Journal of Health Scope
Volume:10 Issue: 2, May 2021

Context: 

Stroke is one of the main causes of premature death and disability, imposing significant costs on the healthcare system, especially due to expensive hospital care. Home care service is one of the interventions used in the last two decades to reduce the cost of services provided for stroke patients in different countries.

 The present study aimed to systematically review studies related to the economic evaluation of home care compared to hospital care for stroke patients.

Data Sources:

 A search was conducted between January 1990 and January 2021. PubMed, Scopus, Web of Science, and Embase databases were searched systematically. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to select the studies.

Data Extraction: 

To evaluate the quality of studies included in this systematic review, Drummond’s ten-item checklist was used.

 Five economic evaluation studies were included in this review. The included studies reported different results regarding the effect of home care on improving different indicators and the cost-effectiveness ratio of home care to hospital care. Most previous studies reported that home care is a more cost-effective option for improving many indicators, such as physical function and quality-adjusted life years (QALY), and for reducing mortality and institutionalization, compared to hospital care.

 Home care is a more cost-effective option than hospital care for stroke patients with regard to some indicators, such as the Barthel index for Activities of Daily Living, Modified Rankin Scale (mRS), quality of life, mortality, and institutionalization. However, there are some exemptions to this conclusion. Due to limitations, such as heterogeneity of interventions in the existing studies, different levels of patients’ disabilities, different perspectives toward economic evaluation, and differences in the healthcare systems of countries, further research is needed according to the context of each country based on clinical trials.

 Public hospitals account for approximately 80% of the health system resources while producing only 20% of the public sector's output.

 This study aimed to analyze the current administration structure (strengths, weaknesses, solutions, and proposed models) of Iranian public hospitals.

 This study is qualitative research with a phenomenological approach. The required data were collected using semi-structured interviews with 58 national experts in the field of hospital management who were selected based on the purposive sampling method. Data were analyzed using the conventional content analysis method.

 Nine main themes and 34 sub-themes were identified in the weaknesses. The strengths contained four main themes and 16 sub-themes. The proposed solutions had five main themes and 22 sub-themes, and the proposed models from the experts' points of view were composed of four main themes and six sub-themes. The important weaknesses were low commitment and motivation, poor financial management and budgeting, and centralized decision-making and management. The strengths included strong infrastructure, extensive service delivery, government support, and positive social functions. The most important proposed solutions were complying with the requirements of structural reform, development of related assessment indicators, public-private partnership, payment system reform, delegation, manpower management, hospital organizational structure, and reform of the tariff system. Finally, the model of the Board of Trustees, while maintaining government ownership but observing the legal requirements of this structure, was the main suggestion of experts on reforming the structure of the administration of public hospitals in Iran.

 According to the expert’s opinions, the current structure of Iranian public hospitals has many problems. Managers and policymakers can make the necessary corrections based on the solutions and models proposed in this study.

 The global population has grown and is still growing. This growth is happening in more cities than in rural areas, given the continual search for economic opportunities. The implication of this growth is the growth of healthcare centers to meet the growing healthcare demand. Accordingly, healthcare waste production has posed a big challenge to health waste disposal and management.

 This study aimed to prioritize and select the best method of waste management in the health sector with multi-criteria decision making (MCDM) approaches.

 The present cross-sectional study was carried out to select the best method of managing healthcare wastes through MCDM approaches in Qazvin. The sample was selected and assigned to two groups of 28 experts (five categories) who evaluated the criteria and a group of 22 individuals (four categories) to rank disposal methods of healthcare waste. First, six waste disposal methods and 12 criteria for designing a questionnaire were identified. After designing the questionnaire, the analytic hierarchy process (AHP) was used to calculate the weights of the criteria. Then, the TOPSIS method was used to rank different waste disposal methods. We used EC (ver. 8), Excel (Microsoft, 2007), and Lingo (ver. 14) for analyzing the data.

 Concerning the rank of health waste disposal methods based on common existing criteria, urban and rural areas should use different disposal methods. The best disposal methods are irradiation (0.839) and microwave (0.794) in urban areas and steam sterilization (0.867) and microwave (0.840) in rural areas. In both areas, incineration was ranked the last.

 To achieve the effective disposal and safety of health waste in urban and rural areas, varied but applicable disposable methods should be used for the management of health waste disposal.

 Today, air pollution is a major issue in the world, particularly in metropolitan areas.

 Accordingly, this study aimed to investigate the relationship between air pollution and mortality in the elderly in Kerman City.

 This ecological study was conducted using 2006 - 2013 mortality data inquired from the Deputy of Health of Kerman University of Medical Sciences. The data on cardiovascular and respiratory mortality, as well as death due to trauma, diabetes, and other diseases that happened in men and women aged 60 and higher were extracted. Air pollution data (CO, SO2, O3, NO, NO2, NOx, and PM10) for the same time frame were inquired from the Environmental Protection Agency of Kerman Province. Negative binomial regression was used to evaluate the relationship between air pollutants and mortality using STATA13 software.

 During the study period, a total of 14,793 deaths occurred in elderly men and women in Kerman City. Cardiovascular diseases were the leading cause of death. The results of multivariate analysis of air pollutants indicated that NO was directly and significantly related to a total number of deaths in the elderly, and an increase in sulfur dioxide and ozone; moreover, NO was significantly related to increased mortality among elderly women. Carbon monoxide was significantly related to cardiovascular death of the elderly. But air pollutants did not show any significant effect on respiratory-, trauma-, and diabetes-related deaths.

 Our findings indicate that there is a significant relationship between air pollution and mortality in the elderly. Accordingly, a warning system is suggested to reduce the elderly’s commuting on highly air polluted days.
 

 Intimacy is one of the basic and psychological needs of couples and is a motivating factor in their sexual participation.

 To determine the impact of couple therapy based on the relationship enrichment approach on the intimacy and sexual function of the couples consulting healthcare centers.

 This research was a quasi-experimental study and was performed on 60 couples referring to Comprehensive Health Centers in the southeast of Iran in 2020. The research instruments included a demographic information questionnaire, three standard questionnaires of intimacy and sexual function of men and women. The educational content was implemented only for the intervention group. Data were collected at baseline, 8th week, and 12th week after the intervention. Data were analyzed using descriptive statistics and two-factor repeated measures ANOVA using SPSS (ver. 21) software.

 The results showed that the intervention had a significant effect on sexual function and intimacy in the intervention group in three time periods (P < 0.001), whereas in the control group, no significant difference was observed in the three time periods (P > 0.05).

 The results showed that relationship enrichment counseling can increase intimacy and sexual function of couples.
 

 There are controversial studies on weight loss, cardiometabolic markers, and quality of life (QOL) in obese aged women participating in water sports.

 This study aimed to determine the effects of the WATERinMOTION exercise program accompanied with no diet on the inactive obese aged women’s weight, cardiometabolic markers, and QOL.

 Sixty-four inactive obese aged women were recruited to participate in this cross-sectional study at the Ukrainian Sports Center, Kyiv, 2019. They were randomly assigned into two Case (n = 32, with the WATERinMOTION aquatics exercise program) and control (n = 32, held in a sitting position simultaneously) groups using the convenient sampling method. The two programs were run twice a week (55 minutes each time) and lasted for one month. Moreover, anthropometric indices (weight, height, waist circumference), cardiometabolic markers (blood lipid markers and glycaemia), QOL (SF-36 questionnaire), and dietary monitoring were assessed before and after the intervention.

 The groups did not differ significantly regarding each of the analyzed variables prior to the intervention. Comparing pre-and post-intervention results revealed significant weight loss (-1.3, P = 0.004) and average BMI (-0.4, P = 0.002) in the case group. Moreover, a significant variation was revealed only in terms of weight after the intervention (P = 0.001). Regarding QOL, improvements in health status, vitality, and social aspects were significant in the case group after the intervention.

 The present study suggests that the WATERinMOTION program accompanied with no diet has a positive effect on weight loss, waist circumference, and metabolic profiles in obese aged women. However, the improvement in the QOL should not be neglected.

 Undernourishment is a major public health challenge worldwide, with severe economic consequences. If occurs in the first years of life, it may cause long-lasting effect, particularly regarding personal development and economic growth of the country.

 The current study aimed to investigate the influence of socioeconomic factors, particularly education and national income, on undernourishment in selected countries of South Asia.

 The annual panel data for 2001 to 2018 were analyzed using the vector error correction model (VECM) technique and the Toda-Yamamoto Granger causality test (TYGCT).

 According to the results of the VECM, adult literacy has mixed effects on undernourishment in the short run, while in the long term, it is associated with significant improvements in undernourishment. There is a negative association between economic growth and undernourishment in the short term; while, it disappears in the long term. The TYGCT is designed to validate the findings of the VECM as well as to investigate their robustness. According to the findings of the TYGCT, adult literacy alone can both improve undernourishment and enhance economic growth.

 This study demonstrated a negative association between undernourishment and adult literacy rate in the long term; that is, higher literacy is associated with lower rates of undernourishment, which in turn results in improved community health. Adult literacy causes declined undernourishment and enhanced economic growth. Therefore, South Asian countries should incorporate appropriate interventions based on health and nutritional evidence in the curricula of schools to, firstly, gear up the nutritional awareness and, secondly, to strive redistribution of income among the relatively poor, which may reduce the undernourishment to a significant extent.
 

 Urban liveability and its relationship with health indices is now an emerging topic in health research. In order to conduct liveability research, initially, the liveability index should be calculated according to a comprehensive, transparent, and standardized methodology.

 The purpose of this paper was to apply the Global Liveable Cities Index (GLCI), to assess and rank liveability in 31 Iranian cities.

 The GLCI is based on 114 indicators in five domains, which include economic, environmental, security and stability, socio-cultural, and political factors. This study was based on two scenarios. The first scenario was to assign equal weights to each indicator. The second scenario was the Shapley weighing method and allocated different weights to indices. City rankings were calculated and compared in both scenarios.

 The cities of Tehran, Sari, and Tabriz generally performed well in the overall liveability ranking. Tehran ranked first based on the economic vibrancy and competitiveness domain, while Sari, Karaj, and Tabriz held the second to fourth ranks in both methods, respectively. Tabriz ranked first in the environmental friendliness and sustainability and domestic security and stability domains, and Sari ranked first in the socio-cultural conditions domain. Tehran and Semnan had the first rank in the political governance domain.

 The findings of this research show that different cities of Iran are very different in regard to liveability. These rankings can help policymakers find out what domains need more attention to improve the liveability of cities.

The need for extensive vaccination of health care workers (HCWs) is felt more than ever. The aim of this study was to investigate the determinants of influenza vaccination using HBM in HCWs of Jahrom hospitals. This cross-sectional study was performed by multicenter method on 614 HCWs in Jahrom, southern Iran, in 2020. Data collection tools included Demographic and researcher-made Influenza Vaccination in HCWs Based on HBM Questionnaires whose validity and reliability were measured and evaluated. Analyzes have been performed using SPSS 21. Increasing age (P < 0.001) and perceived barriers (P < 0.001) have increased influenza vaccination, but perceived benefits (P = 0.002), cues to action (P = 0.001), and self-efficacy (P < 0.001) have had a negative impact on influenza vaccination among HCWs. Perceived severity (P = 0.7) was higher in people with a history of influenza vaccination, while such a difference was not observed in perceived susceptibility. Higher mean age, previous vaccination history, and perceived barriers are predictors of influenza vaccine participation behavior.