Payesh
Year:2025 | Volume:24 | Issue:4|Papers Count:12

Objective(s): Spinal muscular atrophy is a rare genetic disease of neuromuscular and it is considered the main cause of death of newborns, which affects spinal motor neurons. The variety of degrees of this disease and the lack of a complete and integrated information recording system hinder the quality of providing care, early diagnosis and timely treatment. Therefore, the disease registry is considered as a supplement to the patient's medical record. The purpose of this research is to provide a model of spinal muscular atrophy registry in Iran. Methods: First, using a descriptive-comparative method, the characteristics of national registries (Pakistan, Czech Republic, Australia, and Canada) and international registries (Translational Research in Europe, Assessment & Treatment of Neuromuscular Diseases (TREAT-NMD), Smart Care, and RESTORE) for spinal muscular atrophy were examined and compared. Then, the initial model proposed for the spinal muscular atrophy registration system was designed for Iran and was validated by experts using the Delphi method in two rounds. The research community included 15 experts with expertise in medical informatics, health information management, neurologists and medical genetics. Finally, the cases that obtained more than 75% agreement were included in the final model and the cases less than 50% were removed from the model. Results: Out of 79 components have been agreed by experts, 58 components in the first round of Delphi and five components in the second round of Delphi achieved a collective agreement of over 75 percent. Therefore, the final model of the spinal muscular atrophy registry in Iran included eight dimensions, and 63 components. The registry system characteristics for the final model were categorized into the following dimensions: objective, structure (registry type, implementation method and participating organizations), data source (primary and secondary), data collection (method, responsible, data collection location, and data registration criteria), data quality control (evaluation methods and data quality characteristics), security (data access and security methods), data analysis, and reporting and information dissemination (reporting methods, representation, and reporting intervals). Conclusion: It is expected that the presented model can be effective in improving the outcome management of spinal muscular atrophy disease, providing better services, achieving an integrated information system and facilitating research.

Objective(s): To adopt appropriate policies and strategies for securing, maintaining and promoting health, there must be accurate information and indicators. This study, estimated the years of lost life due to premature deaths, which is one of the indicators of prioritizing community health problems. Methods: In this cross-sectional study, information on the number of three major causes of mortality (death due to cardiovascular disease, cancer and tumors and unintentional events) was obtained from National Registry Office in 2017. YLL was calculated according to the 2010 Global Burden of Disease Act. Results: According to the National Registry, 10739 deaths occurred in Kermanshah Province. The distribution of the causes of death showed that the most deaths caused by heart disease (45. 6%). the deaths of cancers and tumors was 11. 1%, accidents were 7. 6%, and other causes was 35. 6%. The number of years lost due to premature death in men due to cardiovascular patients was 48774 years (49. 4 per 1, 000), cancer and tumors 17310 years (17. 5 per 1, 000), and incidents 28941 (29. 3 per 1, 000), In women, due to cardiovascular disease it was 76703 (38. 1 per 1, 000), cancer and tumor 12121 (12. 6 per 1, 000) and incidents 10049 (10. 4 per 1, 000). The lost years for all deaths in men was (29. 29 per 1000) and for women it was (10. 42 per 1000). Conclusion: The findings suggest more appropriate interventions are needed to prevent premature deaths for men and also for different age groups at risk.

Objective(s): Aging is associated with increased incidence of chronic diseases, including swallowing disorders (dysphagia) and neurological conditions, which can significantly impact the quality of life in the elderly. The present study aimed to assess the quality of life in elderly individuals suffering from dysphagia and neurological disorders and to identify related factors. Methods: This cross-sectional study was conducted on a sample 128 elderly patients with dysphagia and neurological disorders who visited neurology clinics affiliated with medical universities in Tehran, Iran in 2023. The samples were selected using a multistage random sampling method. Data were collected using the Persian versions of the Swallowing Disturbance Questionnaire (SDQ) and the MD Anderson Dysphagia Inventory (MDADI). Data were analyzed using descriptive and inferential statistical tests (independent t-test, analysis of variance, multivariate linear and logistic regression) in SPSS version 16. Results: The results showed that the mean score of severity of swallowing disorder in the oral phase was 5. 23 (SD =1. 5), and in the pharyngeal phase was 10. 20 (SD =2. 16), which indicated the weak severity of swallowing disorder in the elderly with nervous disorders. The average score of the quality of life was 66. 44 (SD = 10. 53) out of 100. There was a significant relationship between age and oral disorder (P=0. 021). Moreover, the prevalence of dysphagia in individuals over 80 years old was significantly higher than in other age groups (3. 6 times more in the oral phase and 2. 9 times more in the pharyngeal phase). Conclusion: Dysphagia in elderly patients with neurological disorders is significantly associated with a decline in quality of life. These findings highlight the need for regular screening for swallowing disorders and the implementation of care and rehabilitation interventions to prevent complications such as malnutrition, aspiration, and reduced functional independence.

Objective(s): Studies on the factors related to fathers' anxiety in Iran are few and their results are often contradictory. Therefore, this study was conducted to determine the relationship between perceived social support and marital satisfaction with the state-trait anxiety of fathers in the postpartum period. Methods: This cross-sectional study was conducted in 1402 on 250 fathers under the coverage of selected health centers of Tehran University of Medical Sciences. The data was collected using the demographic questionnaire, Spielberger Anxiety Scale, Perceived Social Support Multidimensional Scale, and Enrich Marital Satisfaction Scale (short form). Data analysis was done using SPSS-16 software, independent t-tests, ANOVA and regression analysis. A significance level of less than 0. 05 was considered. Results: The multiple linear regression model showed that having insurance (p=0. 020), exercising more than twice a week (p=0/048), marital satisfaction (p<0. 001), and perceived social support of the father (p=0. 042) were significantly related to his state anxiety, and marital satisfaction had the greatest effect on state anxiety with a standard coefficient of 0. 403. Based on the coefficient of determination of the model, the significant predictor was state anxiety. Having insurance (p=0. 035), not having a sleep disorder (p=0. 026), and the father's marital satisfaction (p<0/001), were also significantly related to father’s trait anxiety, and marital satisfaction had the greatest effect on trait anxiety with a standard coefficient of 0. 442. Based on the coefficient of determination of the model, the significant predictor was trait anxiety. Conclusion: The results showed the state-trait anxiety of fathers after the birth of a baby has an inverse relationship with perceived social support and marital satisfaction.

Objective(s): Mothers play a crucial role in shaping teenagers' beliefs about puberty and menstruation, as they convey their attitudes and beliefs to their daughters both directly and indirectly. The purpose of this study was to investigate the relationship between mother-daughter attachment and menstrual distress in adolescent girls. Methods: This cross-sectional study was conducted on 347 middle-aged girls using a stratified sampling, living with their mothers, and at least one year had passed since their menarche in Gonabad, Iran, in 2023. The demographics and reproductive checklist, Attachment to Parents and Peers (IPPA), and Menstrual Distress Questionnaire (MDQ) were used. The data were analyzed using SPSS version 26. Results: The mean (SD) age of the students was 14. 8 ± 1. 1 years. Mother-daughter attachment scores showed an inverse and significant correlation with menstrual distress scores (r =-0. 241, P < 0. 001). Additionally, a negative and significant correlation was found between menstrual distress and the subscales of trust (r =-0. 239, p < 0. 001), communication (r =-0. 142, p = 0. 008), and alienation (p> 0. 001). This indicates that as mother-daughter attachment increases, menstrual distress in adolescent girls decreases. Conclusion: The findings revealed a direct relationship between mother-daughter attachment and a positive attitude towards menstruation, as well as a reduction in menstrual distress. It is possible to mitigate teenage girls' menstrual distress by increasing the mother's attachment.

Objective(s): Assessing mothers’ nutritional literacy and its related factors will help to design and implement interventions to improving mothers’ nutritional literacy according to their needs. Therefore, the current study was conducted to examine the nutritional literacy and its related factors among the mothers of under 5-years old children. Methods: This cross-sectional study was conducted on 405 mothers of under 5-years old children in Urmia, Iran. A multi-stage cluster sampling method was used. The questionnaire used included two parts. The first part included items on demographic information and the second part was the Evaluation Instrument of Nutrition Literacy on Adults. Data were analyzed using SPSS, and the results were considered significant at a statistical level (p<0. 05). Results: The mean of nutritional literacy score was 25. 86±4. 60. The lowest mean score was related to dimension of read food labels and ability to do simple calculations. 73. 10% of mothers demonstrated adequate nutrition literacy, while 26. 90% exhibited insufficient nutrition literacy. There was a statistically significant relationship between nutritional literacy and the variables of educational level (p<0. 001), family income (p<0. 001), and age (r=0. 19, p<0. 001). Conclusion: The nutritional literacy of the majority of the mothers was at an adequate level. To improve the nutritional literacy of mothers, it is necessary to pay more attention to dimension of read food labels and do simple nutritional calculations.

Objective(s): Fear of cancer recurrence (FCR) remains a significant challenge for cancer survivors, persisting even after treatment and partial recovery. This study aimed to assess the effectiveness of Paradox Therapy (PTC) in reducing FCR and its trajectory over time in female cancer patients. Methods: This clinical trial employed an experimental pre-test, post-test, and one-month follow-up design, with a control group and random assignment of participants to the experimental and control groups. The study population consisted of all female cancer patients who attended a specialized hematology and oncology center in Ahvaz, Iran, in 2023. A total of 52 participants were recruited using G*Power software. The Fear of Cancer Recurrence Inventory (FCR) was used as the primary measure. The therapeutic intervention applied was Paradox Therapy. Data were analyzed using descriptive statistics and inferential statistics related to the study hypothesis, employing mixed-design ANOVA in SPSS-25. Additionally, assumptions for using repeated measures ANOVA were tested using the Shapiro-Wilk test and Mauchly’s test of sphericity. Results: The findings indicated that PTC effectively reduced FCR, with sustained long-term effects. Cancer patients often endure considerable psychological stress due to the fear of recurrence. Understanding how to alleviate these fears effectively is crucial for enhancing their psychological well-being. Conclusion: This study contributes to filling an important gap in the psychosocial dimensions of oncology by advancing our understanding of the impact of PTC on FCR in cancer patients. Comprehending the long-term effects of this approach can inform the development of aftercare programs and long-term support for cancer survivors.

Objective(s): Ramadan intermittent fasting is a form of Sharia in which Muslims refrain from consuming food and drinks for thirty consecutive days from before sunrise to after sunset. Ramadan can result in changes in body weight, daily activities, sleeping patterns, and eating habits. Recognizing the important role of women in society, we found it necessary to review studies conducted on women's health. Methods: This review study involved searching keywords such as "fasting in women, " "women and fasting, " and "fasting and healthy women" in Medline, Google Scholar, PubMed, Web of Science, and Scopus databases. Additionally, keywords such as "fasting Ramadan, " "fasting Ramadan & female, " and "Ramadan & healthy women" were used to search for relevant articles. Results: After searching the databases and carefully reviewing titles and abstracts, 62 articles were identified. By applying inclusion and exclusion criteria, only 11 articles met the inclusion criteria and were evaluated. Overall, the results of the studies showed that fasting can be introduced as a possible factor in health-related events, including menstrual disorders (without changes in female hormone levels), reversible effects on other body hormones, reduction of harmful body fats, fasting blood sugar and liver enzymes. Conclusion: Overall, the results of the studies showed that fasting is not only harmful, but is also likely beneficial in improving the health of many women.

Objective(s): Considering the complex and challenging work environment of nurses, it is necessary to study the ethical sensitivity of nursing students, for which there is no valid tool in Iran. Therefore, this study was conducted to measure the psychometric characteristics of the Persian version of the ethical sensitivity questionnaire of nursing students. Methods: In this cross-sectional study, conducted in 2023, 280 nursing students of Mashhad University of Medical Sciences were included using the available sampling method. After translating the tool into Persian, its face validity and convergent validity were examined. Exploratory factor analysis and confirmatory factor analysis were performed to assess construct validity. Internal consistency and stability were also estimated to determine the reliability of the instrument. Results: The results of face validity evaluation showed that all items were appropriate, clear, and important. In factor analysis, the loading of all items were higher than 0. 3, so they were all preserved. The results of confirmatory factor analysis showed that the model had a good fit, and its subscales had high internal consistency (overall Cronbach's alpha coefficient of 0. 88, the range of 0. 732 to 0. 838 for three dimensions). Conclusion: The Persian version of the ethical sensitivity questionnaire showed satisfactory results and can be used as a valid and reliable tool to evaluate the level of ethical sensitivity among nursing students in Iran.

Objective(s): The ability of health systems to respond to complex challenges such as the current pandemic depends on the capacity of healthcare workers to fulfill their roles. The objective of this study was to ascertain the role of primary health care (PHC) workers in Rasht City (north of Iran) in response to the COVID-19, based on the World Health Organization (WHO) guidance document. Methods: The descriptive cross-sectional study was conducted with the participation of 297 PHC workers. Data were collected using a 29-item questionnaire which was developed by the research team from the guideline of the World Health Organization on health workforce policy and management in response to the COVID-19 pandemic. The validity of the questionnaire was tested and confirmed by face and content validity. Reliability was confirmed by test-retest and Cronbach's alpha coefficients Data were analyzed using SPSS-26 software. Results: Most PHC workers (98. 6%) stated that they had taught preventive measures such as hand hygiene, respiratory etiquette and physical distancing to the clients,92. 9% had continued to provide other essential health services other than COVID-19,46. 5% of them were not provided with personal protective equipment (PPE) appropriate to their role and hazard exposure. Those who stated that have to collect and report too much data assessed their role status lower than those who said the task was appropriate. Conclusion: To improve performance and provide more comprehensive health services, PHC workers need to be provided with the necessary supplies and equipment, especially PPE. Necessary measures should also be taken to provide training tailored to these workers needs and to determine the standard amount of data required for programs management. .

Objective(s): Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to severe respiratory illnesses and fatalities in both young and elderly individuals without underlying diseases,however, similar groups may also include individuals who are asymptomatic or exhibit mild symptoms. Various studies have indicated that host genetics play a significant role in the severity of diseases caused by SARS-CoV-1 and MERS-CoV, which share substantial similarities with SARS-CoV-2. One of the crucial host genetic factors involved in identifying patterns of disease-causing agents and activating the innate immune system's Toll-like receptors (TLRs) is TLR4, which shows the strongest association with surface markers of SARS-CoV-2. This study was designed to investigate the common polymorphism of the TLR4 gene (Asp299Gly) to examine the relationship between disease severity and the presence of this polymorphism.   Methods: A total of 230 COVID-19 patients, comprising 154 patients with mild COVID-19 and 76 patients with severe COVID-19, were randomly selected and matched for age and gender from individuals referred to COVID-19 healthcare centers. Peripheral blood samples of 5 mL were obtained from the patients, and DNA was extracted for the analysis of the Asp299Gly-TLR4 polymorphism using the Tetra-ARMS PCR technique. Results: The study revealed that 67% of the patients belonged to the mild COVID-19 group, while 33% were in the severe COVID-19 group. The analysis showed no significant correlation between disease severity and the Asp299Gly-TLR4 polymorphism. The frequencies of alleles and genotypes did not exhibit a significant relationship with disease severity in either the mild or severe COVID-19 groups. Conclusion: The findings suggest that there is no significant association between the severity of COVID-19 and the rs4986790 polymorphism in the TLR4 gene. However, further investigation with larger sample sizes is warranted to confirm the effects of different TLR4 polymorphisms on the severity of COVID-19.

Dear Editor, Management is the process of planning, organizing, leading and controlling the organization's activities and the optimal use of resources to achieve the organization's goals. The manager's performance depends on his talent, personality and effort. Talent includes the manager's intelligence, knowledge and skills. Personality includes the manager's beliefs, values ​​and behaviors. Employees copy their managers’ behaviors. Managers should be a good moral role model for employees by being professional, positive, honest, authentic, conscientious, empathic, creative, and accountable. Adhering to organizational ethics’ principles creates a safe work environment for employees, strengthening trust between employees and managers, promoting the organization’s reputation, and meeting the expectations of employees, customers and managers. The healthcare manager must define organizational values and ethical principles, formulate rules and regulations to adhere to these values and principles, and ensure their implementation in the organization. Formulating organizational ethics charter, establishment of organizational ethics committee, training of employees on organizational ethics and the need to comply with them, and creating a culture of not tolerating organizational immorality, helps to institutionalize ethics in the organization. . .