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Sustainability of Non-communicable Disease Prevention and Control Programs in Iran: A Mixed-methods Study from Managers' Perspective 伊朗非传染性疾病预防和控制项目的可持续性:从管理人员角度的混合方法研究
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-04-28 DOI: 10.5812/jhealthscope-133824
Y. Partovi, M. Farahbakhsh, J. Tabrizi, K. Gholipour, A. Kousha, Jabreil Sharbafi, Tohid Jafari Koshki, Andrew Wilson
Background: Non-communicable diseases (NCDs) require multifaceted responses from healthcare systems that must complement sustainable healthcare programs. Objectives: This study aims to investigate the current state of sustainability of Non-Communicable Disease Prevention and Control Programs (NCP-PCP) and to identify related challenges in various intra- and inter-organizational domains. Methods: This mixed-methods study used a researcher-made sustainability assessment tool and qualitative interviews of 46 managers responsible for implementing NCP-PCP in Iran. Graneheim and Lundman's approach, as well as descriptive statistics, were utilized to analyze the data. The sustainability questionnaire comprised nine domains: environmental support, funding stability, partnerships, organizational capacity, program evaluation, program adaptation, communications, strategic planning, and law and governance. Results: The overall mean score for sustainability was 3.54 ± 0.86, with funding stability (2.79 ± 1.03) and program adaptation (4.24 ± 1.12) receiving the lowest and highest mean scores, respectively. Qualitative data revealed several challenges, including financial instability, lack of budget allocation for such programs, absence of specific mechanisms for program evaluation, inadequate resources, deficiencies in intersectoral cooperation, and failure to utilize hidden community capacities. Conclusions: It is crucial to maintain and strengthen the current state of program adaptation and program evaluation to ensure the sustainability of NCD-PCP. On the other hand, funding instability is a significant obstacle in prevention and control programs that can bring the entire program to a halt, regardless of its sustainability in other domains.
背景:非传染性疾病(NCDs)需要卫生保健系统的多方面应对,必须补充可持续的卫生保健计划。目的:本研究旨在调查非传染性疾病预防和控制计划(NCP-PCP)的可持续性现状,并确定各组织内部和组织间领域的相关挑战。方法:这项混合方法研究使用研究者自制的可持续性评估工具,并对46名负责在伊朗实施NCP-PCP的管理人员进行定性访谈。使用Graneheim和Lundman的方法以及描述性统计来分析数据。可持续性调查问卷包括九个领域:环境支持、资金稳定性、伙伴关系、组织能力、项目评估、项目适应、沟通、战略规划、法律和治理。结果:可持续性总体平均得分为3.54±0.86分,其中资金稳定性(2.79±1.03)分最低,项目适应性(4.24±1.12)分最高。定性数据揭示了一些挑战,包括金融不稳定、缺乏此类项目的预算分配、缺乏具体的项目评估机制、资源不足、部门间合作不足以及未能利用隐藏的社区能力。结论:保持和加强项目适应和项目评价的现状,是确保NCD-PCP可持续发展的关键。另一方面,资金不稳定是预防和控制项目的一个重大障碍,无论项目在其他领域的可持续性如何,它都可能使整个项目陷入停顿。
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引用次数: 0
Health Workforce Development Policies in Iran: A Study of In-service Training Policies 伊朗卫生劳动力发展政策:在职培训政策研究
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-04-28 DOI: 10.5812/jhealthscope-132662
A. Choopani, S. Vatankhah, A. Aryankhesal
Background: In-service training is one of the requirements for developing health workforce skills and providing quality services to patients. Objectives: This study aimed to determine the policy formulation of in-service training for the health workforce in Iran. Methods: In this qualitative policy analysis study, semi-structured interviews with key informant persons and document analysis were used to gather data. Interviews were conducted with 12 informed people about health system policies, experts, and managers of in-service training centers of medical universities and the Ministry of Health and Medical Education (MOHME) selected purposively. Targeted and snowball sampling was used to identify the participants. Data analysis was performed using the MAXQDA10 software, and framework analysis was run using the Kingdon model. Results: Centralized planning, lack of access in rural and remote areas, and the inability to use the potential of universities in staff training were the most frequent problems in in-service training of the health workforce. Establishing the Board of Trustees for universities affected the opening of the opportunity window to policy-making, and political entrepreneurs in MOHME took advantage of it and developed policies for in-service training. Conclusions: The development of policies has created a suitable platform for medical universities to increase the number of training hours and develop the skills of the health workforce. It also seems that policymakers' attention can lead to improving processes and using new approaches in the continuous development of health professions.
背景:在职培训是培养卫生工作者技能和为患者提供优质服务的要求之一。目的:本研究旨在确定伊朗卫生工作者在职培训的政策制定。方法:在这项定性政策分析研究中,采用半结构化访谈和文献分析的方法收集数据。对12名知情人士进行了访谈,了解卫生系统政策、专家和医科大学和卫生与医学教育部在职培训中心的管理人员。采用有针对性的滚雪球式抽样来确定参与者。使用MAXQDA10软件进行数据分析,并使用Kingdon模型进行框架分析。结果:集中规划、农村和偏远地区缺乏机会以及无法利用大学在员工培训方面的潜力是卫生工作人员在职培训中最常见的问题。设立大学董事会影响了政策制定机会窗口的开放,教育和人力资源部的政治企业家利用了这一机会,制定了在职培训政策。结论:政策的制定为医科大学增加培训时间和发展卫生工作者的技能创造了一个合适的平台。政策制定者的关注似乎也可以导致在卫生专业的持续发展中改进流程和使用新方法。
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引用次数: 0
Environmental Monitoring and Ecological Risk Assessment of Platinum Complex Drugs in Wastewater Effluent: A Case Study in Qom, Ira) 废水中铂类复合药物的环境监测与生态风险评估——以伊拉克库姆市为例
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-04-27 DOI: 10.5812/jhealthscope-132714
Mohammad R. Khaksar, Y. Ghafuri, A. Yari
Background: The presence of anticancer drugs in water sources has become critical in recent years. Anticancer drugs are used in controlled amounts and conditions in medical centers. Cancerostatic platinum complexes (CPC) like cisplatin, carboplatin, and oxaliplatin are used in oncology centers to treat many cancers. Objectives: We determined the environmental risk of these compounds in municipal wastewater effluent of Qom, Iran. Methods: The LC-MS/MS technique quantified platinum complex drugs in wastewater effluent. Based on the blank laboratory method, the limit of detection (LOD) was determined as 0.009 µg/L, 0.013 µg/L, and 0.017 µg/L for oxaliplatin, carboplatin, and cisplatin, respectively. Results: The cisplatin, carboplatin, and oxaliplatin concentrations in wastewater effluent were 0.19 ± 0.098, 0.22 ± 0.094, and 0.12 ± 0.059 µg/L, respectively. Ecological risk assessment results indicated that RQsw for cisplatin, carboplatin, and oxaliplatin was 0.017, 0.013, and 0.02, respectively, showing that the platinum complex drugs had insignificant ecological exposure risk. Furthermore, ΣRQsw was estimated at < 1. Conclusions: Managing cytotoxic waste from hospital oncology wards is vital for environmental pollution control. The use of other methods to remove these compounds, such as advanced oxidation processes and membrane systems, is inevitable.
背景:近年来,抗癌药物在水源中的存在变得至关重要。抗癌药物在医疗中心以可控的量和条件使用。抗癌铂复合物(CPC),如顺铂、卡铂和奥沙利铂,在肿瘤中心用于治疗许多癌症。目的:我们确定了伊朗库姆市城市污水中这些化合物的环境风险。方法:采用液相色谱-质谱联用技术对废水中铂类药物进行定量分析。基于空白实验室方法,奥沙利铂、卡铂和顺铂的检测限(LOD)分别为0.009µg/L、0.013µg/L和0.017µg/L。结果:废水中顺铂、卡铂和奥沙利铂的浓度分别为0.19±0.098、0.22±0.094和0.12±0.059µg/L。生态风险评估结果表明,顺铂、卡铂和奥沙利铂的RQsw分别为0.017、0.013和0.02,表明铂复合药物的生态暴露风险不显著。此外,∑RQsw估计为<1。结论:管理医院肿瘤病房的细胞毒性废物对控制环境污染至关重要。使用其他方法来去除这些化合物,如先进的氧化工艺和膜系统,是不可避免的。
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引用次数: 0
The Impact of Different Color Temperatures and Sources of Light on Mood and Vision: Acuity and Color Recognition 不同色温和光源对情绪和视觉的影响:敏锐度和颜色识别
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-03-29 DOI: 10.5812/jhealthscope-128709
E. Amouzadeh, S. Zakerian, R. Osqueizadeh, P. Rezasoltani, S. E. Samaei
Background: Light is a physical factor that can influence the mood and vision of people during work and study. According to the importance of these physical factors, the present study aimed to investigate the effect of the source and color temperature on the mood and vision (acuity and color recognition) of students of TUMS and USWR medical universities. Methods: The present study is an applied study, and the research method is quasi-experimental. Twenty subjects were determined by first-type error (0.05) and test power (0.08). The mood was measured using the profile of mood states (POMS), visual acuity in different lighting conditions based on Snellen and FrACT methods, and color recognition by Ishihara’s test. Data were analyzed by SPSS 22, one-way ANOVA, and Greenhouse-Geisser. Results: The results of investigating six subscales of the POMS scale in sunlight, LED, and fluorescent with color temperatures of 4000 K and 3000 K indicated improvement in mood states (P < 0.001). Color recognition under different lighting conditions showed no significant difference (P < 0.05). However, visual acuity with the FrACT method under sunlight showed a significant difference in other lighting conditions (P < 0.001). Conclusions: Light sources can influence mood and vision states (acuity and color recognition) under different lighting conditions. Therefore, using sunlight in educational environments can improve the mood and state of students.
背景:光是一种物理因素,可以影响人们在工作和学习过程中的情绪和视力。鉴于这些物理因素的重要性,本研究旨在探讨光源和色温对TUMS和USWR医科大学学生情绪和视觉(敏锐度和颜色识别)的影响。方法:本研究为应用研究,研究方法为准实验研究。20名受试者采用第一型误差(0.05)和检验权力值(0.08)测定。研究人员使用情绪状态谱(POMS)测量受试者的情绪,使用Snellen和FrACT方法测量受试者在不同光照条件下的视敏度,使用石原的测试测量受试者的颜色识别度。数据采用SPSS 22、单因素方差分析和Greenhouse-Geisser分析。结果:在4000 K和3000 K色温的日光、LED和荧光灯下,对POMS量表的6个分量表进行调查,结果显示情绪状态有所改善(P < 0.001)。不同光照条件下的颜色识别差异无统计学意义(P < 0.05)。然而,在其他光照条件下,FrACT方法在阳光下的视觉灵敏度存在显著差异(P < 0.001)。结论:光源可以影响不同光照条件下的情绪和视觉状态(敏锐度和颜色识别)。因此,在教育环境中使用阳光可以改善学生的情绪和状态。
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引用次数: 0
An Exploratory Research to Assess Total Nutritional Knowledge of Students at the University of Lahore, Pakistan 巴基斯坦拉合尔大学学生全面营养知识评估的探索性研究
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-03-14 DOI: 10.5812/jhealthscope-130511
M. Aslam, Muhammad Barkaat Azam, F. Latif, Muntaha Jaffar, I. Haseeb
Background: Good nutrition is imperative to achieve a better health status. The rate of obesity and related comorbidities is increasing all over the world. The main reasons behind this worse situation are the overconsumption of food groups or exceeding the recommended portion sizes. University life is a period when students are independent in making their food choices. The chances of adopting unhealthy eating behaviors are increased during this tenure. Nutritional knowledge is an important tool in assessing the nutritional status of an individual, group, and community. Objectives: The main objective of the current study was to assess the nutritional knowledge of university-going students. Methods: The pre-tested questionnaire was used to collect the data from the students of the University of Lahore, Pakistan. A total of 300 students participated in this study (150 from the Nutrition Department and 150 from the non-nutrition departments). Demographic data, anthropometric measurements, and total nutritional knowledge (TNK) scores were measured during the 4-month study duration. Additionally, gender-and department-based comparisons of various parameters were performed. The mean TNK of the Nutrition Department students was higher (34.89 ± 0.95/58) than non-nutrition departments (24.05 ± 1.00/58) (P = 0.01). Additionally, the mean TNK of female students was higher (28.53 ± 1.28/58) than male students (27.05 ± 1.27/58) (P = 0.03). Moreover, 61% and 63% of nutrition students were familiar with the relationship between high intake of salt and fats with chronic diseases, respectively. Results: A statistically significant relationship was not observed between gender (P = 0.78) and departments (P = 0.10) with body mass index (BMI). This finding shows that nutritional knowledge alone is not a predictor of the nutritional status (BMI) of an individual. Students, even from the Nutrition Department, failed to transform their knowledge about nutrition into healthy food choices and eating practices. Conclusions: It is necessary to initiate nutrition education programs emphasizing making healthy food choices. Moreover, nutritional knowledge related to dietary guidelines should be incorporated into daily life to remove the disease burden associated with obesity.
背景:良好的营养是达到更好的健康状态的必要条件。肥胖症及相关合并症的发病率在全球范围内呈上升趋势。造成这种糟糕情况的主要原因是过度食用食物种类或超过推荐份量。大学生活是学生自主选择食物的时期。在任职期间,采取不健康饮食习惯的机会增加了。营养知识是评估个人、群体和社区营养状况的重要工具。目的:本研究的主要目的是评估大学生的营养知识。方法:采用预试问卷对巴基斯坦拉合尔大学学生进行问卷调查。共有300名学生参加了这项研究(150名来自营养系,150名来自非营养系)。在为期4个月的研究期间,测量了人口统计数据、人体测量数据和总营养知识(TNK)评分。此外,还对各种参数进行了基于性别和部门的比较。营养系学生的TNK平均值(34.89±0.95/58)高于非营养系学生(24.05±1.00/58)(P = 0.01)。女生的TNK平均值(28.53±1.28/58)高于男生(27.05±1.27/58)(P = 0.03)。此外,61%和63%的营养学学生分别熟悉高盐和高脂肪摄入与慢性疾病之间的关系。结果:性别(P = 0.78)、科室(P = 0.10)与身体质量指数(BMI)无统计学意义。这一发现表明,营养知识本身并不能预测一个人的营养状况(BMI)。即使是来自营养系的学生,也未能将他们的营养知识转化为健康的食物选择和饮食习惯。结论:有必要开展强调健康食品选择的营养教育项目。此外,应将与膳食指南相关的营养知识纳入日常生活,以消除与肥胖相关的疾病负担。
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引用次数: 0
Problems and Solutions of Taxation to Control Unhealthy Goods: A Qualitative Study 不健康食品税收管制的问题与对策:一项定性研究
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-03-12 DOI: 10.5812/jhealthscope-132036
Mahdi Kooshkebaghi, H. Dargahi, Sara Emamgholipour Sefiddashti
Background: Taxes on unhealthy goods, in addition to reducing the consumption of these goods, preventing related diseases, and promoting public health, can provide significant financial resources for the health sector. Objectives: The purpose of this study was to investigate the problems and solutions of taxation to control the consumption of unhealthy goods to improve public health. Methods: This qualitative study was conducted in 2021. Semi-structured interviews with open-ended questions were held to collect information. Sampling was performed by purposive and snowball methods with 31 managers and key experts. The data were analyzed using the content analysis method. MAXQDA software (version 12) was used for classification and coding. Results: This study labeled 2 main themes and 10 subthemes. The main themes included problems of controlling unhealthy goods and solutions to controlling unhealthy goods. Poor decision-making, planning, and execution, production-related problems, smuggling and poor supervision, increased consumption of harmful goods, conflicts of interest, and advertisements of unhealthy goods are the most important of these problems. Imposing taxes, duties, and price hikes, providing alternatives, paying attention to all determinants of supply and demand, and taxation on advertising are also solutions to control unhealthy products. Conclusions: The health level of individuals should be improved by imposing taxes on unhealthy goods, determining accurate tax rates, and simultaneously using measures, such as providing alternatives to unhealthy goods and controlling advertisements. Paying serious attention to the list of harmful goods, coordination and cooperation of related organizations in formulating and implementing tax policies, and providing suitable alternatives to harmful products are the practical suggestions of this study.
背景:对不健康商品征税,除了减少这些商品的消费、预防相关疾病和促进公共卫生外,还可以为卫生部门提供重要的财政资源。目的:本研究的目的是调查税收控制不健康商品消费以改善公众健康的问题和解决方案。方法:本研究于2021年进行。为收集信息,进行了半结构化访谈,并提出了开放式问题。抽样采用有目的和滚雪球的方法,由31名管理人员和关键专家进行。使用内容分析方法对数据进行分析。MAXQDA软件(版本12)用于分类和编码。结果:本研究标记了2个主题和10个子主题。主题包括控制不健康商品的问题和控制不健康产品的解决方案。决策、计划和执行不力、生产相关问题、走私和监管不力、有害商品消费增加、利益冲突和不健康商品广告是这些问题中最重要的。征收税收、关税和价格上涨,提供替代品,关注供需的所有决定因素,以及对广告征税,也是控制不健康产品的解决方案。结论:应通过对不健康商品征税,确定准确的税率,同时采取措施,如提供不健康商品的替代品和控制广告,来提高个人的健康水平。认真关注有害物品清单,协调相关组织制定和实施税收政策,并提供合适的有害产品替代品,是本研究的实际建议。
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引用次数: 0
Malaria Outbreak in the Southeast of Iran in 2022 2022年伊朗东南部爆发疟疾
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-02-24 DOI: 10.5812/jhealthscope-135310
M. Khammarnia, F. Setoodehzadeh
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引用次数: 0
Investigating the Effects of Air Pollution on Plant Species Resistance in Urban Areas 城市大气污染对植物抗性影响的研究
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-02-15 DOI: 10.5812/jhealthscope-129786
N. K. Acwin Dwijendra, M. Mohammadi, S. Aravindhan, A. Turki Jalil, Masoume Taherian, A. Iswanto, Hafez Ajam Ekrami, M. Alborzi, Kiana Mousavion
Context: Air pollution is a serious concern for environmental and human health, especially due to increasing the risk of respiratory and cardiovascular diseases. The purpose of this study was to investigate the effects of air pollution on plant species resistance in urban areas. Evidence Acquisition: This narrative review was conducted by searching the databases of Web of Science, Science Direct, Scopus, PubMed, Google Scholar, and Springer. Sixty-five articles were screened by reading their abstracts and full texts. In the end, 12 relevant papers published from 1993 to 2021 were finally selected. Results: The literature review showed that the green spaces created by municipalities in different areas of the city included a set of trees and shrubs compatible by the climate, grass, soil, and water of the region, leading to a significant improvement in air quality. Based on the results, urban green space has the ability to reduce the amount of artificially produced pollutants, and the use of natural potential of trees can improve the quality of the environment depending on various factors such as the climatic condition of the region and the density and amount of vegetation cover. Conclusions: The most effective ways to reduce health and economic costs include reducing the emission of pollutants from cars and industries, extending urban green space, educating citizens, and organizational planning and cooperation. The findings of this study may have important implications for selecting plant species for vegetation traffic barriers.
背景:空气污染是环境和人类健康的一个严重问题,尤其是由于增加了呼吸系统和心血管疾病的风险。本研究的目的是调查空气污染对城市地区植物物种抗性的影响。证据获取:本叙述性综述通过搜索Web of Science、Science Direct、Scopus、PubMed、Google Scholar和Springer的数据库进行。65篇文章通过阅读其摘要和全文进行筛选。最终评选出1993年至2021年发表的12篇相关论文。结果:文献综述显示,城市不同地区的市政当局创建的绿地包括一组与该地区的气候、草、土壤和水相适应的树木和灌木,从而显著改善了空气质量。根据研究结果,城市绿地有能力减少人工产生的污染物的数量,根据该地区的气候条件以及植被覆盖的密度和数量等多种因素,利用树木的自然潜力可以改善环境质量。结论:降低健康和经济成本的最有效方法包括减少汽车和工业的污染物排放、扩大城市绿地、教育公民以及组织规划与合作。这项研究的结果可能对选择植被交通屏障的植物物种具有重要意义。
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引用次数: 0
Seroprevalence of Q Fever and Risk Factors Affecting Transmission of Coxiella burnetii in Industrial Slaughterhouse; A Survey from Northeastern Iran 工业屠宰场Q热血清流行情况及影响本病传播的危险因素;伊朗东北部调查
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-02-09 DOI: 10.5812/jhealthscope-132858
Majid khadem-Rezaiyan, Golam Ali Azari Garmjan, L. Jarahi, K. Ghazvini, M. Youssefi
Background: Q fever is a generally neglected infection caused by Coxiella burnetii. Slaughterhouse workers exposed to livestock are among occupationally at-risk people. Objectives: This study was conducted to investigate the seroprevalence of anti-Coxiella burnetii (Q fever) IgG antibody among industrial slaughterhouse workers and factors affecting the risk of infection. Methods: In this cross-sectional study serum samples were taken from 91 individuals working at the central industrial abattoir in Mashhad, Iran using a convenient sampling method. Sera were kept at -80°C until assayed for specific anti-Coxiella burnetii IgG antibodies (phase 1) using the commercial ELISA kit. The participants filled out a checklist addressing potential risk factors of acquiring the infection. SPSS 11.5 was used for data analysis considering a significance level of P < 0.05. Results: The participants’ mean age was 38.7 ± 8 years. Fifty-six percent of the studied individuals (51 out of 91) were found positive for anti-Coxiella burnetii antibodies. The most prevalent cases were sheep (29, 57%) and cow (18, 35%) butchers. The odds of Q fever infection increased among those with a history of accidental hand cuts of more than five times during the previous years (OR = 2.56, CI95% = 1.02 - 6.33, P-value = 0.04) and those dealing with sheep as the primary livestock (OR = 2.9, CI95% = 1.09 - 7.66, P = 0.02). Conclusions: The high seropositivity rate of anti-Coxiella burnetii IgG reflects high exposure rate of workers to this potentially serious pathogen in slaughtherhouses; therefore, careful education, follow-up, and revision of decontamination policies and improved occupational care and environmental hygiene should be strictly implemented in slaughterhouses to reduce the risk.
背景:Q热是一种普遍被忽视的由本氏Coxiella引起的感染。接触牲畜的屠宰场工人属于职业风险人群。目的:本研究旨在调查工业屠宰场工人中抗burneti Coxiella(Q热)IgG抗体的血清流行率以及影响感染风险的因素。方法:在这项横断面研究中,使用方便的采样方法从伊朗马什哈德中央工业屠宰场的91名工作人员身上采集血清样本。将血清保持在-80°C,直到使用商业ELISA试剂盒测定特异性抗伯氏Coxiella IgG抗体(第1阶段)。参与者填写了一份清单,列出了感染的潜在风险因素。采用SPSS 11.5进行数据分析,显著性水平为P<0.05。结果:参与者的平均年龄为38.7±8岁。56%的受试者(91人中有51人)的抗伯内氏Coxiella抗体呈阳性。最常见的病例是绵羊(2957%)和奶牛(1835%)屠夫。在过去几年中,有5次以上手部意外割伤史的人(OR=2.56,CI95%CI=1.02-6.33,P值=0.04)和以绵羊为主要牲畜的人(OR=2.9,CI95%CI1.09-7.66,P=0.02)感染Q热的几率增加屠宰场中这种潜在的严重病原体;因此,屠宰场应严格执行仔细的教育、跟踪和修订去污政策,并改善职业护理和环境卫生,以降低风险。
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引用次数: 0
Blood Transfusion and Associated Factors in Pregnant Women Admitted to a Tertiary Care Hospital in Southeast Iran 伊朗东南部一家三级医院孕妇的输血及相关因素
IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-02-06 DOI: 10.5812/jhealthscope-128705
A. Arzani, S. Tabatabaei, Mehdi Mohammadi, Fateme Behmanesh Pour
Background: Effective blood transfusion is a life-saving practice in obstetrics and gynecology emergencies that can prevent blood product wastage in hospitals. Objectives: This study was performed to evaluate the appropriateness of the use of blood products in pregnant women in a tertiary care hospital in Zahedan, southeast Iran. Methods: This cross-sectional study was carried out from September 2019 to March 2020 to assess the patterns of blood utilization in a tertiary care hospital in Zahedan, Iran. Blood bank registries and the data of 1,500 pregnant women were used for data analysis, using blood transfusion indices, including cross-matched to transfusion (C/T) ratio, transfusion probability (T), and transfusion index (TI). Results: Out of 1,064 units of requested blood products, 581 (54.6%) were cross-matched, and 774 (72.7%) were transfused to patients. The blood transfusion indices of C/T, T%, and TI were 2.11, 48.48%, and 0.76, respectively. The transfusion rate was 6.2%, and the commonest associated obstetrics complication requiring transfusion was uterine atony (32.2%), followed by anemia (17.2%). There was a statistically significant relationship between the type of delivery, uterine and placental problems, coagulation disorders during pregnancy, number of deliveries, and residence place, and the probability of blood transfusion (P > 0.05). Conclusions: The overall blood utilization indices were encouraging; however, the proportion of blood wastage was relatively high. Regular auditing is needed to optimize the use of blood and blood products in obstetrics and gynecology departments.
背景:有效输血是妇产科急诊中的一种救命措施,可以防止医院血液制品浪费。目的:本研究旨在评估伊朗东南部扎黑丹一家三级护理医院孕妇使用血液制品的适宜性。方法:这项横断面研究于2019年9月至2020年3月进行,以评估伊朗扎黑丹一家三级护理医院的血液利用模式。使用血库登记和1500名孕妇的数据进行数据分析,使用输血指数,包括交叉匹配输血率(C/T)、输血概率(T)和输血指数(TI)。结果:在1064单位要求的血液制品中,581单位(54.6%)是交叉匹配的,774单位(72.7%)输给了患者。C/T、T%和TI的输血指数分别为2.11、48.48%和0.76。输血率为6.2%,最常见的需要输血的产科并发症是子宫无力(32.2%),其次是贫血(17.2%)。分娩类型、子宫和胎盘问题、妊娠期凝血障碍、分娩次数和居住地之间存在统计学显著关系,以及输血概率(P>0.05);然而,血液流失的比例相对较高。需要定期审计,以优化妇产科血液和血液制品的使用。
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