Social Determinants of Health

Background: Leprosy is a chronic disease that can cause disability as a result of nerve damage and causes complex problems. Stigma and association of psychosocial problems tends to occur and increases the risk of mental health disorders of the patients.

  Methods: This research approach is mixing method with AB design type (intervention only). Assessment was conducted by interviewing methods, knowledge tests about leprosy and instrument Self Reporting Questionnaire-20 (SRQ-20). The sampling technique used purposive sampling, obtained 3 participants and allocated individually. Psychoeducational intervention provided through the description, discussion, sharing, chores and directly exercise through experiential learning approach, which consists of 5 sessions for 90 minutes and delivered every week.   

  Results: The result showed psychoeducational intervention was effective for improving mental health, which marked by the decline of psychological distress symptoms after the intervention. 

  Conclusion: This research suggests the follow-up session of the implementation from the interventions and psychoeducation material can be implemented as routine education in primary health centers for leprosy patients who experience psychological distress.

Background: Violent behaviors in professional relationships of social workers have become a growing concern for the international society. The outcomes of violence are effective in professional relationships. The purpose of this study was to better understand the consequences of violence in the professional relationships of Iranian social workers in order to improve their performance and coping skills.

  Methods: The study was carried out through qualitative content analysis and 20 semi-structured interviews were conducted with 17 social workers. The participants were selected through purposeful method and data gathering was stopped after data saturation.

  Results: Two main categories including “distress” and “development opportunity” and four subcategories including “distress and social worker’s reactions,” “distress and client’s reactions,” “personality development,” and “reinforcement of professionalism” were identified.

  Conclusion: The cognition of violence consequences and learning coping skills in professional communication in social work can improve professional performance. Paying special attention to distress and violence repercussions and making appropriate decisions by putting in practice scientific and practical training in workplaces and educational settings can help social workers in preventing and reducing violence. As experiences in social work settings are not enough, it is suggested to look at the objective of this research from a macro-social and organizational perspective and plan both at the micro and macro levels to reduce violence.

Background: The people involved in food preparation play a major role in contaminating it due to improper food handling. The goal of this study was to examine the knowledge and practice of food handlers in district two of Tehran.

  Methods: A cross sectional descriptive- analytical study was designed and data were collected via questionnaires. The reliability of the questionnaires were measured using Cronbach's alpha and Intra-class correlation obtained from test and re-test in an interval of 10 days. The reliability indices of the questionnaires were found to be above 70%, which were acceptable. The participants were selected by a simple random method (n=390). Correlation coefficient was used for analysis.

  Results: The highest number of male participants, with diploma education belonged to the age group of 20 to 29 years old with a job experience of two to five years and more than 50% of them had passed the public health course. The results showed that there was a significant relationship between knowledge and practice (P<0.001). In knowledge section 215 (55.3%) of respondents were at middle level. About the practice, although 195 (50%) of participants were placed at a good level, in some cases, such as how to find out the optimal temperature for cooking burgers and chicken, the right way to defrost food and the time needed to reheat the food were found lacking. 

  Conclusion: Knowledge and practice in food handlers must be improved specially about the importance and role of temperature in food safety.

Background: A high percentage of people suffering from emotional problems emotional regulation strategies guide people in dealing with life events in addition to preventing problems. The purpose of this study was to analyze the content of elementary school textbooks as an essential educational tool based on emotion regulation components.

  Methods: The present study was a content analysis, and its population consisted of all elementary school textbooks. The primary source for determining the components of mental health was the “comprehensive curriculum of health education in schools from pre-school through to the end of high school,” which was approved by eight mental health experts.   

  Results: In elementary school textbooks, the components of emotion recognition and emotion expression had the highest, and stress management had the lowest information load. The most frequent educational axes pertained to knowledge, while the textbooks lacked the skills axis in the field of emotion regulation components. 

  Conclusion: The results of the analysis showed that each component of emotion regulation is differently addressed. Given that about 35% of children experience stress-related health problems, it appears necessary to address stress coping strategies for children.

Background: Head and neck neoplasm (HNN) is one of the most common neoplasms in 6th and 7th of life. Its incidence rate is different in various human societies. Some neoplasms have an increasing trend in the young population, and some have a decreasing trend. According to the limited evidence in Iran, we decided to investigate the types and basic characteristics of HNN in young patients with less than 40 years and old patients more than 40 years of age.

Methods: In this cross sectional study, we assessed the medical records of 695 patients in the department of Ear Nose and Throat (ENT) of Loghman Hakim Hospital during 2007- 2017 to compare the fundamental characteristics and types of HNN in young and old adults. Chi-square test and Mann-Whitney U test were used and interpreted with a significant level of less than 0.05.

Results: The average age of our patients was 51.80±17.39 years old. The majority of the patients were more than 40 years old (n=514, 73.95%) and the rest were younger (n=181, 26.05%). Significantly, the percentage of male patients, diabetic patients, positive history of smoking were more predominant in old adults as compared to young adults (72.76% vs. 49.18%, 10.31% vs. 2.20%, 66.99% vs. 25.44%; all P<0.001). However the neoplasms of salivary glands, thyroid, and paranasal sinus had a significantly higher frequency in young adults (41.98%(n=76); P<0.001, 21.55%(n=39);P<0.001, 6.10%(n=11); P=0.033 respectively).

There was a high percentage of larynx neoplasm in old adults as compared to young adults (42.22 %(n=217) vs. 4.41%(n=8); P=0.001).

Conclusion: Larynx neoplasm was common among old smokers. The percentage of salivary glands and thyroid neoplasms were higher than other HNN in young adults (≤40 years old), especially female patients and non-smokers. Therefore, HNN is not rare in young people and the physicians must consider it while cancer screening young adults.

Background: Urolithiasis is a common condition with a high recurrence rate associated with serious complications. Moreover, it imposes a great financial burden on the patients and healthcare system. We aimed to study the frequency of the patients admitted to Shiraz hospitals because of urinary stones.

  Methods: In this study, the information of 1420 patients was collected during 2013 based on the consensus method. The collected information included age, sex, place, time and duration of admission, family history of diseases, the characteristics of urinary stones, and received treatments.

  Results: The male-to-female ratio was 1.96:1 with mean±SD age of 47.5±17.3 years. Most of the patients were 40-60 years old. The incidence rate of urolithiasis ranged from 22.2% to 27.8% in different seasons (P>0.05). Mean duration of hospital admissions was 3.8±3.3 days and 37.7% of the patients had another associated medical disease. The most stones were located in the kidney (49.2%) and the ureter (39.4%). Composition of 70.8% of pure stones was calcium oxalate and 18.7% were stag-horn type. Hematuria was the most prominent paraclinical finding (78.3%), and the most used method of treatment was lithotripsy procedures (72%) and 11.1% of the patients underwent open surgery. 

  Conclusion: Based on the current research, a significant percentage of the patients had urinary stones that highlight the role of effective treatment and follow-up.

Background: Patient Safety Events (PSEs) are important preventable issues with high morbidity and mortality rates, imposing high costs and the occurrence of legal and social problems in societies. Therefore, having a prevention program is very important for it. In this study, we have selected the most common and important errors and provide simple preventive measures for users.

  Methods: In this review study, to obtain information associated to patient safety prevention, we used the scientific reliable literatures, registered in US National Library of Medicine/National Institutes of Health (PubMed), Google Scholar and Scopus data banks.

  Results: Simple preventive measures for prevention of mistakes due to misidentification (nominal similarities, displacement of the patients, switching the newborns, etc.), miscommunication (improper communications, patient disrespect, misinterpretations due to language differences, giving bad news, etc.), misinterpretations, irrational administration and use of drugs (inappropriate medication, for the wrong patient, with wrong amount, via the wrong way, and for the wrong duration), incompatible blood transfusion, mistakes in anesthesia, surgeries and other procedures, medical complications due to PSEs (Health care associated infections, trauma and fall, thrombophlebitis and thromboembolism, bed sores, suicide, violence, and mismanagement of the hospital affaires were extracted and suggested to the hospital authorities.

  Conclusion: We have extracted numerous suggested preventive measures from the accomplished studies for prevention of unpleasant patient safety related events in the hospitals.