SOCIAL DETERMINANTS OF HEALTH
Year:2018 | Volume:4 | Issue:3|Papers Count:7

Stroke is the fourth leading cause of mortality and first cause of adult morbidity in the US. The burden of stroke care in the US is about $68. 9 billion for 2009 (1). . .

Background: For many in the United States, standard health insurance does not cover eye care, leading to lapses in care and exacerbations of pre-existing conditions. Touro College of Osteopathic Medicine (TouroCOM) recognizes the importance of ocular health and offers the opportunity to engage the community through student-run vision screenings. This study aims to assess the effect of medical student-run vision screenings in supplementing pre-clinical education and to review health fair data on common vision pathologies seen in Harlem, New York. Methods: Pre-and post-surveys were administered to medical student volunteers to assess their comfort in performing a basic vision screening. Training was given in regards to screening protocols and applied at health fairs. Results: Of all medical students 18 (90%) indicated discomfort in performing a basic vision screening when solely relying on their preclinical coursework. In comparison, after a training session and use during a health fair, all of the participants indicated that they were comfortable with performing a vision screening. Among the health fair participants, 116 (60%) met referral criteria for further testing or follow-up care. All the participants had some degree of refractive error, with 7 (6%) having concomitant color vision abnormality and 11 (9%) with macular abnormalities. Conclusion: Osteopathic medical students are better equipped to perform basic vision screenings and recognize visual disease with additional training and practice at health fairs. This engagement allows for early clinical experience, osteopathic outreach, and interprofessionalism. Furthermore, this provides an opportunity for community members to receive information that may guide future health decisions.

Background: A new competitive factor between universities is the production of knowledge, in which the material benefits are gained. Competition in achieving such a situation has created the new systems of ranking and evaluation of universities. The purpose of the present study was to present an appropriate model for university ranking and to evaluate the effectiveness of social factors in the final ranking model. Methods: First, the indices of 29 global ranking systems were studied and analyzed using content analysis method. Then, an interview was conducted with faculty members and the model was presented through theme analysis and open coding. A questionnaire was designed for the study and to confirm the reliability of the questionnaire, Cronbach's alpha coefficient was used. Also, the validity of the questionnaire was confirmed using the expert opinions. Convergent validity technique was also used using Amos graphics software. Results: The importance of social factors affecting academic ranking was obtained through calculation of the means. Based on our results, the importance of the factors from the largest to the smallest was as follows: educational performance; research performance; entrepreneurship and employment; scientific rank, national and international image; and the ability of the university to meet the needs of the society. All of which show moderate to high levels. Conclusion: Based on the results, the calculated values of fitness indices were in desirable range and the proposed model for the ranking of universities was suitable with empirical data and enjoys a favorable situation.

Background: Marital satisfaction has been identified as one of the most important determinants of healthy and quality functions of family life. The present study aimed at examining the mediatory effects of quality of life in the relationship between lifestyle and marital satisfaction among employed women. Methods: In the context of a cross-sectional study, 120 married employed women were studied in Abadeh, Iran. Lifestyle Questionnaire (LSQ) including 70 items was used to evaluate different aspects of participant's lifestyle. The Short Form Health Survey (SF-36) questionnaire was used to assess the health-related quality of life. Also, ENRICH Marital Satisfaction Questionnaire, including 35 items, was used to examine marital satisfaction. Data analysis was done using IBM SPSS Statistics for Windows, Version 24. 0., running Pearson's correlation coefficient, and Structural Equation Modelling using AMOS. Results The mean age of participants was 38. 9 (9. 84). Also, 58% (70) of participants had a bachelor's degree, 36 (30%) had associate degrees, and 14 (12%) had masters and above. The results showed that there was a significant relationship between lifestyle and quality of life (r=0. 061 and P<0. 001). Also, there was a correlation between lifestyle and marital satisfaction (r=0. 039 and P<0. 001), and a significant relationship between quality of life and marital satisfaction (r=0. 058 and P<0. 001). It was also found that the quality of life partially mediates the relationship between lifestyle and marital satisfaction (β =0. 32, P<0. 001). Conclusion: Lifestyle based on cooperation and common goals leads to a life of marital satisfaction. By modifying their lifestyle, married employed women can amend their selfish tendencies and choose goals with high social orientation.

Background: Emotional dysregulation and coping strategies of individuals in coping with distress and their significance in promoting general health have always been of interest to researchers. The present study was conducted to examine the effectiveness of emotion regulation and distress tolerance skills training on coping strategies, emotion regulation, and perceived stress in prisoners. Methods: A quasi-experimental study was conducted. The statistical population consisted of 200 prisoners in Fuman Prison, Iran. A total of 30 individuals who met the inclusion criteria were selected using convenient sampling method and then randomly assigned into two experimental and control groups (15 each). Participants in the two groups were matched for education level and age. Experimental group received 12 sessions of teaching emotion regulation and distress tolerance skills one hour per week. Both groups filled out cognitive emotion regulation questionnaire (CERQ-P), Blinger and Mouse’ s coping responses inventory (CRI), Cohen’ s perceived stress scale (PSS-14) at baseline and after treatment. The data was analyzed using one-way ANOVA and multivariate analysis of covariance in IBM SPSS Statistics for Windows, Version 21. 0. Results: About 60% of the participants were in age range of 31-45 and more than 60% had imprisonment experience. Moreover, 80% of them were illiterate and 66% were unemployed. Since Eta value was 0. 97 for variables including coping strategies, emotion regulation, and perceived stress, it seems that teaching emotion regulation and distress tolerance skills have been highly effective in improving coping strategies and reducing perceived stress in prisoners (P<0. 001). Conclusion: Emotion regulation and distress tolerance skills improved emotion regulation and coping strategies, and reduced using emotion-focused coping strategies and perceived stress in prisoners.

Background: There exist gaps in the implementation of guideline-recommended treatments and interventions to manage syncope. The present study aimed to investigate the adherence to the current guideline for the diagnosis and management of syncope patients referred to a tertiary center. Methods: A cross-sectional study was carried out with the study group consisting of 324 consecutive patients, who were diagnosed with unexplained syncope with one or more attacks and were referred for head-up tilt table test (HUTT) between September 2009 and September 2011 to Tehran Heart Center. All the patients underwent a thorough evaluation, including a careful medical history and physical examination as well as a thorough history of all procedures performed before referral. The data collected was compared between patients with positive and negative HUTT results and also based on the referring physician, in order to assess the deviation from syncope guideline in their management. We compared the selected groups using a chi-square test for categorical variables and student t-test or analysis of variance (ANOVA) for continuous variables where appropriate. Results: A total of 324 patients with a Mean (SD) age of 41. 04 (17. 74) years were enrolled in the study (158 patients, i. e. 48. 8%, were male). HUTT was positive in 181 (55. 8%) patients. Brain computed tomography scan and coronary angiography were performed more in the initial assessment of the patients with a negative HUTT compared with patients with negative HUTT (P=0. 001 and P=0. 01, respectively). Significantly higher rates of brain MRI (P=0. 01), brain imaging (P=0. 03), and electroencephalography (P=0. 002) were observed among the neurologists' referrals while echocardiography (P<0. 001), exercise tolerance test (P=0. 001), electrocardiogram Holter monitoring (P<0. 001), and coronary angiography (P=0. 02) were significantly more performed in patients referred by a cardiologist. Conclusion: We observed a noticeable deviation from the current guideline for the management of syncope although the patients underwent expensive tests with little benefit.

Background: Knee osteoarthritis (OA) is a common type of articular disorder worldwide. Interleukin 10 (IL-10) and tumor necrosis factor-α (TNF-α ) are considered as an essential regulator contributing to inflammation and knee OA pathogenesis. In this study, the effects of mesenchymal stem cells (MSCs), ozone (O3) and exercise training were considered on IL-10 and TNF-α expression in rats with knee OA. Methods: In this experimental study, knee OA was induced by surgical method in rats. OA rats were randomly divided into the patient, MSCs, ozone, and exercise groups. Rats in the MSCs group received an intra articular injection of 1×10 cells/kg. Rats in the ozone group received O3 at the concentration of 20μ g/ml, once weekly for 3 weeks. Rats in the exercise group were trained on rodent treadmill for three times per week. 48 hours after the programs, cartilage tissues were isolated and expression of IL-10 and TNF-α was considered using RealTime PCR (RT-PCR). Results: Ozone therapy significantly increased the expression of IL-10 compared to the patient (3. 12 fold; P=0. 031), MSCs (2. 78 fold; P=0. 042) and exercise (4. 64 fold; P=0. 034) groups. The patient group had significantly higher expression of TNF-α compared to the control (32. 27 fold; P<0. 001), MSCs (1. 58 fold; P=0. 001) and ozone (3. 02 fold; P<0. 001) groups. MSCs and ozone therapies significantly decreased TNF-α expression compared to the patients (P=0. 001 and P<0. 001, respectively) and exercise (P=0. 042 and P<0. 001, respectively) groups; however, ozone therapy was significantly more effective than MSC therapy (P=0. 007). Conclusion: Ozone therapy was significantly more effective than exercise and MSC therapy to improve knee OA in rats.