Iranian Journal of Public Health最新文献

Background: Despite the significant efforts in tuberculosis (TB) management, TB case detection remains a challenge in developing countries. Traditional methods such as Directly Observed Treatment Short-course (DOTS) have often underperformed, necessitating the implementation of the public-private mix (PPM) strategy in recent decades. However, varied PPM models yielded varied results across different countries. Hence, this systematic review assesses the effectiveness of various PPM models and seeks innovative strategies to enhance TB detection.

Methods: A systematic search was conducted using PubMed, Scopus, Embase, and Web of Science up to August 2024. Studies evaluating the efficacy of PPM models on TB case detection in developing countries were pooled. From the initial 731 potential studies, a total of 10 studies were finally included in this systematic review.

Results: The review identified a variety of PPM interventions, including mass campaigns, mobile screening units, home-based tracking, and digital CXR examination. These approaches significantly raised tuberculosis detection rates compared to control groups or previous years. Notably, private sector involvement and novel approaches, such as application-based tracking in Vietnam and mobile vans equipped with digital X-rays in India, yielded favorable results. However, the variation in effectiveness rate underscored the importance of personalized approaches based on local contexts.

Conclusion: PPM models, especially those with innovative techniques, significantly enhance TB case detection. Scaling up and modifying these strategies to various country circumstances is critical to meeting global TB reduction targets.

Background: Inferiority complex is a common psychological disorder occurring in adolescents during their psychological development and the root cause of most psychological problems. However, inferiority complex in adolescents has rarely been examined in previous intervention studies. This practice-oriented study combined character strengths theory with group psychological counseling to examine adolescents with high inferiority complex scores.

Methods: A survey was conducted on 512 adolescents selected using convenience sampling from three middle schools in Wuhan, Hubei Province, China, to collect information regarding the degree and characteristics of their inferiority complex. Those with a high inferiority complex score were recruited for a grouped experiment, where the experiment group received group counseling grounded on character strengths theory.

Results: The participants had a moderately high degree of inferiority complex (mean = 2.92). Significant differences were observed in the total inferiority complex score across gender, left-behind experience, and academic performance (P < 0.05). After the intervention, the inferiority complex score of the experiment group was significantly lower than that of the control group, and the difference was statistically significant (P< 0.05).

Conclusion: The intervention model constructed in this study effectively reduces inferiority complex in adolescents, providing a reference for exploring an effective approach to adolescent-targeted mental health education.

Background: We evaluated diet plans generated by ChatGPT for hypertension and dyslipidaemia.

Methods: In October 2024, ChatGPT was used to generate meal plans for 24 simulated patients with different cardiovascular health problems. Data were used from men (n=12) and women (n=12), aged 56 yr, with mean heights of 176 cm and 161 cm respectively. Weight categories were based on BMI: normal, overweight, and obese, using weights of 56, 71, and 84 kg for women and 67, 85, and 101 kg for men. Four health conditions were assessed: hypertension stages 1 and 2 (systolic BP 130-139 mm Hg and ≥140 mm Hg; diastolic BP 80-89 mm Hg and ≥90 mm Hg), and elevated LDL levels (≥130 mg/dL and ≥160 mg/dL). Menus were evaluated for adherence to Mediterranean and DASH diets, including recommendations.

Results: Adherence to the Mediterranean and DASH diets was low across all groups, with median scores below 9 and 4.5, respectively. Common recommendations included weight loss, physical activity, reduced salt intake, stress management, and omega-3s for both hypertension and LDL reduction. Plant sterols/stanols were suggested only for LDL. No advice was given on smoking or alcohol use. Nutrient content did not differ significantly between hypertension and LDL menus (P>0.05).

Conclusion: This pioneering study found that AI-generated dietary models had low adherence to DASH and Mediterranean diets, though most recommendations were generally appropriate. Since the prompts only requested basic nutrition plans, future research should use more specific, personalized prompts to better assess AI's role in managing chronic diseases.

Background: Considering the high importance of the problem of obesity and its related factors, we aimed to investigate the mediating role of physical activity in the relationship between personality traits and body mass index (BMI) in the participants of the employees' health cohort study of Iran (EHCSIR) using generalized structural equation modeling (GSEM).

Methods: A secondary analysis with cross-sectional approach was conducted on the existing data using multilevel GSEM. The primary data of the cohort was collected from July 2017, Iran University of Medical Sciences, Tehran, Iran. Personality traits were exposure, physical activity was the mediator, and BMI was the outcome. Sex was the stratifying variable. Then, pathways with the largest P values were removed one by one using backward stepwise approach.

Results: The data of a total of 3554 participants of EHCSIR were used. Sex was subjected for grouping the analysis. In males, extroversion (EX) was the only personality trait associated with both physical activity and BMI. In the direct pathway, EX was positively associated with BMI. In the indirect pathway, EX was negatively associated with BMI (P <0.1). The total effect was positive. In females, physical activity was not associated with BMI, and therefore, no indirect pathway was formed from personality traits to BMI (P >0.1).

Conclusion: The role of personality traits in obesity was more dominant in females, while in males, physical activity had a role in obesity. The hypothesized mediation pathway of the study title was not approved in females, and in males, was approved only for EX personality trait.

Background: We aimed to validate a thorough ergonomic risk assessment method for tea harvesting farmers. A comparative analysis with established methods such as OWAS (Ovako Working Posture Assessment System), RULA (Rapid Upper Limb Assessment), and REBA (Rapid Entire Body Assessment) was also conducted.

Methods: The research was carried out in 2023 in Guilan Province. The research consisted of three phases: identifying risk factors influencing Musculoskeletal Disorders, validating these factors using the fuzzy Delphi technique (FDT) and fuzzy analytic hierarchy process (FAHP) methods, and developing a method that included a customized posture evaluation technique and questionnaire design. The criteria were categorized into personal, task-related, tools and equipment, environmental, and organizational factors. A team of experts evaluated the validity and reliability of the developed method.

Results: Out of 60 identified risk factors, 43 were approved. Task-related factors were deemed the most important, while organizational factors were considered the least important by experts. A comparison of evaluator agreement across different tasks using various evaluation methods revealed good agreement in the developed method and REBA, but low agreement in the other two methods. Kappa coefficients for reliability assessment ranged from 0.61 to 0.80 among expert groups.

Conclusion: The proposed developed technique had acceptable validity and reliability. In addition to posture evaluation, this technique evaluates personal, environmental, and organizational items using a questionnaire. Comparisons with established methods, including OWAS, RULA, and REBA, revealed that the developed method demonstrates a stronger correlation with disorders due to shared characteristics.

Background: Catastrophic health expenditures can lead to severe household financial burdens, exacerbating poverty and limiting access to necessary health services. This study examined the prevalence and determinants of catastrophic health expenditures among households in six provinces of Iraq.

Methods: A cross-sectional design was employed, gathering data from 2,400 households in Baghdad, Wasit, Karbala, An-Najaf, Babil, and Maysan in 2023. A two-stage cluster sampling method was utilized, selecting 400 households from each province. Data were collected using WHO "World Health Survey" questionnaire, focusing on health expenditures and household income. Catastrophic health expenditures as defined as out-of-pocket costs exceeding 40% of a household's capacity to pay. Statistical analyses, including logistic regression with calculating adjusted odds ratio, were performed using STATA14 software.

Results: Overall, 246 households (12.6%) faced Catastrophic health expenditures, with a higher prevalence among female heads of households (13.1%) compared to males (12.6%). The multivariate logistic regression analysis indicated that households with 4 to 6 members had 1.52 times higher odds of facing catastrophic health expenditures (AOR=1.52, CI: 1.06 to 2.20). Furthermore, the poorest households had an AOR of 95.28 for experiencing catastrophic health expenditures (OR=95.28, CI: 13.12 to 691.49).

Conclusion: This study underscores the urgent need for tailored policies to reduce the impact of CHE on Iraqi households. By improving access to healthcare and promoting equitable health insurance enrollment, policymakers can alleviate financial strain and support the health and well-being of vulnerable communities.

Euthanasia is a highly controversial issue which keeps the scientific community and the general public divided into those in favour and those opposed to this manner of terminating a person's life. Ethical, medical, legal, religious and other reasons are used both to justify its legalisation and to argue against it. The main question which attracts differing opinions is whether-beside the right to life as the universal and most important right recognised by the European Convention for the Protection of Human Rights and Fundamental Freedoms-there is the right to die, implying that a person could choose how and when to end their life. The author of the paper analyses several issues. In addition to the introduction which considers the right to life in general, and in the light of international documents, the paper deals with the concept of euthanasia and its historical development, as well as the types of euthanasia. This is followed by an overview of the positions of the proponents and the opponents of the legalisation of euthanasia. Finally, the paper discusses the various ways in which euthanasia is regulated in contemporary criminal legislation.

Background: We aimed to investigate whether 20(S)-ginsenoside Rg3 (Rg3) reduced heterogeneity by inducing the maturation of HepG2 cells via the AMP-activated protein kinase (AMPK)/hepatocyte nuclear factor 4A (HNF4A) pathway.

Methods: This in vitro cell research study was conducted under the guidance of Hebei Medical University, Hebei, China, from Sep 2022 to Dec 2023. HepG2 cells were treated with varying concentrations of Rg3 in a low glucose microenvironment. The mRNA expression of ALBUMIN (ALB, a marker for hepatocyte function) and HNF4A (a marker for differentiation of HCC cell), and AMPK protein levels were measured after significant changes in cell morphology were observed. Additionally, 5-Aminoimidazole-4-carboxamide1-β-D-ribofuranoside (AICAR) (an AMPK agonist) and Compound C (an AMPK inhibitor) were used to explore further the underlying mechanism.

Results: Under treatment of 5 μM, 10 μM, and 20 μM Rg3, some cells became flattened and larger, and there was an increase in the mRNA expression of ALB and HNF4A (P<0.05). However, there was a decreasing trend in AMPK protein content with 8 μM Rg3 (P<0.05). Compared to the control group, some cells exposed to 8 μM Rg3 exhibited pronounced morphological changes, along with upregulated expression of ALB and HNF4A mRNA. However, no such changes were observed when 8 μM Rg3 was combined with 1.6 mM AICAR. Compared to the control group, 10 μM Compound C or 8 μM Rg3 treatments led to similar changes in cell morphology and showed an increasing trend in HNF4A mRNA expression. Additionally, after treatment with Compound C, pHNF4A was mainly in the nucleus, while after Rg3 treatment, it was mostly in the cytoplasm.

Conclusion: Rg3 partially induced the maturation of HepG2 cells through the AMPK/HNF4A pathway.