Iranian Journal of Public Health最新文献

Background: We have included literature on changes in immune cells in patients with schizophrenia and have systematically and quantitatively reviewed these studies through meta-analysis, with a view to understanding the potential effects of immune system dysfunction on the pathophysiology of schizophrenia.

Methods: We conducted a systematic search in PubMed, Embase, Web of Science, and the Cochrane Library, covering publications from inception to Sep 25, 2023. The systematic review followed the PRISMA guidelines, and a random-effects meta-analysis was performed. Heterogeneity was evaluated using the I² index, and sensitivity analyses were conducted to assess the stability of the findings.

Results: The systematic review includes 42 studies on schizophrenia. Meta-analysis revealed that compared to the control group, schizophrenia patients had significantly higher white blood cell counts (WBC, P<0.01), CD4 absolute values (P=0.02), CD4 percentage (CD4%, P=0.05), CD4/CD8 ratio (P<0.01), monocyte-to-lymphocyte ratio (MLR, P<0.01), neutrophil-to-lymphocyte ratio (NLR, P<0.01), and platelet-to-lymphocyte ratio (PLR, P<0.01). No significant differences were observed for other immune markers in the meta-analysis.

Conclusion: The number of immune cells in the blood of patients with schizophrenia increased. Therefore, more research on immune system abnormalities in schizophrenia patients is needed to better understand the underlying mechanisms between schizophrenia and immune cell parameters.

Background: Extreme obesity pathology is with a risk factor for heart failure (HF), whereas the obesity paradox in HF shows that obese subjects had a good prognosis. The mechanism underlying the obesity paradox in HF prognosis is unclear till now. We aimed to provide evidence for the molecular mechanisms of the obesity paradox in HF.

Methods: Differentially expressed genes (DEGs) in ischemic HF samples were identified in the GSE57338 and GSE5406 datasets. Weighted gene co-expression network analysis (WGCNA) modules and a protein-protein interaction network (PPI) were constructed. HF-associated DEGs and pathways were screened in the Comparative Toxicogenomics Database (CTD). The expression of hub genes in adipose tissues from obese patients and LV samples from HF patients were validated in microarray datasets.

Results: Three HF-associated WGCNA modules were identified and DEGs were associated with the 'hsa04115: p53 signaling pathway'. SERPINE1 was the only common gene between DEGs and HF-associated genes in the CTD database. The SERPINE1 gene was downregulated in the white adipose tissues compared with brown adipose tissues (P = 3.90e-03) and was upregulated in the omental adipose tissues from obese patients compared with lean subjects (P = 3.85e-02).

Conclusion: The downregulation of SERPINE1 expression might be responsible for the obesity paradox in HF via interacting with ESR1.

Background: We aimed to determine the prevalence of carbohydrate metabolism disorders among pregnant women in Kyrgyzstan based on the 2013 WHO diagnostic criteria, to study their frequency, and to assess the influence of key risk factors on the likelihood of developing gestational diabetes mellitus (GDM) and overt diabetes.

Methods: A prospective cohort study was conducted, including 617 pregnant women between 2022 and 2024. All participants underwent an oral glucose tolerance test (OGTT) in the second half of pregnancy. Diagnosis of GDM and overt diabetes was carried out according to WHO criteria. Multivariate logistic regression was used to analyze risk factors. ROC analysis was performed to assess the diagnostic value of the number of risk factors in predicting carbohydrate metabolism disorders.

Results: The incidence of GDM was 18.8% (116/617), and overt diabetes - 6.96% (43/617). The main risk factors for GDM were: age over 35 years (P = 0.002), arterial hypertension (P = 0.001), second-degree family history of diabetes (P = 0.001), pre-pregnancy overweight or obesity (P = 0.002), and multiparity (P = 0.000). For overt diabetes, key risk factors included first-degree family history of diabetes (P = 0.034), second-degree family history (P = 0.001), and overweight or obesity (P = 0.018).

Conclusion: An increase in the number of risk factors correlates with the incidence of GDM and overt diabetes. However, for GDM, the number of risk factors is not a reliable predictor, highlighting the need for universal screening of all pregnant women. For overt diabetes, the number of risk factors showed satisfactory predictive value.

Background: We aimed to analyze the epidemiological characteristics of road accident mortality and identify high-risk areas, considering the years of life lost (YLL) in Fars Province, central Iran.

Methods: The present study was conducted cross-sectionally in 2019. We used Kernel Density and hot spot analysis to identify statistically significant clusters of road accidents. For the descriptive analysis, we utilized the chi-square test, considering a P-value of less than 0.05 as statistically significant. To calculate years of life lost, R 4.3.3 software and the "YLL" package were used.

Results: A total of 1,604 people died in road accidents, with the majority being male (1,304). The mean age of the subjects was 37.63+36.61 years. The axes with a greater concentration of accidents included Shiraz-Marvdasht-Abade towards Esfahan, Shiraz-Kazeroun towards Bushehr, and Kazeroun-Noorabad towards Yasouj. Head injury and multiple fractures were the most prevalent causes of death among both sexes. The number of deaths and YLL due to accidents was higher in men than in women, in all age groups. In men, the number of deaths and YLL were more between the ages of 15 and 34 years, while in women, the distribution of the number of deaths and YLL did not differ much until the age of 70 years.

Conclusion: There is significant accident hotspots along the Shiraz-Marvdasht-Abade towards Esfahan, Shiraz-Kazeroun towards Bushehr, and Kazeroun-Noorabad towards Yasouj routes. In addition, the highest number of YLL due to road accidents occurred among teenagers and young adults. Policymakers need to focus on targeted interventions in these high-risk areas and develop strategies aimed at reducing accidents, particularly among younger males, to enhance road safety and decrease mortality rates.

Background: Post-COVID-19 pandemic showed a marked increase in nurse resignations, which has exacerbated pressure on healthcare systems globally. Mental health and Perceived Organizational Support have emerged as critical factors influencing nurses' commitment to their organizations in the post-pandemic era. We aimed to explore the complex relationships between psychological well-being, work engagement, organizational commitment, and perceived organizational support within the Vietnamese healthcare context.

Methods: The research employed a cross-sectional quantitative approach. The questionnaire was distributed through Google Forms during March and April 2024, providing valuable insights into the studied phenomena within Vietnam's unique socio-cultural landscape. Convenience and snowball sampling were used to gather data. Upon completion of data collection, a total of 302 valid observations were obtained. The analysis was conducted using PLS-SEM.

Results: Work Engagement mediates the Psychological Well-being - Organizational Commitment relationship; Perceived Organizational Support moderates the Psychological Well-being - Organizational Commitment relationship; Perceived Organizational Support also moderates the mediation of Work Engagement between Psychological Well-being and Organizational Commitment. This study enhances the understanding of how Psychological Well-being and Work Engagement influence nurses' Organizational Commitment and highlights the role of Perceived Organizational Support as a key organizational resource in shaping these mechanisms. Furthermore, Organizational Commitment is linked to demographic variables such as age and monthly income, with age being a positive predictor and monthly income a negative predictor.

Conclusion: Healthcare managers can promote Nurses' Organizational Commitment by employing strategies to enhance their Psychological Well-being, Work Engagement, and Perceived Organizational Support.

Background: As an important psychological antecedent of smartphone addiction, loneliness may have a far-reaching effect on the mental health of teenagers, especially their psychological depression. Interpersonal trust, which is an important psychological trait of individuals in social interaction, may play multiple mediating roles between loneliness and psychological depression.

Methods: Overall, 691 adolescent smartphone addicts in Henan Province, China were surveyed by a group questionnaire. Relevant data were collected via loneliness scale, psychological depression scale, and interpersonal trust scale (including overall trust, emotional trust, and reliableness). The effect of loneliness on the psychological depression of adolescent smartphone addicts was discussed via statistical analysis, and the multiple mediating roles played by interpersonal trust in this relationship were tested.

Results: Loneliness has a significantly positive effect on the psychological depression of adolescent smartphone addicts (P<0.01). Overall trust and emotional trust play a partial mediating role in the influence of loneliness on psychological depression, whereas reliableness plays a masking role in this influence relationship. Significant differences are observed in the influence of two factors-the length of smartphone use and the age-on the psychological depression of adolescent smartphone addicts (P<0.01).

Conclusion: This study reveals the effect of loneliness on the psychological depression of adolescent smartphone addicts and the mediating role of interpersonal trust. To reduce the risk of adolescent psychological depression, psychological health intervention measures should attach importance to the enhancement of interpersonal trust, especially overall and emotional trust.

Background: Understanding how enhanced medical insurance benefits influence labor decisions of rural elderly individuals is crucial for addressing the challenges posed by population aging on labor market. This study investigated the effects of enhanced welfare levels resulting from medical insurance integration on labor decisions of rural elderly individuals. The objective was to offer policy recommendations to the government to mitigate the decline in the working-age population and sustain the momentum and vibrancy of economic and social development.

Methods: This study conducted an empirical analysis, utilizing two waves of data from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2015 and 2018. This analysis employed the Difference-in-Differences (DID) approach, treating the enhancement of medical insurance benefits for rural residents, due to China's medical insurance integration as a quasi-natural experiment.

Results: Enhancing medical insurance benefits increased the labor supply of older rural individuals, as evidenced by higher labor participation rates and increased hours of work. It also facilitates migrant work while decreasing the willingness to work indefinitely. Medical insurance benefits indirectly influence labor decisions by alleviating healthcare burdens and improving the health status. Notably, the effect is more pronounced among females, higher-income groups, and individuals with poorer health status.

Conclusion: The enhancement of medical insurance benefits resulting from China's medical insurance integration increased the social labor supply and reduced the necessity for elderly individuals to continue working indefinitely. The integration provides disadvantaged groups with improved social security, thereby allowing them to enjoy their later years more fully.