Shiraz Emedical Journal
Volume:25 Issue: 5, May 2024

 Equity in access to health resources is a fundamental goal of health systems worldwide.

 This study aims to assess the distribution of essential health resources necessary for healthcare provision in Bushehr Province.

 This cross-sectional study spans ten years and utilizes several widely recognized indices in health resource distribution equity and equality, including the Gini Coefficient, Concentration Index, Horizontal Inequity, Robin Hood Index, Theil Index, Atkinson Index, and Quantile Ratio. These indices were calculated based on both the population level and the proposed resource allocation model (PRAM) using Excel Software 2018 and Stata version 18.

 The findings indicate a degree of inequality in the distribution of all health resources examined, with special beds exhibiting much higher levels of inequality than others. The sensitivity of the studied indices varied across the distributed resources. Moreover, the trend of inequality generally decreased for all examined resources. The PRAM results suggest that adopting a different approach to resource distribution can significantly reduce inequality levels.

 Despite a downward trend in the inequality of health resource distribution, significant disparities persist. Altering the resource distribution system from the conventional geographical division could aid in achieving equity and equality in healthcare. Such changes could also reduce the costs associated with the health system.

Context: 

This research focuses on the impact of HIV/AIDS on transgender communities, aiming to assess their knowledge, attitudes, perceptions of risk, and practices concerning HIV/AIDS.

Evidence Acquisition: 

During this systematic review, a variety of keywords, including HIV, AIDS, knowledge, attitudes, practices, behavior, action, risk perception, perceived risk, risk susceptibility, severity perception, perceived self-efficacy, cues to action, benefit, barrier, health belief model, sexually transmitted disease, sexually transmitted infection, alcohol, drugs, amphetamine, opium, trans, transgender, transsexual, gender dysphoria were used. From Scopus, PubMed, Web of Science (ISI), and Google Scholar databases, 805 articles were initially identified and screened based on their titles, abstracts, and full texts. Exclusions were made for articles not in English and grey literature. Ultimately, 13 full-text articles met the selection criteria, adhering to COREQ and STROBE guidelines.

 The review encompassed studies involving 3,252 transgender participants. Among these, five articles evaluated knowledge levels, nearly all addressed attitudes (including perceived threats by 12 articles, perceived benefits/self-efficacy by three, and perceived barriers by seven), and 11 examined behaviors related to HIV/AIDS. The findings indicate a generally high level of knowledge about HIV/AIDS among transgender individuals, with peer health promoters playing a significant role in enhancing knowledge and facilitating access to health services. The perceived risk and severity of HIV/AIDS varied, with 52 - 82% acknowledging a perceived risk and 25 - 65% understanding the severity. The perceived benefits of HIV prevention were generally rated high, though self-efficacy in preventing HIV ranged from low to high. Barriers to HIV testing and accessing appropriate care were identified, including discrimination, distrust in health staff, lack of guidelines, and fear of test results or treatment side effects, among others. Risky sexual behaviors were common, with two-thirds engaging in such practices, 20% reporting 3 - 51 sexual partners, up to 91% having unprotected sex, around 60% using alcohol or drugs, 21 - 45% experiencing rape, and 14 - 68% being HIV-positive.

 In conclusion, the transgender community remains overlooked. Despite an adequate knowledge level and a moderate perception of HIV/AIDS risk, the prevalence of risky sexual behaviors and significant barriers to accessing health services highlight the urgent need for establishing long-term healthcare facilities and an effective surveillance system for this marginalized group.

 Past studies have revealed that positive psychological intervention has a positive impact on social isolation.

 The purpose of this investigation was to examine the effect of positive psychological interventions on students' social isolation during the COVID-19 pandemic.

 The research design of the study was quasi-experimental, comprising post-test and pre-test types with experimental and control groups. The population of this study included all female students of the 10th grade at Isfahan Conservatory during the academic year 2022 - 2023. The sample size consisted of 30 female students who were selected through convenience sampling and randomly assigned to two groups: The control group (15 students) and the experimental group (15 students). Eight sessions of positive psychological intervention were conducted with the experimental group, while the control group did not receive any intervention.

 The results of Fisher’s Exact test and chi-square test did not reveal any significant difference between the two groups of fathers in terms of education level (P = 0.169), and there was also no significant difference between the two groups of mothers in terms of education level (P = 0.715). The mean scores of social isolation (control: 50.00 ± 7.44, intervention: 30.00 ± 7.60) significantly decreased in the intervention group (P = 0.0001), but there was no significant decrease in the control group (P = 0.45). Accordingly, the pre-test mean scores of social isolation (P = 0.143) did not show significant between-group differences, and the post-test mean scores of social isolation (P = 0.001) in the intervention group were significantly lower than in the control group.

 The positive psychological intervention had a significant effect on the students' social isolation in the experimental group during the COVID-19 pandemic, indicating that this intervention can be used to reduce the social isolation of students.

 Clinical education in medical sciences is highly stressful. Students face stressors not only related to the learning environment but also in the clinical setting.

 This study aimed to investigate the impact of group counseling on clinical stress management among midwifery students at a medical university in southeastern Iran.

 In this quasi-experimental interventional study, a before-after design was employed using the census method involving 48 midwifery students. A researcher-designed questionnaire was utilized to evaluate factors contributing to stress. The educational interventions were conducted in eight group sessions from November 2021 to February 2022 at Pastor Educational and Medical Hospital in Bam City, Kerman province. Data analysis was conducted using the MIC-MAC model, and statistical analyses included the paired sample t-test and Pearson correlation coefficient through SPSS.

 Overall, mean scores of stressors decreased significantly after the educational intervention (P = 0.006). Before the intervention, the highest and lowest mean scores were related to "teacher role" (3.15 ± 0.84) and "student's personality" (2.18 ± 0.61), respectively. After the intervention, these subareas continued to have the highest and lowest mean scores of stressors, (2.73 ± 0.94) and (2.19 ± 0.66), respectively. All stressors showed a significant correlation with the total stress score after the intervention.

 The presence of stress management programs tailored to the specific needs of medical science students, both in academic and clinical settings, is crucial. These programs should prioritize enhancing communication skills between teachers and students, improving interpersonal relationships, and providing incentives to boost student self-confidence.

 In light of the global COVID-19 pandemic and the subsequent emergence of functional gastrointestinal disorders (FGIDs) post-recovery, this study aimed to evaluate the frequency and risk factors associated with FGIDs one year after recovering from COVID-19.

 This cross-sectional study included a total of 357 patients who had recovered from COVID-19 for a year and were seen at Al-Zahra Hospital in 2021. Participants were chosen through simple random sampling. The ROME questionnaire, alongside patients' clinical histories regarding irritable bowel syndrome (IBS) and its variants, functional dyspepsia (FD), and other GI symptoms, was utilized for data collection.

 Findings indicated that one year post-COVID-19, the prevalence rates of IBS, GI symptoms, and FD stood at 15.4%, 44.9%, and 9.5%, respectively. It was observed that women had a higher propensity than men to develop these FGIDs (P-value = 0.044). Anxiety was linked to a 1.910-fold increase in IBS risk (P-value = 0.039), a 2.225-fold surge in GI symptoms (P-value < 0.001), and a 1.110-fold rise in FD risk (P-value = 0.042). Moreover, depression was associated with a 1.772-fold and 3.753-fold elevated risk of developing IBS (P-value = 0.040) and FD (P-value < 0.001), respectively.

 The findings suggest that FGIDs such as IBS, FD, and other GI symptoms are significant long-term sequelae of COVID-19 infection. Anxiety and depression appear to be key risk factors for these conditions, with a more pronounced impact observed in women than in men.

 Anxiety disorders are the most common mental health problems in adolescents. Uncontrolled anxiety disorders during this period not only negatively affect adolescents' current performance but can also have long-term negative consequences on their physical and mental health.

 This study is designed to investigate the relative frequency of anxiety and its correlation with individual and family characteristics among first-grade high school students in Shiraz, 2020.

 This is a descriptive and analytical cross-sectional study, conducted on 360 first-grade high school students who were selected using a multi-stage sampling method in Shiraz, Iran. Data were collected through online questionnaire software, which included the Beck Anxiety Inventory and a Demographic Questionnaire, and were analyzed using SPSS software version 24.

 The relative frequency of anxiety disorders in the study samples was 59.7% (60.9% in girls and 56.6% in boys); among them, 13.1% experienced severe anxiety, 16.9% had moderate anxiety, and 29.7% had mild anxiety. The results of univariate analysis showed correlations between anxiety disorders and factors such as father's unemployment (P = 0.04), a history of physical and mental problems in teenagers (P = 0.04 and P = 0.001, respectively), and the lack of friendly relations between family members (P = 0.001). Additionally, the results of logistic regression analysis indicated that adolescents with mental illness and those lacking friendly relationships within their family had higher chances of experiencing anxiety disorders compared to other participants (OR = 5.00, P = 0.04 and OR = 9.95, P = 0.002, respectively).

 In this study, mental illness and the lack of friendly relations between family members emerged as significant factors contributing to adolescents' anxiety. Therefore, identifying and addressing these related factors, along with timely diagnosis and treatment of this disorder in adolescents, should be prioritized by mental health officials.