A study on factors that drive variation in the levels of social capital among people living with HIV/AIDS in Iran

INTRODUCTION: Social capital is increasingly used in relation to health issues, particularly in sexually transmitted diseases/infections and health behaviors. Experiences indicated that social capital can contribute in changing HIV related risk behaviors and a decline of HIV infection through social groups and networking and make more effective use of HIV/AIDS prevention, care, and treatment services. We aimed to assess social capital in these persons through a quantitative study. METHOD: This cross-sectional study was performed with a convenience sample of 300 people living HIV/AIDS referred to a counseling center of behavioral diseases, in Imam Khomeini Hospital, in Tehran, the capital of Iran, during September 2011 to May 2012. Data collection tools were a demographic questionnaire and World Bank Social Capital Questionnaire (SC-IQ). The analysis of data was performed by the SPSS statistic software version 18. To identify factors influencing social capital in participations, Pearson correlation coefficient, ANOVA, t-test, and a multiple regression were applied. The significant level was considered 0.05 in this study. RESULTS: 165 (55) were male and the rest female. The mean age of participants was 34.3 ± 7.5. The mean score of total social capital was 2.34 ± 0.5 in all participants. The domain of individual trust had the highest mean score (2.53 ± 0.66). The lowest mean score was related to the domain of social trust and associative relations (2.23 ± 0.62). Variables such as ethnicity, age, and middle economic status had a significant impact on the domain of individual trust so that the mean score of this component of social capital was lower among women (0.396) than men. Factors affecting total social capital were ethnicity and middle economic status. CONCLUSION: Finding emphasized on the role of economic status, ethnicity and gender in persons living with HIV/AIDS. Thus recommended that policy makers and program managers consider social groups and networks, especially in women in the design and delivery of intervention strategies to reduce HIV transmission

Utilization and Determinants of Postnatal Care Services in Ethiopia: A Systematic Review and Meta-Analysis

BACKGROUND: Postnatal care use is vital in saving mother and newborn lives which is a continuum of care for maternal, neonatal and child health. This reviewaimed to determine the utilization and determinants of postnatal care use in Ethiopia.METHODS: PubMed, Scopus, Web of Science, and Embase databases were searched on June 25, 2017. The study screening, data extraction and quality assessment were done independently by two reviewers. Effect sizes were pooled using a random-effectsmodel.RESULTS: Nine articles were included in the review. The pooled estimate for utilization of the service was 32% (95% CI: 21%, 43%). The pooled results of determinants of postnatal care use was statistically significant among those mothers who had ability to make decisions (1.89; 1.25, 2.54), had a history of antenatal care utilization (2.55; 1.42, 3.68), received more than two antenatal care visits (1.84; 1.28, 2.40), and received the service from skilled service provider (3.16; 1.62, 4.70). It was also found that mothers who gave birth in health faciliteis (2.13; 1.14, 3.12), had middle monthly income, richer, were from urban areas, and had knowledge of obstetric danger signs were significantly associated with increased odds of postnatal care use.CONCLUSION: Utilization of the services is low in Ethiopia. Antenatal care utilization, skilled service provider, being from urban area and delivery in health facility had a significant effect on postnatal care utilization. More rigorous studies are needed to identify determinant with the causal association to postnatal care utilization. The review was registered on PROSPEROCRD42017060266

Investigation of relationship between social capital and quality of life in female headed families

Background: Although most studies on female-headed families focus on women's access to social support, the associations between social capital and quality of life in these families are unclear in many societies (such as Iran). This study aimed to determine the associations between social capital and quality of life in Iranian female headed families. Methods: This cross-sectional study was performed on 152 female-headed households supported by Tehran Municipality, district 9 from April 2011 to July 2012. Convenience sampling was employed. Data were collected using demographic questionnaire, the Iranian version of World Health Organization Quality of Life, and the Word Bank Social Capital. Descriptive and multiple regression methods were used to analyze the data. Results: The mean±SD age of participants was 50.8±13.8 years. Findings revealed that in quality of life, the domains of environment health and social relation received the lowest (9.87 ± 2.41) and the highest (12.61 ±3.43) scores respectively; and with respect to social capital, membership in groups and social trust had the least (19.61 ± 17.11) and the most (51.04 ± 17.37) scores, respectively. The multiple regression model revealed a significant positive association between total score of the quality of life and the total score for the social capital (p < 0.001). Conclusion: Findings suggest that quality of life of female-headed families and social capital domains are strongly related. This means that by improving the social capital, women's life can also be improved

Assessing breast cancer risk among Iranian women using the gail model

Background: Breast cancer risk assessment is a helpful method for estimating development of breast cancer at the population level. Materials and Methods: In this cross-sectional study, participants consisted of a group of 3,847 volunteers (mean ± SD age: 463 ± 7.59 years) in a convenience sample of women referred to health centers affiliated to Tehran University of Medical Sciences in Tehran, Iran. The risk of breast cancer was estimated by applying the National Cancer Institute's online version of the Gail Risk Assessment Tool. Results: Some 24.9 of women reported having one first-degree female relative with breast cancer, with 8.05 of them having two or more first-degree relatives with breast cancer. The mean five-year risk of breast cancer for all participants was 1.61±0.73, and 9.36 of them had a five-year risk of breast cancer > 1.66. The mean lifetime risk of breast cancer was 11.7±3.91. Conclusions: The Gail model is useful for assessing probability of breast cancer in Iranian women. Based on the their breast cancer risk, women may decide to accept further screening services

Characteristics of high-risk sexual behaviors for human immunodeficiency virus infection among Iranian drug abusers

Objectives: This study was conducted to estimate the prevalence and the associated factors of high-risk sexual behaviors among drug abusers referred to a methadone clinic in Gorgan, the capital of Golestan province in the northeast of Iran, to help health care decision makers on designing interventional programs. Methods: In this cross-sectional study, 400 drug abusers referred to our methadone clinic were evaluated for high-risk sexual behavior. A logistic regression model was fitted for the association between independent variables and high-risk sexual behavior. Results: Approximately a quarter of patients (25.5%) had high-risk sexual behavior among which 47% had not used a condom in their last sexual contact. Drug abusers who had poor economic status had a lower chance of high-risk sexual behavior than those with good economic status (adjusted odds ratio [AOR] = 0.35, 95% confidence interval [CI] = 0.13-0.96). Also, 1-year increase in age reduced the chance by 6% (AOR = 0.94, 95% CI = 0.91-0.98). Heroin abusers, compared with opium abusers, had a duplicated chance of having high-risk sex (AOR = 2.11, 95% CI = 1.12-3.96). Conclusion: According to this study, high-risk sexual behavior in the drug abusers referred to methadone clinic was associated with younger age, good economic status, and heroin addiction. Hence, in interventional planning, more attention should be paid to young drug abusers, patients with good economic status, and heroin addicts as well. Copyright © 2012 American Society of Addiction Medicine

Religious coping and quality of life in women with breast cancer

Background: The aim of this study was to assess the predictive role of religious coping in quality of life of breast cancer patients. Materials and Methods: This multi-center cross-sectional study was conducted in Tehran, Iran, from October 2014 to May 2015. A total of 224 women with breast cancer completed measures of socio-demographic information, religious coping (brief RCOPE), and quality of life (FACT-B). Data were analyzed using descriptive statistics and the t-test, ANOVA, and linear regression analysis. Results: The mean age was 47.1 (SD=9.07) years and the majority were married (81.3). The mean score for positive religious coping was 22.98 (SD=4.09) while it was 10.13 (SD=3.90) for negative religious coping. Multiple linear regression showed positive and negative religious coping as predictor variables explained a significant amount of variance in overall QOL score (R2=.22, P=.001) after controlling for socio-demographic, and clinical variables. Positive religious coping was associated with improved QOL (β=0.29; p=0.001). In contrast, negative religious coping was significantly associated with worse QOL (β=-0.26; p=0.005). Conclusions: The results indicated the used types of religious coping strategies are related to better or poorer QOL and highlight the importance of religious support in breast cancer care

Different patterns of association between education and wealth with non-fatal myocardial infarction in Tehran, Iran: A population-based case-control study

Background: Myocardial Infarction (MI) is a main cause of death and disability worldwide, which involves a number of genetic, physiopathologic and socio-economic determinants. The aim of this study was to assess the patterns of association between education, wealth and some other risk factors with non-fatal MI in Tehran population. Methods: Data derived from a second round of large cross-sectional study, Urban HEART-2, conducted in Tehran in 2011. Out of 118542 participants, all 249 self-reported incident cases of nonfatal MI were selected as the case group. A number of 996, matched on age and sex, were selected as controls. Principle component analysis (PCA) was used to calculate wealth index and logistic regression model to assess relations between the study variables. Results: Mean (SD) age of participants was 60.25 (12.26) years. A total of 870 (69.9) of the study subjects were men. Education, wealth status, family violence, hypertension and diabetes were observed as independent predictors of non-fatal MI. Overall, as the level of education increased, the odds of non-fatal MI decreased (p<0.001). We observed an almost J-shaped association between wealth status and non-fatal MI. No significant associations were found between marital status, BMI and current smoking with non-fatal MI (p<0.05). Conclusion: We found different patterns of association between education and wealth with nonfatal MI among Tehran adults. Lower risk of non-fatal MI is linked to high educated groups whereas economically moderate group has the lowest risk of non-fatal MI occurrence

Research collaboration in Tehran University of Medical Sciences: two decades after integration

Background: In 1985 medical schools were integrated into the Ministry of Health, and the Ministry of Health and Medical Education was created in Iran. Under this infrastructure education, research and service provision are unified, and it is expected that collaboration between researchers and decision makers become easier in such an integrated context. The question here is how the researchers behavior in the biggest medical university of the country towards collaboration is, i.e. how much do decision makers participate in different stages of research? Which factors affect it? Methodology: The samples under study were all Tehran University of Medical Sciences (TUMS) completed research projects that had gotten grants in 2004 and were over by the time this study was done. Two questionnaires were designed for this study: i) the research checklist which was filled for 301 projects, ii) the researcher's questionnaire, which was sent to principle investigators, 208 of which were collected. Multiple linear regression analysis was used for evaluating the potential factors affecting individuals 'collaboration score'. Results: Only 2.2 percent of TUMS' projects initiated in 2004 have had collaboration as a joint PI or co-investigator from non-academic organizations. The principle investigators mean collaboration score was 2.09, where 6 was the total score. So the collaboration score obtained was 35%. The 'type of research' had significant association with the collaboration score which is shown in the linear regression; collaboration was seen more in clinical (p = 0.007) and health system researches (p = 0.001) as compared to basic research. Conclusion: The present study shows that not many individuals collaborated as co-investigators from outside the university. This finding shows that research policy makers need to introduce interventions in this field. And assessment of barriers to collaboration and its facilitating factors should be considered in order to make it actually happen. © 2009 Majdzadeh et al; licensee BioMed Central Ltd

Nutrition labels� strengths & weaknesses and strategies for improving their use in Iran: A qualitative study

Background This study aimed to explain the strengths and weaknesses of the Traffic light label (TLL) and nutrition facts label (NFL) and the strategies for improving their use in Iran, based on the perspectives of different stakeholders, including mothers, food quality control experts (FQC), nutritionists and food industry experts. Methods We conducted 10 Focus Group Discussions (FGDs) with 63 mothers, 10 semi-structured interviews with FQCs, 1 FGD with 6 nutritionists and 1 FGD with 8 food industry experts. To clarify some of the questions that arose from the interviews, the researcher interviewed three policy makers who had sufficient information about the TLL. The discussions and interviews were transcribed verbatim and MAXQDA10 software was used for coding. Results The most important findings of this study based on different stakeholders� perspectives were as follows: mothers believed that nutrition labels reduced the consumption of high-calorie products, although they found the TLL to be easier to understand than the NFL because of its red color. However, their weaknesses were their incompatibility with culture and the lack of trust in the information provided by manufacturers. FQCs pointed out the possibility of changing formulations and the appropriateness of the traffic light for patients, but like mothers, they believed that the labels did not suit the governing culture. Further weaknesses were, misleading the consumer, problems in the colorings reported by different laboratories, and different approaches adopted by regulatory experts. The simplicity of understanding TLL for the general public has been suggested by some nutritionists. Nevertheless, the multiplicity of colors of the TLL was the most important weakness presented by nutritionists and food industry experts and the failure to implement nutrition labels was another issue raised by experts. To improve the use of nutrition labels, notification via media especially television, community education and culture building were suggested by all stakeholders. Conclusions The findings of this study underscore the importance of implementing the policy of nutrition labeling in Iran. Mothers and nutritionists believed TLL to be more appropriate for the public to understand, however, FQCs and food industry experts believed that NFL was more suitable in guiding consumers toward healthy food choices. Education and information dissemination via media on interpretive TLL may affect consumer behavior toward food purchases. © 2020 Seyedhamzeh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

The causal effect and impact of reproductive factors on breast cancer using super learner and targeted maximum likelihood estimation: a case-control study in Fars Province, Iran

Objectives: The relationship between reproductive factors and breast cancer (BC) risk has been investigated in previous studies. Considering the discrepancies in the results, the aim of this study was to estimate the causal effect of reproductive factors on BC risk in a case-control study using the double robust approach of targeted maximum likelihood estimation. Methods: This is a causal reanalysis of a case-control study done between 2005 and 2008 in Shiraz, Iran, in which 787 confirmed BC cases and 928 controls were enrolled. Targeted maximum likelihood estimation along with super Learner were used to analyze the data, and risk ratio (RR), risk difference (RD), andpopulation attributable fraction (PAF) were reported. Results: Our findings did not support parity and age at the first pregnancy as risk factors for BC. The risk of BC was higher among postmenopausal women (RR = 3.3, 95 confidence interval (CI) = (2.3, 4.6)), women with the age at first marriage �20 years (RR = 1.6, 95 CI = (1.3, 2.1)), and the history of oral contraceptive (OC) use (RR = 1.6, 95 CI = (1.3, 2.1)) or breastfeeding duration �60 months (RR = 1.8, 95 CI = (1.3, 2.5)). The PAF for menopause status, breastfeeding duration, and OC use were 40.3 (95 CI = 39.5, 40.6), 27.3 (95 CI = 23.1, 30.8) and 24.4 (95 CI = 10.5, 35.5), respectively. Conclusions: Postmenopausal women, and women with a higher age at first marriage, shorter duration of breastfeeding, and history of OC use are at the higher risk of BC. © 2021, The Author(s)