Iranian Journal of Public Health最新文献

Male breast cancer (MBC) is a rare type of cancer that affects men, accounting for only 1% of all cancers in men and all breast cancer cases worldwide. Its rarity is due to the differences in male endocrine function and the smaller amount of mammary tissue in males. Due to its infrequency, there is limited knowledge about the disease, and treatment recommendations are often based on extrapolation from clinical trial data involving female breast cancer patients. Men with MBC typically present in their 50s or older and may mistake a suspicious breast mass for a benign condition called gynecomastia. Various known risk factors contribute to breast cancer in men. Currently, there are no international randomized control trials (RCTs) specifically focused on MBC, and management guidelines are primarily derived from studies conducted among female patients. Localized and resectable cases of breast cancer typically require surgical intervention, followed by radiotherapy, chemotherapy, hormonal therapy, or potentially utilizing recent advancements in immune-oncology agents. A comprehensive approach that involves a multidisciplinary team ensures appropriate treatment and can lead to favorable outcomes. However, screening for MBC is limited due to the lack of large-scale international RCTs demonstrating its effectiveness in reducing MBC-related mortality.

Background: Community Health Volunteers (CHVs) are crucial in achieving universal health coverage and vital in public health activities, including the COMBI (Communication for Behavioral Impact) approach for dengue prevention and control and assessing the performance of COMBI CHVs are essential in evaluating the program effectiveness. We aimed to measure the level of performance and determine predictors of high-performance among COMBI CHVs in Kuala Lumpur and Putrajaya.

Methods: A cross-sectional study was conducted in 2023 among 285 COMBI CHVs from 5 health operational zones in Kuala Lumpur and Putrajaya. The CHVs were stratified proportionately, with 45.5% of respondents randomly selected from each stratum based on their zones. Self-administered questionnaires assessed their performance level and associated factors, including training, supervision, knowledge, motivation, and job satisfaction. Chi-square and Multiple Logistic Regression tests were used to determine the factors and predictors of high-performance COMBI CHVs.

Results: The prevalence of high-performance COMBI CHVs was 59.3%, significantly associated with training factors (experience, duration, and adequacy of training), supervision factors (being supervised, supervision frequency, and encouragement from supervision), motivation and job satisfaction level. As for significant predictors, having at least one day of training (AOR=14.557), being supervised by medical personnel (AOR=4.997), having a high motivation level (AOR=5.538) and having a high job satisfaction level (AOR=4.562) were more likely to have a high-performance level.

Conclusion: Training duration, supervisor background, motivation and job satisfaction can contribute to high-performance levels among COMBI CHVs, which can applied in evidence-based policies and strategies for performance improvement and more effective community healthcare delivery.

Background: This systematic scoping review aimed to investigate and delineate the dimensions of the Community First Responder (CFR) model implemented in emergency medical services (EMS) across different countries. The primary focus was on identifying key components and characteristics associated with CFR programs.

Methods: This study conducted an extensive search across multiple databases (PubMed, Scopus, and Web of Science) and grey literature sources (Google Scholar, official sites) until Mar 2023 using keywords related to community first responders. Initially, 14,135 articles were found. After removing duplicates and similar titles, 37 articles were reviewed. The analysis covered training, motivation, public awareness, emotional support for responders, coordination with ambulance staff, program development, and the impact on patient outcomes.

Results: This review revealed key dimensions and components common to CFR models worldwide. Notable findings included insights into the significance of training, the motivating factors for individuals joining CFR groups, public awareness regarding the role of CFRs, the importance of emotional support for CFRs, effective coordination with ambulance staff, development requirements of CFR programs, and the consequential effects of plan implementation on patient outcomes.

Conclusion: This systematic scoping review offers valuable insights into CFR models worldwide, enhancing understanding of their effectiveness, challenges, and capabilities. Its recommendations can influence policy, guide future research, and strengthen CFRs' contributions to emergency medical services.

Background: The global maternal mortality rate has increased annually. This study aimed to examine the role of emotional support and the social support theraphy on the experience of emergency caesarean deliveries.

Methods: The narrative study was conducted using scientific journal database sources from PubMed, Proquest, Ebsco, Science Direct, and Google Scholar from 2016 to 2023. After the articles were obtained, they were tabulated using an Excel table. Overall, 184 articles were identified based on the search titles. Ten articles focused on the influence of emotional support on patient experiences, and five articles focused on the influence of sociocultural atmosphere on patient experiences.

Results: The influence of emotional support and the socio-cultural atmosphere on emergency caesarean section patients is one strategy for reducing maternal mortality rates. The poor sociocultural atmosphere regarding cesarean delivery is still a hot issue in the community, and the lack of emotional support from health service providers can cause patient and family approval to be late in agreeing to informed consent for emergency cesarean care, which should be provided immediately.

Conclusion: There is a need for adequate emotional support in the form of empathy, interactive communication, presence and availability, motivation and hope, nonverbal communication, sense of humor, and ambient environment.

Background: Countries that are becoming aging societies are struggling to establish financial support policies due to their increasing numbers of retired people. In particular, the increase in middle-aged retirees has been reported as unusual and influenced by various factors. This study aimed to identify the subjective health conditions of middle-aged retirees and explore the factors that help provide basic data for developing health-related programs for them.

Methods: This cross-sectional study was conducted among 7,893 people who participated in the 6^th Korean Longitudinal Study of Aging in 2016. Among them, the data of 315 participants were analyzed. A theoretical framework guided the use of multiple regression analysis to examine the factors related to the subjective health status of middle-aged retirees.

Results: The significant factors influencing the subjective health status were socioeconomic status (middle/high: β=.14, P=.005), number of chronic diseases (β=-.11, P=.035; above 2: β= -.38, P<.001), depression (β = -.17, P<.001), and retirement satisfaction (β=.32, P<.001).

Conclusion: This study can help policymakers create effective retirement programs for middle-aged individuals and re-socialize them by enhancing physical and psychological support.

Background: We aimed to determine the differences in physical fitness between older adults with and without indicators of possible sarcopenia and the associations between possible sarcopenia and fear of falling.

Methods: Individuals aged >75 years living in Harbin City, China in 2023 were recruited through a local community center. The presence of possible sarcopenia was defined using the Asian Working Group for Sarcopenia 2 criteria via grip strength measurement, with cut-off points of >28 kg for men and >18 kg for women. Physical fitness, gait ability tests, and a fear of falling questionnaire were administered. An independent t-test was used to compare differences in physical fitness and gait between individuals with and without possible sarcopenia. Multivariate logistic regression was used to investigate the association between possible sarcopenia and fear of falling.

Results: The possible sarcopenia group had lower extremity strength, flexibility, and aerobic endurance than the group without possible sarcopenia (P<0.001). Regarding dynamic balance, the time taken was longer in the possible sarcopenia group (P<0.001). There was also a difference in gait ability and fear of falling between the two groups (P<0.001). Compared to individuals without possible sarcopenia, those with possible sarcopenia had significantly increased odds ratios for fear of falling (odds ratio, 9.66; 95% confidence interval, 4.06-22.98).

Conclusion: Possible sarcopenia based on the grip strength criterion was associated with decreased physical fitness and gait performance in Chinese community-dwelling older adults.

Background: Nipah virus is a pathogenic virus of ruinous zoonotic potential with inflated rate of mortality in humans.

Methods: Considering the emerging threat of this pandemic virus, the present investigation amid to design vaccine by using the bioinformatics tools such as host and virus codon usage analysis, CD8+ peptide prediction, immunogenicity/allergenicity/toxicity, MHC-I allele binding prediction and subsequent population coverage and MHC-I-peptide docking analysis.

Results: In this study (conducted in 2022 at School of Biotechnology, Katra, India), a set of 11 peptides of the structural proteins of Nipah Virus were predicted and recognized by the set of MHC-I alleles that are expressed in 92% of the global human population.

Conclusion: The strong interactions between these peptides and the MHC-I protein suggest them as strong peptide candidates for the development of vaccine against Nipah Virus.