Journal of Health Scope
Volume:8 Issue: 4, Nov 2019

The prevalence of obesity is an increasing public health problem.

The present study aimed at estimating the prevalence of unhealthy diet among children aged 10 - 12 years in Kurdistan, west of Iran and assessing the association of unhealthy diet with socioeconomic inequality.

The present cross-sectional study was conducted on 2506 children living in Sanandaj city, west of Iran in 2015. The subjects were selected from the schools by multistage sampling method. The required data were collected using the food frequency questionnaire. The socioeconomic status (SES) was calculated by measuring household asset by using principal component analysis technique. The inequality was measured using concentration index, and Blinder-Oaxaca decomposition method was utilized to determine the proportion of different determinants causing inequality.

The prevalence of unhealthy diet was 50.75% (95% confidence interval (CI): 48.79 - 52.71). The concentration index for unhealthy diet was -0.14 (95% CI: -0.18, -0.09), indicative of concentration of unhealthy diet in the group with low SES (P < 0.001). The Blinder-Oaxaca decomposition analysis showed that the poor-rich gap in the prevalence of unhealthy diet was 27.77%, while 59.41% of the observed gap attributed to the explained component. The major causes of inequality were mother’s level of education and place of residence, respectively.

The obtained results showed that the prevalence of unhealthy diet was higher in children with low SES. Increasing mothers’ awareness of health literacy and performing place-based interventions can be effective in decreasing socioeconomic inequalities in unhealthy diet and prevention of chronic diseases in children.

Exposure to inhalation aerosols and particulate matter (PM) in different concentrations can increase the risk of respiratory, cardiovascular, and other related diseases. The inhalation exposure studies are implemented to assess the biological effects of these hazardous agents in human or animal models, in whole-body (WB) or nose/head-only conditions. Several factors can affect the performance of the inhalation exposure chambers and if left uncontrolled, the results may not be desirable. The current study reviewed the characteristics, structures, and factors affecting the performance of the WB chambers, especially the ones designed for small animal exposure to the PM. At the primary stage, the criteria and the search strategy were determined and the keywords were searched in the scientific electronic databases. Totally, 1051 articles were extracted in the first stage, and finally seven articles were adopted. The technical and design details, materials, coefficient variations (CVs) of concentration, assessment methods, type and number of laboratory animals, procedure, and animals housing conditions were extracted from the selected articles. Then the most desirable WB inhalation exposure chamber was determined based on the criteria for assessing the presented exposure chambers such as the animal housing and least CVs of the concentration in the respiratory zones of the animals under study. It was concluded that the Kimmel design was the best and the most desirable chamber structurally and geometrically, since the concentration of the particle (NaCl) injected into the chamber varied from 3.5% to 5.2%, under standard conditions.
 

Recently, driving simulators have been widely used in various studies in the traffic safety domain, especially to investigate the effects of a mobile phone conversation on driving performance. As the characteristics of simulators and scenarios designed in previous studies were quite diverse, the cognitive workload resulting from scenarios in each study and their effects on the results varied significantly so that it made it difficult to compare the results. Therefore, the present study was conducted aiming at providing a checklist of cognitive specification control in this category of studies by investigating the methodological characteristics of previous studies. Evidence Acquisition: The articles were searched in Springer, Elsevier, PubMed, and Google Scholar databases during 2002 - 2017. The author used mobile phone, cell phone, driving simulator, distraction, and mental workload keywords with the “and” and “or” operators. Based on certain criteria, 14 articles were selected among the retrieved articles.

Methods and purposes of articles were evaluated in terms of factors affecting cognitive function. Based on reliable and valid scientific documents, a checklist of the cognitive profile of scenarios and simulators was designed and presented in three macro domains.

Considering various simulator designs the scenario design characteristics effective in cognitive workload, the studies were not convergent so that different aspects of the main variables were reported in various studies. Inattention to reporting these variables led to the incorrect estimation of the effects of a mobile phone conversation on driving performance.

The variance of attitudes among stakeholders of health resource allocation has rarely been reported because health officials play a dominant role in most countries with implicit rationing.

The aim of this descriptive study is to explore the priority-setting value in local health resource allocation in the province of Chongqing, China.

To test the local health rationing values in Chongqing, a survey was conducted on attitudes through a self-administered Likert scale questionnaire. The data were collected from February 1, 2013 to August 30, 2016. Attitudes among respondents (174 health officials and 480 health workers) were analyzed and compared through convenience sampling with the help of the local health bureau by using IBM SPSS Statistics 21.0.

The mean values of officials’ self-perception and health workers’ assessment were opposite, with a coherent and optimistic perception from officials (most mean values > 4) versus a varied and pessimistic evaluation among health workers (most mean values < 3). Officials ranked highly on the severity of the disease, the fair distribution of resources, and public satisfaction, while health workers gave all the items of the questionnaires below 3 points. Officials ranked deemed the procedural process fair and officials depended more on themselves and public hospitals for health rationing, while the health workers prefer media and scholars. Value-based preferences for priority setting between the two groups were quite different.

The study concludes that local health rationing in Chongqing is a matter of political and value preference rather than an evidence-based decision. Officials were not willing to share their rationing power, and the lower evaluation of health workers than officials’ assessment may result from insufficient participation.

 Identifying the causes of health services overutilization is an effective way of preventing misspending of insurance organizations' resources.

 The present study was conducted to identifying demographic factors and the causes of health services overutilization among those insured by the Iran Health Insurance Organization (IHIO).

 The present cross-sectional study was conducted in 2017. The study population consisted of excessive users insured by IHIO in Isfahan province, of whom, 175 were randomly selected. Data obtained by the IHIO medical information system, insurance booklets and a data collection form was analyzed in SPSS-22 using descriptive statistics at a significant level of 0.05. Then, they were categorized based on their main referral cause.

 About 1.2 percent of the people insured by the IHIO in Isfahan province are among the health service over users. Participants' mean age was 50.7 ± 15.8 years. Among them, 56.6 percent were female. Mean frequency of physicians’ visits were 16.3 ± 11.7 (more than 10 times greater than others) and the mean of paraclinical services usage was 19 ± 13.08 (more than 12 times greater than others) in the first 8 months of 2017. Mean of all physicians’ visits among females was 18.47 ± 14.7 and means of paraclinical services usage among them was 20.63 ± 14.83. The most common causes of health services over utilization among the insured included complicated medical problems (chronic disease 47.42 percent, being elderly 17.14 percent and pregnancy 6.28 percent), health anxiety disorder (HAD) (24 percent), and administrative causes (breaking or missing papers) 2.9 percent.

 According to the findings, people with complicated and chronic illness account for the majority of the over users. Others with health anxiety are in the next category. Then, identifying the over user group, their demographic characteristics, and their causative categorization can lead to a variety of solutions to suit each category. This study recommends insurance organizations to pay more attention to the service-seeking behaviors of different population groups and to consider utilization review studies as an important research approach.
 

 Health policymakers need to use prioritization for resource allocation in the health system because of limitations to financial resources.

 This study aimed to explore the criteria affecting the appropriate allocation of health system resources to different diseases.

 A qualitative study was carried out in 2017 using semi-structured interviews. Participants were chosen using purposeful and snowball sampling methods. Totally, 25 experts in the health care system were interviewed. The present study employed conventional content analysis and data were analyzed using MAXQDA10 software.

 The findings were categorized into four main categories and 21 sub-categories. The main categories included criteria related to “type of disease”, “patients’ characteristics”, “type of treatment”, and “ethical and responsiveness issues”. Furthermore, the most effective factors on resource allocation included the emergency or non-emergency aspects of the disease, disease severity, disease onset, treatment effectiveness, and disease prevention.

 Health policymakers should direct resources toward emergency and severe diseases that significantly affect people’s quality of life. According to the findings of the present study, the “type of disease” was one of the most important criteria in health resources allocation. Therefore, similar to DRG, we can categorize diseases and health system problems based on their priority and use such grouping for health resources allocation.
 

 Occupational exposure to crystalline silica is still an important health problem, especially in developing countries. Exposure to silica may be associated with the induction of toxic oxidative stress.

 This study was conducted to assess oxidative stress biomarkers in workers exposed to respirable crystalline silica (RCS) in Hamadan city, the west of Iran.

 This descriptive-analytical study was conducted on two groups of exposed workers selected from four industries and unexposed office workers in 2017. The analysis of RCS in air samples was done by NIOSH method No. 7602. Malondialdehyde (MDA), total antioxidant capacity (TAC), and catalase (CAT) activity were measured in serum samples.

 In this study, 48 healthy workers exposed to silica and 47 unexposed workers as controls were selected. The mean MDA levels (26.91 ± 14.26 nmol/mL) and CAT activity (10.83 ± 5.06 U/mL) were higher in the exposed group than in the unexposed group (P < 0.001). However, no statistically significant difference was observed in the TAC levels between the groups and no correlation was observed between exposure to RCS and oxidative stress biomarker levels in exposed subjects.

 Although there was a significant difference in the oxidative stress levels between the groups, according to other results of our study, it is not possible to claim that oxidative stress biomarkers are appropriate biological indices for silica exposure monitoring in occupational settings. Therefore, we still require a comprehensive study of other aspects of this research field.
 

 Lead is one of the metals, which has an important role in the industry.

 We designed a study to assess the serum lead level in battery manufacturing workers and its association with neurobehavioral performance.

 In this cross-sectional, 154 individuals who worked in a battery factory participated. Venous blood samples were collected for measuring blood lead levels by atomic absorption method. Three selected tests of neuropsychological performance approved by World Health Organization were conducted, including simple reaction time (SRT), Benton Visual Retention Test (BVRT), and Santa Ana manual dexterity test.

 The present study demonstrates a positive correlation between blood lead levels and work experience. The higher blood lead levels and longer work experience were associated with lower scores on the Benton Visual Test. Simple reaction time showed a significant relationship with the work experience.

 The results of this study suggest that occupational exposure to lead can induce a neurobehavioral dysfunction in battery manufacturing workers. Thus neurobehavioral assessment in health surveillance of exposed workers can be effective in the early detection of cognitive impairment.
 

Fungi spores are virtually everywhere and can be seen under any circumstances. Aerobiologic studies have shown that Aspergillus, Cladosporium, Alternaria, and Fusarium from Ascomycetes are the most common fungi spores in the ambient air. These fungi are a cause of allergic and infectious respiratory diseases.

 The aim of this study was to determine the effect of dust storms on fungi spore’s diversity in hot and cold seasons in Ahvaz, Iran.

 In this cross-sectional study, three areas of Ahvaz were selected. The study took place during the summer and autumn of 2017. Ninety-three samples from the ambient air were taken by Quick take pump with 28.3 (L/min) flow rate in 3 minutes. Sampling was carried out on Potato Dextrose Agar based on Anderson method.

 The means of most isolated fungi spores in the summer were as follows: Cladosporium 239, Aspergillus flavus 88, Penicillium 82 and Aspergillus niger 58 CFU/m3. In the autumn season, the mean of most isolated fungi spores was as follows: Cladosporium 1,733, Penicillium 82, Aspergillus niger 55 and Ustilago 32 CFU/m3. Moreover, the mean of most isolated fungi spores in normal air days was: Cladosporium 440, Penicillium 97, and Aspergillus flavus 68 CFU/m3 and in dusty air days, they were: Cladosporium 2,277, Aspergillus niger 74, and Penicillium 49 CFU/m3.

 The results of this study showed that Ahvaz ambient air contains diverse fungi spores, and there was a significant difference between normal and dusty days in terms of the mean value of fungi spores. Also, a significant difference was found between the mean value of fungi spores in hot and cold seasons.
 

 Organophosphorus pesticides are one of the widely consumed poisons in agriculture. The consumption of drinking water, which contains an excessive amount of poison, therefore, contributes to adverse health and hygiene outcomes in humans.

 In this study, a new sodium alginate/biosilicate/magnetite (SABM) nanocomposite made by the precipitation method was used to remove Malathion from aqueous solutions. The properties of MBSA were analyzed using XRD, SEM, EDX, and FTIR techniques. The possible impact of several parameters such as contact time, pH, initial Malathion concentration, temperature, and MBSA dosage on the adsorption process were investigated. The equilibrium isotherm and kinetic models were employed to evaluate the fitness of the experimental data.

 The highest removal (94.82%) of MBSA was obtained at an optimum pH of 7, the contact time of 120 minutes, the adsorbent dosage of 4 g/L, Malathion concentration of 10 mg/L, and temperature of 318°K. The adsorption process followed the Freundlich isotherm model (R2 = 0.999), which implied that the adsorption process of Malathion molecules onto MBSA might be mainly a multi-molecular layer.

 The results of this study showed that MBSA had a good removal efficiency, lower cost of processing, and as well as not producing substances harmful to the environment, which make it a promising adsorbent to remove Malathion from aqueous environments.
 

 Policymakers are interested in investigating effects of governments' policies on socioeconomic inequality in public health.

 This study aimed to analyze levels of and changes in socioeconomic inequality of unintended pregnancy after the changes in family planning policies and to investigate determinants of its changes in Iran.

 Required data were extracted from Iran's Multiple Indicator Demographic and Health Surveys conducted in 2010 and 2015. We used data from 1123 and 900 married pregnant women aged 15 - 49 years in 2010 and 2015, respectively. Wagstaff normalized concentration index was used to measure unintended pregnancy inequality. The contribution of various factors to the measured inequality in 2010 and 2015 was investigated by decomposing concentration index. Changes in the unintended pregnancy inequality in 2010 - 2015 and its determinants were assessed using Blinder-Oaxaca decomposition method.

 Pro-rich unintended pregnancy inequality declined by 120% from -0.145 to 0.030 in 2010 - 2015. However, the pro-poor unintended pregnancy inequality in 2015 was not statistically significant. Households’ economic status and women’s age at pregnancy were the two leading factors with positive contributions while contraceptive non-use before pregnancy and women’s education level had the most negative contributions to the reduced pro-rich inequality of unintended pregnancy in 2010 - 2015.

 Pro-rich unintended pregnancy inequality not only did not increase, but also declined to zero after the changes in family planning policies. Providing sustainable livelihood for disadvantaged households with women at reproductive ages can maintain this favorable condition in the future.