Cultural appropriateness of interventions to prevent and reduce musculoskeletal disorders among students: a systematic review.

This systematic review was conducted to identify the types of interventions and cultural appropriateness of intervention studies for preventing and reducing musculoskeletal disorders (MSDs) in students. In this systematic review, articles were retrieved from scientific databases including PubMed, Sciencedirect, Web of Science, Scopus, SAGE journals, and Cochrane library using a search strategy. The types of interventions for preventing and reducing MSDs among students published in English up to 2022 were examined, with a comparison of studies in terms of the cultural appropriateness of strategies. Also, studies were categorised based on six intervention types: physical exercise, education, ergonomics, participatory ergonomics, stress management, and multicomponent. Out of the 29 studies included in this review, ten were randomised controlled trials, fifteen were controlled pre-test/post-test studies, and four were pre-test/post-test studies. The articles measured students' knowledge, beliefs, behaviour, good posture/performance, pain intensity decrease, and back care as outcomes. Only two articles were categorised as having moderate cultural adaptation. The results showed that any type of intervention was successful, and two studies were evaluated as having high quality. Our review found evidence of efficacy for interventions aimed at preventing and reducing MSDs in students.Practitioner summary: Musculoskeletal disorders are common problems that affect students of all ages. To prevent these problems from getting worse or affecting students' future health, it is important to find effective ways to prevent and reduce musculoskeletal disorders in students.

Preferences of Iranians to select the emergency department physician at the time of service delivery.

BACKGROUND: Understanding patient preferences in emergency departments (EDs) can provide useful information to enhance patient-centred care and improve patient's experience in hospitals. This study sought to find evidence about patients' preference for physicians when receiving services in EDs in Iran. METHODS: In this discrete choice experiment survey, 811 respondents completed the scenarios with 5 attributes, including type of physicians, price of services, time to receive services, physician work experience, and physician responsibility. Analyses were conducted for different social and economic groups as well as for the total population. RESULTS: This study showed that the willingness to pay (WTP) for being visited by a physician with a high sense of responsibility was 67.104US$. WTP for being visited by an emergency medicine specialist (EMS) was 22.148US$. WTP for receiving ED services 1 min earlier was 0.417US$ and for being visited by 1 year higher experienced physician was 0.866US$. WTP varied across different age groups, sex, health status, education, and income groups. CONCLUSION: As the expertise and experience of providers are important factors in selecting physicians in EDs by the patients, providing this information to patients when they want to select their providers can promote patient-centred care. This information can decrease patients' uncertainty in the selection of their services and improve their experience in hospitals.

Identification of factors related to behaviors associated with musculoskeletal pain among elementary students.

BACKGROUND: Musculoskeletal pains are among evident health problems in children and adolescents. Backpack carrying behaviors and the sitting postures are among behavioral factors associated with musculoskeletal pain in schoolchildren. Therefore, this study aims to identify the factors related to these important musculoskeletal behaviors, using Health Promotion Models. METHODS: In this cross-sectional study, a questionnaire was created based on PRECEDE Model and Health Belief Model and was administered to 673 Iranian students, whom were selected randomly from elementary schools of Hamadan, Iran, in 2018. RESULTS: The findings of the study revealed that proper sitting postures and backpack carrying were 42 and 33%, respectively. The findings also showed that predisposing factors including perceived susceptibility (p < 0.05, ß = 0.219), perceived severity (p < 0.05, ß = 0.166), perceived barriers (p < 0.05, ß = - 0.191), perceived self-efficacy (p < 0.05, ß = 0.188) and also enabling factors (p < 0.05, ß = 0.329) were significantly related to sitting behaviors. Moreover, backpack carrying behaviors had significant relationships with predisposing factors of perceived susceptibility (p < 0.05, ß = 0.198), perceived barriers (p < 0.05, ß = - 0.258), perceived self-efficacy (p < 0.05, ß = 0.185) and reinforcing factors (p < 0.05, ß = 0.208). CONCLUSIONS: It seems necessary for future preventive programs to take factors of musculoskeletal pains among children and adolescents into account.

Neck and shoulder pain among elementary school students: prevalence and its risk factors.

BACKGROUND: Neck and shoulder pain is relatively common among children and teenagers and has a negative impact on their physical and psychological health. This study was carried out to assess the prevalence of neck and shoulder pain among elementary school students, and to investigate the relationship between this pain and its risk factors. METHODS: In this cross-sectional study, 693 elementary school students aged 7 to 12 years from Hamadan city, located in western Iran, were selected through the multistage cluster random sampling method. Data were collected through interviews and questionnaires. For the social and psychological variables, the parent version of the Strengths and Difficulties Questionnaire (SDQ) was used. For assessing each student's posture, an observational checklist, the Rapid Upper Limbs Assessment (RULA), was used. The data was analyzed using the unadjusted (univariate) and adjusted (multivariate) logistic regression. RESULTS: The prevalence of the neck pain was slightly higher than that of shoulder pain. The prevalence reported over a month was 35.8 and 30.9% for neck and shoulder pain, respectively. The logistic regression analyses showed that, very high desk height (odds ratio (OR) =1.96, 95% confidence interval CI: 1.02-3.74), backward seat pan inclination (OR = 2.10, 95% CI: 1.37-3.24), forward seat pan inclination (OR = 3.12, 95% CI:1.46-6.68), difficulty in viewing the board (OR = 2.54, 95% CI: 1.10-5.84), too much homework (OR = 2.59, 95% CI: 1.49-4.51), RULA score at level III (OR = 2.88, 95% CI:1.64-5.05), and RULA score at level IV (OR = 3.12, 95% CI: 1.72-5.63) increased the risk of neck pain independently. On the other hand, sitting on desk and seat (OR = 0.59, 95% CI: 0.39-0.91) and laying position for doing homework (OR = 0.53, 95% CI: 0.34-0.81) reduced the related risk. Very short desk height (OR = 2.41, 95% CI: 1.26-4.61) and too much homework (OR = 1.94, 95% CI: 1.10-3.42) increased the risk of shoulder pain. CONCLUSION: The elementary school students reported a high prevalence of shoulder and neck pain. This study found that improper sitting positions, as well as physical factors such as the school furniture, too much homework, and difficulty in viewing the classroom board, were associated with pain. Proper interventions considering the risk factors assessed in this study, are suggested.

Measuring Catastrophic Costs in Families Facing Traumatic Brain Injury in Iran.

Objectives: Traumatic brain injury (TBI) is preventable and expensive. The medical costs of TBI can be too high for some households and might lead to poverty, malnutrition, and loss of assets, which are called catastrophic expenditures. In this study, we investigated the incidence of catastrophic costs associated with TBI caused by road accidents in a province in northern Iran. Methods: This prospective study involved a 1-year follow-up after the accident. Data of 220 patients were collected from the medical records of the Poursina Hospital, Rasht, Iran from March 2018 to February 2020. Direct and indirect costs faced by the households of patients with TBI and catastrophic costs related to TBI were calculated. Regression models were obtained and sensitivity analyses were performed at the end of the study. Results: In total, the prevalence of households TBI-related catastrophic costs (TBICC) was 45.5% . Households of female patients (odds ratio [OR]: 0.289, p=0.042), households of retired patients (OR: 0.053, p=0.005), and households falling in the fifth quintile of wealth (OR: 0.370, p=0.050) faced lower TBICC compared to other groups. The Activities of Daily Living scores had a significant negative relationship with TBICC. Conclusions: Political interventions such as implementation of insurance schemes, exemptions from payment for certain groups, identification of poor households, and coverage of assistance services can protect households from catastrophic health expenditures.

A population-based and symptom-based COVID-19 prevalence survey.

The current study aimed to determine the community-based COVID-19 prevalence and compare the symptom-based and test-based prevalence rates in the Omicron peak (February 20 to March 20, 2022) to assess community involvement and provide effective healthcare. This cross-sectional and population-based study examined the prevalence of COVID-19 from February 20 to March 20, 2022, in the city of Khomein in Markazi Province (located in central Iran) through random cluster sampling. The period prevalence of recurrent Omicron symptoms was 37.69%. Factors such as residence in urban areas (OR = 1.25, 95% CI: 0.95-1.66), number of COVID-19 vaccine doses (OR = 0.80, 95% CI: 0.67-0.95), the interval of last vaccination dose (OR = 1.04, 95% CI: 0.97-1.11) and a history of COVID-19 (OR =1.20, 95% CI: 1.04-1.39) were among the most important risk factors for Omicron. Ongoing efforts to vaccinate high-risk populations as well as stronger actions to diminish the Omicron consequences are fundamental obligations of the health system.

Prevalence of non-alcoholic fatty liver and its related factors in Iran: Systematic review and meta-analysis.

Non-alcoholic fatty liver disease (NAFLD) is a systemic disorder with a complex multifactorial and heterogeneous pathogenesis and has become the most common cause of chronic liver disease in many countries around the world. Numerous studies in Iran have presented different results on the prevalence and risk factors of NAFLD, in this study, which has been done in a systematic review and meta-analysis, provides a good estimate of the prevalence and risk factors of the disease in Iran. Following the peer review of electronic search strategies (PRESS and the preferred reporting items for systematic reviews and meta-analyses [PRISMA] statement, we searched Web of Science, PubMed, Embase, Scopus, and Persian scientific searcher (Elmnet) from inception to September 19, 2022. In the present study, 71 articles were reviewed for qualitative and meta-analysis. The overall mean prevalence of NAFLD in children studies was 22.4% (95% confidence interval [CI]: 10.9% to 33.9%). The prevalence was notably higher in adult studies 40.5% (95% CI: 35.1% to 46%). In 24 studies, the association between NAFLD and sex was reported, 10 of which showed significant relationships. Out of 46 studies observed that NAFLD prevalence increased significantly with body mass index (BMI). Eight out of 14 studies reported significant associations between FBS and NAFLD in children's studies. Though Iran has a high NAFLD prevalence compared to most areas, and due to the unfavorable situation of risk factors contributing to the NAFLD, it is necessary to take the necessary interventions to control these risk factors and prevent NAFLD.

Risk factors for low back pain among elementary school students in western Iran using penalized logistic regression.

OBJECTIVES: This study investigated the prevalence of low back pain (LBP) and its risk factors among elementary-school students. METHODS: In this cross-sectional study, 693 elementary students from Hamadan city, western Iran, were selected by multistage stratified cluster sampling. Data were collected through interviews using questionnaires. Posture and psychosocial elements were assessed using the observational Rapid Upper Limb Assessment (RULA) checklist and the standard Strengths and Difficulties Questionnaire, respectively. Penalized logistic regression with the group smoothly-clipped absolute deviation regularization method was used for variable selection and data analysis (α=0.05). The chi-square test was also used. RESULTS: In total, 26.6% of the students (7-12 years old) reported LBP in the last month. Older age (odds ratio [OR], 3.08; 95% confidence interval [CI], 1.80 to 5.26), watching TV for more than 3 hours a day (OR, 2.62; 95% CI, 1.46 to 4.68), very short seat backrests (OR, 3.08; 95% CI, 1.61 to 5.90), excessively curved seat backrests (OR, 4.36; 95% CI, 2.08 to 9.13), very short desks (OR, 3.44; 95% CI, 1.61 to 7.35), a family history of LBP (OR, 2.49; 95% CI, 1.58 to 3.91), carrying a school bag on one shoulder (OR, 1.91; 95% CI, 1.03 to 3.54), and RULA scores of 3 (OR, 2.26; 95% CI, 1.13 to 4.50) or 4 (OR, 2.85; 95% CI, 1.37 to 5.91) were associated with LBP. CONCLUSIONS: A high prevalence of LBP was found among elementary-school students. This study underscores the importance of recognizing vulnerable children and teenagers and developing interventional health promotion programs to prevent LBP based on an appropriate consideration of its contributory factors.