Journal of Health Scope
Volume:12 Issue: 3, Aug 2023

A 30-year-old Iranian woman referred to Yasrabi Hospital in Kashan, Iran, developed fever and swollen neck lymph nodes after receiving the Sinopharm vaccine. An ultrasound-guided needle biopsy of the patient's lymph nodes confirmed the Kikuchi-Fujimoto disease (KFD) diagnosis, and her fever and swelling resolved 22 days after treatment. Although the exact cause of this disease which is arising from COVID-19, is unknown, it can be said that vaccination against COVID-19 can be the cause of KFD.

Population aging, the burden of chronic diseases, and the cost-effectiveness of home care (HC), compared to hospitalization and institutionalization, have increased the importance of HC. Therefore, there is a need to share the experiences of leading countries in home-based long-term care (LTC) for older individuals.

This review aimed to explain the structure of HC for older adults in different countries.

A scoping review was performed on HC published in English using PubMed, Embase, Scopus, Web of Science, CINAHL, Google Scholar, and grey literature. The search began in January 2022, and the latest search was conducted in June 2023. The main keywords ‘home care’, ‘old*’, ‘Funding’, ’organization’ and ‘training’ and ‘policy’ and ‘formal care’ and ‘home-based services’ were used for searching. The data were classified into 7 domains, including 1) governing, 2) long-term care insurance (LTCI), eligibility for HC services and financing, 3) benefits, 4) marketization and free choice system, 5) workforce training, 6) quality assurance of care, and 7) supporting caregivers.

Overall, 44 documents out of 4072 studies were included in the final analysis, containing data from 23 countries. Each study covers some domains of HC, and some other studies compare domains in some Asian and European countries. The regulation makes authorities organize high-quality care. Ministries set legal frameworks, and municipalities are autonomous in determining principles and financing of services. Older adults are eligible to receive cash and in-kind benefits based on their needs or assets. Financing is done using insurance, taxes, or privately. Some countries have made the quality assessment of services mandatory.

This review can generate novel insights into designing HC systems according to different contexts. Comprehensive information on HC organizations for older adults was only available in some countries. Therefore, further in-depth studies are needed to assess each component of the HC system separately. Defining legal rights and responsibilities for caregivers and older individuals, universal coverage of LTCI for all older adults, financial and care options to help pay for HC, and training family caregivers are recommended for developing countries.

Vaccination is a strategy for controlling the COVID-19 pandemic. After the vaccine is produced, the utilization of the vaccine becomes crucial.

The study aims to investigate the public attitudes toward COVID-19 vaccination in Iran.

A cross-sectional study was conducted in Iran from March 21 to July 6, 2021. The questionnaire collected attitudes towards the COVID-19 vaccination and priorities for COVID-19 vaccination. Based on the formula for calculating the sample size to estimate the ratio, the sample size was approximately 715 people. A convenience sampling technique was used to select participants. Data were collected both online and face-to-face from individuals over 18 years old. Logistic regression analysis was used to analyze the factors predicting willingness to pay for vaccines.

About 46% of the participants stated that they would use the COVID-19 vaccine, and 36% of them stated that their use of the vaccine depends on the type and specifications of the vaccine. About 71% were willing to pay for a COVID-19 vaccine. The most important reason for not using the vaccine was "concerns about side effects of the vaccine" (44.9%). About 88% of respondents agreed that the COVID-19 vaccine should be free for everyone, and 56.6% favored that COVID-19 vaccination should be mandatory and everyone should be vaccinated. There was a significant relationship between the willingness to pay for the vaccine with educational status and the perceived risk of being infected with COVID-19 (%). Healthcare workers (31.4%) had the highest priority for receiving the COVID-19 vaccine.

Most respondents were willing to receive and pay for the vaccine. The results provide useful information for decisionmakers to identify individual and social values for a suitable vaccination strategy.

Myocardial infarction (MI) is the main cause of illness, mortality, and stress worldwide. Oxidative stress is the major cause of myocardium tissue damage associated with cell necrosis.

The current study was designed to compare biochemical parameters with in vitro antioxidant activity in MI patients.

This observational cohort study was conducted on 53 MI patients, and the samples were collected on the basis of a nonrandom sampling technique from April 2022 to November 2022. Lipid profile (i.e., total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), and triglycerides (TG)) and cardiac profile (i.e., troponin T, troponin I, creatine kinase MB (CK-MB), and creatine phosphokinase (CPK)) were measured for the confirmation of variation in biochemical parameters. Afterward, the inhibition of oxidative stress was analyzed through the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay on the serum samples of the patients.

Of 53 MI patients, 33 and 20 cases were male and female, respectively. Moreover, the correlation of the DPPH assay with TC, troponin T, and troponin I was determined by Pearson correlation. The correlation coefficients range from -1 to 1, indicating the strength and direction of the linear relationship between the markers. The concentrations of lipid profile (i.e., TC, TG, LDL, and VLDL) or cardiac profile (i.e., CK-MB, CPK, troponin T, and troponin I) were significantly elevated in all MI patients. However, the HDL level (P = 0.001) was decreased.

According to obtained results, reactive oxygen species (ROS) might be the causative agent of MI. Therefore, if an antioxidant medication is used as administrative content, it would be helpful for the treatment of MI and a lead mark for pharmaceutical companies in drug designing for MI patients.

The coronavirus disease 2019 (COVID-19) pandemic is an emerging global threat to public health.

This study examined the epidemiological and clinical characteristics and death-related factors of COVID-19 in inpatients in Zahedan, Iran.

This multicenter study included all COVID-19 patients admitted to Zahedan hospitals within February to April 2020. Demographic, epidemiological, and clinical characteristics were extracted from medical records. Bivariate and multivariate logistic regression models were used to examine the risk factors associated with inpatient mortality.

Of 425 patients in this study, 237 and 188 were male and female, respectively. Moreover, 31 (7.29%) patients died. The patients with a severe stage of pneumonia and those with a severe/critical condition of COVID-19 were 35.8% and 35.1%, respectively. The most prevalent symptoms were cough (70.8%), shortness of breath (62.1%), fever (34.1%), bruising (28.7%), and shivering (28.5%). The most prevalent underlying diseases were hypertension (23.3%), diabetes (16.7%), cardiovascular disease (13.2%), chronic pulmonary disease (9.6%), and asthma (5.4%). Adjusted odds ratio (OR) of in-hospital mortality increased for patients with older age (OR = 3.74, 95% CI: 1.39 - 10.32), at least one underlying disease (OR = 1.16, 95% CI: 1.01 - 1.32), severe disease (OR = 30.9, 95% CI: 4.01 - 239.09), and critically severe disease (OR = 736.5, 95% CI: 74.75 - 7256.1) compared to mild/moderate disease.

This study showed that older age, disease severity, and underlying diseases were mortality risk factors due to COVID-19 infection. This finding indicates that priorities for hospital admission must be given to patients with a higher risk of mortality due to limited facilities, especially in less privileged areas.

A short pregnancy interval (long fertility acceleration (Tempo)) is associated with adverse health and perinatal outcomes, including maternal, child, and neonatal mortality.

We aimed to investigate the duration and determining factors of first birth intervals among women of reproductive age in Semnan, Iran.

In this cross-sectional study, the fertility history of 600 married women aged 15 to 49 in Semnan (Iran) was investigated from the list of health centers. Individuals were selected using a multistage sampling method in 2018. Finally, a married woman (15 - 49 years) was selected randomly from each household. Data were obtained by interview questionnaire, calculated tempos, and analyzed with a Cox proportional hazard model.

The median (first – third quartile) time of first birth intervals and age of women and men at the first marriage were estimated to be 24.0 (12 - 44) months, 20 (18 - 23), and 25 (22 - 28) years, respectively. The lowest estimated tempo was for third births (68.63 months), and the highest was for the 1st (26 months). Among explanatory variables of interest, the number of children expected, the father’s age at the first marriage, the mother’s occupation, and the desire to have children were significant predictors of the first birth intervals.

Due to the decrease in the number of births in the past several years and also the prediction of a decrease in the coming years, one of the ways to reduce the birth interval and, as a result, increase the fertility rate is to reduce the age of marriage among young people and in general to marry on time among young people, as well as to control inflation and reduce the cost of having children.

A short, valid, and reliable instrument is required for the easy assessment of health literacy in online surveys.

In this study, we investigated the validity and reliability of the Persian version of the 8-item Health Literacy Questionnaire as a brief online survey tool in 18-65-year-old Iranians.

This was a cross-sectional study undertaken in thirty-one provinces of Iran. A total of 2374 Iranian people with age 18 - 65 years participated in this study. To ensure the quality of English-to-Persian translation, the process of forward-backward translation was conducted. The scale’s factor structure was assessed using a series of exploratory factor analyses (EFA) and confirmatory factor analyses (CFA). In order to assess reliability, Cronbach’s alpha estimation, test-retest reliability, and Spearman correlation coefficients were applied.

Most of the participants were male (1610, 67.8%), married (1610, 67.8%), and 31 - 59 years old (1672, 70.4%). Cronbach’s alpha coefficients for the factors of finding & evaluating, understanding, decision making, interaction, and the questionnaire as a whole were 0.76, 0.46, 0.75, 0.82, and 0.59, respectively. Test-retest correlation coefficients for these factors and the questionnaire as a whole were 0.85, 0.94, 0.75, 0.82, and 0.86, respectively. Based on CFA, the four-factor structure of the 8-item health literacy (HL) fitted the data well.

The validity and reliability of the online version of the Persian 8-item Health Literacy Questionnaire to measure the HL of the public were approved. This short online tool can be helpful for future online survey studies on the health literacy of Persianlanguage populations at a large scale.

Context: 

Risk management in hospitals is essential for improving healthcare quality. This study analyzed the characteristics of risk management programs implemented in operating rooms of hospitals across countries worldwide.

Evidence Acquisition: 

This study was a scoping review of online database studies, includingWeb of Knowledge, PubMed, Scopus, Cochrane, Springer, ProQuest, Iranian SID, and Magiran databases and the Google Scholar search engine. Three people independently performed the study selection, quality assessment, data extraction, and analysis among studies that reviewed risk management programs in health systems and those conducted outside the health system. Articles in non-English languages (including Persian) were excluded.

A total of 21 studies with similar purposes and data collection methods were included. The characteristics of risk management programs were classified into six main factors: Objectives, components, steps, results, prerequisites, facilitators of risk management programs, and 35 sub-factors.

The conceptual framework of any risk management program should include at least the objectives Risk eradication, safety promotion, qualityimprovementandpreventionandreduction of risks, component: Communicationandmonitoring; steps: (1) Preoperative evaluation during (logging); (2) evaluation during surgery; (3) post-surgery evaluation (logout); and the results Achieving effective methods in reducing errors; prerequisites: Human resource, knowledge and information, and facilitators such as the use of monitoring technologies and error detection and reporting in the operating room.

The joint operational plan was introduced by Iran’s Ministry of Health and Medical Education in 2015 as a way to improve the quality and efficiency of healthcare services by promoting collaboration and coordination among medical sciences universities. The plan aimed to address issues related to overlapping responsibilities, duplication of efforts, and resource constraints among universities.

This study was conducted to analyze this policy intervention and explore its challenges and opportunities.

Using a qualitative policy analysis approach, this study collected data through documentary analysisandsemi-structured interviews with stakeholders at various health system levels. Research participants were selected using purposive and snowball sampling methods. The collected data were analyzed using the framework analysis approach, supported by the policy triangle framework and heuristic model.

The policy analysis results yielded 14 categories and 29 sub-categories grouped into four overarching themes: Content, context, process, and actors/stakeholders. The content theme included categories such as the plan’s goals, the linkage between the plan’s goals and upstream policy documents, and the consistency between the plan’s goals and the visions and missions of medical universities. The context theme included structural characteristics, economic and financial factors, and social and cultural situations. The process theme included the issue’s priority, service delivery, policy design and formulation, implementation approach, and assessment and evaluation. The actors/stakeholders theme included categories such as the owner and leader of the policy, political support, and ambiguity in assigning responsibilities.

While enforcing a joint operational plan in medical universities can boost performanceandfoster competition, itmay also hinder universities’ ability to pursue innovative interventionsandactivities outside the plan. Toaddress this issue, stakeholders from various health system levels should work together to modify the plan’s development and implementation process. Effective use of planning tools is crucial for ensuring that medical universities and the health system achieve their goals.

As an unavoidable experience in oncology departments, grief following a patient’s death, coupled with work difficulties, can affect health professionals’ individual and work performance.

The present research was conducted to explain the positive consequences followingthe experience of grief for oncology nurses.

In 2021, the present qualitative study utilized content analysis and interviewed 20 nurses working in the oncology wards of hospitals affiliated with universities of medical sciences in Iran. Purposive sampling was performed, and data were collected through unstructured interviews until reaching data saturation. The data collected were analyzed in MAXQDA10 based on conventional content analysis.

The main concepts were categorized into three themes and seven subthemes. The themes included “promoting and practicing religious beliefs,” “feeling rewarded after experiencing grief,” and “promoting ethical virtues.”

According to the present findings, the nurses identified having profound religious and spiritual beliefs, promoting ethical virtues, and using positive experiences associated with grief over patient deaths as the positive implications of experiencing grief. These results can be employed to design interventions for preventing burnout in nurses and assisting them in providing high-quality care. Strengthening the positive implications of experiencing grief is one way to prevent the negative effects of grief on health professionals. Recommendations include implementing educational programs to improve these outcomes.