مجله دانشکده بهداشت و انستیتو تحقیقات بهداشتی
سال نوزدهم شماره 1 (پیاپی 73، بهار 1400)

The realist review has been introduced to review and synthesize the evidence related to the implementation of complex healthcare interventions. This method interprets the results of an intervention by explaining the causal relationships between the intervention and the results. This study aimed to explain the methodology of realist review in the health system.

This study was conducted using the scoping review. The following databases were used to find articles using appropriate search strategies and relevant key words: Pubmed, Scopus, Science Direct, and Embase electronic databases, as well as Google Scholar and Google search engines. Finally 49 articles were selected (in the period between January 1990 and December 2020) for review.

The realist review is a theory-based approach to synthesize evidence related to the complex interventions, explaining the reasons for the successes or failures of interventions based on the causal relationships between the interventions, contexts, mechanisms and outcomes. A protocol was introduced to conduct a realist review composed of three phases ─ explaining, development and correcting the intervention program theory ─ and including seven steps of determining research questions; explaining the initial program theory; developing search strategies; collecting, evaluating and selecting evidence; synthesizing evidence; modifying the initial theory; and making suggestions. In addition, the structure of a realist review article was described and a checklist for evaluation of a realist review study was introduced.

The realist review is a suitable method for reviewing the complex health system interventions, explaining how an intervention relates to the results obtained. A realist review explains how, under what conditions and for whom a health and therapeutic intervention works.

High concentrations of particulate matter-25 (PM2.5) have been the cause of the unhealthiest days in Tehran, Iran in recent years. This study was conducted with the aim of the spatio-temporal analysis of traffic volume and its relationship with PM2.5 pollutant concentrations in Tehran metropolis, Tehran during 2015-2018, using the Geographic Information System (GIS).

In this study in different regions of Tehran, the Inverse Distance Weighting (IDW) model was used for prediction and zoning of the PM2.5 concentrations and traffic volume during the period 2015-2018. In addition, the association between the PM2.5 concentrations and traffic volume was determined based on the Geographically Weighted Regression (GWR) model.

The findings showed that the southern and southwestern regions of Tehran had the highest PM2.5 pollutant concentration (annual average more than 40 μg/m3), while the eastern and northern regions had the highest traffic volume. In addition, based on the GWR model, the eastern regions were found to have the highest local R2 values (between 0.36 and 0.70).

In most regions of Tehran, no strong association can be found between high concentrations of PM2.5 and traffic volume. However, based on the findings of this study we cannot reject the relationship between traffic volume and PM2.5 pollutant but postulate other sources to be the main reason for the high concentrations of PM2.5. Thus, in the first step, these sources should be identified, followed by adopting strategies for traffic volume control and reduction aiming at having a cleaner air in Tehran.

Patients with diabetes need continous support for sustainable self-care behaviors. The use of supportive forces to improve the level of self-management of diabetes is felt. The aim of this study was to compare the effectiveness of direct and indirect virtual educational interventions on the promotion of self-management behaviors and diabetes control in women with type 2 diabetes. The study was conducted in 2019.

This clinical trial study included 100 females with type 2 diabetes under the coverage of three health centers affiliated to Tehran University of Medical Sciences, randomly divided into two groups of direct and indirect education (50 subjects in either group). A questionnaire was used as the standard tool of diabetes self-management. The education imparted to the subjects was based on the latest version of Diabetes Self-Management Education (DSME), and the educational sessions were based on the Stanford Universitychr('39')s self-management model, including six 90-minute sessions during three weeks. Data were analyzed using SPSS-16 statistical software, the statistical tests being covariance analysis, etc.        

There were no statistically significant differences between the direct and indirect educational groups as regards the self-management scores and HbA1c levels in the first and second pre-tests (p<0.05). However, both the self-management scores and HbA1c levels of the two groups, determined at 3- and 6-month follow-ups, were found to be statistically significantly different (p<0.05).               

The findings of this study indicate the feasibility of using volunteers, after empowering them properly, to implement diabetes self-management educational interventions.

Public health expenditures and the quality of governance are among factors affecting the health status of a population. Therefore, the purpose of this study was to investigate the interaction effects of good governance and public health expenditures on the health status of children in upper-middle income countries.

This descriptive-analytical applied study was performed using the panel data regression with the fixed effects method and quantile regression for panel data for the years 2000-2017 in 2020. The statistical population was upper-middle income countries, and annual time series data were extracted from the World Bank databases. The models and required tests were determined using the Stata-16 software.

The coefficient of good governance variable and the index of interaction effects of good governance and the public health expenditures for the under-five child mortality as the dependent variable were -0.002 and -0.003, and for the infant mortality as dependent variable -0.002 and -0.002, respectively. Also, the coefficient of the index of the interaction effects of good governance and public health expenditures in the quantiles of 0.25, 0.50 and 0.75 for the under-five child mortality as the dependent variable were -0.0333, -0.0447 and 0.048, and for the infant mortality as the dependent variable were was -0.044, -0.048 and -0.049, respectively.

Improvement of governance indicators will increase the efficiency of public health expenditures and improve the children’s health status. Therefore, in order to improve health status, especially in countries with higher child mortalities, it is recommended to improve good governance, increase public health expenditures and government investment in health infrastructure, as well as increase gross domestic product and womenchr('39')s employment.

Although staying at home seems to be the best way to reduce the risk of Covid 19 virus and stay safe from it, the home has physical and psychological effects on people, especially vulnerable populations. Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders in women which, in addition to many physical problems, it has many psychological manifestations. Thus, the present research was conducted to determine the effect of home-made aerobic activity on the psychological state of adolescent girls with PCOS in home quarantine conditions.

In this 12-week study a sample of 40 adolescent girls with PCOS participated ─ 20 in the intervention, and 20 in the control, group, the intervention group performing home-based aerobic training for the whole period. In both groups anxiety and depression, as well as body image concern were determined at the beginning and at the end of the period, using the Hospital Anxiety and Depression and Littleton Body Image Concern questionnaires, respectively; so was body composition by weight and height. The data were analyzed using the SPSS-22 software, the statistical tests being the Kolmogorov-Smirnov test and Analysis of covariance.

Before the intervention, the experimental and control groups did not differ significantly as regards anxiety, depression, body image concern and body composition (p> 0.05). Further analysis of the data revealed significant differences between the two groups regarding these variables (p = 0.001) at the end of the period.

Supervised aerobic exercise in the home has a favorable effect on the psychological state of adolescent girls with PCOS and can be recommended as a safe therapy for these patients in corona conditions.

Internet addiction means excessive and unnecessary use of the Internet. The aim of this study was to investigate the role of brain-behavioral systems in Internet addiction among university students.

This was a descriptive and correlational research. The statistical population was all the students of Islamic Azad University, Karaj Branch in the academic year 1397-98. A sample of 162 students were selected, based on the Tabachnick & Fidell formula, using the multi-phase cluster sampling technic. The tools used to collect data were the harmful Internet use and the brain and behavioral system questionnaires.

Based on the multivariate regression analysis, 66.7% of Internet addiction among the students could be explained by brain-behavioral systems.  Active avoidance and approach, as components of the behavioral activation system, could predict Internet addiction negatively, while passive avoidance and extinction, as components of the behavioral inhibition system, and fight and flight from the components of the fight/flight system, could predict Internet addiction positively.

Purposeful communication and information search (pleasant unconditional stimuli), tedium and constant logic dominating the internet environment (unpleasant unconditional stimuli) have their own conditional cues on the Internet that indicate the degree of susceptibility of brain-behavioral systems to internet addiction.

The human mental health is a multidimensional and complex issue affected by a wide range of biological, psychological, sociological, economic and cultural factors. Considering the social nature of human life, the purpose of this study was to investigate the relationship between some social variables, e.g., social support, social bond, social trust and social status, and teachers’ mental health.

This study was a cross-sectional quantitative survey using a questionnaire to collect. The sample included 373 primary school teachers (first and second grades) in Najafabad, Isfahan, Iran selected in 2020 by multi-stage random sampling.  Data were analyzed using the structural equation modelling technic, with the SPSS-25 and Amos-23 software.

The confirmatory factor analysis of the items showed that they could explain 63.25% of the variance of the teacherschr('39') mental health variable, the social support, social status and social trust variables affecting it (0.65, 0.45 and 0.18, respectively), with a confidence interval of 99% and p<0.001. On the whole, the independent variables could explain 76% of the variance of the teachers’ mental health. In addition, moderation analysis showed that in general gender moderates the effects of social variables on the teachers’ mental health, the female gender having stronger effects in these relationships.

The results of this study show that primary school teacherschr('39') mental health, which is an individual/private phenomenon, is greatly affected by their quality of social life, some factors such as social support, social status and social trust potentially influencing it. Moreover, this effect is much more pronounced among women than men.

This study was performed to investigate the effect of mental wellbeing on flow at work with the mediator variable of perceived organizational support in Payam Noor University in Khuzestan Province, Iran.
Matrials and

This was an applied research project. The research population was the personnel of Payam Noor University in Khuzestan Province, Iran. The sample size was, based on the Cochran formula, 228 subjects selected by stratified random sampling. Data were collected using a standard questionnaire (on a 5-point Likert scale), the validity of which was determined based on experts’ confirmation and confirmatory factorial analysis and the reliability by Cronbach alpha (in both cases over 0.7). Data analysis was done using the SPSS-21 and Amos software.

The effects of mental wellbeing on flow at work and perceived organizational support were found to be 0.76, 0.48, respectively, the effect of perceived organizational support on flow at work being 0.23.

Based on the findings, it is concluded that mental wellbeing has a significant positive impact on flow at work and perceived organizational support. In addition, the mediating effect of perceived organizational support is confirmed.