross-sectional study included 472 employees from different units of IUMS in Tehran. The participants were selected by a multistage sampling method. Interviews were conducted by using an international physical activity questionnaire, a questionnaire for stages of behavioral change, the World Health Organization Well-being Questionnaire, and a demographic checklist from July to October 2019. Analysis of variance, t test, and logistic regression analysis were used. Data were analyzed using IBM SPSS (Version 21.0).  

Total physical activity in the study population was 6216.58 ± 5886.09 MET-minutes/week. The mean score of the well-being index was 54.72 ± 22.4; there was an association between sex and location of work with physical activity in domains (p<0.05). The highest prevalence rates for change of stage of physical activity were found in the maintenance stage for men and the contemplation stage for women. There was a significant difference between men and women's well-being index—men reported being more active and energetic than women (p<0.001). Results also revealed that having vigorous physical activity compared with a moderate level could increase the well-being index.  

Physical activity behavior at the workplace was associated with well-being level. It could, therefore, be postulated that enhancing physical activity may be beneficial to improving well-being in an academic environment.

 Training is a complex process, especially when the students are being prepared for patient's management. Therefore, the development of effective teaching methods is critical for to improvement of learning and communication between the content and concepts. In algorithm-based education, more focus is placed on more involvement of students in the subject, thereby providing a better understanding of the concept. In this study, we compared students' attitudes about the effectiveness of algorithm-based education (education based on the patient's complaints and symptoms) with lecture-based education in the learning ability of the medical students presented in the clinical course of the orthopedic group. 

 This research is a single-group quasi-experimental study; we assessed the students' attitudes on a five-point Likert scale questionnaire with confirmed validity and reliability. The scores of two teaching methods were assessed after the training course, which was presented using the algorithmic method for selective titles and lectures for the other titles. Data were analyzed on SPSS software using a paired t-test.

 A total of 220 internship medical students, including 58.7% of girls with a mean age of 22.9 ± 1.19 years, participated in the study. The mean score of the questions was 3.92±0.54 and 2.17±0.58 in the algorithmic and the lecture training, respectively. After comparing the results with a paired t-test, there was a significant difference between students' attitudes toward the two teaching methods (p ˂ 0.001), so the students’ attitude was more positive toward the algorithm-based method.

 For the education of medical students, algorithm-based training is more efficacious compared to traditional methods such as lecture-based training.

 Colorectal cancers are the third common malignancies after lung and breast neoplasms. Some contributing factors for pathological complete response (pCR) to neoadjuvant therapy of rectal cancer have been defined. Despite various studies in this era, there are few studies on the location of tumors.

 Regarding the high prevalence of colorectal cancer in Iran and the importance of neoadjuvant chemoradiation for survival and morbidity, this study was carried out to determine the association between pathologic complete response and tumor location in patients with rectal cancer after neoadjuvant chemoradiotherapy.

 In this prospective cohort, 100 cases with rectal adenocarcinoma from 2017 to 2019 were enrolled. Distance between anal verge and tumor was measured by clinical examination, colonoscopy, endo-sonography, and MRI. Tumors were defined as distal (less than 5 cm from the anal verge) and none distal (more than 5 cm from the anal verge). Another subdivision was inferior (0 - 4.99 cm), middle (5 - 9.99 cm), and superior (10 - 15 cm). The pathological response was compared across the groups.

 In this study, the pCR was seen in 30%. In univariate analysis body mass index (BMI), grade, N-stage, and distance from anal verge were related to pCR. In cases with BMI over 25 kg/m2 and in tumors with low to medium grade N0/N1, and distance less than 5 cm from the anal verge (low lying tumors) the pCR to neoadjuvant treatment was higher. In multivariate analysis tumor grade, N stage, and distance from anal verge were still related to pCR.

 According to the obtained results in this study, there may be some association between rectal tumor location and pathologic complete response.

Cardiovascular disease (CVD) is the leading cause of death globally and has enormous costs for healthcare systems. This disease has a strong association with lifestyle behaviors. Therefore, applying reliable and effective strategies for prevention and treatment of CVD is important. In this study, we aimed to evaluate the adherence of cardiologist physicians to the American Heart Association (AHA) guideline for prevention of CVD. Using a cross-sectional study, data were gathered for 208 patients using their medical records in the cardiology ward of a general teaching hospital. A physician systematically reviewed the medical records and completed the checklist in each domain. Adherence to the AHA guideline was evaluated in treating physician's choices and recommendations regarding these eight variables: hypertension (HTN), dietary intake, weight management, diabetes management, physical activity, blood lipid management, smoking, and aspirin prescription. Medical records of 208 patients (109 men and 99 women) with the mean age of 62 ± 14 years were reviewed. The frequency of CVDs was 5.3% for coronary heart failure (HF) and 67.8% for the acute coronary syndrome (ACS). Cardiovascular risk factors of patients were HTN (53.8%), diabetes (34.6%), hyperlipidemia (17.3%), smoking (17.8%), and obesity (31.7%). We found a proportion of 59%, 15%, and 26% for high, moderate, and low adherence to AHA guideline, respectively. Our study showed almost 60% high adherence to the AHA guideline by physicians in a teaching hospital. The most and the least adherence to the AHA guideline were for obesity and diabetes recommendations, respectively. More studies are needed to evaluate preventive guideline adherence in Iran. Establishing national preventive and therapeutic guidelines may increase the physicians' adherence to them.

Screening and behavior consultation are considered to be limited, dispersed and expensive services across the country. To deliver efficient and equitable services current disordered practices need to be consolidated. An analysis of current situation, learned lessons and future scopes of country’s preventive care delivery, along with a review of international experience and generous participation of various stakeholders, led to proposing a model for screening and behavior consultation practices in IR. Iran. Upon the results of the previous steps, the desired model was based on the network system and family physician. Comprehensive health centers and other centers affiliated to the network are the most appropriate service positions. However, private and academic preventive centers are playing their rules. The proposed model matches the overall pattern of service delivery in the health system (network system with the private sector and the educational sector).

Despite the importance of Tuberculosis (TB) control program and elimination of disease as its target, only a few studies have been carried out to evaluate tuberculosis control in Iran. In the present study, we intended to ask the opinions from experts and managers of Iran University of Medical Sciences about the TB control program in Iran.
A Qualitative study was carried out to determine experts’ and managers’ opinions about the national TB control program. Experts and stakeholders were listed for focus group discussions (FGD) and interviews using purposive sampling method. We interviewed all levels of staff involved in the tuberculosis control program (managers, physicians, and administrative and executive staffs). Three FGD sessions were held with 28 participants. The participants were excluded if they had less than six months of experience in TB program. FGD and interviews were manually coded and the themes and sub-themes were extracted. After analyzing the results, the final report was drafted.
The results were classified into four themes and 15 subthemes (6 in input, 3 in process, 2 in outputs, and 4 in outcome). There were positive points and problems in each part. To achieve the goal of End TB, we will need to review the process, incorporate with other sectors, apply new diagnostic methods, and participate with other stakeholders (internal and external).
Because of the effects of socio-economic factors on tuberculosis, considering the current implementation of the program; it is not possible to eliminate tuberculosis.