Iranian Journal of Public Health最新文献

Background: We aimed to identify and classify barriers and facilitators of implementation of research finding in healthcare.

Methods: A scoping review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR). Articles were extracted from online databases. The initial search was implemented on Jun, 2022, and updated until end of 2023. Two independent reviewers screened, selected, and extracted the data. Data were synthesized using thematic analysis.

Results: Overall, 32 studies from 3,435 documents met the inclusion criteria. From which 60 barriers and 45 facilitators were identified. The main barriers and facilitators extracted were grouped into eight components: Organization, Collaboration to knowledge utilization, Researcher role, Methodology and technical aspect of research, Management, Cultural and social determinants, Training, and Government and community. Organizational barriers and facilitators were the most concerning with insufficient attention, methodology and technical aspects of research were salient barriers, and the other components had similar roles.

Conclusion: This study directly addresses a gap in implementing the research findings in organizations. The government would benefit from knowledge implementation with respect to evidence utilization. Additionally, implementation knowledge was not transferred to healthcare practice to a sufficient extent, thus restricting the systematic use of implementation knowledge in practice.

Background: Suicide is a critical global issue with profound social and economic consequences. Implementing effective prevention strategies is essential to alleviate these impacts. Deep neural network (DNN) algorithms have gained significant traction in health sectors for their predictive capability. We looked at the potential of DNNs to predict suicide cases.

Methods: A descriptive-analytical, cross-sectional study was conducted to analyze suicide data using a deep neural network predictive prevention system (DNNPPS). The analysis utilized a suicide dataset comprising 1,500 data points, provided by a health research center in Kerman, Iran, spanning the years 2019-2022.

Results: Factors such as history of psychiatric hospitals, days of the week, and job were identified as the most important risk factors for predicting suicide attempts. Promising results were obtained by applying the DNNPPS model to a dataset of 1453 individuals with a history of suicide. The problem was approached as a binary classification task, with suicide history as the target variable. We performed preprocessing techniques, including class balancing, and constructed a DNN model using a sequential architecture with four dense layers.

Conclusion: The success of the DNN algorithm depends on the quality and quantity of data, as well as the model's architecture. High-quality data should be accurate, representative, and relevant, while a large dataset enables the DNN to learn more features. In our study, the DNNPPS model performed well, achieving an F1-score of 91%, which indicates high accuracy in predicting suicide cases and a good balance between precision and recall.

Background: Sensory impairments, notably hearing loss (68% in those aged 70+) and vision loss (24%-50%), are prevalent in older individuals. We investigated the correlation between visual and hearing impairments in older adults, considering sociodemographic factors, mental health, and social support.

Methods: The study is part of The Serbian 2019 National Health Survey, conducted in 2019. Questionnaires were used as the research tool, following the methodology of the European Health Survey. Multivariable logistic regression was used to assess predictors of visual and hearing impairments.

Results: Findings revealed a higher prevalence of vision difficulties among women (P< 0.001) and a significant reduction in reported vision issues with increased social support (P< 0.001). Higher education, particularly at the doctoral level, demonstrated a strong protective effect against hearing difficulties (P< 0.001).

Conclusion: Education at the doctoral level provides significant protection against sensory difficulties, especially in the case of hearing loss, while a high level of social support positively influences the reduction of vision-related problems. Further research is necessary for a better understanding of relationships and the development of effective support strategies for the elderly population with vision and hearing impairments.

Cervical Intraepithelial Neoplasia grade III (CIN III) represents a critical precursor to invasive cervical cancer, necessitating a comprehensive understanding of its etiology, progression, diagnosis, and preventive strategies. This review integrates an approach to synthesize current literature, conducted through a meticulous search of databases (Scopus, Web of Science, and Google Scholar) for relevant articles discussing CIN III and its association with Human Papillomavirus (HPV). The review delineates the multifaceted landscape of CIN III, elucidating the pathogenesis involving high-risk HPV types, demographic factors (age and sexual behavior), behavioral determinants (smoking and contraceptive use), and environmental influences impacting disease epidemiology. Diagnostic modalities, including Pap smears, HPV testing, and colposcopy, were assessed for their role in early detection and intervention. The results highlight the significance of HPV vaccination, screening programs, and robust public health policies in mitigating the burden of CIN III. Effective interventions, particularly excisional procedures, demonstrate efficacy in reducing the risk of progression to invasive cancer, emphasizing the importance of vigilant follow-up. A comprehensive approach integrating vaccination initiatives, early detection through screening, and equitable healthcare policies stands pivotal in combating CIN III. The review underscores the imperative of evidence-based interventions for disease prevention, reducing disparities, and enhancing public health outcomes for individuals affected by or at risk of CIN III.

Background: We aimed to identify the factors affecting sleep quality in community-dwelling older adults.

Methods: This cross-sectional descriptive study was conducted from 6 to 13 October 2021. A hypothetical model based on Spielman's 3P model of insomnia was constructed using the multiple factors that influence sleep quality in older adults. Data were collected from 114 elderly adults at two welfare centers located in, South Korea and analyzed using IBM SPSS 21.0.

Results: The hierarchical regression model showing the predictors of sleep quality was significant, and it explained 23.9% of the variance (F=9.879, P<.001). Pre-sleep arousal (β=0.283, P=.005) and sleep hygiene (β=0.269, P=.014) were associated with sleep quality.

Conclusion: Sleep improvement interventions which consider pre-sleep arousal and sleep hygiene for older adults may improve sleep quality.

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.