Journal of research in health sciences最新文献

Background: If colorectal cancer (CRC) is diagnosed in the early stages, the patients will have higher survival rates. Although some other factors might affect the survival rate, the type of treatment available based on existing health and therapeutic facilities is extremely important as well. Accordingly, this study aimed to explore the best type of treatment for CRC patients.

Study design: This study employed a retrospective population-based cohort design.

Methods: The data of 335 patients with CRC in Kurdistan province were collected through a population-based cancer registry system from March 1, 2009 to 2014. Demographic and clinical-pathologic data of the patients were gathered through their medical records, pathology reports, and reference to patients' homes. The survival rate was calculated using the Kaplan-Meier curve, log-rank test, and univariate and multivariate Cox regression. The data were analyzed using Stata 14 software.

Results: In this study, the mean age±standard deviation at diagnosis was 61.7± 1.05 in men and 60.5± 1.12 in women, respectively, and 203 (60.5%) patients were males. There was less mortality rate among the patients who received both surgical and chemotherapy treatments compared to those who did not receive any treatment (Hazard ratio [HR]=0.57, 95% CI: 0.24-0.93).

Conclusion: When CRC patients are treated using both surgical and chemotherapy treatments, they will exhibit a higher survival rate. Therefore, it is suggested to use both treatments for CRC patients.

Background: With the increasing watching of programs such as Mukbang, the study of eating behaviors and anthropometric parameters and their relationship with Mukbang should be considered to prevent chronic diseases and eating disorders. This study investigated the relationship between watching Mukbang with eating behaviors and anthropometric parameters in female students at Islamic Azad University, Science and Research Branch, Tehran, Iran.

Study design: A cross-sectional study.

Methods: In this study, 114 female students aged 18 to 31 years were selected using simple random sampling. General information, watching Mukbang status, and the Dutch Eating Behavior Questionnaire (DEBQ) were administered to the participants online.

Results: The prevalence of Mukbang watching in female students of the present study was 60.5%. Furthermore, there was no significant relationship between the frequency of Mukbang watching and emotional or restrained eating behavior (P > 0.05), while there was a significant relationship between external eating behavior and the frequency of watching Mukbang (P=0.0001). It was found that with increasing watching time, external eating also increased. According to the results of logistic regression analysis, the external eating chance was 27% lower in students who watch Mukbang rarely than those who have never watched such a show. However, this chance was 0.31 and 9.58 times higher in students who occasionally and always watch Mukbang, respectively.

Conclusion: There is a significant relationship between external eating behaviors and watching Mukbang.

Background: Wastewater treatment plants (WWTPs) are a source of airborne bacterial contamination that can pose health risks to staff. The aim of this study was to evaluate seasonal variations in the health risks of exposure to Staphylococcus aureus bioaerosols using the quantitative microbial risk assessment (QMRA) approach in a WWTP in Hamadan, Iran.

Study design: This was a descriptive cross-sectional study.

Methods: This study determined the emission concentrations of S. aureus bioaerosols in summer and winter. Then, the health risks of three exposure scenarios (the worker, field engineer, and laboratory technician) were evaluated using the QMRA approach. The bioaerosol samples were collected every 12 days in both summer and winter of 2021 with a nutrient agar using a single-stage cascade impactor (Quick Take 30, SKC Inc.) in both outdoor and indoor environments.

Results: The results demonstrated that in both seasons, S. aureus bioaerosol concentrations in outdoor and indoor environments were below the standard established by the American Conference of Governmental Industrial Hygienists (500 CFU/m³ ). While in summer, the annual infection risks and the disease burden for the three exposure scenarios in both outdoor and indoor environments were higher than the United States Environmental Protection Agency (≤10^-4 pppy) and the World Health Organization (WHO) (≤10^-6 DALYs pppy^-1) benchmarks, respectively.

Conclusion: The findings provided high health risks for staff in the three exposure scenarios of an indoor environment, which should not be ignored, as well as emphasizing the use of the QMRA approach to estimate health risks caused by occupational exposure to bioaerosols and taking executive measures to protect staff working in the WWTPs.

Background: Maternal, fetal, and neonatal complications of brucellosis in pregnant women are probably higher than those in the general population. This comparative study aimed to survey the mentioned complications in pregnant women with positive and negative Brucella serologic tests.

Study design: This is a prospective cohort study.

Methods: In this study, 2160 pregnant women residing in the rural area of Hamadan province were screened for Brucella infection by agglutination test. Then, 106 (4.90%) pregnant women with a positive test (exposed group) were compared with 210 subjects (non-exposed group) who were randomly selected from more than 2000 pregnant women with a negative serological test in terms of maternal, fetal, and neonatal outcomes from October 2018 to March 2020. Data were analyzed by SPSS 20 software at a 95% confidence level.

Results: The mean age of mothers in both exposed and unexposed groups was 27.84±6.13 and 38.71±6.85 years, respectively. Past medical history of brucellosis, animal contact, and the consumption of unpasteurized dairy products were reported to be 14 (13.2%), 63 (59.4%), and 82 (77.4%), respectively, in the exposed group. The mentioned measures were 3 (1.5%), 109 (51.9%), and 54 (26.9%) in the unexposed group, respectively. Among exposed and unexposed groups, the incidence of abortion was 9 (8.6%) and 5 (2.4%) with P=0.005, intrauterine fetal death was 2 (1.9%) and zero with P=0.211, low birth weight was 10 (10.6%) and 7 (3.4%) with P=0.012, and premature birth was 15 (15.2%) and 18 (8.8%) with P=0.066, respectively.

Conclusion: Brucella infection in pregnant women appears to be associated with the risk of miscarriage, low birth weight, and premature birth.

Background: This study aimed to investigate the effects of biopsychosocial interventions on non-specific chronic low back pain (NSCLBP) and disabilities caused by it among Students.

Study design: A two-group pretest-posttest randomized clinical trial.

Methods: The statistical population of the study was female students enrolled at the first-stage secondary school in Hamadan, Iran. A total of 200 students were selected through cluster sampling and randomized into two groups of intervention and control. The primary evaluation was performed by the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), the Health-Related Quality of Life (SF-36), the International Physical Activity Questionnaire-Short Form (IPAQ-S), the World Health Organization Disability Assessment Schedule (WHODAS), and the visual analogue scale (VAS). Upon developing and implementing the biopsychosocial model-based interventions for ten weekly two-hour sessions, the secondary evaluation was fulfilled, and the extracted data were analyzed using the IBM SPSS version 21.

Results: The independent-group t-test results revealed that the mean scores of quality of life (QOL) and physical activity significantly elevated in the intervention group, compared to the control. In addition, the mean value of disabilities, the amount of disorder in the lumbar region, and the VAS scores in the intervention group substantially declined compared to the control group.

Conclusion: The significant variations in the biopsychosocial factors demonstrated that the development of some interventions based on the bio-psychosocial model (BPSM) could help manage the NSCLBP and its ensuing disabilities. Therefore, the BPSM-based interventions could be exploited to minimize musculoskeletal disorders (MSDs) in students.

Background: Health is a fundamental issue in recent years, highlighting the importance of harmonizing the policies of any sector with health strategies. The present study aims to identify the socio-economic factors affecting health and to provide a cognitive map of the social determinants of health in Iran.

Study design: A retrospective cohort study.

Methods: This study follows a developmental process with an exploratory sequential mixed methods approach. First, a meta-synthesis qualitative method determines the most critical health determinants by reviewing 54 studies from 2000 to 2019. Then, the fuzzy cognitive map (FCM) is drawn based on interviews with six experts to derive the causal relationships among the social determinants of population health in Iran.

Results: Stage 1 introduces 170 factors as the health determinants, classified into four levels: individual, local, national, and global levels, with 7, 4, 13, and 3 branches, respectively. According to the causal relationships and the out-degree (od) index, the most effective factors are the economic system (18.24), governance and policy-making (17.13), and national policies (16.93). According to the degree of centrality, these factors are the economic system (33.27), health system (30.37), and governance and policy-making (30.15).

Conclusion: Considering health as a complex and comprehensive system, the resulting FCM displays that the policies developed in other sectors than health are profoundly affecting population's health in Iran. Specifically, the comparative analysis of this research shows that policies regarding the economic system and people's livelihood are more effective than the policies regarding the health system itself on the population's health in Iran.

Background: Road traffic injuries (RTIs) are one of the most critical factors that endanger human health. More specifically, head and neck injuries are the main causes of deaths and disabilities among motorcyclists. This study aimed to investigate the predictive factors of helmet use behavior among motorcyclists based on the theory of planned behavior (TPB).

Study design: This study followed the cross-sectional design.

Methods: This study was conducted on randomly selected 730 motorcyclist employees in Qom, Iran, in 2021. The data collection tool was a self-administered researcher-made questionnaire, including items on demographic characteristics, history of RTIs, and constructs of TPB. Data were analyzed using descriptive summary statistics, analysis of variance, independent samples t test, Pearson correlation coefficient, and structural equation modeling (SEM).

Results: In this study, only 9.8% of the participants reported that they always used a helmet while riding a motorcycle. About 60% reported a history of a motorcycle crash, and 11.5% had a history of head injuries. The direct effect of attitude, subjective norms, and perceived behavioral control on the intention to use a helmet were statistically significant, explaining 59% of the variation in behavioral intention (intention to use a helmet) (R²=0.59). Moreover, perceived behavioral control and behavioral intention had significant effects on helmet use behavior (R²=0.26).

Conclusion: The prevalence of helmet use among the studied population was very low. Moreover, TPB was useful in identifying the determinants of behavior and especially behavioral intention of helmet use among motorcyclists.

Background: Asbestos is a natural fiber leading to health risks like chronic lung diseases. The current study aimed to estimate pleural mesothelioma and lung cancer risk for population exposure to asbestos in Tehran, Iran.

Study design: A cross-sectional study.

Methods: According to the annual report of Air Quality Control Company (AQCC), from 2011-2020, carcinogenic risk and mesothelioma were assessed based on the Environmental Protection Agency (EPA) method using the Monte Carlo simulation (MCS). The relative risk (RR) of mortality cancer was calculated based on Camus and colleagues' model. Moreover, mesothelioma risk was estimated by Bourgault and colleagues' model.

Results: The mean concentration and health risk of asbestos in ambient air generally reduced from 2011 to 2020. The highest mortality risk for lung cancer was 8.4 per 100000 persons in 2011 and reduced to 1.8 in 2017. For mesothelioma, the corresponding values were 8.96 per 100000 persons in 2011 and reduced to 1.92 in 2017.

Conclusion: The findings of this study could be helpful to health policymakers in the management of asbestos risk.

Background: The evaluation of the risk factors associated with the long-term survival rate of patients with myocardial infarction (MI) and the effects of discharge medications can significantly help select the most effective strategies for improving treatment.

Study design: A retrospective cohort study.

Methods: The participants of this retrospective cohort study were 21,181 patients who suffered from MI and were hospitalized in the cardiac care unit (CCU) of different public, private, and military hospitals in Iran from 20 March 2013 to 20 March 2014. Participants were followed up until February 2020 for any cardiovascular disease (CVD) mortality. To evaluate survival rate, the differences between groups, and the factors related to MI death, Kaplan-Meier, log-rank test, and Cox proportional-hazards model were used, respectively.

Results: One, three, five, and seven-year survival rates of patients were 88%, 81%, 78%, and 74%, respectively. Regarding the interaction effect of prescribed medical drugs, the highest 7-year survival rate of 86% (95% CI: 72%, 93%) was related to people who consumed anticoagulants, aspirin, clopidogrel, beta blockers, angiotensin-converting enzymes (ACEs), and angiotensin II receptor antagonist simultaneously. Considering the effect of other variables, the consumption of anticoagulants was associated with a decrease in survival rate (HR=1.13 CI: 1.06, 1.19).

Conclusion: As evidenced by the results of this study, different combinations of prescribed medication drugs had protective effects on long-term mortality compared to the group without any drug. Nonetheless, according to the drugs in each combination therapy, this protective effect ranged from HR=0.27 to HR=0.89. It is recommended that further studies compare the long-term effects of different drug combinations and also consider adherence to treatment in evaluating the effects of these combinations.

Background: Hypertension and diabetes are common comorbidities in patients with COVID-19 and could be influencing the mortality of such patients. The present study aimed to evaluate the effects of hypertension alone and in comorbidity with diabetes on the death within 30 days among inpatients with COVID-19 in presence of well-known determinates of COVID-19 death.

Study design: A case-control study.

Methods: Four groups of COVID-19 inpatients including controls, diabetes alone, hypertension alone, and hypertension and diabetes comorbidities were defined. Each study groups did not have underlying diseases other than hypertension and diabetes. Demographic and general characteristics, underlying diseases, and hospital course events were extracted from medical records. The outcome of interest was alive at discharge/ death within 30 days after admission. Multivariable binary logistic analysis was employed to estimate the effect measures.

Results: The number of death within 30 days among controls (n=1359), diabetes alone (159), hypertension alone (406) and hypertension and diabetes comorbidities (188) were 12.68%, 15.72%, 20.74% and 26.74%, respectively. According to three multivariable analyses after adjusting older age, hospital length of stay, and intensive care unit (ICU) admission separately, the odds of death within 30 days in COVID-19 patients with having hypertension and diabetes comorbidities was 1.58, 2.13 and 1.91 times of patients without such comorbidities, respectively (P<0.015). The effect of hypertension alone was also significant after adjusting hospital length of stay and ICU admission but not for older age.

Conclusion: Our results suggest that comorbidities, such as hypertension and diabetes may be associated with COVID-19-related deaths independent of other underlying diseases, older age, and adverse hospital course events.