Food insecurity status and its contributing factors in slums’ dwellers of southwest Iran, 2021: a cross-sectional study

Background: One major factor causing food insecurity is believed to be poverty. Approximately 20 million Iranians live in slums with a vulnerable socioeconomic context. The outbreak of COVID-19, on top of the economic sanctions against Iran, has increased this vulnerability and made its inhabitants prone to food insecurity. The current study investigates food insecurity and its associated socioeconomic factors among slum residents of Shiraz, southwest Iran. Methods: Random cluster sampling was used to select the participants in this cross-sectional study. The heads of the households completed the validated Household Food Insecurity Access Scale questionnaire to assess food insecurity. Univariate analysis was utilized to calculate the unadjusted associations between the study variables. Moreover, a multiple logistic regression model was employed to determine the adjusted association of each independent variable with the food insecurity risk. Results: Among the 1227 households, the prevalence of food insecurity was 87.20%, with 53.87% experiencing moderate and 33.33% experiencing severe food insecurity. A significant relationship was observed between socioeconomic status and food insecurity, indicating that people with low socioeconomic status are more prone to food insecurity (P < 0.001). Conclusions: The current study revealed that food insecurity is highly prevalent in slum areas of southwest Iran. The socioeconomic status of households was the most important determinant of food insecurity among them. Noticeably, the coincidence of the COVID-19 pandemic with the economic crisis in Iran has amplified the poverty and food insecurity cycle. Hence, the government should consider equity-based interventions to reduce poverty and its related outcomes on food security. Furthermore, NGOs, charities, and governmental organizations should focus on local community-oriented programs to make basic food baskets available for the most vulnerable households

Household food security status in the Northeast of Iran: a cross-sectional study

BACKGROUND: An important issue the world faces today is ensuring that households living in different countries have access to enough food to maintain a healthy life. Food insecurity is prevalent in both developed and developing countries. The objective of this study was to assess the household food security status and related factors among different rural districts of Neyshabur (A city in northeast of Iran). METHODS: Of 5000 selected rural households 4647 were studied in this cross-sectional study. A validated short questionnaire (with six questions) was used to measure food security. Chi-square test and logistic regression were used for data analysis through SPSS software. RESULTS: In total, 2747 households (59.1%) were identified as food secure. The highest prevalence of food security was observed in Central district (62.3%) and the lowest was in Miyanjolgeh district (52.9%). Backward multiple logistic regression revealed that car ownership, presence of chronic disease in household and household income (per month) were significantly associated with food security in all of surveyed districts (p< 0.05). CONCLUSION: According to results of this study, lower than 60% of Neyshabur rural households were food secure and economic variables were the most important factors. Therefore, a special attention should be paid to this health problem in these regions

The Prevalence of Metabolic Syndrome According to Different Criteria and its Associated Factors in Type 2 Diabetic Patients in Kerman, Iran

Metabolic syndrome is highly prevalent in type 2 diabetics and is a strong risk factor for cardiovascular diseases in such patients. The aim of this study was to determine the prevalence of metabolic syndrome according to the three criteria of ATPIII, IDF and the new criteria for metabolic syndrome diagnosis in Kerman, Iran. This cross-sectional study was performed on 950 diabetic type 2 patients. Data was analyzed by independent t-test, chi-square and logistic regression using the SPSS (revision 20) software. The prevalence of metabolic syndrome in Kerman was 73.4, 64.9, and 70.4%, according to the above criteria. Fasting blood sugar, gender, triglyceride, HDL, waist circumference, and systolic blood pressure were related to the prevalence of metabolic syndrome according to the above-mentioned criteria.The prevalence of metabolic syndrome is high in type 2 diabetic patients and the above-mentioned factors exacerbate the situation

How sex work becomes an option: Experiences of female sex workers in Kerman, Iran

Sex work is rarely an occupation of choice for Iranian women and is often described as a last resort. While several factors play a role in creating an environment where individuals become involved in sex work, female sex workers' experiences regarding entry into sex work in Iran are poorly understood. In this qualitative study, a convenience sample of 24 participants was recruited from a drop-in centre for vulnerable women in Kerman, Iran. Through in-depth interviews, participants were asked about their personal lived experiences of initiating sex work. Grounded theory was used to analyse findings from this research. We learned that major factors impacting on women's initiation into sex work circulated around their vulnerability and chronic poverty. Participants continued to sell sex due to their limited opportunities, drug dependence and financial needs. Improving sex workers' economic status could be a vital intervention in providing vulnerable women with options other than sex work. Female sex workers should be provided with government support and educational programmes delivered through special centres. Despite the illegal status of their work, sex workers' needs should be recognised across all aspects of policy and legislation

Sex Differences in 28-Day Mortality of Ischemic Stroke in Iran and Its Associated Factors: A Prospective Cohort Study

Introduction: The mortality and morbidity rates of stroke in men and women have been reported differently and its effective factors have been discussed. The purpose of this study was to investigate sex differences in 28-day mortality of ischemic stroke and its associated factors. Materials and Methods: This is a prospective cohort study conducted from June 2018 to September 2019 in patients with ischemic stroke referred to Firoozgar, Shariati and Sina hospitals in Tehran. Demographic data, risk factors, disease history, drug use, severity of stroke, and patient functional status were recorded in the hospital. The patients' functional status and severity of stroke were measured using the Modified Ranking Scale (MRS) and the National Institutes of Health Stroke Scale (NIHSS). After 28 days, the patients' survival status was monitored. Logistic regression was used to analyze the data. Results: In this study, 703 patients were enrolled; of them, 260 (37.00) were female and 443 (63.00) were male. After 28 days, 21 female cases (8.17) and 26 male (6.08) ones died (P = 0.299). Functional status (OR = 4.65; 95CI: 2.09 to 10.38), diastolic blood pressure (OR = 0.91; 95CI: 0.85 to 0.96), warfarin use (OR = 0.15; 95CI: 0.04 to 0.55), and hemoglobin (OR = 1.17; 95CI: 1.02 to 1.35) were associated with 28-day mortality. Poor functional status in men had a greater association with 28-day mortality than women (OR 4.65 vs. 1.64). High diastolic blood pressure had a negative association with the 28-day mortality of cases and this association is more in women than in men (OR 0.88 vs. 0.91). High hemoglobin is a risk factor in men and a protective factor in 28-day mortality in women (OR 1.73 vs. 0.73). Smoking also had a greater association with 28-day mortality in women than men (OR 2.67 vs. 1.2). Discussion: Twenty eight-day mortality was more in women than in men, but this difference was not significant. Women were older, had more severe stroke and poorer functional status than men. Variables including functional status, diastolic blood pressure, hemoglobin level, and smoking had interaction with sex, and their association with 28-day mortality rate was different between men and women. Sex differences should be considered, so that we can better manage stroke patients. © 2020 Elsevier Inc

Body image, internalized stigma and enacted stigma predict psychological distress in women with breast cancer: A serial mediation model

Aims: To investigate the roles of total stigma, enacted stigma, and internalized stigma in the prediction of psychological distress among breast cancer patients, and to evaluate the mediating effect of body image in this process. Design: Cross-sectional. Methods: Between Oct-2014 to May-2015, a cross-sectional study was conducted with participation of 223 patients from three cancer centres located in Tehran, Iran. The study variables were assessed using the stigma scale for chronic illnesses 8-item version (SSCI-8), body image scale (BIS), and depression anxiety stress scale (DASS-21). Structural equation modelling using MLR estimator was employed based on the two-step procedure to validate both the full measurement models and the structural models. Five models were tested to determine predictability of all stigma constructs for psychological distress, including stress, anxiety, and depression, through the mediation of body image. Three equivalent models were further examined to re-evaluate the direction of the relationships. Results: Psychological distress and body image were largely predicted by total stigma, enacted stigma, and internalized stigma. The effect of stigma on psychological distress was mediated through body image. In a serial mediation model, the significance of the pathway of enacted stigma > internalized stigma > body image > psychological distress was confirmed. The serial model in which internalized stigma precedes body image was also supported by the equivalent models. Conclusion: Stigma has been identified as a major source of psychological distress among women with breast cancer. Enacted stigma not only psychologically disturbs the patients but also triggers a chain of other identity transformations (i.e. internalization of stigma and distortion of body image), their ultimate result being a full-blown psychological distress. Impact: Both enacted and internalized stigma distorts breast cancer patients' perception of their body image, which in turn renders them psychologically distressed. The serial process of enacted stigma, internalized stigma, and body image plays an important role in perpetuating distress in these patients. To break this chain of psychological consequences and for interventions to have a greater impact on overall well-being of patients, the effect of enacted stigma on distress via the sequence of two mediators needs to be specifically targeted at each stage. © 2021 John Wiley & Sons Lt