فهرست مطالب

Preventive Medicine - Volume:13 Issue: 1, Jan 2022

International Journal of Preventive Medicine
Volume:13 Issue: 1, Jan 2022

  • تاریخ انتشار: 1400/11/09
  • تعداد عناوین: 13
|
  • Soudabeh Yarmohammadi, Mohtasham Ghaffari, Parisa Mashayekhi, Ali Ramezankhani, Jamal Mirzaei Page 1
    Background

    Different strategies can promote healthy behaviors. Although the human papillomavirus (HPV) vaccine is very important due to its effect in reducing cervical cancer, the behavior of HPV vaccination is low among young adults in Iran. Therefore, this study aimed to determine strategies for improving HPV vaccination among young adults.

    Methods

    The present study was conducted with a qualitative content analysis method. The participants were 30 health professionals and young adults in Tehran city who were selected using purposive and snowball sampling. The data were collected through semistructured interviews and analyzed by Graneheim and Lundman’s approach.

    Results

    In total, two categories were identified: (1) access to services: access to the vaccine, vaccine insurance coverage; (2) educational coverage: subgroup training, educational content, time for training, educational channels, education strategies, and educational conditions.

    Conclusions

    This is the first study conducted to determine strategies for improving HPV vaccination in Iran. The policymakers and planners, schools, and health centers are recommended to use the strategies obtained from this study to increase HPV vaccine imports, as well as increase the community members’ knowledge and acceptance of the HPV vaccine.

    Keywords: Human papillomavirus vaccine, qualitative research, strategy
  • Maryam Tajvar, Mehdi Yaseri, Roya Mahmoudi, Asghar Zaidi Page 2
    Background

    Iran is one of the fastest ageing countries in the world. The model of Active Ageing (AA) could be a strategy contributing in addressing the problem of population ageing in Iran. This study measured the status of AA in Iran and examined its associations with the health‑related quality of life of older people.

    Methods

    A quantitative cross‑sectional survey of a random sample of 623 people aged 55 + years resident in Tehran was conducted. In total, 590 people responded. The AA was measured using the Active Ageing Index (AAI) questionnaire and the health‑related quality of life was measured using SF‑36 questionnaire. Associations between the domains and the overall AAI scores with the quality of life were examined by MANCOVA analysis in four models using the STATA software.

    Results

    The score of overall AAI was calculated at 26.8 (men 33.9 vs. women 20.6) out of 100. We found a stronger association of the AAI with the physical component than the mental component of the SF‑36. Generally the 1st (employment) and the 2nd (participation in society) domains of the AAI showed little or no association with SF‑36, but there was an association between the 3rd domain (enabling environment for active ageing) and the SF‑36 and a particularly strong associations with the 4 th domain (independent, healthy and secure living capacity).

    Conclusions

    Iranian elderly, particularly women, are experiencing relatively inactive life, which negatively influence on their health‑related quality of life. To improve the AAI status in Iran, some aspects including “enabling environment” and “independent, healthy and secure living capacity” need special attention.

    Keywords: Aged, healthy aging, Iran, quality of life
  • Fathemeh Eghbalian, Ali Hasanpour Dehkordi, Roya Raeisi Page 3
    Background

    Neonatal jaundice is a prevalent disease that causes many complications, including kernicterus and even death. Previous studies have shown that clofibrate as an aryloxy isobutyric acid derivate can be effectively applied for the treatment of neonatal jaundice. Thus, this review was carried out to investigate the effects and mechanism of action of clofibrate on neonatal jaundice.

    Methods

    The keywords such as “Clofibrate” in combination with “Neonatal jaundice” or “Neonatal hyperbilirubinemia” or “Newborn Jaundice” were used to search for relevant publications indexed in the Institute for Scientific Information (ISI), Scopus, PubMed, and Google Scholar databases. Finally, after reviewing the studies, 24 papers were included in this study.

    Results

    Results showed that the processes of albumin‑bound bilirubin transfer to the hepatocytes, hepatic uptake, and storage via ligandin, hepatic conjugation via uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1), conjugation into the bile via MRP2 represent the main action mechanism of clofibrate that turns it into the bilirubin conjugates and expels it from the bile. Besides, clofibrate has been shown to reduce the level of Total Serum Bilirubin (TSB) in infants even at a dosage of 25 mg/kg without leaving side effects.

    Conclusions

    The results of this review revealed that clofibrate effectively reduces TSB in short‑term usage and can even have a promising effect at the dosage of 25 mg/kg in full‑term infants. Most studies have shown this property over a short period in term infants, and there is no evidence about long‑term usage in this regard.

    Keywords: Clofibrate, hyperbilirubinemia, neonatal jaundice, newborn jaundice
  • Hassan Okati Aliabad, Alireza Ansari Moghaddam, Hamidreza Roohafza, Mahdi Mohammadi, Leila Vakili, MohammadHadi Abbasi, Hossein Heidari, Gholamreza Masoudy, Safoura Yazdekhasti, Masoumeh Sadeghi Page 4
    Background

    Cardiovascular diseases are the leading causes of mortality all around the world. Patients with Ischemic heart disease (IHD) are at an increased risk of ischemic events; therefore, secondary prevention measures should continue for these patients. Although Cardiac rehabilitation (CR) is one of the secondary prevention measures for IHD patients which has favorable clinical outcomes, only 50% of patients are referred and among them, a small percentage attends CR. Therefore, other strategies should be considered, one of which is home‑based cardiac rehabilitation.

    Methods

    A multicenter, parallel‑group randomized controlled trial has been conducting in three hospitals in Isfahan and patients have been assigned into a 1:1 ratio for the evaluation of the effectiveness of home‑based cardiac rehabilitation versus usual care. Psycho‑educational consultation based on the Health Action Process Approach including heart‑healthy diet, stress management, lifestyle changes, smoking cessation, and physical activity has been performed. Primary outcomes, including the quality of life, psychological and smoking status, body mass index, blood pressure, blood cholesterol level, and physical activity level have been measured at 6 months after the randomization and intervention. One year after the intervention, primary and secondary outcomes, including cardiovascular events, the frequency of hospital admissions, and the death rates due to cardiovascular reasons will be assessed.

    Conclusion

    HBCR program can increase patient accessibility to CR services its implantation can be reduce burden IHD.

    Keywords: Cardiac rehabilitation, coronary disease, exercise, home‑based
  • Fariborz Rezaeitalab, Fariba Rezaeetalab, Farzaneh Akbari, Seyyed MohammadAta Sharifi Dalooei, Soheila Saberi, Saeedeh S Mirtouni Page 5
  • Reza Jafarzadeh Esfehani, Mohammad Shariati, Ariane Sadr Nabavi, HamidReza Bidkhori Page 6

    Relative internet search volumes (RSV) is now being consider as a measurement of awareness for most of the trending topics. During the recent coronavirus disease (COVID‑19) outbreak, many researchers used the RSVs to interpret the population responses to the pandemic in various ways. By using the RSVs searched by Persian language people, we demonstrated that the Iranian people increased their knowledge and awareness of COVID‑19 during the early phases of the disease before the first peak. However, their relative searches about the COVID‑19 and its clinical symptoms decreased gradually despite of the gradual rise of the confirmed cases. Their less tendency to seek information about the COVID‑19 could be one of the possible explanation for the increasing number of confirmed cases even several days after easing the disease related lockdown.

    Keywords: Awareness, COVID‑19, internet
  • Leila Dehghani, Arash Khojasteh, Masoud Soleimani, Saeed Oraee-Yazdani, Saeed Heidari Keshel, Mohammad Saadatnia, Masih Saboori, Alireza Zali, Seyed Mahmoud Hashemi, Reyhane Soleimani Page 7
    Background

    Malignant middle cerebral artery infarct (mMCAI) largely contributes to high mortality and physical disability among adults. Surviving individuals may not have proper outcomes and suffer from severe lasting disabilities. Utilization of stem cells and paracrine factor for regenerative purposes is considered as a potential strategy for patients with neurological deficits. While preclinical stroke studies have shown that mesenchymal stem cells (MSCs) reduce post‑treatment neurological deficits and prevent disability and also promote recovery, few randomized clinical trials (RCT) have assessed exosome therapy in humans.

    Methods

    In this RCT, we assessed the safety of intraparenchymal injection placenta MSC‑derived Exosome in mMCAI patients with average age of 62 years between January, 2019, till September, 2020. The study was done in a single‑center as an open‑label RCT, with a 3‑months follow‑up. Primary outcomes assessed the safety and also disability indexes were followed.

    Results

    Five mMCAI patients were included with mean NIHSS: 17.6 ± 5.02. The mean MRS was 3.25 ± 0.95 in three patients. No serious adverse events were observed. Hematoma or local reaction as excessive edema were not seen at the site of injection.

    Conclusions

    Intraparenchymal implantation of MSC‑EXO showed no post‑interventional adverse effects in five ischemic stroke patients. It is proposed Local injection Exosome treatment following mMCAI can be safe and in future, it would be applied as a supportive, restorative and preventive treatment in patients who suffer from acute ischemic stroke and post ischemic disability.

    Keywords: Allogenic mesenchymal stem cell, decompressive craniectomy, exosome, mMCAI
  • Neda Kabiri, Rahim Khodayari zarnaq, Manouchehr Khoshbaten, Ali Janati Page 8

    This qualitative systematic review was conducted to summarize the policies for prevention of common gastrointestinal cancers worldwide. This study was conducted using PubMed, Web of Science, SCOPUS, and ProQuest databases. Two independent reviewers assessed included studies for methodological quality and extracted data by using standardized tools from Joanna Briggs Institute (JBI). Primary study findings were read and reread to identify the strategies or policies used in the studies for prevention of gastrointestinal cancers. The extracted findings were categorized on the basis of their similarity in meaning. These categories were then subjected to a meta‑synthesis. The final synthesized findings were graded according to the ConQual approach for establishing confidence in the output of qualitative research synthesis. From the nine included studies in this review, 39 findings were extracted and based on their relevance in meaning were aggregated into 12 categories. Four synthesized findings were developed from these categories. We used World Health Organization report on 2000 for synthesizing the findings. The four synthesized findings were “service provision”, “resource generation”, “financing”, and “stewardship”. In order to reach a comprehensive evidence informed policy package for the prevention of gastrointestinal cancers, there should be a great communication among the interventions conducted directly on patients, health system infrastructures, and resources.

    Keywords: Gastrointestinal cancer, policy, primary prevention, secondary prevention, strategy
  • Soha Zahid, Ahtisham Saleem, Nazuk E Qureshi Page 9
  • Shiva Yousefian, Katayoun Jahangiri, Yadollah Mehrabi, Sanaz Sohrabizadeh Page 10
    Background

    Collaboration, as a key factor in disaster risk management, is a mechanism that prevents the loss of time, investment, and resources. The variety of units in the health sector has made collaboration a major challenge. The present study aimed at developing a tool for assessing collaboration in the health sector during disasters.

    Methods

    In this mixed‑methods study, a questionnaire was developed by integrating the findings of a systematic literature review and a qualitative study. Face and content validation were performed. The reliability of the tool was tested through a 15‑day interval test–retest by Cronbach’s alpha and intraclass correlation coefficient (ICC) with 30 participants. Confirmatory factor analysis was done to test the validity and reliability of instrument using SmartPLS in a case study with 450 health sector staff.

    Results

    The factors affecting intraorganizational collaboration of the health sector were identified in six categories and 19 subcategories by searching 46 articles in the systematic review and content analysis of 16 semistructured interviews with health sector staff. The results of content validity ratio (=0.81), content validity index (=0.92), Cronbach’s alpha (=0.975), and ICC (=0.970) confirmed the validity and reliability of the tool. Convergent validity, discriminant validity, and reliability were approved by AVE (average variance extracted) >0.5, Fornell and Larcker matrix, and CR (composite reliability) >0.7. According to the positive result of R2, Q2, and goodness‑of‑fit (GOF) criteria, the model fit was confirmed.

    Conclusion

    The results of validity and reliability measurements approved the proposed tool. The use of this tool is recommended for developing collaboration in the health sectors of different countries.

    Keywords: Disaster planning, disasters, health care sector, intersectoral collaboration, naturaldisasters, surveys, questionnaires
  • Hassan Nourmohammadi, Zahra Abdan, Seyed Mohammad Amin Hashemipour, Diana Sarokhani, Mohsen Abdan, Moloud Fakhri, Ali Hasanpour Dehkordi Page 11
    Background

    Osteoporosis in the elderly has dangerous complications, the most important of which are bone fractures and reduced quality of life in the elderly. The present study was aimed at estimating the prevalence of osteoporosis in Iranian elderly using systematic review and meta‑analysis.

    Methods

    This search was conducted using authentic Persian and English keywords in national and international databases including Scientific Information Database, Magiran, IranDoc, PubMed, Scopus, Cochrane, Embase, and Web of Sciencewith no time limit until 20.06.2020. Heterogeneity of studies was assessed using I 2 index. Data were analyzed using STATA Ver. 15 software.

    Results

    In 30 studies with a sample size of 13,347 people, the prevalence of osteoporosis and low bone density in people over 60 years in Iran were 34% (95% CI: 27%, 42%) and 47% (95% CI: 41%, 53%), respectively. We also found that 34% of women and 41% of men over the age of 60 suffer from osteoporosis. Prevalence of osteoporosis was in lumbar bone 23% (95% CI: 20%, 26%), spine 25% (95% CI: 19%, 31%), hip 35% (95% CI: 7%, 62%), and femur 23% (95% CI: 15%, 31%). Prevalence of low bone density was in lumbar bone 41% (95% CI: 19%, 63%), spine 30% (95% CI: 15%, 46%), and femur 35% (95% CI: 21%, 48%).

    Conclusion

    The prevalence of low bone density in people over 60 years is higher than the prevalence of osteoporosis in them. About one‑third of Iranian elderly people suffer from osteoporosis, but about half of them have low bone density.

    Keywords: Age‑related bone loss, elderly, Iran, low bone density, metabolic bone disease, osteopenia, osteoporoses, osteoporosis
  • Shafaghi Shadi, Ghorbani Fariba, Taranian Zohreh, Doozandeh Neda, Varahram Mohammad Page 12
    Aims

    At present, there is no definitive treatment for COVID‑19 and to break the pandemic chain, prevention is the best choice. Meanwhile different controlling strategies are considered, in this study, we aimed to understand public insights toward the medical advisement.

    Material

    A self‑constructed questionnaire including information regarding various preventive elements such as wearing a mask, using gloves, attention to safe social distance, using disinfectant materials was prepared. After content validity, the questionnaire was circulated in cyberspace and the public was invited to complete it. After five days, the percentage of risky behavior related behaviors to the mask (RBM), hygiene (RBH), and social distance (RBD) were analyzed and compared in different situations with tableau and SPSS 26.

    Results

    A total of 7,000 people with the mean age of 31.5 ± 12.2 years completed the questionnaire, of which 39% were men. RBM was 76.54% whereas hand hygiene and distance risky behaviors were 11.49% and 15.33%, respectively (P = 0.01). RBD was significantly higher among people with COVID‑19 patients in their families. The pattern of RBH based on the level of worry about getting COVID‑19 was similar in the group without worry and with the highest level of worry.

    Conclusions

    In this ever‑changing situation of the COVID‑19 pandemic, community awareness, and logical perception regarding correct use and has a crucial role in optimal COVID‑19 controlling, which should not be neglected. It is important to have the latest information, which comes from trustworthy sources as a preventive key in both healthcare and community settings.

    Keywords: COVID‑19, pandemics, society attitude, surveys, questionnaire
  • Naif H Alqahtani, Mohammad Eid M Mahfouz Page 13
    Background

    Irritable bowel syndrome (IBS) is a common chronic functional gastrointestinal (GI) disorder. The aim of this study is to assess the prevalence of IBS and its risk factors among the general population of Saudi Arabia, as there is no previous study has done so.

    Methods

    A cross‑sectional study was carried out to evaluate the prevalence of IBS, IBS subtypes and IBS risk factors among the general population of Saudi Arabia from June 22 to November 30, 2019. A designed questionnaire that is based on ROME IV criteria and licensed from Rome Foundation was used. A total of 1,680 eligible individuals from different parts of Saudi Arabia took part in this national survey and were included in the statistical analysis. The statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS) program (version 22).

    Results

    The prevalence of IBS in the study was 18.2%. IBS‑M was the most common subtype among IBS patients (42.3%). Risk factors that are significantly associated with IBS were shown to be smoking habits, gastroesophageal reflux disease (GERD), food allergy, anxiety, psychological stress, family history of IBS, regular use of non‑steroidal anti‑inflammatory drugs (NSAIDs), history of infection before occurrence of symptoms and residence in the south of Saudi Arabia (P < 0.05*).

    Conclusions

    IBS is prevalent in Saudi Arabia. The most common risk factor among IBS patients is a positive family history of IBS (80%). Raising public awareness and further prospective studies are both advocated and needed.

    Keywords: Anti‑bacterial agents, body mass index, contraceptive agents, genetics