Association of Maternal Working Condition with Low Birth Weight: The Social Determinants of Health Approach

Background: The socioeconomic conditions have made more job opportunities available to women. This has created interest to conduct studies on the effect of working lifestyle on pregnancy outcomes. Aim: This study was conducted with the aim to assess the relationship between mothers’ working status as a social determinant and the incidence of low birth weight (LBW) of the newborn. Subjects and Methods: This case–control study was conducted on 500 women with normal weight infants (control group) and 250 women with LBW infants (case group) in selected hospitals in Tehran. Data were collected using a researcher‑made questionnaire, designed to assess the effect of mothers’ prenatal lifestyle, as a social determinant, on LBW of the newborn. A section of the questionnaire involved assessment of mother’s working condition in terms of the work environment, activities, and job satisfaction. Data were analyzed using Chi‑square and logistic regression tests. Results: LBW among employed mothers was 5 times more likely than unemployed ones (odds ratio = 5.35, P < 0.001). Unfavorable work conditions such as humid environment, contact with detergents, and being in one standing or sitting position for long hours were significantly associated with LBW (P < 0.001). Conclusion: The present study showed that unfavorable work conditions were associated with LBW; therefore, they need special attention.Keywords: Low birth weight, Pregnancy, Socioeconomic factors, Working condition

Local perceptions of mental health in Iran, Semnan Province

Introduction: Understanding local perceptions of mental health in different cultures and contexts is crucial for designing and implementing appropriate mental healthcare services. Methods: This qualitative study was conducted to investigate local perceptions of mental health in two highly populated provincial districts in Iran. Data were collected using the free list technique and interviews. A two-phase training workshop was held with the research team at a local health center, followed by a pilot study with the participation of six subjects. All the interviews were audio-recorded, transcribed, and then analyzed by the third and fourth authors in DEDOOSE. Results: A total of 30 individuals (20 in the free list and 10 as key informants in the interviews) took part in the study. Based on the study findings and the key informants' ideas, mental health problems were categorized into three categories of depression, anxiety, and obsessive�compulsive disorder (OCD). Conclusions: Mental health problems appear to be expressed in different ways and with different symptoms in different cultures, and there is a distinct need for examining mental disorders in each culture and nationality separately using culturally appropriate tools for disease screening. © 2020 The Authors. Brain and Behavior published by Wiley Periodicals LL

An explanatory model of depression among female patients in Fars, Kurds, Turks ethnic groups of Iran

Background: Depressive disorder is globally estimated to be as many as one in five visits to primary health care. Approximately more than 50 of depressed women in primary care are not diagnosed. As a part of a major investigation into perceptions of women's depression, this study explored how female patients and their relatives conceptualize patients' conditions in three ethnic groups in Iran (Fars, Kurds and Turks). Methods: Qualitative methods were used for data collection. Depressed women and their relatives were purposively selected from the public psychiatric clinics affiliated to university of medical sciences in the three study cities. Twentyfive depressed women and 14 relatives were interviewed in three ethnic groups. Results: One theme "illness meaning", including three categories: perceived symptoms, label of the illness, and effects of the illness was found through the content analysis. The participants perceived symptoms of illness as somatic and psychological depending on the participant's assumed reason for the onset of the illness. There were most similarities in term used for of the illness in the three ethnic groups. Most of the study participants described the illness in terms of nerve problems/illness, and depression "afsordehgi". The most important effects that depressed women had experienced because of their illness were marital conflict or a guilt feeling originating from their inability to support family. Conclusion: These findings suggest the need to recognize and choose appropriate diagnostic approach for depressed women in the context of Iran

How patients understand depression associated with chronic physical disease - A systematic review

Background: Clinicians are encouraged to screen people with chronic physical illness for depression. Screening alone may not improve outcomes, especially if the process is incompatible with patient beliefs. The aim of this research is to understand peoples beliefs about depression, particularly in the presence of chronic physical disease. Methods: A mixed method systematic review involving a thematic analysis of qualitative studies and quantitative studies of beliefs held by people with current depressive symptoms. MEDLINE, EMBASE, PSYCHINFO, CINAHL, BIOSIS, Web of Science, The Cochrane Library, UKCRN portfolio, National Research Register Archive, Clinicaltrials.gov and OpenSIGLE were searched from database inception to 31st December 2010. A narrative synthesis of qualitative and quantitative data, based initially upon illness representations and extended to include other themes not compatible with that framework. Results: A range of clinically relevant beliefs was identified from 65 studies including the difficulty in labeling depression, complex causal factors instead of the biological model, the roles of different treatments and negative views about the consequences of depression. We found other important themes less related to ideas about illness: the existence of a self-sustaining depression spiral; depression as an existential state; the ambiguous status of suicidal thinking; and the role of stigma and blame in depression. Conclusions: Approaches to detection of depression in physical illness need to be receptive to the range of beliefs held by patients. Patient beliefs have implications for engagement with depression screening

Health Research Evaluation and Its Role on Knowledge Production

Background: Knowledge production and evaluation are two important functions of health research system (HRS). In this article, we aimed to reveal the correlation between evaluation of health research organizations and health knowledge production promotion.Methods: A comprehensive evaluation system was developed to evaluate the academic performance of national medical science universities on an annual basis. It assess following domains; stewardship, capacity building and knowledge production. Measurable indicators for each domain were assigned, a research profiles; for each department was provided. In this study, we compared the results of annually national Health Research System evaluation findings during 2005-2008.Results: The number of scientific articles has been increased from 4672 to 8816 during 2005 to 2008. It is mentionable that, the number of articles which has been published in indexed data bases has risen too. This fact could be related to directed policy for more international publication of scientific articles from Iran. The proportion of total articles to the number of academic members was 1.14 in 2008, comparing to 0.84 in 2005. It means that this proportion have increased about twice (0.7 Vs 0.45) during mentioned time. Moreover, other scientific products such as authored books based on domestic researches and cited articles in textbooks have increased according to special attention to knowledge production by policy makers.Conclusion: We conclude that Health System Research evaluation could be used as a mean for implementing policies and promoting knowledge production

An Explanatory Model of Depression among Female Patients in Fars, Kurds, Turks Ethnic Groups of Iran

Background: Depressive disorder is globally estimated to be as many as one in five visits to primary health care. Approximately more than 50 of depressed women in primary care are not diagnosed. As a part of a major investigation into perceptions of women's depression, this study explored how female patients and their relatives conceptualize patients' conditions in three ethnic groups in Iran (Fars, Kurds and Turks). Methods: Qualitative methods were used for data collection. Depressed women and their relatives were purposively selected from the public psychiatric clinics affiliated to university of medical sciences in the three study cities. Twenty-five depressed women and 14 relatives were interviewed in three ethnic groups. Results: One theme "illness meaning", including three categories: perceived symptoms, label of the illness, and effects of the illness was found through the content analysis. The participants perceived symptoms of illness as somatic and psychological depending on the participant's assumed reason for the onset of the illness. There were most similarities in term used for of the illness in the three ethnic groups. Most of the study participants described the illness in terms of nerve problems/illness, and depression "afsordehgi". The most important effects that depressed women had experienced because of their illness were marital conflict or a guilt feeling originating from their inability to support family. Conclusion: These findings suggest the need to recognize and choose appropriate diagnostic approach for depressed women in the context of Iran

Interventions Plans for High-Risk Behaviors of Vulnerable Women: Rapid Assessment and Response Model

Background: In recent years, given the accelerated social changes, the prevalence of high-risk behaviors among different social strata has become a major concern for the society. Accordingly, this study was conducted to present proposed interventions for reduction of high-risk behavior of vulnerable women in Iran, based on rapid assessment and response model. Methods: This was a qualitative study using rapid assessment and response to identify needs of vulnerable women with such behaviors conducted over 8 months in 2 selected cities in Iran. In the assessment stage, study population consisted of vulnerable women, working professionally and illegally in the sex trade, selling their bodies in the city for money or commodity, during the period of this study and at least three months earlier, and key informants with experience, skill, and sufficient knowledge and history of management in issues of high-risk behaviors among SEX-workers. Semi-structured interview techniques, and question guide and open observations were used to explain high-risk behaviors. Results: According to the results obtained, 3 categories were identified, including high-risk behavior patterns and influencing factors, awareness and attitude, and diagnoses and medical services needs. Based on the 3 categories found, interventional strategies were designed separately for each one. Conclusion: Among benefits of rapid assessment and response methods, is design of interventions with participation of stakeholders and vulnerable groups, which increases the likelihood of interventions becoming operational