Publications by authors named "Hossein Fallahzadeh"

84 Publications

Investigation of the association between pesticide exposure and the prevalence of type 2 diabetes in Shahedieh population in Yazd.

Environ Sci Pollut Res Int 2021 Apr 8. Epub 2021 Apr 8.

Environmental Science and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

This study aimed to investigate the effect of exposure to pesticides and the prevalence of type 2 diabetes (T2D). In a cross-sectional study with a population of 9088, the data were collected through Persian Adult Cohort Questionnaire in Shahedieh area of Yazd, Iran. Based on the results, variables such as age, gender, body mass index, physical activity, and education level in the studied population had a significant association with the prevalence of diabetes. Although the obtained data in this study did not show a relationship between exposure to pesticides and the risk of developing T2D, further prospective studies are needed to determine the association between exposure to pesticides and the development of T2D.
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http://dx.doi.org/10.1007/s11356-021-13821-wDOI Listing
April 2021

Exploring the nutritional beliefs of pregnant women in Yazd city.

J Prev Med Hyg 2020 Dec 14;61(4):E545-E552. Epub 2021 Jan 14.

Research Center of Prevention and Epidemiology of Non-Communicable Disease, Departments of biostatistics and Epidemiology, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Introduction: During the pregnancy, a woman as a healthy person grows another human being in her body and needs more cares due to changes in psychological and physical needs. This study aimed to explore the nutritional beliefs of pregnant women in Yazd city.

Methods: This was a qualitative study conducted with a conventional content analysis approach. A total of 12 participants were selected from women referred to the community health centers in Yazd, Iran, by the purposeful sampling method. Data were collected through recorded semi-structured interviews that were transcribed verbatim and analyzed by the Lundman and Granheim's content analysis method.

Results: In this study, after analyzing the data, 10 main categories and 26 subcategories were extracted. The codes were 446 cases with no overlap, which was reduced after careful review and integration of similar items. Topics of categories included: The concept of nutrition during pregnancy, Nutrition limitations during pregnancy, Myths about food during pregnancy, Doubts about nutrition during pregnancy, Pregnancy food style, Sources of nutritional information in pregnancy, Positive Consequences of Healthy Nutrition in Pregnancy, Consequences of inappropriate pregnancy nutrition, Religious Beliefs in Pregnancy Nutrition, social support.

Conclusion: The results indicated that the women were committed to their own nutritional beliefs that derive from their culture and this study provided a clear picture of the cultural beliefs of Yazdi women regarding pregnancy nutrition. According to the results, it is necessary to design the education process based on the culture of the community in order for that process to be effective.
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http://dx.doi.org/10.15167/2421-4248/jpmh2020.61.4.1625DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7888392PMC
December 2020

The effect of L-Carnitine supplementation on clinical symptoms, C-reactive protein and malondialdehyde in obese women with knee osteoarthritis: a double blind randomized controlled trial.

BMC Musculoskelet Disord 2021 Feb 17;22(1):195. Epub 2021 Feb 17.

Department of Biostatistics and Epidemiology, Research Center of Prevention and Epidemiology of Non-Communicable Disease, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Backgrounds: L-carnitine decreases oxidation and inflammation by reducing the fatty acid in plasma and using oxygen in ATP synthesis. As such, knee osteoarthritis (KOA) can be improved by reducing apoptotic chondrocytes. This study was designed to compare the effect of L-carnitine supplementation and low-calorie diet on improving KOA among obese women. We further investigated the effect of L- carnitine on improvement of KOA in obese women on low calorie diet.

Methods: To conduct the study, 76 obese women with KOA were randomly assigned into two low-calorie diet groups: the first received 1000 mg of LCG and the second took the placebo (PLG) (n = 38). Anthropometry indices, body composition, lipid profile, C-reactive Protein (CRP), Malondialdehyde (MDA), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were assessed at the baseline condition and after 12 weeks.

Results: The mean change of body mass index (BMI) (- 1.21 ± 0.84 vs. -0.79 ± 0.70; P = 0.02) and weight (- 2.76 ± 1.69 vs. -1.95 ± 1.73; P = 0.05) were significant in the LCG compared with the PLG. Likewise, LCG compared to the PLG showed insignificant improvement in waist circumference (WC) (- 5.65 ± 5.85 vs. -3.64 ± 3.37; P = 0.08). Total cholesterol (P = 0.02), MDA (P = 0.03), fat mass (P = 0.03) and visceral fat (P = 0.001) only showed decreased levels in LCG in comparison to the baseline condition. There was no significant difference between LCG and PLG, in the mean changes of hip circumference, visceral fat, free fat mass, fat mass, lipid profiles, CRP, MDA as well as stiffness, physical function, decrease of pain and total scores (P > 0.05).

Conclusion: The 12-week L-carnitine supplementation could improve BMI, but had no significant effect on other anthropometric and body composition measures as well as clinical symptoms, CRP, MDA, and lipid profile in women with KOA. Further trials with higher doses and longer durations are required. IRCT registration number: IRCT2017011932026N2. Registration date: 2017-04-27.
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http://dx.doi.org/10.1186/s12891-021-04059-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891026PMC
February 2021

The effects of resveratrol supplementation on PPARα, p16, p53, p21 gene expressions, and sCD163/sTWEAK ratio in patients with type 2 diabetes mellitus: A double-blind controlled randomized trial.

Phytother Res 2021 Feb 13. Epub 2021 Feb 13.

Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

The present study sought to evaluate the effect of resveratrol supplementation on mRNA expression levels of peroxisome proliferator-activated receptor alpha (PPARα), p53, p21, p16, and serum levels of cluster of differentiation 163 (CD163) to TNF-like weak inducer of apoptosis (TWEAK) ratio in patients with type 2 diabetes. In this double-blind randomized controlled trial, 71 patients were randomly assigned to receive either 1,000 mg of trans-resveratrol or placebo (methyl cellulose) for 8 weeks. Expression levels of genes of interest, and serum levels of sCD163 and sTWEAK were assessed at baseline and at the end of the study. Resveratrol supplementation significantly increased mRNA expression levels of p53 and p21 genes, compared with the placebo group (fold change of p53 = 1.29, p = .04; fold change of p21 = 1.46, p = .006). However, no significant effect on expression levels of PPARα and p16 genes was observed after supplementation. In addition, resveratrol significantly reduced serum levels of sCD163/sTWEAK ratio compared with the placebo group (p = .003). Resveratrol supplementation resulted in significant changes in p53 and p21 genes expression, while serum levels of sCD163/sTWEAK ratio also improved in the resveratrol group, without any significant change in adjusted sCD163 levels. More research is needed to confirm the beneficial effects of resveratrol for patients with diabetes.
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http://dx.doi.org/10.1002/ptr.7031DOI Listing
February 2021

Determiners of fast-food consumption in Iranian university students: Application of prototype/willingness model.

J Educ Health Promot 2020 29;9:345. Epub 2020 Dec 29.

Department of Education and Psychology, Yazd University, Yazd, Iran.

Background: Today, marked by advanced scientific approach, urbanism, and changing life style, there is an ever-growing rate of fast-food consumption, which has significantly affected public health. Hence, the present research aimed to predict factors involved in fast-food consumption in light of the prototype/willingness model among the students of Rafsanjan University of Medical Sciences.

Materials And Methods: In the present descriptive/analytical research conducted in 2018-2019, 350 students in Rafsanjan University of Medical Sciences were selected through proportionate stratified random sampling. The required data were collected using a self-administrated questionnaire in light of the constructs within the prototype/willingness model and fast-food consumption behavior. The data were analyzed in SPSS version 16.0 using descriptive and inferential statistics including mean scores, standard deviation, correlation coefficient, and linear regression.

Results: Behavioral intention of fast-food consumption showed to be positively correlated with positive willingness, positive prototype, positive subjective norms, and positive attitude toward fast-food consumption. Furthermore, the correlation between positive behavioral intention of consuming fast food and positive subjective norms and positive attitude toward fast-food consumption was statistically significant ( < 0.05). The underlying constructs of prototype/willingness model altogether managed to explain 13% of the total variance of fast-food consumption behavior. Behavioral intention showed to be the strongest predictor of the behavior (β = 1.613).

Conclusion: It is suggested that the preventive measures aimed to reduce fast-food consumption among the youth focus more on strengthening negative attitudes and subjective norms concerning fast-food consumption.
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http://dx.doi.org/10.4103/jehp.jehp_466_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871928PMC
December 2020

Safety assessment of genetically modified rice expressing Cry1Ab protein in Sprague-Dawley rats.

Sci Rep 2021 Jan 13;11(1):1126. Epub 2021 Jan 13.

Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Shohadaye Gomnam Blvd., Yazd, 8916188638, Islamic Republic of Iran.

Rice is considered one of the most important staple food crops. Genetically modified (GM) Bt rice, harbored cry1Ab gene expressing the insect-resistance protein has been developed to resistance to the insects. In this study, we assessed the safety of the GM Bt rice on Sprague-Dawley rats for 90 days. Totally, 120 rats in both sexes were used for three different diets, including 50% GM Bt rice, feeding with 50% rice, and standard feeding. Each 40 SD rats including 20 males and 20 females were considered as each diet. The clinical variables such as body weight and food consumption were measured and a range of clinical tests was examined, including hematology, serum chemistry parameters, urinalysis profile, thyroid, and sex hormone levels. Pathological assessments were also done. The results showed that the mean weekly feed utilization (%) had no significant difference among the studied groups. Also, blood biochemistry, hematological parameters, urine analysis, and hormonal levels had no significant differences among the groups. However, alanine aminotransferase was less in males versus female feeding with GM Bt rice. No histopathological changes were observed among the groups. In conclusion, this study demonstrated that GM Bt rice had no obvious adverse effects on rats' health.
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http://dx.doi.org/10.1038/s41598-021-80958-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807014PMC
January 2021

Dielectric barrier discharge plasma with photocatalysts as a hybrid emerging technology for degradation of synthetic organic compounds in aqueous environments: A critical review.

Chemosphere 2021 Jan 23;263:128065. Epub 2020 Aug 23.

Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Dielectric barrier discharge (DBD) plasma has been recently used for removal of synthetic organic compounds (SOCs) from aqueous environments. The removal of SOCs by alone DBD is significantly limited by its high electricity needs and inefficient mineralization, which affects the further application of DBD for SOCs. The combined application of DBD with other technologies and the addition of a supplementary substance for energy-saving were proposed to resolve these problems. The addition of catalysts is considered to be a promising and innovative approach to increase the energy yield of DBD, improve the environment friendly of DBD, develop the variety of goal SOCs, and improve the removal efficiency of DBD system. Despite the increasing use of the coupling form of DBD and catalysts, as catalytic dielectric barrier discharge (CDBD), but it still requires a comprehensive review to summarize the last studies and highlight the future perspectives in this area. Therefore, this work is the first literature review aimed to critically assess the latest developments of catalysts coupling with DBD employed in aqueous environments. Moreover, performance evaluation, energy yield, toxicity, eco-friendly, and future perspectives of the CDBD systems for SOCs removal were discussed and overviewed. The results showed that the coupling of catalysts with DBD presents synergistic effects and had excellent removal performance for aqueous SOCs. Overall, it can be concluded that the essential principles of environmental and economic sustainability have been addressed for the removal of persistent pollutants from aqueous environments in the CDBD systems.
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http://dx.doi.org/10.1016/j.chemosphere.2020.128065DOI Listing
January 2021

A questionnaire on factors affecting the precaution adoption process model for cervical cancer - Psychometric properties.

J Educ Health Promot 2020 30;9:278. Epub 2020 Oct 30.

Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

Background: Implementing a cervical cancer prevention program requires an exploration of certain behaviors concerning this disease. This study is aimed to evaluate the psychometrics of a questionnaire that enquired about the factors involved in Precaution Adoption Process Model (PAPM) for cervical cancer among suburban women in Bandar Abbas, south of Iran.

Materials And Methods: The primary draft of the questionnaire was developed with a review of the related literature on cervical cancer and the constructs affecting PAPM, with 68 items. The face validity, content validity ratio (CVR), and content validity index (CVI) of the questionnaire were approved by a panel of 10 experts. The internal consistency and test-retest reliability of the questionnaire were estimated too. Field testing sample included 300 women recruited from a women's healthcare center in suburban areas of Bandar Abbas in the south of Iran. Exploratory factor analysis was used to evaluate validity, and Cronbach's alpha coefficient was estimated for reliability.

Results: After the face validation, 11 items were eliminated. Once CVR was estimated, two items were discarded. The remaining items had a CVR >0.79. All had a CVI >0.79. Six items were eliminated in the factor analysis. The final questionnaire included 49 items organized in 8 factors including awareness, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, social norms, fear, and self-efficacy. Principal component analysis with varimax rotation indicated eight main components that explained 56.25% of the variance. Reliability assessment showed a good internal consistency for all subscales and the Cronbach's alpha score ranged between 0.82 and 0.90. The test-retest reliability showed that the correlation coefficients (between 0.81 and 0.89) were significant at the 0.01 level for all sub-scales.

Conclusions: The final questionnaire was a new instrument comprised the effective constructs of PAPM and had a high reliability and validity. Thus, this questionnaire is recommended to be used to explore and enhance preventive behaviors of cervical cancer.
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http://dx.doi.org/10.4103/jehp.jehp_119_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709773PMC
October 2020

Construction and Validation of Breast Cancer Awareness Scale in Iranian Women.

J Caring Sci 2020 Aug 18;9(3):140-147. Epub 2020 Aug 18.

Departement of Biostatistics and Epidemiology, Research Center of Prevention and Epidemiology of Non-Communicable Disease, School of Public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Application of a single valid and reliable questionnaire in future studies in the area of Iranian women's awareness of breast cancer provides the health policymakers with a comprehensive view over the issue. In designing the current questionnaires in Iran, the prior researchers neither explained about the design procedure, nor calculated the validity and reliability of the questionnaire completely. In this regard, researchers decided to design a standard questionnaire to examine women's awareness about the symptoms and risk factors of the breast cancer. This methodological study was conducted on 250 women in Yazd. Data were collected by a researcher-made questionnaire. The reliability was determined using the Cronbach's alpha and test-retest method. Factor analysis was used to determine the construct validity in SPSS version 21. The face validity of the questionnaire was evaluated by the target population. The results of the impact score indicated that all questions had a score equal or greater than 1.5. The qualitative content validity of the questionnaire was evaluated by the expert panel. Content validity ratio (CVR) and content validity index (CVI) obtained close to one for questionnaire. Construct validity was confirmed by performing factor analysis and dimensions of the questionnaire were determined. Cronbach's alpha coefficient for all dimensions was higher than 0.8. Also, intraclass correlation coefficient (ICC) for all dimensions was close to one and was between 0.84-0.95. Validity and reliability of designed questionnaire in this study for Iranian women are acceptable and suitable.
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http://dx.doi.org/10.34172/jcs.2020.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492964PMC
August 2020

The effect of canola, sesame and sesame-canola oils on body fat and composition in adults: a triple-blind, three-way randomised cross-over clinical trial.

Int J Food Sci Nutr 2021 Mar 20;72(2):226-235. Epub 2020 Jul 20.

Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

The present study aimed to examine the effect of replacing edible oils with sesame oil (SO), canola oil (CO) and sesame-canola oil (SCO) on body weight and composition in adults. Adults without any chronic diseases ( = 77) were entered a 4-week run-in period and then were randomised to receive SO, CO and SCO for their household use in 9-week intervention periods (separated by 4-week washout intervals). Anthropometric measurements, as well as body composition markers, were assessed at baseline, middle and after each intervention period. In total, 73 participants completed the study. Although significant time effects were seen for waist and hip circumference, waist-to-hip ratio, central obesity index, body adiposity index, muscle mass and body fat percent (<.05), the treatment and treatment × time effects were not significant (>.05). The present clinical trial revealed that CO, SO and SCO might not differently affect body fat and composition. Trial registration code: IRCT2016091312571N6 (http://en.irct.ir/trial/12622).
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http://dx.doi.org/10.1080/09637486.2020.1786024DOI Listing
March 2021

Perceived Threats toward Esophageal Cancer among Immediate Relatives of Sufferers: a Qualitative Study.

J Gastrointest Cancer 2020 Jun 24. Epub 2020 Jun 24.

Department of Biostatistics, Research Center of Prevention & Epidemiology of Non-Communicable Disease, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Purpose: Considering life-threatening nature of cancer and the problems that it causes for patients and families, recognizing their perspectives toward this issue is important. Therefore, the aim of this study was to determine perceived threats by immediate relatives of patients with esophageal cancer.

Methods: Using content analysis approach, the present qualitative study was conducted in Golestan Province (north of Iran) in 2018. Through purposive sampling, 23 immediate relatives of patients with esophageal cancer were included in the study. The research techniques included semi-structured and deep interviews. We continued data collection to ensure data saturation was achieved. All interviews were recorded, transcribed, and then analyzed with Graneheim and Lundman's approach of conventional content analysis. The MAXQDA 11 software was applied to conduct the coding process.

Results: Following data analysis, two main categories including "perceived susceptibility" and "perceived severity" were identified for perceived threats. The main category of "perceived susceptibility" comprised of four subcategory, namely, perception of individual, environmental, psychological, and nutritional predisposing factors to the disease. Four subcategories were also extracted for the "perceived severity," including perception of physical, psychological, therapeutic, and social consequences of the disease.

Conclusions: Immediate relatives of patients with esophagus cancer perceived high severity and susceptibility toward this disease and considered themselves vulnerable to this disease. Hence, they suffered from a lot of psychological stress. Development of appropriate interventions regarding the effects of disease-related individual and environmental factors and empowerment of individuals with regard to preventive disease behaviors can be an important step for improving the health of this group.

Registration Number: IRCT20180725040588N1, date registered: 2 October 2018.
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http://dx.doi.org/10.1007/s12029-020-00422-yDOI Listing
June 2020

The impacts of pill contraceptive low-dose on plasma levels of nitric oxide, homocysteine, and lipid profiles in the exposed vs. non exposed women: as the risk factor for cardiovascular diseases.

Contracept Reprod Med 2020 10;5. Epub 2020 Jun 10.

Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: Consuming oral contraceptive pills is one of the methods for preventing pregnancy worldwide. As using the pills has always caused the greatest concern for the likelihood of developing cardiovascular diseases and also given the limited conducted studies in this regard, this study was carried out to determine the impacts of low dose birth control pills on plasma levels of nitric oxide, homocysteine, and lipid profiles in the exposed vs. non exposed women as the risk factors for cardiovascular diseases.

Methods: This was a combined cohort study conducted on 100 women, having the age range 20-35 years and normal menstrual cycles, referred to the health care centers in Yazd, Iran. The demographic data were obtained through face to face interviews performed by the researcher. Anthropometric indexes were measured and biochemical factors were determined by testing blood samples. Then, using SPSS 16 and statistical independent t-test and Chi- square, the data were analyzed.

Results: The mean ± standard deviations of plasma levels of homocysteine, nitric oxide, cholesterol, triglyceride, Low Density Lipoprotein, and High Density Lipoprotein levels in the group consumed low dose contraceptive pills were 3.84 ± 2.35 μmol/l, 181.36 ± 90.44 μM, 180.7 ± 38.28 mg/dl, 129.82 ± 47.92 mg/ dl, 101.42 ± 30.66 mg/dl, and 56.46 ± 8.42 mg/dl, There were significant statistical differences between those consuming the pills and those not consuming the pills regarding cholesterol ( < 0.05).

Conclusion: Consuming Low Dose contraceptive pills can increase the plasma levels of cholesterol, triglyceride, and Low Density Lipoprotein levels; i.e. this condition is called dyslipidemia. On the other hand, there were no changes in the levels of homocysteine and nitric oxide in the healthy women consuming the pills; therefore, the pills may not develop cardiovascular diseases in healthy women. Accordingly, it is recommended that the health care providers prescribe the pills for the women with cautions.
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http://dx.doi.org/10.1186/s40834-020-00110-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288538PMC
June 2020

Moral courage and psychological empowerment among nurses.

BMC Nurs 2020 24;19:43. Epub 2020 May 24.

Department of Biostatistics and Epidemiology, Faculty of Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.

Background: Moral courage is one of the fundamental values of nursing profession and a powerful method of coping with ethical problems. Psychological empowerment is a suitable method of enabling individuals to coping mental pressures of the work environment. This study determined the correlation between moral courage and psychological empowerment of nurses.

Methods: This was a descriptive cross-sectional study. A total of 180 nurses employed in different wards were selected randomly. Data were collected by Demographics Questionnaire, Sekerka's Moral Courage Scale, and Spreitzer's psychological empowerment Scale and analyzed with SPSS16 using descriptive and inferential statistics.

Findings: The results indicated that the mean score of moral courage was 21.11 ± 69.90 and the greatest amount of moral courage was in the dimension of "going beyond compliance". The mean score of "psychological empowerment" was 30.9 ± 73.58 and the greatest mean belonged to "competence". There was a positive significant correlation between "psychological empowerment" and "moral courage and its dimensions" ( < 0.05).

Conclusion: The findings suggested a correlation between moral courage and psychological empowerment. Thus, nurses' moral courage could be enhanced by reinforcing their psychological empowerment leading to increased patient satisfaction and quality care.
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http://dx.doi.org/10.1186/s12912-020-00435-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247179PMC
May 2020

Effect of palliative care training on perceived self-efficacy of the nurses.

BMC Palliat Care 2020 May 4;19(1):63. Epub 2020 May 4.

Department of Biostatistics and Epidemiology, Faculty of Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.

Background: Nurses are involved in providing end-of-life care for end stage individuals and their self-efficacy is one of the key factors bearing on such care. The purpose of this study was to determine the effect of palliative care on perceived self-efficacy of the nurses.

Methods: This is a quasi-experimental study with pretest-posttest design. Sampling was randomized and included 40 individuals. The intervention consisted of palliative care training for four sessions, each lasting 45 min. Data were collected using demographic and perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed by SPSS 16 software using descriptive and inferential statistics.

Results: The mean age of the participants was 38.6 and their work experience was 14.25 years. The majority of the participants were female (85%) and had a bachelor level of education (92.5%). The findings showed that "perceived self-efficacy", "psychosocial support" and "symptom management" improved significantly after intervention (p < 0.05).

Conclusion: Based on the results, palliative care education has the potential to increase nurses' perceived self-efficacy. Since all members of the health care team Including nurses play an important role in providing palliative care, nursing managers can take an effective step to maximize the capacity of nurses by planning and supporting training in this regard.
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http://dx.doi.org/10.1186/s12904-020-00567-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199299PMC
May 2020

Relationship of zinc status with depression and anxiety among elderly population.

Clin Nutr ESPEN 2020 06 19;37:233-239. Epub 2020 Mar 19.

Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Electronic address:

Background & Aims: Population aging is a global challenge. Old populations are prone to zinc deficiency. This study aimed to determine the association of zinc status with depression and anxiety among men and women aged 60+ years old.

Methods: In this cross-sectional study, 297 elderly participants (144 males and 153 females) were studied. The dietary and serum zinc were assessed using a three-day dietary record and an auto-analyzer, respectively. Depression and anxiety were measured using Geriatric Depression Scale and Hamilton Anxiety Rating Scale, respectively. Chi-squared test was used to compare qualitative variables. Multiple logistic regression analysis was conducted to assess relationship between zinc status and depression/anxiety.

Results: The total zinc deficiency based on serum values was 23.2%. Dietary intake of zinc in 72.4%of participants was less than of the Estimated Average Requirement (EAR). The total depression prevalence was 42.2%. Moreover, 52.5% of the participants suffered from anxiety. The odds of depression among participants in the third tertile of serum zinc concentration was 51% lower than those in the first tertile (OR = 0.49, CI = 0.25-0.96, p = 0.03). No significant relationship was found between zinc intake and depression. Furthermore, serum or dietary zinc levels were not related to anxiety.

Conclusions: This study showed a considerable zinc deficiency and depression/anxiety in the old population. A significant relation was found between serum zinc concentration and depression. Further surveys, especially cohort studies and clinical trials are needed to confirm these results.
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http://dx.doi.org/10.1016/j.clnesp.2020.02.008DOI Listing
June 2020

Effects of synbiotic supplementation on gut microbiome, serum level of TNF-α, and expression of microRNA-126 and microRNA-146a in patients with type 2 diabetes mellitus: study protocol for a double-blind controlled randomized clinical trial.

Trials 2020 Apr 14;21(1):324. Epub 2020 Apr 14.

Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background: The dramatic increase in the prevalence of type 2 diabetes mellitus (T2DM) is a global major challenge to health. Circulating microRNAs have been suggested as promising biomarkers for different disorders such as diabetes. Imbalances in the gut microbiome have been revealed to contribute to the progression of multiple diseases including T2DM. Recently, the consumption of probiotics and synbiotics in the treatment of various diseases has shown a substantial growth. The anti-diabetes and anti-inflammatory effects of synbiotics have been indicated, which may be due to their beneficial effects on the gut microbiome. However, further research is needed to assess the effects of synbiotics on the microbiota and their impacts on expression of microRNAs relating to T2DM. Thus, we will aim to assess the effects of synbiotics on microbiota, serum level of tumor necrosis factor-α (TNF-α), and expression of microRNA-126 and microRNA-146a in patients with T2DM.

Methods: Seventy-two patients with T2DM will be recruited in this double-blind randomized parallel placebo-controlled clinical trial. After block matching based on age and sex, participants will be randomly assigned to receive 1000 mg/day synbiotic (Familact) or placebo for 12 weeks. The microRNA-126 and microRNA-146a expression levels will be measured by real-time polymerase chain reaction and serum TNF-α level will be assessed by enzyme-linked immunosorbent assay kit at the beginning and at the end of the study. Determination of the gut microbiota will be done by quantitative polymerase chain reaction methods at baseline and at the end of the trial. Biochemical assessments (glycemic and lipid profiles) will also be conducted at onset and end of the study.

Discussion: This is the first randomized controlled trial that will determine the effect of synbiotic supplementation on the gut microbiota and its probable impacts on serum levels of TNF-α and expression of related microRNAs in patients with T2DM.

Trial Registration: Iranian Registry of Clinical Trials: IRCT20180624040228N2. Registered on 27 March 2019. http://www.irct.ir/trial/38371.
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http://dx.doi.org/10.1186/s13063-020-04236-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7158024PMC
April 2020

The effect of Nigella sativa on the measures of liver and kidney parameters: A systematic review and meta-analysis of randomized-controlled trials.

Pharmacol Res 2020 06 20;156:104767. Epub 2020 Mar 20.

Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Electronic address:

The aim of this systematic review and dose-response meta-analysis was to determine the effect of Nigella sativa (N.S) supplementation on liver and kidney parameters. We searched PubMed, Scopus, ISI Web of Science, Cochrane central register for controlled trials and Google Scholar from database inception to April 2019 for relevant controlled trials. Mean differences and standard deviations for each outcome were pooled using a random-effects model and a dose-response analysis was performed using a fractional polynomial model. Quality of evidence was evaluated using Cochrane Collaboration Risk of Bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Nineteen trials (n = 1295 participants) were included in the meta-analysis. We observed that N.S supplements had significant reducing effects on alkaline-phosphatase (ALP) [9 trials, n = 710 participants, weighted mean difference (WMD)= -10.825; 95 %CI: -19.658, -1.992 U/L; P = 0.016; I = 75.7 %; P-heterogeneity = 0.000) and blood urea nitrogen (BUN) (12 trials, n = 821 participants, WMD= -1.016; 95 % CI: -1.760, -0.273 U/L; P = 0.007; I = 87.7 %; P-heterogeneity = 0.000) concentrations. Subgroup analysis showed that, an intervention of more than 12 weeks was found to have a reducing effect on aspartate- aminotransferase (AST) measures (2 trials, n = 201 participants, WMD= -11.317; 95 % CI: -15.007, -7.626; P = 0.000; I = 0.0 %; P-heterogeneity = 0.977). Creatinine levels increased significantly in studies that considered adjusted analysis based on covariates (3 trials, n = 152 participants, WMD = 0.070; 95 % CI: 0.027, 0.112 U/L; P = 0.001; I = 0.0 %; P-heterogeneity = 0.788). A daily dose of 1100-1500 mg of N.S supplements was observed to have a substantial reducing effect on ALP levels (5 trials, n = 340 participants, WMD= -11.323; 95 % CI: -21.418, -1.229 U/L; P = 0.028; I = 0.00 %; P-heterogeneity = 0.686), while a dosage of more than 2000 mg per day led to a significant increase in BUN concentrations (2 trials, n = 101 participants, WMD= -1.016; 95 % CI: -1.760, -0.273 U/L; P = 0.007; I = 87.7 %; P-heterogeneity = 0.000). Our data suggested that N.S supplementation had significant impacts on liver and kidney parameters leading to a decrease in ALP and BUN levels. Longer duration of intervention and normal daily dosages of N.S supplements led to significant reductions in ALP and AST concentrations, respectively, while higher daily dosages increased BUN levels. Hence, in spite of favorable impacts of N.S supplements on liver and kidney parameters, due to the herbal nature of N.S, more studies with high-quality, large-scale, long-term intervention and precise baseline characteristics are needed to assess the exact effective dose, duration and efficacy of N.S supplementation on kidney and liver parameters.
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http://dx.doi.org/10.1016/j.phrs.2020.104767DOI Listing
June 2020

The effect of resveratrol supplementation on serum levels of asymmetric de-methyl-arginine and paraoxonase 1 activity in patients with type 2 diabetes: A randomized, double-blind controlled trial.

Phytother Res 2020 Aug 6;34(8):2023-2031. Epub 2020 Mar 6.

Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

The present study sought to investigate the effect of micronized resveratrol supplementation on serum levels of asymmetric de-methyl-arginine (ADMA) and paraoxonase-1 (PON1) activity in patients with type 2 diabetes (T2D). In this double-blinded randomized trial, 76 patients with T2D were recruited. Participants were randomly assigned to consume 1,000 mg resveratrol or placebo capsules (methylcellulose) per day, for 8 weeks. Serum levels of ADMA and PON1 enzyme activity were measured at the beginning and end of the intervention using the enzyme-linked immunosorbent assay method. In total, 71 participants completed the study. Our results showed that resveratrol significantly decreased serum levels of ADMA (-0.16 ± 0.11, p < .001) and improved PON1 enzyme activity (15.39 ± 13.99, p < .001) compared with placebo, after adjusting for confounding factors (age, sex, and baseline body mass index). Our findings suggest that 8-week resveratrol supplementation may produce beneficial effects on serum levels of ADMA and PON1 enzyme activity in patients with T2DM. However, further research is needed to confirm the veracity of these results.
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http://dx.doi.org/10.1002/ptr.6655DOI Listing
August 2020

Evaluating perceived threat of skin cancer and preventive measures in South Iranian sailors: A qualitative study.

J Educ Health Promot 2019 31;8:262. Epub 2019 Dec 31.

Department of Dermatology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background: Sailors are exposed to sunlight as their job requires and are, in the long run, more prone to different types of skin cancer. This study aimed to explore sailors' experience of perceived threat and to show protective behaviors against sunlight in the south of Iran.

Materials And Methods: The present follows a qualitative approach and directed content analysis in 2018-2019 among sailors who were selected purposively through an interview procedure. Finally, 22 sailors and 3 patients with skin cancer with an experience of sailing were interviewed until data satiation occurred. The data were collected through a semi-structured interview based on two constructs, perceived susceptibility and perceived severity of protection motivation theory, and were instantly transcribed and read more than once by the present researcher. Simultaneously, the data were entered into MAXQDA 10 for the primary categorization.

Results: Data analysis results were classified into 5 categories and 12 subcategories: protective attempts (change of work time and use of protectives), passivity in self-protection (not showing protective behaviors and not examining skin), inadequate perception of affliction risk (beliefs hindering preventive behaviors and low sensitivity), perceived threat to personal and familial conditions (loss of peace and loss of occupational-familial positions), and threat to health (incurable disease and perceived skin disease).

Conclusions: Awareness of these factors helps planners to choose the best preventive strategies with a focus on correcting beliefs and promoting protective behaviors as well as examining and screening sailors regularly to diagnose skin cancer. Moreover, to develop practical measures of protective strategies against sunlight among sailors, the required steps should be taken. This can help to reduce the rate of work-related risks while exposed to sunlight in this population.
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http://dx.doi.org/10.4103/jehp.jehp_369_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6967113PMC
December 2019

Evaluation of students' mental and social health promotion educational programs: A systematic review.

J Educ Health Promot 2019 31;8:258. Epub 2019 Dec 31.

Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Various programs are implemented internationally to promote the mental and social health of the students in schools. This study systematically reviewed and categorized all resources, indicators, and criteria for evaluating mental and social programs of schools.

Materials And Methods: This systematic review was conducted by collecting data from the PubMed, Google Scholar, Scopus, ProQuest, and Web of Science databases using the keywords of "evaluation, mental health program, social health program, behavioral and emotional program." In the initial review, 4295 studies were found, which reduced to 75 after removing the repetitions and evaluating the studies' quality. The articles were selected using the PRISMA chart.

Results: The findings resulted in three main categories of structure, process, and outcome; 16 subcategories; and 166 codes. The category of structure included the subcategories of human resources, physical space, facilities, training, needed committees and teams, financing, and implementing mental and social programs. The subcategories of process category were functional indicators, guidelines and protocols, communication, documentation, planning/coordination, time management, and monitoring. The subcategories of behavioral-therapeutic, satisfaction, and educational outcomes were associated with the outcome category.

Conclusion: Application of the structure, process, and outcome indicators, derived from the findings of this study, will greatly improve evaluation of the international mental health programs in schools.
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http://dx.doi.org/10.4103/jehp.jehp_416_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6967152PMC
December 2019

Effect of a low energy diet, containing a high protein, probiotic condensed yogurt, on biochemical and anthropometric measurements among women with overweight/obesity: A randomised controlled trial.

Clin Nutr ESPEN 2020 02 21;35:194-200. Epub 2019 Nov 21.

Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Electronic address:

Background & Aims: The aim of this study was to determine the effect of low energy diet containing condensed processed yogurt (Kashk), as a high protein, calcium and probiotic enriched product, on glycemic control, lipid profile, anthropometric measurements and blood pressure among women with overweight/obesity.

Methods: 70 women with overweight/obesity were randomly assigned to receive either a low energy diet contained 50 g of Kashk (intervention group) or a low energy diet without Kashk (control group) for 8 weeks. Anthropometric, blood pressure and biochemical measurements were obtained before and after the intervention.

Results: Between-group comparisons showed that the intervention group significantly decreased triglycerides (P = 0.013) and low density lipoprotein cholesterol (P = 0.049) levels relative to the control group. Significantly greater reductions in body mass index (P = 0.018), fat percent (P = 0.037) and waist circumference (P = 0.047) were observed in the intervention group compared to control. Within-group comparisons revealed significant reductions in systolic blood pressure (P = 0.035) and weight (P = 0.005) in the intervention group.

Conclusions: Long-term consumption of Kashk, as a high protein and calcium product enriched with probiotic that is accompanied by a low energy diet, might have beneficial effects on anthropometric and biochemical indices, though more cross-over and parallel blinded trials with placebo groups are needed to confirm these results. (The clinical trial registration number is IRCT2013042913163N1).
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http://dx.doi.org/10.1016/j.clnesp.2019.10.001DOI Listing
February 2020

Effects of low-dose contraceptive pills on the risk factors of cardiovascular diseases among 15-35-year-old women: A retrospective cohort.

Int J Reprod Biomed 2019 Dec 26;17(11):841-850. Epub 2019 Dec 26.

Department of Nursing, Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: Cardiovascular diseases could be preventable; as a result, understanding the risk factors was regarded as the major priority for healthcare providers.

Objective: The main objective of this research was to achieve a deeper insight into the effect of long-term use of low-dose oral contraceptive pills (OCP) on the risk factors of cardiovascular diseases.

Materials And Methods: This research was a retrospective cohort conducted (historical and prospectively) conducted on 100 women with normal menstrual cycles aged 15 to 35 yr, who were referred to the healthcare centers in Yazd, Iran. The participants were categorized into two groups: The OCP group was consuming the pills for 0-3, 4-23, and 24-36 months, and the non-OCP group. Participants were followed up for a minimum of 3 months and a maximum of six months.

Results: The highest level of low-density lipoprotein (LDL), homocysteine, cholesterol, triglyceride levels, and systolic blood pressure was observed in the OCP group in the duration of 24 to 36 months. The Tukey's test demonstrated that there were comprehensible differences in the LDL (p = 0.01), cholesterol (p = 0.01), triglyceride (p 0.001), and homocysteine levels (p 0.001), also systolic blood pressure (p = 0.04).

Conclusion: It was realized that the long-term consumption of low-dose OCP can augment the incidence of some risk factors (systolic blood pressure, homocysteine levels, cholesterol, LDL-c, and triglyceride) and lead to developing cardiovascular diseases amongst the healthy women.
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http://dx.doi.org/10.18502/ijrm.v17i10.5496DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906853PMC
December 2019

Predictors of mammography based on Health Belief Model in Khorramabad women.

J Educ Health Promot 2019 30;8:180. Epub 2019 Sep 30.

Department of Midwifery, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Lorestan, Iran.

Background: Health beliefs play an important role in people's willingness to participate in health-promoting behaviors. Given the role of beliefs in women's function and the importance of the benefits of mammogram, and because the predictors of a behavior are a major prerequisite to codification of an effective prevention program, the present study was conducted with the aim of predicting mammography based on Health Belief Model (HBM) in women in Khorramabad.

Materials And Methods: In this cross-sectional study, 262 women referring to health centers in Khorramabad, Lorestan province, in 2018, were selected by randomly sampling. The data collection tool was a four-part questionnaire including demographic information, knowledge on breast cancer and mammography, Champion's Health Belief Model, and Champion's Self-Efficacy Questionnaire for Mammography. Validity and reliability of the tool were investigated and confirmed. Data were analyzed by version 16 of SPSS software using descriptive statistics, Chi-squared test, and multiple logistic regression.

Results: The mean (standard deviation) age of the participants was 49.26 (±7.79) years. Seventy-nine (30.85%) of the 262 participants reported mammography. Constructs' sensitivity, benefits, barriers, and perceived self-efficacy were significantly different in terms of performing mammography ( < 0.05). Participants with a history of breast cancer (odds ratio [OR] = 11.18, 95% confidence interval [CI] = [3.73-33.46]) had lower perceived barriers (OR = 3.54, 95% CI= [1.77-7.09]), were more likely to undergo mammography than women with no family history of breast cancer, and had moderate-to-high perceived barriers ( < 0.001).

Conclusion: The results of this study indicate that health managers are required to pay more attention to training and promoting screening methods. Understanding the barriers to mammography in women by managers can help design and implement effective programs that enhance mammography in women.
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http://dx.doi.org/10.4103/jehp.jehp_63_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796297PMC
September 2019

Predictive factors for preventing hookah smoking and health promotion among young people based on the protection motivation theory.

J Educ Health Promot 2019 30;8:169. Epub 2019 Sep 30.

Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Background: Smoking hookahs is one of the most preventable risk factors for non communicable diseases. It is also considered as the gateway to youth addiction. Planning and training to prevent this health problem is considered an important priority. The aim of this study was to determine the predictive factors for preventing hookah smoking (PHS) in the youth of Sirjan city, based on the protection motivation theory (PMT).

Materials And Methods: This research was a cross-sectional study conducted in 2018, and participants were chosen by simple random sampling. Data were collected by a researcher-made questionnaire which was valid and reliable and was designed based on the PMT constructs. This questionnaire was completed by 280 young people in Sirjan, Iran. Data were analyzed through descriptive statistics, Pearson correlation coefficients, and linear regression.

Results: Pearson correlation coefficients showed that there was a significant correlation between protection motivation and the structures of the PMT, except for the response cost structure. The strongest correlation was between protection motivation and self-efficacy ( = 0.502) and fear ( = 0.470). The structures of the PMT predicted 36.5% of PHS, and fear (β =0.27) was the strongest predictor of PHS.

Conclusion: The results of this study show that the constructs of the PMT can partially predict PHS. This theory can be used as a tool for designing and implementing educational interventions to prevent hookah smoking among the youth.
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http://dx.doi.org/10.4103/jehp.jehp_78_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796312PMC
September 2019

Identification and Prioritization of Key Components Influencing Prehospital Emergency Related to Preventable Road Traffic Injuries Deaths in Iran; A Delphi Study.

Bull Emerg Trauma 2019 Oct;7(4):381-389

Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objective: To identify and prioritize the key Components of prehospital emergency system to prevent mortality in road traffic injuries.

Methods: A total of 25 emergency medicine practitioners, emergency ward nurses, and managers of prehospital emergency centers participated in this adjusted Delphi study in three rounds. After extracting the primary components through reviewing systematic studies and interviewing experts, the Delphi rounds were performed with the presence of experts. The data were analyzed with both qualitative content analysis and quantitative analysis using SPSS20 software. For the analysis and selection of the final priorities, the coefficient of agreement of over 70% was used.

Results: After doing three Delphi rounds, in the final Delphi round, 10 superior components were selected respectively as follows: correct history taking of the victim, examining possible cervical injury, the time spent from the first call to arrival of technicians to the scene, the time spent from arriving at the scene to the time of hospital transport, passing of re-education courses by EMS technicians, coordination among the rescue organizations, police, the Red Crescent, fire station, and healthcare organizations, integrated commandership at scene, police attendance in the scene before EMS arrival at the scene, proper ambulance equipment with respect to the required equipment (A, B, C) on the basis of victim's condition, and coordination with the target hospital for patient transport.

Conclusion: This study determined the most applicable managerial methods of prehospital emergency components pertaining to preventable fatal road traffic injuries through empowerment of EMS systems in the fields of victim assessment, time management indices, personnel training, coordination between the involved organs, and the presence of the main commander in the scene.
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http://dx.doi.org/10.29252/beat-070407DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6911724PMC
October 2019

Risks threatening the health of people participating in mass gatherings: A systematic review.

J Educ Health Promot 2019 24;8:209. Epub 2019 Oct 24.

Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Context: Mass gatherings (MGs) are established for different religious, social, political, cultural, and sport motivations. Many risks threaten the participants' health in MGs for different reasons. One duty of health-care system is to identify the risks and manage them to reduce the participants' injuries in MGs. This study aimed to identify and classify the risks threatening the health of participants in MGs and review related articles systematically.

Subjects And Methods: In this study, we investigated electronic databases including Science Direct, PubMed, Ovid, ProQuest, Web of Science, Scopus, and Google Scholar. This systematic review investigated those health articles which studied MGs published after 2000. Keywords that were searched included (Mass gathering OR Crowd) AND (Assessment OR Evaluation) AND (Disaster OR Emergencies) AND (Injuries OR Stamped). The final full text articles were assessed qualitatively by STROBE article assessment checklist, and then the data extracted from the results of the articles were analyzed and reported.

Results: Initially, a total of 1874 articles were found, qualitative exclusion and inclusion criteria were applied, and finally 29 full-text articles were selected for the analysis. More than forty health-related risks were recognized. In order to better understand the risks and use of the results more efficiently, the risks were classified and reported into the following five domains: environmental risks, individual risks, psychological risks, public health risks, and management risks.

Conclusion: Many risks threaten the health of participants in MGs. Recognizing and managing the risks are considered the primary and basic essentials of health sector for the better management of MGs.
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http://dx.doi.org/10.4103/jehp.jehp_214_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852309PMC
October 2019

Concerns and Fear of Esophageal Cancer in Relatives of Patients with Cancer: a Qualitative Study.

J Gastrointest Cancer 2020 Sep;51(3):957-964

Department of Biostatistics, Research Center of Prevention & Epidemiology of Non-Communicable Disease, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Introduction: Due to its complications and mortality, cancer is a vital public health problem and one of the most frightening diseases, and its development causes a sense of risk, problems, and discomforts for all, including family of patients. The aim of this study was to elaborate on the concerns and fear of esophageal cancer in relatives with cancer illness.

Methods: Using a content analysis approach, this qualitative study was carried out in Golestan, North of Iran, in 2018. Participants were one of the family members of a patient with esophageal cancer who were selected purposefully. Data were collected using semi-structured and deep interviews and continued until data saturation was achieved. Twenty-three participants were interviewed. Interviews were transcribed line by line and were coded and categorized, and concepts were extracted accordance with qualitative content analysis approach, using MAXQDA 11 software.

Result: Following data analysis on the concerns and fear of cancer among relatives of patients, the main themes "fear of social consequences," "fear of treatment consequences," "fear of psychological consequences," "cancer phobia," "concern about lack of information on the disease," "fear of disease reactions," and "fear of disease-related changes" were extracted.

Conclusions: Family of patients with esophageal cancer were afraid of disease-induced consequences and lack of knowledge about the disease. Through educating people about the symptoms of the disease, we can reduce their fears and empower them for self-caring and preventing cancer.
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http://dx.doi.org/10.1007/s12029-019-00335-5DOI Listing
September 2020

Hookah is the enemy of health campaign: a campaign for prevention of hookah smoking among youth.

Health Promot Int 2020 Oct;35(5):1125-1136

Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Hookah smoking is now a serious health threat especially for adolescents. Implementation of planned interventions can help reduce hookah smoking. This study was conducted to investigate the effect of a campaign Hookah is the Enemy of Health Campaign (HEHC) based on the protection motivation theory to prevent hookah smoking among the youth in Sirjan city, in 2018. This was a pre- and post-intervention study. Participants were 280 male and female youth who were selected randomly through the health centers of Sirjan. The educational campaign was conducted during 3 months and participants were trained through interpersonal, group, organizational and community channels and mass media. Data were collected by filling out a questionnaire (containing 64 questions) by the participant before the intervention and 3 months after. Data were analyzed by descriptive statistics (frequency and percentage), chi-square and Wilcoxon signed-rank test by SPSS20 software. The prevalence of hookah smoking was 44.3% in the target group. There was a significant change in the mean scores of knowledge and perceived susceptibility, perceived severity, response efficiency, self-efficacy, rewards, fear and protection motivation after the HEHC (p < 0.05), but there was no significant difference in the structure of perceived cost (p > 0.05). Also, the prevalence of hookah smoking among the target group for those who had ever consumed decreased from 8.9 to 4% and for those who used it occasionally decreased from 35 to 19.4%. The HEHC was effective in reducing hookah smoking, raising knowledge and improving the constructs of the protection motivation theory among the youth of Sirjan.
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http://dx.doi.org/10.1093/heapro/daz109DOI Listing
October 2020

Management of Preventable Deaths due to Road Traffic Injuries in Prehospital Phase; a Qualitative Study.

Arch Acad Emerg Med 2019 24;7(1):32. Epub 2019 Jun 24.

Department of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Introduction: Prehospital care plays an important role in decreasing the number of deaths due to road traffic injuries (RTIs). This study aimed to identify the challenges of preventable deaths due to RTIs in the prehospital phase based on the attitudes of stakeholders.

Methods: Conventional content analysis of qualitative study was used to analyze the data. The participants were 24 RTI prevention experts from fire-fighting organization, traffic police, the Red Crescent, Emergency Medical Services staff, emergency medicine specialists, and hospital emergency nurses who were selected by means of purposive sampling. Data were collected using unstructured interviews and analyzed by means of data coding, followed by extracting sub-categories, and main categories.

Results: Six main categories were extracted as the major challenges of preventable deaths in RTIs in the prehospital phase including "poor management of the crash scene" with two subcategories of lack of rapid access to the patient and lack of scene safety, "lack of adequate rules and regulations" with two subcategories of lack of protocols and guidelines and lack of clear duties checklists, "poor management of time" with two subcategories of elongated response time at the crash scene and elongated time of victim transport, "low quality of training" with two subcategories of insufficient training of Emergency Medical Services (EMS) staff and inadequate public training, "poor communication and coordination" with two subcategories of poor communication of EMS staff and lack of uniform commandership at the crash scene, and "low quality of victim management" with two subcategories of low quality of clinical care and lack of accurate clinical assessment.

Conclusion: The following measures are necessary to reduce preventable deaths due to RTIs in the prehospital phase: accurate clinical assessment of the victim on the scene, provision of high quality and accurate clinical care, enforcement of legal obligations and using protocols in the field of victim management, coordination of the involved organizations through identifying the duties and responsibilities of each organization, and full management of the crash scene by assigning a unique commander to each unit and creation of the highest level of safety on crash scene.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732201PMC
June 2019

Responsibility-Evading Performance: The Experiences of Healthcare Staff about Triage in Emergency Departments: A Qualitative Study.

Iran J Nurs Midwifery Res 2019 Sep-Oct;24(5):379-386

Department of Nursing Education, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background: Correct triage is one of the most important issues in delivering proper healthcare in the emergency department. Despite the availability of various triage guidelines, triage is not still appropriately implemented. Therefore, this study was conducted to investigate the role of different underlying factors in triaging emergency patients through a qualitative approach.

Materials And Methods: This study was conducted by conventional content analysis. For this purpose, 30 interviews were conducted with 25 participants. The participants included triage nurses, emergency general physicians, emergency medicine specialists, and expert managers at different position rankings in hospitals and educational and administrative centers in Yazd, selected by purposeful sampling. Data were collected through in-depth and unstructured interviews from April 2017 to January 2018, and then analyzed by inductive content analysis.

Results: Four categories of profit triage, exhibitive triage, enigmatic, and tentative performance triage were drawn from the data, collectively comprising the main theme of responsibility-evading performance.

Conclusions: The dominant approach to the triage in the emergency departments in a central city of Iran is responsibility evasion; however, the triage is performed tentatively, especially in critical cases. To achieve a better implementation of triage, consideration of the underlying factors and prevention of their involvement in triage decision-making is necessary.
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http://dx.doi.org/10.4103/ijnmr.IJNMR_217_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714131PMC
September 2019