Iranian Journal of Public Health最新文献

Background: We aimed to investigate Tehran's University of Medical Sciences (TUMS) affiliated hospitals organizational readiness toward implementing the 'Autonomous Hospitals' program as a change initiative from a managerial perspective in 2020.

Methods: A census covering all eligible managers working in TUMS affiliated hospitals, Tehran, Iran (350 individuals) was carried out. Overall, 281 questionnaires were returned (a 30% non-responsiveness rate). A standard construct was adopted for data collection which was validated through a process of translation- back translation, face validity, and content validity (CVI=0.86, CVR=0.76). The reliability was acquired using Cronbach's alpha coefficient (0.87 and over 0.7). Both descriptive and inferential statistics were employed to draw conclusions .SPSS 26 was used for data analysis.

Result: Total organizational readiness for change (TORC) in hospitals was 60.75%±10.11 showing a state of medium to upper-medium readiness status. Also, the 'Clear mandate and centralized leadership' theme scored the lowest mean (53.02%±15.78) for ORC. 'Hospital accreditation level' (r=-0.14, P≤0.05), 'bed occupancy rate' (r=-0.19, P ≤0.05), and 'leadership status' (r=0.26, P≤0.001), also showed significant association with TORC. In addition, 'standardized bed occuPancy rate' (P≤0.05, B=-2.41), a 'male' leader (P ≤0.05, B=3.42), and 'academic affiliation' (P≤0. 1, B=-9.52), were good Predictors of TORC based on 'Backward Multiple Linear Regression' analysis.

Conclusion: Full support from hospital and headquarters executives, delegation of sufficient decision-making authority to hospital managers, and implementation of comprehensive performance evaluation criteria were prerequisites for robust hospital autonomy in TUMS-affiliated hospitals.

Background: We aimed to determine the prevalence of sedentary time in diabetes and metabolic syndrome worldwide via a systematic review and meta-analysis study.

Methods: This study was conducted using the systematic review method following PRISMA 2020 criteria. Searches were conducted in PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar from January 2000 to December 2022. The heterogeneity of studies was measured using the I² test.

Results: The prevalence of sedentary time in diabetic patients was 52.3% (CI 95 %:46.2-58.2) and the prevalence of sedentary time in metabolic syndrome was 43.3% (95% CI: 31- 56.5). Also, the results of subgroup analysis show that the prevalence of inactivity in diabetic women was 60.3% higher than that of diabetic men. The prevalence of inactivity in patients with metabolic syndrome was 28.6% in men and women, respectively.

Conclusion: Sedentary time has a very high prevalence in metabolic syndrome and diabetic patients. In other words, almost half of these patients experience their life patterns. Therefore, effective and efficient efforts to improve activity and exercise in patients with diabetes and metabolic syndrome will have a more effective therapeutic effect and improve their quality of life.

Background: Pornography, encompassing explicit images, videos, audio, and written content, has adverse impacts on individuals' well-being. We aimed to explore the relationship between mental health and communication quality with parents and the use of pornography, considering the moderating effect of gender.

Methods: Quantitative data collection and descriptive-correlation analysis were employed. The study included university students in Tehran, Iran during the 2021-2022 academic year. Through purposive sampling, 210 participants completed an online questionnaire on Porsline. The survey assessed pornography use, quality of communication with parents, and general health. SPSS 23 software facilitated correlation and hierarchical regression analysis.

Results: Gender significantly influenced pornography use (β=0.557). Anxiety symptoms (β=0.45) and social dysfunction (β=0.351) had significant positive effects on pornography use. Moreover, quality of relationships with parents, both mother (β=-0.47) and father (β=-0.27), exhibited negative associations with pornography use (P=0.01).

Conclusion: High quality relationships with parents, lower anxiety and social dysfunction could potentially decrease the likelihood of pornography use on the internet. It is recommended that educational efforts and cultural interventions focus on protecting young adults from the negative effects of pornography use. Such interventions may include psychoeducational training on effective communication skills, mental health literacy, and stress management skills.

Background: The global SARS-CoV-2 pandemic has disrupted health systems and put a huge strain on hospitals and healthcare workers. Prioritizing COVID-19 patients in hospitals caused irreversible harm to cardiac patients. Although multiple studies have shown that ST-segment elevation myocardial infarction (STEMI) patients have worse admission circumstances than before the pandemic, the hospital outcomes of these patients have remained limited. This systematic review and meta-analysis examined STEMI patient outcomes during the COVID-19 epidemic.

Methods: We conducted systematic searches of MEDLINE (through PubMed), Web of Science, Scopus, and Embase through Jan 10, 2021. All studies with reporting in-hospital mortality, length of stay, and door-to-balloon time with over twenty participants were included. Articles without clear definitions or results were excluded. The study followed PRISMA guidelines. The outcomes of interest were door-to-balloon time, death, and hospital stay during COVID-19 pandemic compared prior.

Results: Our meta-analysis included 12 studies and 21170 people (115-6609). The pooled analysis showed significantly more pandemic mortality (OR=1.24; 95% CI: 1.07-1.43). Ten studies (13,091) recorded door-to-balloon times. Door-to-balloon time (in minutes) significantly increased during the pandemic (Standardized Mean Difference [SMD]= 0.46; 95% CI: 0.03-0.89). The length of hospital stay was reported by five studies (n=9448). Length of hospital stay (in days) was not significantly longer during the pandemic than before the outbreak (SMD= 0.04; 95% CI: -0.19-0.26).

Conclusion: The COVID-19 pandemic is associated with increased mortality and door-to-balloon delay that might be attributable to the strict infection control measures in outbreak. Studies with a longer follow-up time are needed to investigate the outcomes of STEMI patients.

Background: One of the upcoming challenges in hospital accreditation is using the same and similar standards for all types of hospitals in size and type of activity. We aimed to identify the accreditation modules for all types of hospitals in size (small hospitals) and type of activity (special hospitals).

Methods: This research was conducted as a scoping review from Mar to May 2023. "Arsky and O'Malley" six-step protocol was used to conduct this study. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) was used to identify, evaluate, and select research articles. The "framework analysis" method was used to analyze the data.

Results: Of 14 articles, 64% have been published in peer-reviewed scientific journals. Moreover, 36% of them were accreditation organizations' standards at the national level. The accreditation modules of small hospitals are Responsibilities of Management, Care of Patients, Management of Medication, Patient Safety, Infection Control, Continuous Quality Improvement, Patient Rights and Education, Blood and Blood Products, and Partnering with Consumers. The accreditation modules of special hospitals are Governing Body and Administration, Clinical Management, Prevention and Health, Care and Treatment, Diagnostic Services, Patient Rights, and Quality Improvement.

Conclusion: Identifying the main modules of accreditation for small and special hospitals can help policymakers and hospital managers improve the quality and safety of their hospitals by using appropriate standards and help improve the services provided to patients and increase their satisfaction.

Background: MicroRNAs (miRNAs) are implicated in several biological processes, such as control of tissue homeostasis, cell signaling, differentiation, proliferation, neoplastic transformation, and activation/inhibition of apoptotic mechanisms. In this systematic review, we evaluated the changes in the expression pattern of miRNAs in salivary gland tumors (SGTs).

Methods: A comprehensive search was conducted in PubMed, and Scopus with no language and date restrictions in Feb 2023. All the studies on SGTs that evaluated miRNA profiling were included. Relevant data regarding the overexpression and down-regulation of the miRNAs were extracted. The quality of the included studies was evaluated with Newcastle-Ottawa checklist. The altered expression of miRNAs was evaluated between SGTs and normal cases, benign and malignant tumors, and primary and high-grade tumors.

Results: Thirteen studies were included in this systematic review. There were considerable differences between malignant and benign tumors regarding the miRNAs expression level. In the five studies, the miRNA profile of the primary tumors was compared with metastatic tumors to reveal the involvement of the miRNA in the prognosis of the salivary tumors. The miRNAs expression changes were correlated with tumor size, stage, recurrence, and occurrence of solid components. Perineural invasion and lymph node metastasis were also reported in ACCLM cell line and recurrence of adenoid cystic carcinoma (ACC) tissues.

Conclusion: The miRNA profiling confirms their prognostic value in salivary gland tumors. Significant alternations of the miRNAs expression are useful for distinguishing different types of salivary tumors and malignant tumors from benign types. The miRNA expression changes also affect the prognosis of salivary tumors.

Background: Several health, environmental, and lifestyle-related factors have been separately linked to multiple sclerosis (MS) by different studies. However, these studies did not adequately account for the temporal association of these factors with MS while considering the influence of other variables in the analysis. A comprehensive investigation of these factors remains scarce.

Methods: A hospital-based case-control study was carried out between Jun 2020 to Mar 2021 on 525 cases and 1050 controls frequently matched by age and sex. Cases and controls were selected at the same time and from the same centers (Motahari and Imam Reza referral centers) in Shiraz (the capital of Fars Province). Health, socio-demographic, and lifestyle status during adolescence were studied in this case-control study.

Results: The likelihood of having a history of autoimmune disease(s) (OR_yes/no=15.67, P<0.001) and family history of MS (OR_yes/no=11.57, P<0.001) were higher in cases. In addition, the likelihoods of reporting a history of head/neck traumas (OR_{having a history/no history}=9.16, P<0.001), smoking (OR_{regular/other} =2.24, P=0.008), and stressful events (OR_yes/no=1.47, P=0.007) were higher among the case group. On the other hand, the odds of sun exposure (OR_{most the time/seldom} =0.14, P<0.001), physical activity (OR_{active/inactive}=0.45, P<0.001), and good quality sleep (OR=0.93, P<0.001) were significantly lower in the case group.

Conclusion: This study provided a broad picture of the factors associated with MS, most of which were modifiable. Positive alterations to these factors through social and health educational programs are likely to reduce the burden of MS in Iran.

Background: Dietary habits are influenced by environmental factors. Among these environmental factors are the place of residence, cultural characteristics, food accessibility, and economic status, which can all contribute to changes in the dietary pattern. Migration is another factor that can influence changes in the aspects mentioned above. We aimed to assess the dietary habits of individuals who have migrated from Turkey to Germany in comparison to those living in Turkey.

Methods: In this descriptive and cross-sectional study, 254 individuals were enrolled with 102 individuals in Germany and 152 individuals in Turkey between April 2022 and July 2023. The data collection tools included Socio-demographic Characteristics Forms, Dietary Habits and Health Status Forms, and Food Consumption Frequency Forms. The data was collected online via Google Forms.

Results: There were statistically significant differences in the consumption frequency of processed meats, meat and poultry, sweetened beverages, sugar, desserts and pastries, vegetables, fruits, eggs and grains, olive oil, sunflower oil, hazelnut oil, grains, dairy products, coffee, starch, and carbonated beverages between the two groups (P<0.05). Statistically significant differences were not found in terms of butter and tea consumption frequency.

Conclusion: Overall, the study results have revealed significant differences in dietary habits between Turks living in Germany and those living in Turkey. The most noteworthy dimension of these differences is that individuals living in Turkey exhibit a stronger adherence to the Mediterranean dietary pattern, while those living in Germany tend to follow a Western dietary pattern.

Background: Type 2 diabetes mellitus (T2DM) is associated with a wide range of health outcomes, including an increased risk of depression and anxiety and a decline in quality of life. Even though the significance of biopsychological factors in the mental health status of T2DM patients has been discussed in other studies, the role of environmental factors has been lacking. Therefore, this review aimed to identify the relationship between environmental factors and mental health status among T2DM patients.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews was utilized in this study. Using predetermined keywords, a systematic search was conducted on three electronic databases from 2005 to 2023, namely, Web of Science, Scopus, and PubMed. Articles written in English, and studies focusing on the research question are among the inclusion criteria. Ten articles were extracted that were relevant to the research question.

Results: Poor socioeconomic status, urban areas, the influence of neighborhood, greenness, and air pollution had associations with mental health status among T2DM patients.

Conclusion: The possible implications of these factors for mental health demand further research and policy consideration.