Journal of Health Research in Community
Year:2025 | Volume:10 | Issue:4|Papers Count:8

Introduction and purpose: Studies on the relationship between the dietary fat quality index (FQI) and the risk of cardiovascular diseases (CVD) are very limited. Therefore, the present study was conducted with the aim of investigating the relationship between FQI and CVD risk among adults participating in the Tabari Cohort study. Methods: This cross-sectional study was conducted on 9,408 people aged 35 to 70 years who participated in the initial stage of the Tabari Cohort study. The usual food intake of the participants was evaluated using a semi-quantitative 118-item food frequency questionnaire. FQI was calculated using the relevant equation for all individuals, who were then classified based on quartiles of FQI score. A binary logistic regression test was used to investigate the relationship between FQI and CVD risk. Results: The mean (standard deviation) age of the participants in the study was 49.90 (9.31) years. The prevalence of CVD in the study population was 8.6% (807 people). The results of the crude model showed that there was no significant relationship between FQI score and CVD risk (odds ratio [OR]: 1.07; 95% confidence interval [CI]: 0.87-1.32). When this analysis was adjusted for a number of confounding factors, the association between FQI score and CVD risk remained non-significant (OR: 1.23; 95% CI: 0.97-1.55). Conclusion: No significant relationship was found between FQI score and CVD risk in the Tabari Cohort population. Further studies, especially with a prospective design, are recommended to investigate the relationship between dietary fat quality and CVD.

Introduction and purpose: During the COVID-19 pandemic, healthcare workers were at the forefront of combating the disease and were exposed to significant psychological pressures. This study aimed to compare the mental health status of employees in COVID and non-COVID units at Dr. Shariati Hospital affiliated to Tehran University of Medical Sciences, Tehran, Iran. Methods: This descriptive-comparative study was conducted cross-sectionally in 2021. The participants included 232 individuals who were selected using systematic random sampling. The data were collected using a demographic characteristics form and the General Health Questionnaire (GHQ-28). The obtained data were then analyzed utilizing SPSS software (version 24) through descriptive and analytical statistical methods (independent t-test).  Results: The mean (SD) age of participants was 35.5 (±8.28) years. Based on the GHQ criterion (>23), out of those working at the COVID and non-COVID units, 53.3% and 44.7% of the employees were suspected of experiencing varying degrees of mental health disorders, respectively. The overall mean (SD) score of the GHQ questionnaire for all employees was obtained at 30.67(10.80). Independent t-test results revealed that the employees at the COVID unit demonstrated significantly worse conditions in overall mental health disorder status (t=4.20, P<0.05), anxiety symptoms (t=5.55, P<0.05), and physical symptoms (t=4.09, P<0.05), compared to those in other units. Conclusion: The research findings indicate a relatively high prevalence of mental health disorders among employees, particularly those working at COVID units. Therefore, identifying individuals at risk and adopting coping strategies, along with providing psychological counseling and support, appears crucial for enhancing employee mental health status.

Introduction and purpose: Multiple sclerosis (MS) is a chronic, autoimmune, inflammatory disease of the central nervous system that remains an incurable disease. Pharmacological treatment aims to minimize the debilitating symptoms, slow disease progression, and protect the quality of life. Medication adherence is one of the main success factors in the treatment of this chronic disease, which is influenced by various factors. This study aimed to determine the relationship between depression and medication adherence in patients with MS. Methods: This descriptive-analytical study was conducted on 200 patients with MS referred to Bu Ali Sina Hospital and Multiple Sclerosis Association in Qazvin City, Iran, in 2023. Patients were included in the study following convenience sampling. Data were collected by demographic checklist, Morisky Medication Adherence Scale (MMAS-8), and Beck Depression Inventory (BDI). Bivariate and multivariate logistic regression analyses were carried out using the SPSS-v25 software. Results: The mean and standard deviation of the scores of medication adherence and depression were 6.93±1.66 and 36.19±10.26, respectively. In 23.3% of the participants, the level of medication adherence was low, and depression was at moderate (30.5%) and severe levels (69.5%). In the multivariate regression analysis, with an increase in depression scores, the odds of non-adherence to treatment increased by 1.72 times, and patients suffering from more severe depression had lower medication adherence (P<0.0001). The odds of non-adherence to treatment in patients receiving oral medications compared to those receiving injectable medications was 2.144 times higher (P<0.039), and in unemployed patients compared to employed patients, it was 0.286 times higher (P<0.046). Conclusion: Depression has a significant negative impact on medication adherence in MS patients. Employment status and type of prescribed drugs are related to medication adherence in these patients. Therefore, the role of these factors should be taken into account when designing educational, caring, and supportive interventions.

Introduction and purpose: Assessing hospital productivity is crucial for identifying opportunities to enhance performance. This study aimed to examine productivity changes at hospitals affiliated with Zahedan University of Medical Sciences. Methods: This descriptive-analytical study assessed the productivity changes at seven hospitals affiliated with Zahedan University of Medical Sciences over a 12-year period (2010-2022). The Malmquist index was used to assess productivity. Inputs included the number of active beds and physicians, while outputs included the number of inpatient admissions and surgeries. Data were analyzed using DEAP. 2 and Excel 2020 software. Results: The average Malmquist index for hospitals during the study period was 0. 993, indicating an approximately 1% decline in the overall productivity of production factors. Hospitals experienced an average growth of roughly 2% in technological change, while average technical efficiency showed nearly zero growth. In the first year of implementing the Health System Transformation Plan, hospitals experienced an approximately 12% improvement in productivity,however, the average Malmquist Index decreased after the COVID-19 pandemic. Conclusion: The results of this study indicated that the hospitals were not able to utilize available resources effectively. Healthcare managers can take steps to improve hospital productivity. These measures include investing in staff training, making necessary changes to the organizational structure of hospitals, using efficient management information systems, investing in new equipment and technologies, and conducting periodic performance evaluations of hospitals.

Introduction and purpose: The quality of healthcare services holds a significant position in the healthcare system. Understanding patients' expectations and perceptions is essential for improving the quality of health services. The present study aimed to assess the quality of healthcare services in public (governmental) teaching hospitals of Ferdows using the HEALTHQUAL model in 2019. Methods: This descriptive-analytical (cross-sectional) study was conducted in two public (governmental) teaching hospitals in Ferdows. The study population consisted of 350 hospitalized patients who were selected via convenience sampling in 2019. The patients’ perceptions and expectations regarding the quality of hospital services were evaluated using the HEALTHQUAL questionnaire, which assesses four dimensions: environment, human interactions, effectiveness, and efficiency. Data were analyzed in SPSS software (version 24) using independent t-tests, one-way ANOVA, and mean comparison tests. Results: The study reported the overall mean quality score of hospital services as moderate to high. A significant difference was observed between the mean perception score (3.83±0.49) and the mean expectation score (4.54±0.56) across all dimensions of healthcare service quality (P<0.001). Conclusion: As evidenced by the obtained results, patients' mean scores of perception of service quality were notably lower than their mean expectation scores, indicating a significant gap between the two domains. These results highlight considerable opportunities for improving the quality of healthcare services. Policymakers and hospital administrators should identify and address this gap to implement effective measures for enhancing healthcare service quality.

Introduction and purpose: Many studies have pointed out the benefits of exercise training in preventing various diseases. In the body's physiological conditions, there is a balance between oxidants and antioxidants, which plays an important role in health. However, performing exercise training by increasing the metabolism and oxygen consumption rate causes this balance to be disturbed. In this meta-analysis, malondialdehyde as an oxidative index and the activity of catalase and superoxide dismutase enzymes as salivary antioxidant indices were investigated concerning exercise training in non-athletes. Methods: All articles published in Persian and English until September 2024 were searched from PubMed, Google Scholar, ScienceDirect, Scientific Information Database (SID), Scopus, and Irandoc databases and included in the meta-analysis. Fixed and random effects models for meta-analysis of average effect size (difference in mean with 95% confidence interval) in research related to malondialdehyde (11 studies), catalase (9 studies), and superoxide dismutase (9 studies) were performed with the help of CMA2 software. Results: The present meta-analysis indicated that exercise training caused a significant increase in malondialdehyde (ES=1.253, 95%CI=1.05 to 1.45, P=0.001), catalase (ES=2.235, 95%CI= 0.75 to 3.719, P=0.001), and superoxide dismutase (ES=0.894, 95%CI= 0.660 to 1.128, P=0.001). Conclusion: The results demonstrated that exercise training increases the production of malondialdehyde, which is an indicator of oxidative stress, and on the other hand, the antioxidant defense system increases as a biological reaction of the body to neutralize the destructive effects of free radicals.

Introduction and purpose: The elderly population is increasing in most countries, and as age increases, balance disorder and fall risk become important health-related indicators. The aim of this study was a systematic review related to the effect of neurofeedback rehabilitation protocol on balance and fall risk in the elderly. Methods: In this research, a systematic library review was conducted according to the guidelines established by PRISMA. Articles were selected from the information databases of the SID, Magiran, Irandoc, SPORTDiscus, PEDro, Trip, PubMed, and Google Scholar using the following keywords: “Balance,” “Elderly,” “Rehabilitation,” “Neurofeedback training,” “Fall risk,” and “Fear of falling” in Persian and English language. Results: Following the initial review, a total of 491 articles were retrieved from various databases. Specifically, there were 14 articles from the SID database, 82 articles from the Magiran database, 19 articles from the Irandoc database, 121 articles from the Google Scholar database, 68 articles from the PubMed database, 42 articles from the SPORTDiscus database, and 17 articles from the CINAHL database. Subsequently, 7 studies were chosen for further examination. In terms of study quality, as per the National Institute of Health criteria, 3 studies were classified as high quality, 1 study as medium quality, and 3 studies as low quality. Conclusion: The current study showed that neurofeedback training using the protocol of increasing the Beta brain waves and decreasing the Theta brain waves could be more effective in improving balance and reducing the risk of falls in the elderly than balance training, somatosensory training, and physical training.

Introduction and purpose: Climate change is a major public health challenge, particularly for vulnerable populations, such as the elderly and people with dementia. With global warming, understanding the relationship between high temperatures and health outcomes, such as mortality, hospital admissions, and hospitalizations due to dementia, becomes increasingly important. This narrative review aims to collect and analyze existing evidence on the impact of rising temperatures on dementia. Methods: This narrative review study was conducted using the SANRA checklist. Key terms, including "dementia," "temperature," and their equivalents, were searched in databases, such as PubMed, ProQuest, Web of Science, and Google Scholar, without time restrictions. Screening was also performed based on inclusion and exclusion criteria and study objectives. Results: Evidence suggests that rising temperatures are associated with increased mortality, hospital admissions, and emergency department visits, especially among the elderly. In addition, exposure to heat during both day and night significantly increases the risk of dementia-related mortality. In fact, both extreme heat events and continuous exposure to high temperatures adversely affect the health of people with dementia. Conclusion: Given the direct relationship between rising temperatures and dementia, it is imperative that policymakers take necessary steps to protect the elderly from the dangers posed by rising temperatures. These measures can not only reduce healthcare costs but also improve the quality of life for older adults.