Review Articles
Ali Mohammad Mokhtari; Rebecca Susan Dewey; Alireza Mirahmadizadeh
Abstract
Background: The COVID-19 pandemic is a challenging health problem around the world. At time of this study, the pandemic is still underway, so prevention and control are of great importance. This review provides a comprehensive examination and analysis of the literature related to the challenges of controlling ...
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Background: The COVID-19 pandemic is a challenging health problem around the world. At time of this study, the pandemic is still underway, so prevention and control are of great importance. This review provides a comprehensive examination and analysis of the literature related to the challenges of controlling COVID-19. Methods: In this narrative review study, the search was performed on international databases including PubMed, Scopus and Embase, using relevant keywords. The resulting articles and texts were reviewed and screened, and then the relevant information was extracted. Results: The number of patients who are thought to have contracted COVID-19 is much higher than that in the SARS and MERS epidemics. Despite a lower mortality rate, COVID-19 has caused more deaths. One of the challenges that have made the control of the disease more difficult include the emergence of multiple viral mutations. In this review, it was found that the best course of action comprises continuous monitoring of disease-related indicators as part of a series of measures taken together to ensure their effectiveness. Conclusion: It is recommended that governments should form international partnerships in their efforts to overcome the pandemic, and that preventive and control measures should be taken simultaneously. Introduction Coronavirus disease 2019 (COVID-19) started in December 2019 in Wuhan, the capital of Hubei Province, China, and one of China's main transportation hubs, and spread to other parts of the world (1, 2). One of the main reasons for the spread of the disease was the intense migration of Chinese people during New Year celebrations (1). With the rise of international trade, epidemics of new infectious diseases such as COVID-19 are able to spread more rapidly than ever before (3). On December 31, 2019, China announced the outbreak of the disease, at the time named 2019-nCoV, to the World Health Organization (WHO) (2, 4). On February 11, 2020, the WHO adopted a new name called coronavirus disease (COVID-19). In acknowledgement of the genetic structure of the virus, the International Committee on Virus Classification renamed 2019-nCoV as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (5). On January 30, 2020, the WHO announced that the outbreak was a public health emergency of international concern (5, 6) and in March 2020 classified it as a pandemic (7, 8). COVID-19 has been declared the sixth international public health emergency and, therefore, requires the public, health professionals and governments to work together to prevent its spread worldwide (5). Rapid production and sharing of knowledge at the international level is one of the useful measures for disease control that has been done (9). One of the greatest fallacies of the 21st century is that infectious diseases are disappearing, which is not the case (10). The COVID-19 epidemic has become a challenging health problem for many countries around the world (8), and as of 28 February 2021, it was estimated that there were 113,472,187 cases of the disease, 2,520,653 deaths, and about 91 million cases of recovery reported worldwide (11, 12). Although more than a year has passed since the beginning of this epidemic, the disease has not yet been controlled and no specific treatment has been found for it (13), so measures related to its prevention and control are very important. The aim of this study was to examine and characterize the global challenges of controlling COVID-19, and to provide comprehensive recommendations for action.
Original Article
Seyyed Mansour Kashfi; Tayebeh Rakhshani; Shahla Farhoodi; Zahra Motlagh; Raziyeh Bagherzadeh; Noushin Kohan
Abstract
Background: As a physiological event, menopause is an important milestone in women's lives. Numerous studies have shown the negative impact of this stage of women's lives on their quality of life.The present study aimed to assess the effectiveness of education about physical activity via social networks ...
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Background: As a physiological event, menopause is an important milestone in women's lives. Numerous studies have shown the negative impact of this stage of women's lives on their quality of life.The present study aimed to assess the effectiveness of education about physical activity via social networks on the quality of life of menopausal women. Methods: This randomized controlled trial was conducted at Khormoj, Southwest of Iran, in 2018 on 54 menopausal women (27 experimental group (EG) and 27 control group (CG)). For the EG, a WhatsApp group was created and, every week, three educational written messages, clips, or pamphlets about physical activity and its importance during menopause were sent for 10 weeks. The study outcome (quality of life) was measured via Menopause-Specific Quality of Life Questionnaire (MENQOL) at the onset and one month after the intervention. Data were analyzed through SPSS 19, using independent and paired T-tests. Results: One month post-intervention, there was a significant difference between the EG and CG groups in the total quality of life, and vasomotor, physical and sexual dimensions compared to the CG group (p <0.05). Between the baseline and one month post-intervention, a greater increase in quality of life was observed in the EG than in the CG, giving a mean difference of -10.52 (p <0.0001). Conclusion: The present study showed that holding an educational program using the WhatsApp social network enhanced quality of life of menopausal women. Introduction Throughout their lives, women experience several stages including puberty, menstruation, pregnancy, childbirth, and menopause. Reaching any of these stages and passing through them will encounter women with situations and sometimes crises that may affect different aspects of their lives (1). Meanwhile, as a physiological event, menopause is an important milestone in women's lives; according to the definition by the World Health Organization, it refers to the cessation of menstruation for 12 months, following the loss of ovarian follicular activity (2). Various studies carried out in Iran and in the world have shown that the age of menopause could potentially depend on a variety of factors including race, genetic characteristics, socioeconomic status, fertility status, physical activity, nutrition, sexual behaviors, and diseases (3). The mean age of menopause has been estimated 50-52 years. In Iran, the mean age of menopause is 51 years (4-6). Following the incidence of menopause, changes in the hormonal, physical and metabolic processes of the woman’s body would lead to many physical, psychological, and social disorders including hot flash, sweating, palpitation, sleep disorder, irritability, lethargy, depression, amnesia, decreased eroticism, painful intercourse, and urinary symptoms (7-10). Numerous studies have shown the negative impact of this stage of women's lives on their quality of life. The results of previous studies indicated that menopause women were 3.5 times more likely to be at risk of mental disorders. They were also 5.7 and 3.2 times more likely to be at risk of physical impairment and sexual dysfunction, respectively. According to these studies, menopause could reduce the quality of a person's life regardless of the factors such as age and other demographic variables (11-14). Therefore, it seems important and inevitable to find some ways to prevent the minimization of the quality of life and to lower the symptoms and complications in menopause women to the possible extent. It seems that using non-medical methods, such as changing and improving lifestyle, can be useful for minimization of the symptoms and complications of this critical period. One of the appropriate health behaviors is to have mobility and do regular physical activities. Regular physical activity might increase the individual's ability to do his/her tasks and to feel healthy, empowered, and self-confident (15, 16). Doing regular physical activity would reduce blood glucose and blood pressure, stimulate the increase of catecholamins as well as adrenaline and noradrenaline, increase muscle strength, increase aerobic and cardiovascular endurance, and increase balance and coordination (17,18). Social networking is built on the idea of the way should people know and interact with each other. It gives people the power to share making the world more open and connected [19]. Nowadays, social networking has a vital influence on our live as it helps a lot in every aspect of life such as political,, Economic, and educational field s. Flexibility, convenience and accessibility have a vital influence on the use of social networking in education (20). The phenomenon of social media has become part of Internet culture, and published literature describing social media interventions for chronic disease management are becoming more prevalent (21). In recent years, instant messaging applications, which can be identified as mobile-based social networks, have started to become popular. Though there are a lot of instant messaging applications that can operate on mobile devices, it is seen that WhatsApp application is one of the most favored mobile-based applications (22). Ebrahimi et al. in 2017 indicated a positive role for using WhatsApp software to promote lifestyle, thus improving the level of health of women under study (23). Also, Estaji et al. conducted a study in 2016 using cellular text messaging that led to self-care promotion in hemodialysis patients under study(24). Mirghafurvand et al. conducted a study entitled “the influence of aerobic exercise program on the quality of life of pre-menopause and menopause women: a randomized, controlled clinical trial” and found that moderate aerobic exercise was effective in improving the quality of life of pre-menopause and menopause women (25). Given the influence of menopause on women's quality of life and the fact that itis considered as an indicator for assessment of health status, the present research was conducted to examine the effectiveness of education about physical activity via WhatsApp on the quality of life of menopausal women.
Original Articles
Mahin Nazari; Fatemeh Jokar; Mohammad Fararooei; Mohammad Hossein Kaveh
Abstract
Background: Decreasing and preventing isolation and social loneliness among the elderly are important fields for policymaking and action commitment in social health. Evidence shows that the nature and spectrum of an individual’s social network including the quality and quantity of social relations ...
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Background: Decreasing and preventing isolation and social loneliness among the elderly are important fields for policymaking and action commitment in social health. Evidence shows that the nature and spectrum of an individual’s social network including the quality and quantity of social relations and contact frequency can affect the old people’s health considerably. Social participation leads to a decrease in mortality and depression and improves people’s cognitive function. Since few interventions on assessment of the effect of social participation on old people’s loneliness have been done, this study was conducted to determine the impact of the educational program of social participation on the feeling of loneliness. Methods: This is a quasi-experimental study based on convenience sampling method, on 239 elderly people aged ≥60 years living in rural regions of Baiza. The intervention was held for the intervention group during five weeks through five 60-80 minute educational sessions. The data were collected by CCHS-SP and UCLA Loneliness Feeling Questionnaires before and after the intervention in the experiment and control groups. The data were analyzed usingSPSS (version19). Results: The significance level was assumed 0.05 in statistical analysis. After one month of educational intervention program, the mean score of social participation increased in the intervention group from 6.17±3.86 to 17.98±3.84 after the intervention. The findings showed a remarkable improvement in loneliness feeling scores of the mentioned group form 62.24±.7.53 to 28.86±6.88 after the intervention (p <.001). The studied cases in the control group experienced no significant changes in the two mentioned variables. Conclusion: This study revealed a reduction in the feeling of the elderly in rural areas by predicting, improving, and modifying behaviors related to social participation and forming self-help groups in rural communities.
Introduction:
In recent decades, prevention from loneliness and social isolation among the elderly has been an important issue in social health promotion (1). While there is no experience that loneliness is unique to old age, it is common among older adults, with 12% to 46% reporting at least some level of loneliness (2). About one third or even half of the elderly suffer from loneliness and social isolation (3). An investigation in Spain indicated that 23.1 percent of the elderly often suffered loneliness. (4) However, Khichadi reported that this amount was between 16 and 35 in this country (5). In Iran, the rate of loneliness has been reported between 11% and 70% in various studies. (6, 7) Loneliness and social isolation affect the quality of life remarkably, so that it is comparable with the impacts of cigarette, obesity, inactivity, and hypertension. (8) Immune deficiency, infections, cognitive disorders, mental problems such as depression and dementia, high levels of disabling chronic diseases, lack of physical activity, and the possibility of death are more probable to happen among those people feeling lonely remarkably (9.10.11). These consequences are clearly so important in making economic problems. Recently, numerous investigations have been done with different plans among the elderly to reduce loneliness and social isolation. However, the low quality of most of these studies and the high variety of the studied population in the mentioned studies make the generalization of their findings difficult since they are conducted in communities with different social, cultural and economic contexts (12, 13). One way to improve the health of people, especially to reduce the loneliness in the elderly, is social participation. Social participation in itself is both a theoretical and a practical concept that has been shown to be related to health in many studies. Many people over the age of 65 are in a state of social isolation and this does not allow them to have a close and intimate relationship with others. This may be due to the negative view of society and the belief in the imminent death of the elderly, which hinders planning to improve their quality of life, while various studies indicate that having social contact and public personality with is related to life satisfaction in old age. (14). Nevertheless, recent findings emphasize the importance of social interactions and relations for improving and promoting mental health and also preventing social isolation and their consequences among the elderly. (13). Loneliness and social isolation among the elderly in rural regions is so important. The offspring leave home or move due to marriage or for occupational reasons, low economic status and literacy in these regions, limited access to health services, and social welfare, which makes the issue of elderly Loneliness and social isolation so critical (15.16). Lack of enough experimental evidence and the limitations of the conducted studies highlight the necessity of conducting more research regarding the programs which help decrease social loneliness isolation among the elderly in rural regions. Therefore, the goal of the present study was to determine the impact of Social Participation Educational Program on the loneliness of in old people in rural areas.
Original Article
Foruzan Tavan; Abdolrahim Asadollahi
Abstract
Background: Frailty syndrome involves a complex combination of the natural process of getting old with different medical problems. Different indexes have been designed for each physical, mental, and social dimensions of frailty. Fried’s five-item index of frailty syndrome checklist is one of the ...
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Background: Frailty syndrome involves a complex combination of the natural process of getting old with different medical problems. Different indexes have been designed for each physical, mental, and social dimensions of frailty. Fried’s five-item index of frailty syndrome checklist is one of the most applicable scales to screen frailty. This study aimed to determine a psychometric index of frailty and the cut-off points for the Iranian elderly population. Methods: In a cross-sectional and psychpmetric study, 249 frail elderly people were selected among members of two Iranian Army Retirees Clubs in 2019. This was a cross-sectional-psychometric study which aimed at determining the psychometric index and cut-off points of a brief checklist of 5-item FSC among Iranian adults older than 60 years old and comparing this to prior results in different countries. Results: The data were analyzed by ANOVA, multi-variable regression, confirmatory, and exploratory factor analysis, and ROC analysis via SPSS 25 and AMOS 24. The validity of the study findings was determined by internal validity, high correlation of 5 questions, confirmatory and exploratory factor analysis of 3 subdomains with a clarity value of 0.87, and high goodness of fit index (GFI). Conclusion: The determined cut-off points were compatible with those of Fried’s prior study. The designed tools used in this study evaluated frailty syndrome of the Iranian elderly in elderly rehabilitation studies with high confidence. The application of the tool would provide caregivers and policymakers with additional information as to caring for this population.
Introduction
The world population has become older due to the decreasing mortality rate, increasing life expectancy, and enhanced healthcare technologies.(1) Worldwide, the elderly population is expected to increase from 9% to 16% during 35 years from 1995 to 2030. Regionally, the elderly population is expected to increase in Asia and Iran from 9.3% to 18.6% and from 5.17 to 6.5 % over the same period, respectively.(2) Increased chronic diseases and multi-morbidity in the elderly and the associated increased prevalence of inabilities are the main concern in the growth of the elderly population . Senescence syndromes are groups of prevalent characteristics among the elderly and, as such, are not considered a disease. These syndromes are a group of prevalent characteristics among the elderly, which are not considered a disease. Frailty syndrome involves a complex combination of the natural processes of getting old with different medical problems,(3)such as weakness, dullness, decreased energy, decreased physical activity, and unintentional weight loss (in more intense cases).(3)Frailty syndrome consists of physiological disorders in six different systems (hematic, inflammatory, hormonal, obesity, neuromuscular, and nutritional).(4) The brain, endocrine, musculoskeletal, and immune systems are mostly associated with frailty syndrome, which have been studied considerably.(4) The prevalence of frailty due to its wide definition and variety of measurement tools is estimated 19.6% in Latin America and the Caribbean (5), from 3.9 per cent in China to 26% and 51.4% in India and Cuba, respectively (6), 35.7% in Brazil (7), 10% in Japan (8), and in European countries from 7.7 per cent of the Swedish elderly to 15.6% Portuguese older adults (9). There are no national frailty data in the elderly population of Iran, bBut it can be assumed to be similar to developing countries like India and Brazil. Most of the tools developed to evaluate frailty have a frailty pre-diagnosis, enabling the authorities to identify people at high risk of frailty.(10, 11)
Frailty can be examined in both clinical and social contexts. The clinical view argues that frailty increases the risks of side effects, such as fall, hospitalization, inability, and death.(12) The social view identifies the groups in need of additional medical care services and at high risk of dependency.(12) Policymakers and providers of health services have realized that frailty could significantly affect people, caregivers, healthcare systems, and society.(11, 12) Furthermore, concerns have been raised regarding prevention and health management plans due to the effect of frailty on the healthcare of patients.(13) If frailty can be diagnosed, prevented, and treated by identifying its different reasons and factors, this can lead to the prevention or at least delay in the onset of frailty syndrome. As some recent studies have suggested, frailty sequences could be reversed by implementing specific practical plans and nutritional supplements (3, 14, 15). Therefore, identification of consequences relevant to frailty is highly vital, indicating the need for a tool to predict frailty challenges in Iran. These challenges can be screened, and definite cut-off points can be determined for Iranian frail patients. These actions help the healthcare policymakers in the country to systemize and optimize their decisions, just as many developed countries have done in recent years.(16) Fried’s five-item index of frailty syndrome checklist (5-Item FSC) is one of the most applicable scales to screen frailty.(16)
Psychometric properties and cut-off points of FSC differ from one country to another regarding their cultural, social, nutritional, and even phenotypical differences (17) compared to other indices. Therefore, the present study aimed to determine the validity, reliability, and cut-off points of 5-item FSC for Iranian elderly.
Original Article
Gayan Surendra; Irosha Perera; Sumith Attanayake
Abstract
Background: Oral and Maxillofacial (OMF) injuries constitute a multifaceted public health threat in Sri Lanka. Surveillance of OMF injuries has become crucial for planning and monitoring of preventive and control strategies. A pilot project was undertaken aiming at strengthening the OMF injury surveillance ...
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Background: Oral and Maxillofacial (OMF) injuries constitute a multifaceted public health threat in Sri Lanka. Surveillance of OMF injuries has become crucial for planning and monitoring of preventive and control strategies. A pilot project was undertaken aiming at strengthening the OMF injury surveillance system at National Dental Hospital (Teaching) Sri Lanka (NDHTSL). Methods: The current interventional study with pre- and post-evaluation was conducted from March 1, 2020 to May 31, 2020 at NDHTSL. Pre-intervention assessment was performed to identify the deficiencies in the injury surveillance system. Subsequently, a novel OMF injury surveillance system was introduced and implemented at NDHTSL. The interventions were conducted over a period of 3 months, following which a post-intervention assessment was performed to assess the success of the interventions. Results: The previous injury surveillance system had many deficiencies, such as lack of comprehensiveness, not specific to dental trauma, lack of data flow and high respondent burden, etc. Interventions included development of a novel OMF injury surveillance form, circulating comprehensive guidelines on the new system and awareness program for relevant staff. Quality indicators of injury surveillance demonstrated improvements from pre-intervention stage to post-intervention stage, such as coverage from 2.7% to 72.2%, completeness from 95% to 100%, and accuracy from 66% to 100%. The perceptions and satisfaction of the dental surgeons on OMF injury surveillance system was significantly improved by the intervention (p≤0.001). Conclusion: The strengthened OMF injury surveillance system was deemed efficient and effective. Further studies are warranted at different service levels prior to island wide expansion of the present system by incorporation and integration of it into the existing National Injury Surveillance System.
Introduction
Oral and Maxillofacial (OMF) injuries constitute a multifaceted public health threat in Sri Lanka. The victims of this tragedy are more often children, adolescents and young males who are in economically productive age group (1–3). Hence, OMF injuries impact the economic productivity of the country while increasing the public health expenditure. Furthermore, road traffic accidents are on the rise which result in an enormous burden of OMF injuries (3–6).
“Oral and Maxillofacial injuries” is a composite term which includes injury to the oral and facial region, teeth and related structures (7); prevalence, causes and factors related to OMF injuries across the globe have been described by many published researches (8–11).
Surveillance is defined as ongoing systematic collection, analysis, interpretation and dissemination of health-related data for evidence-based decision making (12–14). Injuries are acute non-communicable diseases which should be prevented and controlled, based on the surveillance data (15). Therefore, developing the capacity of global injury systems has attracted attention as one of the most significant opportunities in global public health (16). Hence, a strengthened OMF injury surveillance system would be a prerequisite for the development of policies, strategies, guidelines as well as for expedition of the current OMF injury prevention activities (17).
Injuries are the leading cause of hospitalization over the last two decades, accounting for about 1 million hospitalizations each year which underpins the importance of a complete, accurate and timely injury surveillance system (17). Furthermore, a study published in 2004 revealed that OMF trauma was the leading cause of dental inpatient service utilization (18).
Dental trauma is the most common cause of dental emergencies (19). Moreover, dental trauma is recognized as a major dental public health problem across the globe which requires regular updates of knowledge in dental traumatology for preventive and control measures (20). One of the important prerequisites for development and evaluation of such prevention strategies at local level would be the establishment of a specially designed injury surveillance system which provides accurate, complete, and timely data (21). However, lack of timely, complete and accurate data on OMF injury surveillance has become a global issue that hampers timely action and research (22). Surveillance systems for Oral and Maxillofacial Injuries have been designed by other countries with some strengths. A study conducted in Victoria, Australia, emphasized that oro-dental trauma data can be combined with injury surveillance data that are routinely collected to improve service planning and the design of oro-dental injury prevention interventions (23). Even though epidemiological data are required for service planning related to dental and oral trauma, it is evident that epidemiological data are limited and have deficiencies in coverage, comprehensiveness, and timeliness in the field of oral and dental injuries (15).
The present injury surveillance system at NDHTSL is not efficient and the collected data are not being analyzed and utilized for decision making and planning at the central level. Therefore, health staff is demotivated and does not participate in the surveillance system (24). Moreover, the current injury surveillance system is not comprehensive with regard to collection of data pertaining to OMF injuries which could be considered as a huge deficiency in this system. Against this backdrop, a strengthened OMF injury surveillance system consisting of complete, accurate, and timely collection, analysis, interpretation, dissemination, and utilization of data for decision making has become a timely need.
NDHTSL is the premier tertiary care public dental hospital in the country where patients with OMF injuries are admitted, referred, and managed, with the mission to be the center of excellence in patient centered care, education, research, and innovation. However, all such endeavors should be evidence-based for optimal outcomes. Therefore, this project aims to strengthen the OMF injury surveillance system at NDHTSL by addressing aforementioned weaknesses of injury surveillance systems.
Original Article
Mohammad Khammarnia; Mehdi Zanganeh Baygi; Morteza Mooziri; Mohammad Okati; Mostafa Boolaghi; Mehdi Okati; Fatemeh Setoodehzadeh
Abstract
Background: In 2014, Health Transformation Plan (HTP) started in Iranian health system to improve productivity of health organizations. The aim of the present study was to assess the employees’ productivity in health centers after HTP. Methods: This cross-sectional study with analytical approach ...
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Background: In 2014, Health Transformation Plan (HTP) started in Iranian health system to improve productivity of health organizations. The aim of the present study was to assess the employees’ productivity in health centers after HTP. Methods: This cross-sectional study with analytical approach was carried out in Zahedan University of Medical Sciences in 2018. 150 health workers were selected using census method. Data were collected by Hersey & Goldsmith Workforce Productivity Questionnaire. For the data analysis, descriptive and statistical methods such as Pearson correlation 2-tailed, one-way ANOVA, T-tests and regression model were used. Results: Our findings showed that 96% of health workers were female. Mean score of productivity was 63.8±12.7, which is in the moderate level. Besides, we found a significant negative relationship between productivity and job experience of the employees (P = 0.021, F = 2.975). Conclusion: In this study, productivity was at a moderate level. It seems with better motivation of the staff, there might be an improvement in productivity. Introduction Human resources are considered as fundamental resources and the most important factor for developing any organization. Today, due to the effect of the employees’ efficiency on overall function, many organizations preliminarily focus on increasing the employees’ productivity. European Productivity Agency defines productivity as “the level of using each producing factor properly, which first seems an overview that constantly tries to improve the existing condition” (1-3). Today, the most important factor in community development is increased attention to human productivity, and organizations can only reach their achievement via using human resources because human being defines waste or productivity of physical resources or materials (4). To motivate the employees, who provide high quality cares and help the development of a society, we need to invest on human resources management. Despite this global importance, today, health systems ignore the mentioned fact; as a result, decreased human productivity has become a challenge (5). According to the existing reports, health centers and organizations in Iran, in contrast to industry and business ones, have rarely investigated effective ways of improving the employees’ productivity; also, Iranian human productivity index is weaker than the mean East Asian countries (4). Studies have shown that without long-term, thorough, and evidence-based plan, this goal seems unachievable (6). We should also consider that decreased productivity in health area can lead to decreased quality of life and social security in communities (3). According to a study, the costs that are the result of decreased productivity in health care organizations can be many times more than direct costs of medical conditions (7). This is also important that the human resources productivity in health organizations is more significant than other organizations because these organizations, besides doing their routines, have the ability to face the crisis, too. This area of health is considered as one of the most basic parts of economic development in different countries. In health care organizations, in order to get productivity, we need to take a systemic, local, and practical overview. That is, organizational factors like employees’ motivation, working culture, mental health, right choice of workers, effective leadership, occupational function, and other factors cannot improve productivity individually and they must work as a system. We should also pay attention to reciprocal relationship between these factors. Sufficient organizational structure, effective function, proper work equipment, balanced area, and most importantly professional and effective human resource are necessary to reach adequate productivity (3, 6, 8). On May 5, 2014, a series of reforms has been done in Iranian health system under the title of Health Transformation Plan (HTP), with three main approaches of financial protection of patients, fairness in access to health services, and improvement of the quality of services (9). Because there is a special look at health area in this plan, and absence of proper research on this topic, this study seemed necessary to be conducted. Therefore, this study aimed to evaluate the employees’ productivity in health centers after HTP. The results of this study can provide required information for health policymakers and managers to improve the human resources productivity and in turn can result in increased quality of service delivery.
Original Article
Ali Ojaghi; Ebrahim Fataei; Siamak Gharibi Asl; Ali Akbar Imani
Abstract
Background: The aim of this study was to provide a suitable system for disposal of hospital waste and design and construction of a safe device for infectious waste using a combination of chemical and mechanical methods.
Methods: This research is a laboratory study and based on the existing problems, ...
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Background: The aim of this study was to provide a suitable system for disposal of hospital waste and design and construction of a safe device for infectious waste using a combination of chemical and mechanical methods.
Methods: This research is a laboratory study and based on the existing problems, design and construction of a decontamination device for hospital infectious waste was performed by combination of chemical and mechanical methods in a closed reactor. To determine the appropriate mixture of different compounds of sodium hydroxide with lime and sodium carbonate with lime, three treatments were selected and used.
Results: The results of this study showed that the decontamination waste device by chemical and mechanical methods was effective in eliminating 98% of bacterial, fungal, and viral contaminants. The results showed that the neutralization rate for total bacterial contamination of the coliform, pathogenic viruses, Escherichia, Bacillus subtilis, Salmonella, and Shigella using a 30% ratio was related to the chemical composition of lime and sodium hydroxide, lime and sodium carbonate, respectively. In the designed device, the best temperature, humidity and pH conditions were determined to be 15°C, 45% and 12.8, respectively.
Conclusion: The results of the decontaminated waste tests revealed that the simultaneous application of physical and chemical methods can be used as a safe and suitable alternative in infectious waste disposal systems.
Original Article
Gideon. I.A. Okoroiwu
Abstract
Background: Ascaris worm, as one of the commonest helminthic infections, constitutes a major public health challenge and concern in the majority of developing countries. This study was conducted to assess the prevalence of Ascaris worm infection and its associated risk factors among primary school children ...
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Background: Ascaris worm, as one of the commonest helminthic infections, constitutes a major public health challenge and concern in the majority of developing countries. This study was conducted to assess the prevalence of Ascaris worm infection and its associated risk factors among primary school children in Lambata community to determine the prevalence of Ascaris infection, age, gender and associated risk factors among them to create awareness and effective management program. Methods: This is a cross-sectional descriptive study conducted between January 2019 and November 2020, in nine selected primary schools in Lambata community. A total of 303 stool samples were collected using random sampling to determine the prevalence of Ascaris infection using stool smear technique. The socio-demographic data were collected, using a structured interview questionnaire. The collected data were analyzed using simple percentages, OR and chi-square analytical methods. Results: Out of the 303 screened stool samples, 156 (51.5%) had Ascaris infection. The most infected age-groups were 11-12 years old (73.8%; OR = 2.11) and 9-10 years (57.1%; OR = 2.01), while 6-8 year old subjects had the lowest rate (42.3%; OR = 1.00) of infection. Males (65.9%; OR= 2.00) were more infected than their female (39.9%; OR = 0.09) counterparts (p <0.05). Age, educational status / occupational status of parents, and defecation habits were significantly(p <0.05) associated with the prevalence of Ascaris infection. Conclusion: With the overall prevalence of 51.5% of Ascaris infection among the subjects, there is an indispensable need for health education promotion and coordinated de-worming of the primary school children in this community
Case Study
Ladan Khajeh Hoseini; Reza Jalilzadeh Yengejeh; Ali Mahmoudie; Maryam Mohammadi Rouzbehani; Sima Sabz Alipour
Abstract
Background:The spread of urbanization and industrialization, as well as changes in lifestyle and consumption patterns in recent years, especially in developing countries, has led to the production of huge volumes of pollution in urban and industrial areas. How to plan and manage them is one of the issues ...
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Background:The spread of urbanization and industrialization, as well as changes in lifestyle and consumption patterns in recent years, especially in developing countries, has led to the production of huge volumes of pollution in urban and industrial areas. How to plan and manage them is one of the issues and problems in the world today. And if the environment is not taken into account at the same time as the industrialization of a society, not only will economic development not be achieved, but there will be many problems so that sometimes the long-term benefits of an industry are spent on compensation. Methods: The isa descriptive-analyticalstudy. Various steps were taken, including the results of statistical analysis, Delphi questionnaires, analysis of validity and reliability of the research, and extraction of influential factors affecting the performance of the ROP unit of Abadan Oil Refinery in 2019 until 2020. Finally, the results of weighting and ranking of effective strategic parameters in decision-making, decision-making and policy-making processes of different items including factors (components), criteria, sub-criteria, and strategic plans are presented. Using Expert Choice 2000 software, we weighed the parameters, and Cronbach's alpha was determined to be 0.932. Results: The results of weighting and ranking of effective strategic parameters in the decision-making process and policymaking of various items are presented.Finally, the component of human environment around the refinery with a weight priority of 0.288 in the first rank, the component of natural environment, the HSE component of the refinery with a weight of 0.244 in the second rank, and the components of technical characteristics and conditions of the refinery with a weight of 0.112 were in the third place. Conclusion:In this case study, we found thatthe greatest need for management was specific to the human environment, such as land use and development plans around the refinery, and the state of air and soil pollution and water resources. Introduction Developing and advanced countries in their development process have faced the problem of wastewater from oil, gas, petrochemical and energy industries[1,2], which is one of the problems of their industrial development process, as one of the important sources of environmental pollution[3]. There are currently many efforts around the world to overcome this problem[4]. Given the process of industrial development of countries and the increasing use of oil and energy resources[5,6], the existence of wastewater in related industries is an inevitable phenomenon that requires proper management[7,8]. Refineries are one of the most widely used water sources in Iran which are often in the center or adjacent to large cities and even some within cities. Abadan Oil Refinery, due to its location in the city centre, causes a lot of pollution and produces unpleasant odors in the region. This affects the health of the refinery staff and the residents. In this research, to strategically manage the ROP system of Abadan Oil Refinery wastewater treatment plant, we usedAHP [9,10]. The ROP (Recovery Oil Plant) unit is the one used to purify petroleum products at the Abadan Oil Refinery. At the beginning of this unit, there is a uniform pool where the unit effluent first enters. In this pool, the flow rate decreases to a large extent and the flow alleviates, so the oil materials have a higher chance of rising due to being lighter than water [11-12,13]. They are found on the surface and the suspended solids settle in the structure. After that, the oil that has accumulated on the surface of the water enters the separating ponds with the water. AHP is one of the decision-making methods[14,15]. The term AHP stands for Analytical Hierarchy process, meaning the analysis of hierarchical process[16,17]. Selection of the criterion is the first part of AHP analysis[18,19]. Candidates are then assessed based on the identified criteria. The word options or candidates also means the word alternative or candidates and is used interchangeably. The reason for the hierarchical reading of this method is that we must first start with the goals and strategies of the organization at the top of the pyramid, and by expanding them, we can identify the criteria to reach the bottom of the pyramid. This is one of the most widely used methods for ranking and determining the importance of factors, which is used to prioritize each of the criteria using pairwise[20]comparisons. The goal of the analysis of hierarchical process technique is to select the best option based on different criteria through pairwise comparison. This technique is also used to weigh the criteria. Because increasing the number of elements in each cluster makes it difficult to compare the pairs, they usually divide the decision criteria into sub-criteria.
Letter to Editor
Fatemeh Setoodehzadeh; Mohammad Khammarnia; Mostafa Peyvand
Abstract
Nowadays, information and communications technology (ICT) has deeply influenced different aspects, especially healthcare sector.(1) Increasing public awareness and expectations has encouraged healthcare providers to use modern technologies to improve service quality.(2) Health technologies provide useful ...
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Nowadays, information and communications technology (ICT) has deeply influenced different aspects, especially healthcare sector.(1) Increasing public awareness and expectations has encouraged healthcare providers to use modern technologies to improve service quality.(2) Health technologies provide useful information for improving planning, implementing, monitoring, and policy making based on evidence (3). In fact, an electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR contains the medical and therapeutic histories of patients, an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care.(4) From the beginning of applying family physician and rural insurance program in Iran, different software packages have been developed for making EHR; however, due to technical and structural constraints and also different personal motivations, it is removed from the registration process and recording data in the early stages .(5) After implementing the health transformation plan (HTP) in 2014, the Ministry of Health and Medical Education (MoHME) launched the health integrated system (SIB) in 2016 with the aim of recording the EHR of households. SIB system follows valuable goals such as applying electronic health record, creating a national health information base, and providing referral systems in the family physician plan. Now, all health workers such as supervisor, general practitioners and dentists, health care providers, midwives, dietitians, mental health and social workers at the first level of service delivery record information on the SIB system. The information that is registered by users on SIB system are as follows: demographic information, disease reporting, physicians' visit, medical history, medications, vaccinations, and radiology and laboratory results. (6) After four years of SIB implementation at the comprehensive health centers, health centers, and health houses, the significant strengths of this system are:(5) • Possibility of supervision and direct and online evaluation by all managers in the health system • Establishment of a comprehensive EHR system for individuals from birth to end of life • Exclusion of the paper and bureaucratic system and quick extraction of health statistics • Application of new care guidelines and instant access of users On the other hand, constraints of the SIB systems are: • Extensive data recording and time-consuming nature of service registration in the system • Absence of proper internet infrastructure, especially in rural areas • Increase in the possibility of unrealistic data entry by compulsion of officials in order to increase service recordings • Incompatibility of certain system information with community needs and local preferences and specific diseases in each region of the country, and also lack of connection of SIB system information between specialized and sub-specialized centers after five years from the establishment of this system in Iran. Therefore, for successfully implementation of the system in the health field, it is recommended that we should provide hardware infrastructure, rationalize the number of required services in the system in the first years and then add other services in the long term, hold regular training courses, encourage family physicians as primary caregivers of services at the first level to accept this system, and record the information(7). E-health not only could increase the wellbeing of user, but also the pressure on the health care system could be somewhat relieved. By introducing the SIB, we have expanded the toolkit of user-centered design methods for e-health development. The method facilitates easy communication with novices about a future e-health technology, the identification of factors that can hinder or support end-user acceptance of a future e-health technology, and early and cheap possibility for testing functional design decisions (8). Keywords: Information, Health transformation plan, family physician Iran Ethics approval and consent to participate: Not applicable Consent for publication: Not applicable Availability of data and material: Not applicable Competing interests: The authors declare that they have no competing interests. Funding: Not applicable Authors' contributions: All authors have contributed in all sections of the manuscript preparation. Acknowledgements: Not applicable Study highlights: Although Integrated Health System has limitations, by taking some measures, it can be useful for health care system of Iran.
