Iranian Journal of Public Health
Volume:50 Issue: 4, Apr 2021

More and more people realize that implementation of preventive measures is the only option left to counteract the coronavirus disease 2019 (COVID-19) before specific antiviral drugs are developed. Hence, a number of behavioral, clinical and state interventions have been conducted by dozens of countries to stop or slow down the spread of the virus in the early stages of the epidemic. At present, with the evolution of COVID-19 pandemic getting worse, synthesizing and implementing all measures available are of paramount importance. However, some measures are still being controversial. We aimed to assist policymakers in decision making for better pandemic preparedness. We reviewed the literature that reported accumulated scientific experience to date and summarized the epidemic prevention and control measures in three aspects: control the source of infection, cut off the routes of transmission and protect the susceptible population. First of all, some new approaches were introduced to control the source of infection, such as implementing contact-tracing apps, nucleic acid mixed detection, repeated testing and the establishment of some specialized laboratories. Second, we need to take various measures to cut off all possible routes of transmission, especially persistently pay close attention to checking cold chain foods. Third, due to no valid vaccine has yet been developed, some measures that can cut development time of more conventional vaccines should be implemented or considered. By synthesizing the scientific experience in fighting the COVID-19 epidemic, we suggested the latest effective measures should be carried out concurrently from three aspects, so as to avoid making grim situation even worse.

The COVID-19 pandemic from the coronavirus family is the most important agenda of today's world, also called the “New World”. In this outbreak period, declared a pandemic by WHO and affected the whole world and humanity on a global scale, all kinds of scientific information and evidence-based sharing on the subject gained great importance.

Overall, 12,301 articles from the web of Science (WOS) Core Collection database were analyzed using SciMAT software, conducted to examine the development of coronavirus publications in the process and to reveal the scientific mapping related to the subject. To analyze the development in the process based on periods, the articles covering the 50 years were compared as five periods of 10 years.

The most publications with the Coronavirus theme were made between 2010 and 2020 (n=1020), the total number of citations of these articles was 15,966 and the h-index value was 54. The theme "Coronavirus” was associated with the themes “infection” (w=0.04), “SARS” (w=0.03), “virus” (w=0.04), “identification” (w=0.05) and "swine" (w=0.03). Due to the recent emergence of the COVID-19 theme, it was found to be directly related to the “outbreak” theme (w=0.01). In terms of the distribution of the articles on coronavirus by country, most articles were published by the USA. This country is followed by China, Germany, England and the Netherlands.

This research on the coronavirus family can offer a holistic view of the virus family in the scientific world and can make a scientific contribution to the fight against the virus by creating awareness on this issue.

In the last two decades, we have witnessed three major epidemics of the coronavirus human disease namely, severe acute respiratory syndrome (SARS), Middle Eastern respiratory syndrome, and more recently an ongoing global pandemic of coronavirus disease 2019 (COVID-19). Iran, a country of nearly 84 million, in the Middle East, severely involved with the COVID-19 disease. A documented multidimensional approach to COVID-19 disease is therefore mandatory to provide a well-balanced platform for the concerned medical community in our county and beyond. In this review, we highlight the disease status in Iran and attempt to provide a multilateral view of the fundamental and clinical aspects of the disease including the clinical features of the confirmed cases, virology, pathogenesis, epidemiology, and laboratory methods needed for diagnosis.

Musculoskeletal disorders are responsible for significant problem for workers' health. The present study aimed to investigate the prevalence of musculoskeletal disorders among mining workers.

This systematic review and meta-analysis study were designed in 2020 (from Jan to Mar). The researchers searched five international databases Medline/PubMed, ProQuest, Scopus, Embase and Web of Science. All analyzes were performed using STATA statistical software.

The search results were 447 articles and after screening stage finally 50 studies were included in review. The highest number of studies (26 studies) reported the prevalence of musculoskeletal disorders of upper back and 4 studies reported the prevalence of musculoskeletal disorders of the arms and ankles & feet. The results of meta-analysis based on prevalence in different organs showed that the highest prevalence of musculoskeletal disorders was in the upper back and the lowest in the knees with a prevalence of 50.39% (CI 95%: 31.23-54.73%) and 16.03% (CI 95%: 11.78-20.28%), respectively.

The prevalence of musculoskeletal disorders among miners is relatively high. Therefore, supervisors and mine managers should pay more attention to reducing musculoskeletal disorders and increasing the ergonomic level of mines in order to increase workers' health.

Of the most important implications and complaints in the elderly group of the population, is oral and dental health problems. This study aimed to assess oral health- related quality of life in older people.

To data collection, databases were searched including PubMed, EMBASE, Scopus, SID, MagIran, Cochrane Central Register of Controlled Trials and scholar google The keywords were “older adults", “Geriatric” Elderly", "Older", “Aged”, "Ageing", "Oral health", "Oral hygiene" and "Quality of life", "QOL. For manual searching, several specialized journals of related scope as well as the finalized articles' reference list were searched. Studies from 1st Jan 2000 to 30th Jan 2017 were included. Studies were subjected to meta-analysis to calculate indexes, using CMA:2 (Comprehensive Meta-Analysis) software.

Totally, 3707 articles were searched that 48 of them were subjected to the oral and dental health-related quality of life in 59 groups of the elderly population with the mean age of 73.57+6.62 in the 26 countries. The obtained percentage values of dental and oral health were 80.2% (0-60), 14.8% (0-12), 16.4% (0-70), 22% (0-14 or 0-59) and 19.2% (0-196) for GOHAI with the additive method, GOHAI with Simple Count Method, OHIP-14 with the additive method, OHIP-14 with Simple Count method and OHIP-49 with additive method indexes, respectively.

The elderly group of the population had no proper oral health-related quality of life. Regarding the importance and necessity of oral and dental health and its effect on general health care in the target group, it is recommended to improve dental hygiene in the mentioned group of population.

Type A behavior pattern has been presented as a risk for coronary heart disease and defined as a psychological-behavioral construct. This study aimed to identify the influence of type A behavior pattern on blood pressure in the current cultural context of Japan.

This study utilized a cross-sectional design. Self-administered questionnaires were distributed to community residents aged 40-59 yr in western Japan from Aug to Sep 2017. The data included participant’s demographic information (including socioeconomic variables); information related to blood pressure, type A behavior pattern, psychological factors, and health-related behaviors. Logistic regression was used to identify the influence of type A behavior pattern on systolic blood pressure after adjusting for behavioral, psychological, and socioeconomic factors.

The sample included 362 participants with a mean age of 51.5 years (SD = 5.96); 148 (41.2%) men. A logistic regression demonstrated that type A behavior pattern was negatively associated with systolic blood pressure (OR = 0.43, 95% CI [0.22, 0.83]) after adjusting for sex and age. Similar results were observed after adjusting for other covariates.

There may be a negative association between type A behavior pattern and systolic blood pressure among adults living in the current cultural context of Japan.

The effects of transthyretin (TTR) over-expression on the proliferation and cell cycle of non-small cell lung cancer (NSCLC) A549 cells and its possible mechanism were verified.

A total of 196 LC patients and 20 healthy controls were enrolled at Tianjin Hospital, Tianjin, China between Apr 2017 and Oct 2017. The serum TTR content was detected by ELISA. Through lentiviral transfection method, NSCLC cells were divided into non-transfected group (group A), negative control group (group B) transfected with empty vector and experimental group (group C) transfected with TTR over-expression. Cell proliferation was detected by CCK-8 method, TTR mRNA expression was detected by real-time quantitative polymerase chain reaction (RT-qPCR), and TTR protein expression was tested by Western blot (WB). Cell cycle was detected by flow cytometry, Wnt3a/β-catenin protein expression was detected by WB, and mRNA expression was detected by RT-qPCR.

The serum TTR content in early, middle and late LC group was remarkably lower than that in healthy group (P<0.05). Compared with late stage, TTR content in early and middle stages of LC group was higher, and the difference was statistically marked (P < 0.05). The absorbance value of group C was lower than that of groups A and B, indicating that the cell proliferation activity dramatically decreased, with statistically marked difference (P<0.05). LC A549 cells in group C were obviously blocked in G2M, with statistical significance (P<0.05). 

TTR over-expression can inhibit the proliferation of NSCLC A549 cells, and the expression is related to Wnt3a/β-catenin pathway. TTR in serum of patients was helpful for diagnosing LC and has certain clinical value.

We aimed to reveal how chronic diseases, age and gender affected morbidity and mortality in patients with Coronavirus disease of 2019 (COVID-19).

Medical records of all reverse transcription polymerase chain reaction (RT-PCR) positive COVID-19 patients followed up in hospital and home isolation between 13th of Mar 2020 and 12th of May 2020 were retrospectively reviewed. The patients were from Kayseri Province, Turkey. Patients’ demographic and clinical characteristics and the factors associated with morbidity and mortality were analyzed.

Of all the patients, 773 (95.8%) were alive and 34 (4.24%) died. The fatality rate was 4.2%. There were differences between the age groups in terms of fatality rate (P<0.001). The fatality rate in patients above the age of 65 yr was significantly higher. The fatality rate in the male gender was 2.44 times higher (P<0.05). It was 1.104 times higher in advanced age (P<0.001) and 10.893 times higher in patients with at least one comorbid disease (P<0.05). Hypertension increased mortality by 3.635 times (P<0.05) and chronic pulmonary diseases by 2.926 times (P<0.05).

Advanced age, male gender and accompanying chronic diseases have adverse effects on the course and severity of the disease and hospitalization. They also increased the rate and risk of mortality.

Psychological status is a decisive factor for regulating the lung cancer chemotherapy patients’ levels of fatigue and hope. Using the PERMA (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment) framework. We aimed to explore the influences of the psychological intervention on the patients’ negative emotion, cancer-related fatigue, and level of hope.

A total of 100 lung cancer chemotherapy patients admitted in Wuhan No.4 Hospital, China, from Jan 2018 to Aug 2019 were enrolled as research objects divided into the control group and observation group. Positive psychological intervention using the PERMA framework was given to the observation group. The scores of Post-Traumatic Growth Inventory (PTGI), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Cancer Fatigue Scale (CFS), and Herth Hope Index (HHI) were evaluated and compared in the two groups.

After the intervention, PTGI score in the observation group is higher than that in the control group, whereas the SAS and SDS scores are lower in the observation group than in the control group, and the differences are statistically significant (P<0.05). Score of each CFS dimension and total CFS score in the observation group are all lower than those in the control group, with statistically significant differences (P<0.05). Score of each HHI dimension and total HHI score are higher than those in the control group, and the differences are statistically significant (P<0.05).

Positive psychological intervention using the PERMA framework can improve the emotional and fatigue state of lung cancer chemotherapy patients and elevate their level of hope.

Empathic communication is important for nurses to establish therapeutic relationships with patients and to improve the quality of care. Thus, empathy is essential for nursing students who will be future nurses. The aim of this study was to examine the mediating role of empathy in the influence of communication competence on interpersonal competence of nursing students.

This study was conducted at the Catholic University of Korea. Participants were 218 nursing students who completed a survey questionnaire on general characteristics, Interpersonal Reactivity Index, Primary Communication Inventory, and Interpersonal Competence Questionnaire from Feb. 20 to Feb. 21, 2014. Data were analyzed using simple and multiple regression analyses. Mediation analysis was performed according to the Baron and Kenny method and Sobel test.

A three-step regression analysis was performed to verify the mediating role of empathy in the relationship between communication competence and interpersonal competence. Results confirmed that communication competence significantly influenced interpersonal competence, showing that empathy had a partial mediating role (Z=2.40, P=.016).

Communication competence improved interpersonal competence through mediation by empathy in nursing students. Result of this study suggested that nursing schools should implement communication education that can strengthen empathy in order to boost nursing students’ interpersonal competence.

Seasonal agricultural workers group is one of the most disadvantageous groups of working life in Turkey same as many other countries. We aimed to determine the status of cardiovascular disease risk factors among migrant seasonal agricultural workers (MSAW) and to compare obtained data with local residents.

This study cross-sectional study was conducted among MSAW in Eskisehir, Turkey and closest town residents in 2015 during agricultural season. These 455 MSAW were living in camps composed of 20 or more tents. Local residents sample composed of 532 local residents were reached at their houses by using random sampling method with data acquired from health organization records. Both groups were subjected to same questionnaire.

The prevalence of overweight/obesity among MSAW women was 40.5%, hypertension 19.9%, diabetes 4.9% and hypercholesterolemia 6.5%. These prevalences were 68.0%, 38.6%, 13.9% and 20.8% respectively among local residents. The prevalence of smoking risk among local residents was 1.5 times more than MSAW. In addition, the prevalence of overweight/obese risk was 4 times more; hypertension risk 1.8 times more, diabetes risk 3.8 times more and hypercholesterolemia risk 2.7 times more among local residents than MSAW (P<0.05).

The prevalence of cardiovascular disease risk factors of MSAW was lower than local residents in the study groups. Even though health risks that MSAW faced were more linked with environment and life conditions, cardiovascular disease risk factors should not be ignored. Health services should be guided by considering obstacles that MSAW experienced in accessing health services.

The aim of the research was to compare the differences between the self-assessment of the health in the latest National Health Surveys research and in the one before that.

We used the database of the latest National Health Survey in the Republic of Serbia (2013) and of the one before that (2006), as cross-sectional studies (n=29485). Logistic regression was used to predict the relationship between self-assessment of health and independent predictors.

Health condition of the interviewees improved according to their self-assessment. With aging respondents who poorly assessed their health; women assessed their health 1.7 and 1.6 times poorer in the latest research and in the one before that respectively. The odds ratio in patients diagnosed with some disease in the previous 12 months ranged from 2.15 (1.85 – 2.51) to 4.03 (3.22 – 5.05) in the latest research. The strongest predictor was sick leave in the past 12 months with 95% CI = 3.19 (1.87-5.44) in the latest research and 95% CI = 2.27 (1.67-3.08) in the one before that.

There was an improvement of the health condition of individuals. Female interviewees, less educated, unemployed, the ones who have some disease and who were on a sick leave rated their health as bad.

This study evaluated the effects of a 4-week initial rehabilitation program in middle and high school baseball players who underwent removal of a loose body from osteochondritis dissecans of the capitellum humerus.

Middle and high school baseball players with osteochondritis dissecans of the capitellum humerus were enrolled in this study. Each had more than 3 yr of experience and had undergone arthroscopic removal of loose bodies from the same expert at Kim's Orthop Special Clinic in Seoul. The initial exercise rehabilitation program was based on a two-stage program. Body composition, range of motion of flexion and extension in the elbow and wrist joints, grip strength, and subjective pain scale were measured before and after rehabilitation. To assess the differences between groups, we used a two-way analysis of variance.

The range of motion for flexion and extension of the elbow and wrist joints, grip strength, and score on the visual analog scale each were significantly improved following the 4-week program (P<0.001), had an interactive effect in time × group (P<0.001), and had significance between groups (P<0.05).

The 4-week initial rehabilitation exercise program might improve the overall range of motion of the elbow joint and has a positive therapeutic effect on grip strength and visual analog scores. However, future well-designed studies with more subjects and multicentric research groups are necessary for verification.

To investigate the expression of miR-451a in prostate cancer tissues and its effect on prognosis.

Each of 78 specimens of prostate cancer tissues and corresponding adjacent normal tissues were collected from patients in Changshu Hospital Affiliated to Soochow University, Changshu, China from Apr 2014 to Jun 2015. Real-time quantitative RT-PCR (qRT-PCR) was used to detect the expression of miR-451a in tissues. The relationship between the expression of miR-451a and clinical pathological parameters was analyzed. The median expression of miR-451a in the experimental group was used to distinguish the high and low expressions of miR-451a in the experimental group. Kaplan-Meier was used to analyze the survival of miR-451a high and low expression groups.

The expressions of miR-451a in the patient's tissues and serum were decreased, and the correlation analysis found that they were positively correlated. ROC curve analysis showed that miR-451a had a high clinical value in the diagnosis of prostate cancer and the area under the curve was 0.921. The incidence of stage III+IV lymph node metastasis, Gleason score of >7 points and a serum Prostate-specific antigen (PSA) level of >20 ng/ml in patients of the low expression group increased significantly. The 5-yr survival rate of patients with low expression was significantly lower than that of those with high expression (P=0.005). MiR-451a was an independent factor affecting the prognosis of patients.

miR-451a is lowly expressed in prostate cancer, and patients with low expression have a poor prognosis.

Entrepreneurs not only promote a nation’s economic growth but also increase employment. The risk of obesity among entrepreneurs may bring heavy economic burdens not only to the entrepreneurs but also to the national health care system. We aimed to examine the association between entrepreneurship and the risk of obesity.

We utilized data from the 2015 Harmonized China Health and Retirement Longitudinal Survey, including 2,802 individuals aged between 45 and 65 with complete data. This study used BMI (Body Mass Index) (kg/m2) as an indicator of obesity risk. Entrepreneurs were defined as those respondents who run their own businesses as main jobs. We used multivariate OLS regression models and Bayesian Markov Chain Monte Carlo (MCMC) method to examine the link of entrepreneurship and obesity risk.

The multivariate OLS regression results showed that entrepreneurship was positively associated with BMI (P<0.01). The Bayesian MCMC results indicated that the posterior mean was (0.597, 90% HPD CI: 0.319, 0.897), demonstrating that entrepreneurship was indeed significantly positively associated with the risk of obesity.

Being an entrepreneur is positively associated with the risk of obesity. As obesity can cause diseases such as hypertension, diabetes, coronary heart disease and stroke, the health departments should take necessary health interventions to prevent entrepreneurs from being obese in order to increase their entrepreneurial success.

The global outbreak of the novel coronavirus pneumonia (COVID-19) has seriously affected people’s work and lives. Disaster-related traumatic stress events increase the risk of substance abuse. Therefore, the COVID-19 outbreak, as a stress event, inevitably has a negative impact on Chinese adolescents with Internet addiction.

In 2020, 1787 copies of the questionnaire were randomly distributed among adolescents aged 12–16 years in three communities in Shandong Province, China. Among the respondents, 121 Internet addicts voluntarily participated and were divided into the experiment group (60 members) and the control group (61 members). Logotherapy-based mindfulness intervention was carried out on the experiment group. The effects of the intervention were analyzed after eight weeks of intervention.

After the intervention, significant decreases occurred in the scores of Internet addiction and its five dimensions in the experiment group (P < 0.05), thereby implying better invention effects in the experiment group than the control group. The experiment group exhibited an increase in the positive coping score and a decrease in the negative coping score (P < 0.05). Significant decreases were found in the anxiety and depression scores in the experiment group (P < 0.05).

Logotherapy-based mindfulness intervention can significantly reduce the degree of Internet addiction among adolescents during the COVID-19 period, improve their positive emotions, reduce their negative emotions, and alleviate the degree of anxiety and depression in adolescents.

Food insecurity can affect health directly or indirectly through its impact on nutritional status. We aimed at determining the effects of nutrition education intervention on household food insecurity in Zahedan, southeast Iran.

The study was conducted using multi-stage sampling method. The first stage was a cross-sectional investigation whereby 2,160 households were studied in Zahedan in 2015. The prevalence of food insecurity was determined and food-insecure households were identified. Household food security status was assessed through the 18-item US Household Food Security Survey Module. In the second stage, based on the determined sample size of 150 households in each group, eligible households were randomly divided into the intervention and control groups. Before the educational intervention, questionnaires including demographic and socioeconomic information were completed for both groups. Then, data analysis was performed and the intervention was conducted on the intervention group. Six months post-intervention, a final assessment was made by interviewing the two groups to complete demographic, socioeconomic, and household food security questionnaires.

The prevalence of food insecurity in the 2,160 households was 58.8%. After the intervention, the number of food-insecure households diminished by 22% in the intervention group, and these households were assigned to the food secure category. After controlling the confounding variables, the educational intervention was significantly effective in reducing food insecurity score (P<0.001).

The findings demonstrated the beneficial role of nutritional education and the skills of resource management in modifying nutritional behaviors and improving food security in the study population.

The outbreak of the COVID-19 virus has had many destructive impacts on socio-economic and health systems. The health systems of countries could be supportive in crisis management, but they also are affected by the impact of the crisis, consequently, their operational level has declined. This study pursued resilience in an overall national health system under pandemic stress.

Based on WHO building blocks, by interviewing informants of the Ministry of Health and Medical Education, in Tehran-Iran, early 2021 a rich picture of the current situation depicted, the resilience model was extracted via a mixed method of Soft System Methodology (SSM) and total interpretive structural modeling (TISM). Dynamic capabilities were applied for the orchestration of the Iranian health system.

Particular functional and structural suggestions applicable for designing a ubiquitous resilience model for the country-wide health system are presented in this study. The variables of crisis sensing, opportunity seizing, and reconfiguration are the cornerstones of health system resilience.

Well-suited health technology assessment (HTA) and health information system (HIS) play significant roles in the overall strengthening of the health system. All reforms for resilience will have a lasting result when the capabilities created by the resilience model are learned and reused in a dynamic cycle.

Iran has ranked second in the frequency of cesarean delivery (CD) and this rate in 2014 has increased by 56 percent. The CD has multiple complications for the woman and newborn, and due to the women's readmission after surgery impose additional costs to the countries. Although CD has many complications and is not recommended by obstetrician and midwives; some factors affect the choice of this method of delivery.

We used data from the Iranian Institute for Health Sciences Research (IIHSR) in 2015. We studied the effects of factors such as socioeconomic and demographic factors and supplemental insurance status in the choice of CD. We used multilevel Zero-Inflated models for the modeling of data.

The employed women resident in urban areas with the high-income and age greater than 34-yr old and supplemental insurance more likely chose CD. On the other hand, women with high education level, women who use at least one media (e.g. Radio, television, etc.) and women that use contraceptive methods have chosen the less CD.

Our findings highlighted the importance of supplemental insurance and socio-economic status in choosing a CD by women. However, in some cases especially in the rich class of society, the high cost of this type of delivery does not affect the choice decrease of it, and governments should adopt rigorous policies in using this method.

We aimed to verify the association between blood group systems and prognosis of SARS-Cov-2 disease.

In this cross-sectional study, 329 patients infected with SARS-Cov-2 diagnosed based on their COVID-19 RT-PCR results and chest CT scans, were enrolled in the study. These patients were admitted to Kamkar Arab Nia Hospital, Qom, Iran from March to June 2020. Their blood groups and RH were determined, and demographic characteristics and clinical signs of patients were recorded. The patients’ temperature and peripheral capillary oxygen saturation levels (SpO2) were measured. Finally, the duration of hospitalization, intubation, and death rate were also analyzed.

The results of the patients' blood group analysis were as follows: 129(39.2%) patients had A type, 66(20.1%) B type, 21(6.4%) AB type, and 113(34.3%) O type. Of 329 patients, 297 (90.3%) had Rh antigen. The dead cases were higher in O blood type at 13 cases (11.5%). Considering the positive and negative rhesus antigen, 31 (10.4%) and 1 (3.1%) were dead respectively, but the difference was not statically significant. As for the A group, the mean of admission duration (8.4±6.1 days) was not significantly different from the B group (8.8 ±7.2 days). AB group with a mean (7.4 ±4.4 days) was not significantly different from the O group (7.8 ± 5.4 days). There was no significant difference in the duration of hospitalization in RH patients, positive or negative. B blood group showed a significant association with the time interval to return to normal oxygen levels.

Blood type was not associated with COVID-19 death rate, nor was it associated with admission duration. B blood group showed a significant association with the time interval to return to normal oxygen levels.