Effect of Student's Empowerment Program on Brucellosis Prevention: an Application of Extended Health Belief Model

Background: To determine the effect of student's empowerment program using the extended health belief model on the brucellosis prevention in rural high school in Divandarreh, Kurdistan province, Iran.Methods: Quasi-experimental study with repeated measure (pre-test, post-test and at 2-month follow-up).In all 220 rural high school selected using a cluster sampling method.  The data collection tool was a questionnaire based on the Health Belief Model (HBM). Five 1.5 hours sessions using lecture, group discussion, inquiry method, leaflet delivery, and the use of slides with Overhead projector and PowerPoints slide show, designed according to the Systematic Comprehensive Health Education and Promotion Model (SHEP), was presented for intervention group twice a week in schools. Data were analyzed by SPSS 18, using descriptive statistics as well as Chi-square, independent t-test and repeated measures at a significant level less than 0.05.Results: the total mean age of participants was 14.6±2.3. The intervention and control groups had no significant differences in terms of age, gender, and other demographic variables. There was no significant differences in the intervention and control groups before the intervention in terms of awareness, severity, benefits, barriers and self-efficacy. After educational program scores of awareness, severity, susceptibility, benefits, barriers and self-efficacy, and performance were higher in the intervention group compared to the control group.Discussion: Overall, implementation of the educational intervention based on theories and models had good effects on people that are in the risk of infection and zoonotic disease

Investigating geographical accessibility and site suitability of medical laboratories in Kermanshah-Iran

IntroductionOne of the major challenges in developing countries is the inappropriate spatial distribution of medical laboratory centers (MLCs) which can lead to injustice in access to health services. This study aimed to investigate the accessibility to and site suitability of MLCs in Kermanshah Metropolis by GIS.Materials and methodsIn this cross-sectional study, data were collected from the Iran Statistical Center and Deputy of Treatment of Kermanshah University of Medical Sciences. We used Arc/GIS 10.6 software, AHP technique, and network analysis tools to determine the access status of Kermanshah citizens to MLCs in 2019 and site selection for MLCs. The layers used in this study included population density, city development trends, compatible and incompatible land uses, pathways, land slope, river area, and access radius.ResultsAbout 70% of households had inappropriate access to all MLCs in walking scenario. This ratio was 31.26% for 5 min, 9.58% for 10 min, and 6.09% for 15 min driving. Comparisons between public and private MLCs showed that in walking scenario, 88% of households had improper access to public and 80% to private MLCs. Based on 5 and 10 min of driving, 57 and 19% of households had inappropriate access to public MLCs, and 45 and 17% to private MLCs, respectively. Also, with 15 min of driving, 8% of households had improper access to public and 18% to private MLCs. Findings showed that scores provided for population density criteria were (0.298), distance from existing laboratories (0.213), proximity to pathways (0.175), consistent land use (0.129), city development trend (0.087), distance from riverfront (0.053), distance from incompatible land uses (0.015), and land slope (0.03). The final model was obtained by overlaying the layers. The model showed a 9-degree range from very bad to very good in Kermanshah city for the construction of laboratory centers (CR<0.01).ConclusionThe site selection model showed that the location of the proposed centers can be in the north and outskirts of the city to facilitate citizens' access to the MLCs. These results emphasize the justice in the spatial distribution of MLCs for the benefit of deprived populations as a global value

The COVID-19 pandemic and healthcare utilization in Iran: evidence from an interrupted time series analysis

Objectives This study aimed to examine the effect of the coronavirus disease 2019 (COVID-19) outbreak on the hospitalization rate, emergency department (ED) visits, and outpatient clinic visits in western Iran. Methods We collected data on the monthly hospitalization rate, rate of patients referred to the ED, and rate of patients referred to outpatient clinics for a period of 40 months (23 months before and 17 months after the COVID-19 outbreak in Iran) from all 7 public hospitals in the city of Kermanshah. An interrupted time series analysis was conducted to examine the impact of COVID-19 on the outcome variables in this study. Results A statistically significant decrease of 38.11 hospitalizations per 10,000 population (95% confidence interval [CI], 24.93–51.29) was observed in the first month of the COVID-19 outbreak. The corresponding reductions in ED visits and outpatient visits per 10,000 population were 191.65 (95% CI, 166.63–216.66) and 168.57 (95% CI, 126.41–210.73), respectively. After the initial reduction, significant monthly increases in the hospitalization rate (an increase of 1.81 per 10,000 population), ED visits (an increase of 2.16 per 10,000 population), and outpatient clinic visits (an increase of 5.77 per 10,000 population) were observed during the COVID-19 pandemic. Conclusion Our study showed that the utilization of outpatient and inpatient services in hospitals and clinics significantly declined after the COVID-19 outbreak, and use of these services did not return to pre-outbreak levels as of June 2021

Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019

Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. Methods: We distinguished the overall HAQ Index (ages 0–74 years) from scores for select age groups: the young (ages 0–14 years), working (ages 15–64 years), and post-working (ages 65–74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. Findings: Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9–21·3), as well as among the young (22·5, 19·9–24·7), working (17·2, 15·2–19·1), and post-working (15·1, 13·2–17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6–33·0) on average in low-SDI countries to 83·4 (82·4–84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4–89·0), working (33·8–82·8), and post-working (30·4–79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. Interpretation: Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. Funding: Bill & Melinda Gates Foundation

Correction to: Symptoms of anxiety disorders in Iranian adolescents with hearing loss during the COVID-19 pandemic

An amendment to this paper has been published and can be accessed via the original article.</jats:p

Symptoms of anxiety disorders in Iranian adolescents with hearing loss during the COVID-19 pandemic

Abstract Background Anxiety symptoms have been reported in many populations during the COVID-19 pandemic, but not in adolescents with a hearing loss. This study aimed to investigate the presence of symptoms of anxiety disorders (ADs) in adolescents with hearing loss (HL) during the COVID-19 pandemic, 2020. Methods In this cross sectional study, 56 adolescents with HL (aged 12 to 18 years) including 23 deaf, and 33 hard of hearing (HH) were selected from four counties located in western Iran using a census method. Adolescents with HL filled out the self-report of the Screen for Child Anxiety Related Emotional Disorders (SCARED). Results The results showed that the presence of symptoms of ADs in adolescents with HL was 37.5%, and higher in deaf than in HH adolescents (60.9% in deaf vs. 21.2% in HH, p = 0.003). Among the subscales, only the Social Anxiety Disorder (39.1% in deaf vs. 9.1% in HH, p = 0.009) and the School Avoidance (52.2% in deaf vs. 24.2% in HH, p = 0.031) significantly differed. The mean score of Panic Disorder, Social Anxiety Disorder, and Anxiety Disorders in the deaf adolescents were higher than in HH ones. Conclusions Our study showed the presence of significant symptoms of ADs in a sample of Iranian adolescents with HL, especially in deaf adolescents, during the COVID-19 pandemic. </jats:sec

Models and Theories of Health Education and Health Promotion in Physical Activity Interventions for Women: a Systematic Review

Introduction: The present study as a systematic review investigated and analyzed interventions based on models and theories of health education and promotion in the field of physical activity in women. Materials and Methods: Three electronic databases, including Springer, Biomed Central and Science Direct were searched systematically. Only studies were selected that were quantitative, interventional and in English language as well as those that used at least one of the models and theories of health education and health promotion. Finally, 13 studies were reviewed that met the inclusion criteria and published from 2000 to 2013. Results: Of 13 studies reviewed, 10 studies measured levels of physical activity before and after the intervention, which nine interventions increased physical activity in the intervention group compared to the control group. Studies were conducted in different settings of health promotion including health care centers, community setting and workplace. The most widely used model was the Transtheoretical Model applied in eight of investigations. Conclusion: It is suggested to focus more on physical activity and duration of interventions to increase the efficacy of interventions. It is suggested to measure changes of physical activity habits in experimental and control groups in interventions based on the transtheoretical model to prepare a complementary scale to assess the efficacy of interventions. According to the results, no study had focused on changes in institutional policies or general health or providing changes in environment related to physical activity

Post-Traumatic Stress Disorder (PTSD) and Depression in Iranian Adolescents with and Without Hearing Loss (HL) in Previous and During the Outbreak of the COVID-19

Abstract Background: Due to the unavailability of information and resources about COVID-19 in people with Hearing Loss (HL), especially deaf people, the psychological problems, such as PTSD and depression are probably raised in people with hearing loss (HL) during the outbreak of COVID-19. This study was conducted to compare post-traumatic stress disorder (PTSD) and depression in Iranian adolescents with and without HL in previous and during the outbreak of COVID-19. Methods: The statistical sample was 112 adolescents half (56) of whom was with HL, while another half (56) was without HL. The two groups were also homogenized in terms of age, gender, and education. Data were gathered using the Child PTSD Symptom Scale for DSM-5 (CPSS-5) and Children's Depression Inventory Short version (CDI: S). The data obtained were analyzed using two-way MANOVA. Results: Results showed that 46.43% and 41.04% of with-HL adolescents during the outbreak of COVID-19, and 17.87% and 25.00% of them in previous the outbreak of COVID-19 had symptoms of PTSD and depression, respectively. Results indicated that the mean score difference between PTSD and depression during and in previous the outbreak of COVID-19 [(during)-(previous)] was higher in adolescents with HL than the control group. conclusion: We concluded that psychological and medical interventions must be beneficial to decrease symptoms of PTSD and depression in adolescents (especially in deaf and hard-of-hearing adolescents) during the outbreak of COVID-19.</jats:p