Payesh
Year:2020 | Volume:19 | Issue:2 |Papers Count:11

Objective (s): Currently there is no effective treatment and vaccine for COVID-19. However, several studies showed that BCG vaccine has long lasting positive non-specific effects on several infectious and autoimmune diseases via ‘ trained immunity’ mechanisms. Along with these exceptional properties of this vaccine, few ecological studies showed controversial association between the national vaccination policies and morbidity and mortality rate of COVID-19. Methods: This Article, reviewed the immunological mechanisms that explain the enhanced immunity by BCG vaccine against COVID-19. Also the conducted ecological studies and the clinical trials that are being conducted by few countries were reviewed. Results: Considering Iran’ s national BCG vaccination program and the low evidence level of ecological studies, we suggest to Iranian universities of medical sciences to conduct low-cost but better epidemiological studies with short duration, using tuberculin test. These studies including case-control, historical cohort and survival analysis studies, which will assess the association between immunity against tuberculosis and COVID-19 and its prognosis. The results of these studies may guide researchers about the necessity of conducting clinical trials among high risk groups like hospital staffs. Conclusion: Also as few studies have shown BCG vaccine has therapeutic effects on patients with type 1 diabetes and multiple sclerosis, conducting clinical trials among Iranian patients can measure not only the preventive effect of BCG vaccine against COVID-19 but also the therapeutic effect on these two chronic diseases also.

Objective (s): The purpose of this study was to investigate the gaps and needs in the undergraduate nursing curriculum in Iran as a logical prelude to design a competency-based curriculum model. Methods: The present study was a qualitative study consisting of two parts: needs assessment and comparative study. Delphi technique was used for the needs assessment and Bereday model was used for comparative study. Results: After prioritizing the information obtained from the needs assessment, finally the 8 main axes of "student competencies", "content", "content organization", "Educational methods", "student assessment", "time", "community needs" and "overall curriculum" were extracted, each of which focused on the most important issues separately and a total of 35 statements as gaps and needs in the undergraduate nursing curriculum was considered. Also, according to the findings of the comparative study, the status of the undergraduate nursing curriculum in Iran compared to similar curricula in the top universities of the world, in addition to confirming some similarities, suggests significant differences in the curriculums. The main concern of the participants was the lack of skills of nursing graduates. They believed that, despite the efforts of nursing authorities, the curriculum could not motivate students and to provide graduates with the necessary understanding, attitude, and skills in their careers. Conclusion: The present study explored the needs and gaps in the undergraduate-nursing curriculum of Iran and can be used by decision makers in nursing education in the country.

Objective (s): Since suicide attempt is a major challenge among adolescents, this study aimed to investigate the factors related to suicide attempt among adolescents. Methods: This study was a qualitative research using the content analysis method. The samples were 10 adolescents with a history of attempted suicide referred to welfare centers in Larestan, Iran, in 2018. Purposeful sampling was used. Data collection continued through in-depth semi-structured interviews until data saturation achieved. Results: Five themes emerged for m the analysis: failure in love, family involvement, family disruption, psychological problems, and ineffective coping strategies. Conclusion: According to the findings it seems that an appropriate support system focusing on prevention of risk factors might help to prevent suicide attempt in adolescents. Training on how to cope with stress and increasing adolescents' access to specialized counseling services also might be useful.

Objective (s): The aim of this study was to investigate the effect of a school-based educational intervention on safe crossing of streets in elementary school students. Methods: This was a quasi-experimental study with pre-test/ post test design. A total of 66 elementary school students were randomly selected from two selected schools in Yazd, Iran in 2019. The intervention consisted of theoretical and practical education in the school context. Data were collected by a self-designed checklist containing 12 questions. Data analysis was performed using spss21 software. Results: The results showed that the least safe behavior was related to pedestrian crosswalk and pedestrian bridge crossing. The mean score of street safe behavior before and after the training was 9. 24(2) and 11. 62(0. 75), respectively, which was statistically significant (p <0. 001). The mean score of safe traffic behaviors of girls after intervention was 11. 7(0. 48) and for boys was 11. 45(0. 93), which were statistically significant (p = 0. 017). Conclusion: The results showed that the school-based educational intervention was effective on the safe crossing of streets in students.

Objective (s): Iranian women's fertility has experienced a remarkable change in recent decades. Ideal fertility is one of the most important predictors of future fertility. The ideal fertility is one of those behaviors that will affect by social environment and the attitude of important others towards fertility. Hence, in this study an attempt was made to investigate the relationship between attitude of important others in women's social network and their ideal fertility. Methods: This was cross sectional study. A self-designed questionnaire was used to collect data. A total of 1247 married women, using stratified random sampling were surveyed in rural areas of Fars province in 2015. Results: The findings indicated that the mean ideal number of children for women surveyed was 2. 5. The analysis showed that among demographic and socio-economic characteristics, education and religion had a significant impact on the ideal number of children. The findings also indicated that the attitude of husband, mother and friends towards the ideal number of children had the most important and significant impact on ideal fertility among women living in rural respectively. Conclusion: A remarkable part of women's attitude towards childbearing will form in their family and social environment. The findings suggest that demographic and socio-economic characteristics no longer could be the most important determinants of childbearing. It seems that at present childbearing has shifted from individual-biological behavior to social behavior. Iranian women modify their attitude towards childbearing and even shape it in their familial and friendship networks.

Objective (s): Given the importance of health literacy and the role of media in shaping adolescents’ health, this study aimed to identify the dimensions and components of media health literacy with a critical approach among adolescents. Methods: This was a qualitative study conducted on the basis of the grounded theory. Participants in the study included 12 experts in media literacy and health literacy who were selected by purposeful sampling. The data was collected using semistructured interviews. Data were analyzed using MAXQDA2018 software in three stages of open, axial and selective coding. Data validation was performed using the verification method by the participants. Results: In all six dimensions and components of media health literacy emerged from analysis including: ‘ development of media health literacy with a critical approach (pivotal phenomenon)’ , ‘ causal conditions’ , ‘ contextual conditions’ , ‘ strategies’ , ‘ confounding factors’ and ‘ results and outcomes ‘ . Conclusion: The need for integrated and systematic attention to all aspects of critical health media literacy is essential to promote balanced, coherent, integrated and effective media health information.

Objective (s): This study aimed to examine the relationship between self-efficacy and factors that affecting the nutritional status of elderly people. Methods: In this cross-sectional study, a random sample of 250 elderly adults attended to health centers in Mashhad, Iran in 2018 were studied. The Mini Nutritional Assessment (MNA) questionnaire was used to evaluate the nutritional status of the elderly. Moreover, a standard 10-item self-efficacy questionnaire was used to evaluate the self-efficacy. Statistical analysis was performed using SPSS25 and the significance level was set at less than 0. 05. Results: 32. 4% (n=81) of the participants were men and 67. 6% (n=169) were women with age range from 60 to 89 years. It was identified that 20. 4% of the elderly (n =51) were at risk of malnutrition and 79. 6% (n =151) had a favorable nutritional status. The results indicated that people with high self-efficacy had a better nutritional status. Additionally, the evidence suggested a significant relationship between self-efficacy and age, gender, level of education and marital status of the elderly (P value<0. 001). Conclusion: The results indicated that the elderly with a favorable nutritional status had higher self-efficacy than the elderly in the risk of malnutrition.

Objective (s): The purpose of this study was to measure inequality of physician and general practitioner distribution in Sistan and Baluchestan province, Iran. Methods: This was a descriptive cross-sectional study including all physicians and general practitioners in Sistan and Baluchestan provinces, Iran (2009-2017). Data were extracted from yearbooks of Statistical Center of Iran and inequality of physician and general practitioner distribution were calculated by Gini, Robin Hood, Herfindahl-Hirschman and Theil indices in Stata 14 and Excel 2019 software. Results: The mean physicians and general practitioners in the province during 2009-2017 was 0. 438 and 0. 223, per thousand habitants, respectively. Also the mean of Gini, Robin Hood, Herfindahl-Hirschman and Thiel indices for the physician were 0. 21, 0. 19, 0. 20, 0. 24, and those for the general practitioner were 0. 06, 0. 10, 0. 13 and 0. 13, respectively. The indices had the same trend over the study period. Conclusion: Inequality in general practitioner distribution was decreased but for physician was not. The findings suggest that in addition to maintaining general practitioners and increasing proportion to population growth, to reduce inequality in physician distribution, resources such as specialized hospitals, beds and medical equipments in the province should be increased and appropriately distributed among cities. Financial and tariff incentives and student admissions in specialized fields for long-term employment in the province will also be useful.