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Health Sciences and Surveillance System - Volume:12 Issue: 1, Jan 2024

Journal of Health Sciences and Surveillance System
Volume:12 Issue: 1, Jan 2024

  • تاریخ انتشار: 1402/10/11
  • تعداد عناوین: 12
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  • Maryam Nejabat, Mohammadreza Heydari *, Parisa Keshani, Hassan Joulaei, Nazanin Nazari Pages 1-11
    Background

    There are some debates about the possible unintended effects of genetically modified (GM) crops on consumer health. The gut microbiota plays an important role in maintaining the health of the host, especially in gastrointestinal diseases. The current review focuses on the studies with the aim of evaluating whether their outcomes indicate any adverse effects of feeding genetically modified (GM) crops on alteration and the count of gut microbiota.

    Methods

    A structured literature search was performed independently by three authors on Scopus, Web of Science, PubMed, and Embase on the 1st of July 2019. In total, 333 publications were obtained by the search strategy, which decreased to 306 after excluding the duplicates. Furthermore, experimental studies that have designed a control group and were written in English were included in the review. After reviewing the full texts, 16 studies were included. To access the quality of articles, we used the Cochrane checklist.

    Results

    Ten publications (62.5%) used 50% or more genetically modified (GM) diet in the treatment group. In 11 studies (68.7%), the duration of animal feeding was 90 days or more. There were no significant differences in the experimental and control groups of both male and female rats on the 90th day; it can be concluded that non-genetically modified (GM) and genetically modified (GM) rice diets did not cause any changes in the gut bacteria. Data analysis of different animal models showed that the most changes in the microbial flora were observed in the chicken and the least in the rat. In the studies in this review, all microbial isolates were anaerobic, and the Lactobacillus and Enterococcus families were common organisms.

    Conclusion

    Based on our literature review, we claim that there is not any significant difference in gut microbiota between the control group and the group with a transgenic diet. The mechanisms of the effects of genetically modified (GM) foods on the gut microbiota in animals should be explicated in future studies. Nevertheless, this study provides valuable information for research on genetically modified (GM) foods and whether they are useful or detrimental to human health.

    Keywords: Gastrointestinal microbiome, Animals, Genetically modified, Crops, Agricultural, Diet
  • Saeed Hosseini Teshnizi, Samiyeh Sadeghpour, Aref Faghih * Pages 12-19
    Background
    Patients’ adherence to the therapeutic regimen predicts the success of treatment and reduces the complications and severity of the disease. The purpose of this study was to determine the effectiveness of an educational intervention based on Teach-back method with adherence to treatment in patients with type 2 diabetes.
    Methods
    We performed a quasi-experimental study on 90 patients with type 2 diabetes in the control and experimental groups. Data collection tools were a two-part questionnaire which consisted of the demographic information and the Mandaloo treatment adherence questionnaire with 40 questions. An educational intervention was performed for the members of the intervention group. One week and forty days after the intervention, the two groups filled out the treatment adherence questionnaire again. The gathered data were analyzed in SPSS software version 22 using statistical tests of Wilcoxon, Chisquare, Makhli, Ben Foroni, the repeated-measures variance of analysis, and independent t-test. The significance level in this study was considered less than 0.05.
    Results
    The mean scores of adherence to treatment in the training group before the intervention, one week, and forty days after the intervention were 120.52±11.49, 157.60±17.96, and 140.65±18.80, respectively; also, in the control group, the mean scores were 113.38±16.89, 150.67±18.58, and 145.02±18. 47, respectively. There was no difference in terms of adherence to treatment between the control and experiment groups (P=0.164).
    Conclusion
    The findings also showed that adherence to treatment in both groups in all three measurement times was at the fitness level.
    Keywords: Teach-back communication, Treatment adherence, Diabetes mellitus, Type 2, Educational intervention
  • Leila Bazrafkan, Masoud Yousefi, Javad Kojuri, Mohammad Ansarizadeh, Habibolah Rezaei * Pages 20-26
    Background
    The current study examines general dental students’ views about the ethics level in education, research, and provision of dental services.
    Methods
    This descriptive cross-sectional study was performed on all general dental students at Yasuj University of Medical Sciences selected in the census. The researcher-made questionnaire was prepared online with PorsLine. In this questionnaire, examples of observing or not observing ethics in education, research, and provision of dental services by faculty members were presented to the dental students. Finally, all collected data were analyzed by SPSS software version 26.
    Results
    47 students participated in the current study. The participant’s mean age was 25.95 with a standard deviation of 3.5. Results of the study showed that the mean and standard deviation of non-observance of ethics in education, the provision of dental services, and research were 3.05±0.9, 2.37±1.03, and 3.04±1.15, respectively.
    Conclusion
    General dental students reported that the level of ethics in education, research, and provision of dental services by faculty members was unfavorable, so it is recommended that medical education courses related to ethics should be held for faculty members.
    Keywords: dentistry, education, ethics, Iran, Students
  • Kourosh Azizi, Mohsen Kalantari *, Masoumeh Amin Pages 27-31
    Background
    Scorpions, as a group of venomous invertebrates, are distributed worldwide including the Middle East. These arthropods are distributed throughout Iran, are dangerous to humans and animals, and can cause severe damages and even death.
    Methods
    In this cross-sectional study, scorpions were collected from different parts in southern Iran such as Kohgiluyeh and Fars provinces using hand catch method with U.V torch. Morphological identification of scorpion specimens was done using specific keys.
    Results
    Besides different species of scorpions, Hottentotta jayakari Pocock, was identified in Amir Oncology Hospital, Shiraz city, Fars province, South of Iran, 1895.
    Conclusion
    Hottentotta jayakari is endemic in tropical regions and its existence in Shiraz with a mild climate seems unexpected. In addition, Amir Hospital is an oncology treatment center and this scorpion was caught on the hospital grounds. It is possible that more species can be identified in this province by conducting more studies.
    Keywords: Scorpions, Hottentotta jayakari, Androctonus crassicauda, Fars, Iran
  • Efat Mohamadi, Zhila Najafpour, MohammadMehdi Kiani, Morteza Mohammadzadeh, Amirhossein Takian *, Alireza Olyaeemanesh Pages 32-42
    Background

    There are substantial differences in the health outcomes across countries. Then, assessment of the status of health indicators can give us a valuable information to adjust policies to improve the health status in the world. This paper examines differences and relationships of health status and contextual factors.

    Methods

    This is a multi-country cross-sectional study performed using secondary data of different sources in 2019. We identified indicators that revealed the relationships of health status and health coverage and also contextual factors by expert panel which consist of two categories of indicators: (1) producing health indicators as dependent variables (Life expectancy, Healthy life expectancy, Maternal mortality ratio, Under-five mortality rate and Universal Health Coverage (UHC) service coverage indicator); (2) contextual indicators as independent variables (Current Health Expenditure, Skilled health professionals density, Population density and Government Type). Also, countries were categorized based on the income level and six regions of World Health Organization (WHO). We used SPSS 20 software for a descriptive analysis and R 2018 software for statistical analysis and also drawing of scatter charts.

    Results

    Results showed a considerable gap between the average of life expectancy (84.2 vs. 53 years) and healthy life expectancy rate (72-63.3 years). This disparity was observed in the Maternal mortality and Under-5 mortality rate (from 882 to 3 per 100000 live births), (5 is 2.1 and the highest is 127.3). Although there was a marginal correlation between population density indicator and life expectancy, healthy life expectancy, and under-5 mortality rate indicators (±0.2), there was no correlation between population density and maternal mortality rate with UHC (P>0.05).

    Conclusion

    There is a considerable difference between countries in producing health indicators based on contextual indicators; a comprehensive health system approach that can result in improvement in the health outcome.

    Keywords: Produce health, Sustainable development goals (SDGs), Health, Policy, Contextual Factors
  • Behnam Afsar, Ebrahim Fataei *, AliAkbar Imani Pages 43-50
    Background

    Failure to observe proper hygiene principles of water and swimming pool environment is effective in causing health problems and transmission of infectious diseases to swimmers. This study aimed to analyze the level of Escherichia coli and Heterotrophic Plate Count in mineral pools in Sarein.

    Methods

    For this purpose, sampling was performed in each season, and the samples were tested according to the standard method. Shapiro-Wilk and Kolmogorov-Smirnov test was used to determine the normality or abnormality of the data. Then, through ANOVA, the differences between the seasons and the pools were compared in terms of the studied parameters.

    Results

    The results of the analysis of variance showed that there was no significant difference between the spas in terms of the measured parameters. A comparison of the average data showed that the amount of contamination of mineral spas during the seasons with E. coli was more than the allowable value announced by the National Standard Organization of Iran. The amount of residual chlorine in all samples was zero and the pH was equal to 6.8. The results of principal component analysis showed that mineral spas No. 6, 2, and 11 had the highest HPC (Heterotrophic Plate count) and pH and 9 Cheshmeh, Ershad, and Ghahveh Sui mineral spas based on the second component had the highest E. coli; No. 7 had the lowest E. coli.

    Conclusion

    Finally, it can be concluded that the cause of the contamination of mineral swimming pools in Sarein city is the high volume of passengers and the lack of proper sanitary management of swimming pools.

    Keywords: Water pollution, Escherichia coli, Swimming pools, Nonparametric statistics, Principal Component Analysis
  • Kaveh Houman, Alireza Ghorbani, Behrouz Fathi, Bahram Nabilou, Hasan Yusefzadeh * Pages 51-57
    Background
    CT-scan is one of the radiology units in which various services are carried out by injection and without injection to describe the patient’s anatomy better. Given the increasing costs of the CT due to diagnostic equipment, it is necessary to calculate the exact costs of services provided to determine optimal pricing and logical tariff of these services.
    Methods
    The present study is an applied and cross-sectional research performed by step-down costing method using the data of 2018 at the CT-scan unit of the radiology department of Imam Reza Hospital in Urmia. In this study, standard forms related to direct and indirect costs of CT units and other activity centers have been used to collect the data. Appropriate sharing bases were used to determine the share of the costs of other departments in the services of this unit.
    Results
    The cost of a brain scan without injection was calculated 66.7$PPP, the brain with injection 143.9$, the chest without injection 84.4$PPP, the chest with injection 163.5$PPP, upper and lower limbs without injection 150.1$PPP, spine (cervical, thoracic, lumbar) 135.6$PPP, abdomen and pelvis without injection 149.2$PPP, abdomen and pelvis with injection 243.9$PPP, sinus 94.1$PPP, carotid CT angiography (extracranial) 287.5$PPP, and thoracic aortic CT angiography 277.8$PPP.
    Conclusion
    The study results showed a significant difference between the actual price of CT scan services and tariffs. Also, the shorter the service time and the more services in the CT scan department, the lower the unit cost. Comparing the cost of selected CT services in this study, we found that some timeconsuming services, which were mainly related to injection services, imposed higher costs on the centers.
    Keywords: unit cost, Radiology, CT-scan services, Step-down costing, Urmia
  • Neda Amoori, Haydeh Ghajari *, Belghis Afkaneh Pages 58-65
    Background
    Low birth weight (LBW) can cause complications and disorders in the future life of newborns. This study aimed to investigate maternal risk factors affecting low birth weight among term newborns in the affiliated cities of Abadan University of Medical Sciences based on a nested case-control study.
    Methods
    In this study, based on the nested case-control design, namely with the risk set sampling approach, the case and control groups were selected. All in-term newborns born since the beginning of 2018, with less than 2500g birth weight, were considered as the case group. Two were randomly selected as controls from newborns born in the same time frame and geographical location and with over 2500g birth weight. The selection ratio of the cases to control was 1:2. The questionnaires were completed from the beginning of 2019 to the end of 2020. To describe the data, descriptive statistical indicators including mean, standard deviation, frequency, and logistic regression were used in this method.
    Results
    The results of this study indicate that the factors affecting LBW are maternal age, number of pregnancies, number of abortions, history of stillbirth, history of bleeding, mother’s BMI, number of births, twins, and gestational intervals.
    Conclusion
    It is suggested that health policymakers should pay special attention to the necessary interventions for mothers with special pregnancy care conditions. In addition, it is necessary to pay more attention to the continuation and improvement of the quality of educational programs for health and medical personnel to increase the mothers’ awarenessregarding the maintenance of a healthy lifestyle during pregnancy.
    Keywords: Maternal risk factors, Low birth weight, Abadan, Nested case-control
  • Masumeh Daliri, Hesamuddin Taheri, Mohammad Fararouei * Pages 66-74
    Background
    The incidence of traffic accidents in Iran is significantly higher than the global average (more than 17000 deaths a year, mostly young adults). The aim of this study was to determine the risk factors of high-risk drivers based on their observable driving behaviors, police records, and car condition in Fars province (Iran).
    Methods
    In this case-control study, an interviewer interviewed a random sample (about 1 in 5 of the drivers) of all drivers who were referred to Shiraz traffic accident court from March 21, 2021, to June 21, 2021, due to being involved in a traffic accident. Based on the police report, we interviewed at-fault drivers who caused injurious or fatal traffic accidents as the case group (200 at-fault drivers) and those not-at-fault drivers as the control group (200 not-at-fault drivers). No matching was done. Data were collected using a researcher-made questionnaire filled out through face-to-face interviews with the drivers. Using univariate and multivariate logistic regression, the statistical analyses were conducted in R 4.0.2 software.
    Results
    In this study, a total of 400 drivers were interviewed, of whom 367 (91.8%) were male. The mean ages of the case and control groups were 32.35 years (SD=9.84) and 31.75 (SD=10.33) years, respectively (P>0.05). In addition, 102 (51.0%) and 95 (47.5%) drivers were married in the case and control groups, respectively. Based on the results of a multiple logistic regression model, statistically significant associations were observed between the risk of being the at-fault driver in an injurious or fatal traffic accident and receiving a traffic ticket due to speedingovertaking (ORspeeding overtaking/no ticket=3.38, 95%CI: 1.75, 6.49, P<0.001), self-reported high-speed driving (ORyes/no=2.41, 95%CI: 1.25, 4.63, P=0.008), and having a history of car accident within the recent two years (ORyes/no=1.87, 95%CI: 1.11, 3.14, P=0.017).
    Conclusion
    Our study suggested that among several potential factors, recently receiving traffic tickets due to speeding or overtaking, self-reported speed driving, and recent car accidents may effectively be used to screen out high-risk drivers who will probably cause injurious or fatal car accidents in the future. Intervention measures for the defined high-risk drivers including closer supervision and training programs may reduce the risk of fatal accidents in Iran.
    Keywords: Accident, Traffic, Case-Control Studies, Distracted driving
  • Parisa Naseri, Bahman Ahadinejad, Mohammad Amerzadeh, Fariba Hashemi, Sima Rafiei * Pages 75-82
    Background
    Ensuring equal utilization of health services has always been a priority in health systems globally. Iran implemented reforms such as the Health Transformation Plan (HTP), in which one objective was to reduce inequity in access to inpatient and outpatient services. These studies aimed to measure inequality in health services utilization in Qazvin, Iran, and clarify inpatient and outpatient utilization patterns among socioeconomic subgroups of the population.
    Methods
    This cross-sectional study recruited 442 households living in Qazvin, Iran, in 2019. We collected data using a tool that included demographic characteristics, socioeconomic status, and health services utilization. We applied the concentration index to measure inequality and performed data analysis using STATA 15.
    Results
    Based on our estimates, the utilization rates of outpatient and inpatient services in the study sample were 0.89±1.39 and 0.45±0.94, respectively. There was no statistically significant difference in the use of outpatient healthcare services in terms of gender and insurance coverage of the households, while literacy, age, and health condition had statistically significant effects on inpatient healthcare utilization (P<0.05). Furthermore, the marginal effects of age and literacy on the utilization of outpatient services were statistically significant (P<0.05), so that literacy and aging increased the outpatient HSU. Except for age, the marginal effects of other characteristics on the utilization of inpatient services were statistically significant (P<0.05).
    Conclusion
    Our findings indicated that inequality in healthcare utilization reduced over time, showing that in addition to reducing inequality in HSU, population groups with lower socio-economic status have benefited more from both inpatient and outpatient services.
    Keywords: Inequality, Concentration index, socioeconomic status
  • Mustafa Hasan *, Wissam Abdul-Ameer Ali, Rajaa Ahmed Mahmoud Pages 83-89
    Background
    Hospital-acquired infection (HAI) is one of the most frequent issues that hospitals are faced with in every country worldwide. Nurses are an essential part of the medical workforce that play a special role in preventing the transmission of infections within hospitals by implementation of infection prevention standard precautions. This study aimed to assess the level of nurses’ practice regarding standard precautions.
    Methods
    400 nurses from eight hospitals in Babil governorate are included in this cross-sectional study. To assess the knowledge and practice levels, was used an interview questionnaire. SPSS- 27 was used to analyze the data collected from September 2022 to March 2023.
    Results
    Among 400 nurses, the mean age was 29.07 years and a large number of them (43.8%) had a diploma; while most of nurses had less than 5 years of work experience, the main result revealed that 51.5% of them had poor practice regarding standard precautions.
    Conclusion
    The majority of nurses did not always practice these precautions, so there is a need to hold educational courses and training workshops for nurses to improve their practice of these measures.
    Keywords: Standard precautions, Infection prevention, Practice
  • Mojtaba Khadem Al-Hoseini, Mostafa Lofti, Farzaneh Mohammadi *, Gordon A Ferns, Marzieh Akbarzadeh Pages 90-97
    Background
    Today, the use of social media for health care advice has become more popular. The present study aimed to evaluate the opinions of Iranian dietitians on virtual nutritional counseling on the Instagram platform.
    Methods
    The present descriptive, cross-sectional study enrolled Iranian dietitians working in the field of nutrition counseling using Instagram. The link to an online questionnaire including questions on their activity in virtual counseling on Instagram and the challenges of virtual counseling was sent to the 131 participants. Descriptive statistics were used to analyze and interpret the data.
    Results
    Out of 163 dietitians, 131 participated in the study. 47.3% started virtual counseling during COVID-19, and 35.2% had more virtual clients. 58.8% preferred face-to-face counseling for concept transfer, and 43.5% found it more effective. Text and voice messaging were the most practical methods for virtual counseling, with weight loss being the most common topic.
    Conclusion
    During the COVID-19 pandemic, virtual nutritional counseling became more widespread. However, it is believed that face-to-face counseling is more effective in conveying concepts. For virtual platforms, text messaging is the most practical method for nutrition counseling, followed by voice messaging. It has been observed that the elderly have been the least likely people to seek virtual nutrition counseling, while weight loss counseling has been the most frequently requested topic.
    Keywords: Nutrition consulting, Coronavirus disease 2019 (COVID-19), Social Media, Nutritionist, Dietitian