Prevalence and associated factors of overweight and obesity in reproductive-aged women in Rasht

Background and Aims: Obesity is one of the most common nutritional problems. Understanding the prevalence of overweight and obesity in women is essential to planning and prioritizing of health problems. The current study aimed to broaden our understanding of the prevalence and related factors of overweight and obesity in the women at ages of pregnancy in Rasht, Iran, in 2015.Materials and Methods: The present cross-sectional study was designed to investigate the prevalence of overweight and obesity in women aged 20 to 50 years living in Rasht. The multiple-stage sampling method was used to recruit the participants. All participants provided informed consent before entering the study. Body mass indexes of >30 kg/m2 and >25 kg/m2 were considered obese and overweight, respectively. The collected data were analyzed by descriptive statistics, chi-square test and correlation coefficients.Results: The mean age of participants in the study was 19.28 (SD= 6.99). About 2.9% and 24.8% of study participants were obese and overweight, respectively. Also, the relationship between prevalence of overweight, mobility status, age and income was statistically significant.Conclusion: Our study found that overweight and obesity is a major public health problem among women living in the region and, thus, more attention should be given to reproductive-aged women with increased obesity-related measures.Keywords: Prevalence, Overweight, Obesity, Women, Rash

بررسی شیوع چاقی و اضافه وزن و برخی عوامل مرتبط با آن در زنان سنین باروری شهر رشت در سال 1394

ackground and Aims: Obesity is one of the most common nutritional problems. Understanding the prevalence of overweight and obesity in women is essential to planning and prioritizing of health problems. The current study aimed to broaden our understanding of the prevalence and related factors of overweight and obesity in the women at ages of pregnancy in Rasht, Iran, in 2015. Materials and Methods: The present cross-sectional study was designed to investigate the prevalence of overweight and obesity in women aged 20 to 50 years living in Rasht. The multiple-stage sampling method was used to recruit the participants. All participants provided informed consent before entering the study. Body mass indexes of >30 kg/m2 and >25 kg/m2 were considered obese and overweight, respectively. The collected data were analyzed by descriptive statistics, chi-square test and correlation coefficients. Results: The mean age of participants in the study was 19.28 (SD= 6.99). About 2.9% and 24.8% of study participants were obese and overweight, respectively. Also, the relationship between prevalence of overweight, mobility status, age and income was statistically significant. Conclusion: Our study found that overweight and obesity is a major public health problem among women living in the region and, thus, more attention should be given to reproductive-aged women with increased obesity-related measures.زمینه و هدف: چاقی یکی از شایعترین مشکلات تغذیهای است. اطلاع از شیوع چاقی و اضافه وزن در زنان برای برنامه ریزی و اولویت بندی مشکلات بهداشتی ضروری میباشد. لذا مطالعه حاضر با هدف بررسی شیوع چاقی و اضافه وزن و برخی عوامل مرتبط با آن در زنان سنین باروری شهر رشت در سال 1394 صورت گرفته است مواد و روشها: این مطالعه به صورت مقطعی و به روش نمونه گیری چند مرحلهای در سال 1394 بر روی زنان 20 تا 50 سال سان شهر  رشت و در صورت رضایت آگاهانه برای مطالعه صورت گرفت. در این مطالعه شاخص توده بدنی بالاتر از 30 یلوگرم بر مترمربع به عنوان چاق و شاخص توده بدنی بالاتر از 25 به عنوان اضافه وزن در نظر گرفته شد. داده های جمع آوری شده با استفاده از آمار توصیفی و آزمونهای آماری ای دو و ضریب همبستگی مورد تجزیه و تحلیل قرار گرفت. یافته ها : میانگین سنی افراد شر ت ننده در مطالعه، 28/19 و انحراف معیار سن افراد، 6/99 سال بود، بر اساس نتایج مطالعه، 9/2 درصد افراد مورد مطالعه چاق و 24/8 درصد افراد مورد مطالعه دارای اضافه وزن بودند، همچنین بین شیوع اضافه وزن، وضعیت تحرک، سن و درآمد رابطه معنی داری مشاهده گردید . نتیجه گیری: چاقی و اضافه وزن در زنان این منطقه به عنوان یک مشکل عمده بهداشت عمومی و سلامت مطرح است، از این رو، برنامه ریزی برای کاهش این مشکل بهداشتی باید در اولویت قرار گیرد

Designing a Comprehensive Evaluation Model for Health System Reform Plan in Iran: An Approach to Extended Balanced Scorecard

Background: Health and striving to maintain and promote it has always been an important priority in governments, communities, and public policies. To implement health objectives through the Fifth Five-Year National Development Plan of Iran, the health system reform plan with three approaches to the financial protection of the public, creating equity in access to health services, and improving the quality of services has been on the government's agenda since 05.05.2014. Investigations revealed that the lack of a comprehensive and scientific model for evaluating this national program is evident. This study aimed to design a comprehensive model of health reform plan evaluation in Iran. What distinguishes this study from previous studies is the simultaneous attention to the challenges of performance evaluation, social responsibility, and examining them in a comprehensive and coherent model.Materials and Methods: The present study considered as descriptive-survey research in terms of strategy. The research method was a combination that conducted from 2018 to 2019. The sample size of the qualitative part of the research consisted of 17 academic and executive health experts selected by purposive non-random sampling. In the quantitative part of the study, 400 health service providers selected by stratified random sampling. In this study, content analysis and Delphi technique, and Expert choice v24, SPSS V22 and AMOSV14 software were used to collect, classify, deduce and exploit data, and questionnaires.Results: The findings of this study resulted in the design of a 900-scorecard model of the comprehensive evaluation of the health system reform plan in Iran based on 5 dimensions (finance, social responsibility, growth and learning, clients and internal processes), 17 components and 70 indicators.Conclusion: The findings of the quantitative section of the study showed that the indicators, dimensions and levels of the comprehensive evaluation model for health system reform plan in Iran (CEHSRP-IR) qualified for evaluation of the effectiveness of this national program at different organizational levels and executing units of health system reform plan in Iran

Strategy mapping and introducing the Health System Reform Plan: An Iranian social responsibility-based approach

Background: The main function of the strategy map is to determine the relationship between cause and effect among the strategic objectives, dimensions, and components of an organization, a large project or plan in which programs can be implemented effectively.  The current study aimed to map strategy and introduce the health system reform plan using an Iranian social responsibility-based approach.   Methods: The current study was a qualitative and applied one using the Balanced Scorecard (BSC) principles and the Comprehensive Evaluation Model for Health System Reform Plan in Iran (CEHSRP-IR) model in 2019. the views of 17 experts were selected in management and health issues based on purposive non-random sampling, using Delphi technique paired comparisons, common techniques in strategy mapping, and SPSS and EXPERT CHOICE software, the strategy map of the health system reform plan was designed in Iran.   Results: After elaborating on the fundamental aspects of this research, setting the strategic goals, dimensions, and components, as well as determining the relative weight of the components and dimensions and then prioritizing them, explained their optimal relationships to achieve strategic goals. Finally, using VISIO software, a strategy for the health system reform plan was designed and presented concerning social responsibilities. The present study resulted in designing a strategy map of the health system reform plan in Iran based on 5 dimensions of financial, social responsibility, learning and growth, clients, internal processes, 17 components, and 25 connections.   Conclusion: The current strategy map can be sufficiently comprehensive to effectively implement nationally at various organizational and implementing units’ levels of the health system reform plan in Iran

Risk of second primary cancer among breast cancer patients: A systematic review and meta-analysis

ObjectivesThe aim of this study was to estimate the extra risk of second primary cancer among breast cancer patients.Methods and materialsThis is a systematic review. A comprehensive search of literature was performed in PubMed, Web of Science, Cochrane library, and Scopus. The search included all published studies up to October 2022. This systematic review included studies published in the English language that reported the risk of second primary non-breast cancer [i.e., standardized incidence ratio (SIR)] among breast cancer patients older than 15 years. After evaluating the methodological quality of the selected studies, SIRs were pooled with consideration of heterogeneity among studies. The estimates were pooled by age and time since the diagnosis of primary breast cancer for both sexes (male and female). Age was categorized based on before 50 years and after 50 years, and time was categorized as duration of less than and more than 10 years, respectively.ResultsFrom 2,484 articles, 30 articles were eligible for inclusion in the systematic review and meta-analysis. The studies varied in terms of population, number of cases, study design, setting, and year of implementation of the research. The estimated SIR for men and women was 1.28 (95% CI: 1.18, 1.38) and 1.27 (95% CI: 1.15, 1.39), respectively. Women diagnosed with breast cancer before menopause [SIR: 1.52 (95% CI: 1.34, 1.71) vs. 1.21 (95% CI: 1.08, 1.34)] as well as women after 10 years since their breast cancer diagnosis [1.33 (95% CI: 1.22, 1.431) vs. 1.24 (95% CI: 1.10, 1.37)] were at a higher risk of developing second primary cancer. Among men, while there were no differences in risk based on age, with the increase of time, the risk of second primary cancer was reduced [SIR: 1.22 (95% CI: 1.12, 1.33) vs. 1.00 (95% CI: 0.79, 1.22)].ConclusionThere is an extra risk of second primary cancer among breast cancer patients. The extra risk should be considered for further screening and preventive measures among this population.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=336062, identifier (CRD42022336062)

The Impact of Education on Nutritional Behavior Change among Clients of Sardar- Jangal Health Center in 2012

Background and Objective: Nutrition is one of the effective factors in the protection of health and the prevention of disease. Therefore, determination of the relationship between nutrition choices and health of people is emphasized. The aim of this study is to determine the effectiveness of education and nutrition consultation on changing the unhealthy nutritional habits, and improving healthy nutrition behavior among the clients of Sardar-Jangal health center in 2012.    Materials and Methods: This interventional study was performed with the participation clients of Sardar Jangal health center in 2012. The sample size was 1500 and the sampling method was census. Data was gathered through a questionnaire and interview.The questionnaire included information regarding age, sex, education, employment and nutritional status. The scores between 9-11, 5-8 and less than 5, respectively, were considered as favorable, relatively favorable and unfavorable nutritional status. The participants with relatively favorable and unfavorable status were referred to nutrition education and consultation classes. At the end of the consultation classes, their nutritional status were assessed again. The data was analyzed through SPSS 21, using T-Test.Results: In the study, 1500 clients of Sardar Jangal health center participated. The sample included 383 (25.6%) male and 1117 (74.4%) female. The mean age of male and female was 38.3±21.1 and 36.9±17.4 respectively. Before participating in the nutrition education and consultation classes, the nutrition status of 343(30.7%) of females was favorable whilst for 775 (69.3%), the nutritional status was unfavorable. Among 114 (29.8%) of males it was favorable and amongst 268 (70.2%) it was unfavorable. Between the mentioned clients, the nutrition status of 144 (20.1%) females and 28 (12.7%) males improved after nutritional consultation (P &lt; 0.001).Conclusion: The results showed nutritional education and consultation are effective in improving the nutritional behavior and modifying the incorrect nutritional behavior.Keywords: Nutrition, Education, Behavior change, Nutrition consultation, Nutritional status </p

Determinants of survival of common childhood cancers in Iran

Background: Cancer is the second most common cause of morbidity and mortality in children. This study aimed to epidemiologically and demographically assess common cancers in children in Iran. Materials and Methods: This cohort study was conducted on children registered in Mahak Hospital and Rehabilitation Complex (which is a non-governmental organizations (NGO)-related hospital for only malignant diseases). A total of 2232 questionnaires were filled out for cancer patients between 2007 and 2016. The factors including age, gender, race, family history, type of treatment, and type of cancer were entered into Cox regression model to examine their effect on mortality of children diagnosed with cancer. Results: The Cox regression model showed that age, race, type of cancer, family history of cancer, and type of treatment had a significant effect on mortality of children diagnosed with cancer (P < 0.05). The hazard ratio (HR) of mortality in 10–15 years old was higher than that of 1–5 years old (P = 0.03, HR = 1.3). The HR of mortality in patients with brain tumor (P < 0.01, HR = 2.24), sarcoma (P < 0.01, HR = 2.32), and neuroblastoma (P < 0.01, HR = 2.56) was twice the value in patients with leukemia. The HR of mortality in patients who had a family history of cancer was higher than that of patients without it (P < 0.01, HR = 1.33). Patients who had undergone chemotherapy along with surgery and radiotherapy (P = 0.02, HR = 0.68) and patients who received chemotherapy along with surgery (P = 0.01, HR = 0.67) had a lower HR of mortality compared to the chemotherapy group. Conclusion: Young age, multidisciplinary approach, and absence of family history were associated with lower hazard of death in children diagnosed with cancer; brain tumor, leukemia, and sarcoma had higher hazard of mortality compared to leukemia. Children with a family history of cancer should be under regular follow-up. Treatment should be multidisciplinary and comprehensive

The Road Traffic Crashes as a Neglected Public Health Concern; An Observational Study From Iranian Population

<div><p><b>Objective:</b> Traffic crashes are multifactorial events caused by human factors, technical issues, and environmental conditions. The present study aimed to determine the role of human factors in traffic crashes in Iran using the proportional odds regression model.</p><p><b>Methods:</b> The database of all traffic crashes in Iran in 2010 (<i>n</i> = 592, 168) registered through the “COM.114” police forms was investigated. Human risk factors leading to traffic crashes were determined and the odds ratio (OR) of each risk factor was estimated using an ordinal regression model and adjusted for potential confounding factors such as age, gender, and lighting status within and outside of cities.</p><p><b>Results:</b> The drivers’ mean age ± standard deviation was 34.1 ± 14.0 years. The most prevalent risk factors leading to death within cities were disregarding traffic rules and regulations (45%), driver rushing (31%), and alcohol consumption (12.3%). Using the proportional odds regression model, alcohol consumption was the most significant human risk factor in traffic crashes within cities (OR = 6.5, 95% confidence interval [CI], 4.88–8.65) and outside of cities (OR = 1.73, 95% CI, 1.22–3.29).</p><p><b>Conclusions:</b> Public health strategies and preventive policies should be focused on more common human risk factors such as disregarding traffic rules and regulations, drivers’ rushing, and alcohol consumption due to their greater population attributable fraction and more intuitive impacts on society.</p></div