Translation and psychometric assessment of a Persian version of medication safety competence scale (MSCS) for clinical nurses.

Nurses play a key role in medication safety and, by extension, patient safety. Evaluation of medication safety competence in nurses requires valid, specific, and comprehensive instruments. The present study was conducted to translate and psychometric assessment a Persian version of medication safety competence scale (MSCS) for clinical nurses in Iran. This is a cross-sectional and multi-centric work of research with a methodological design. A total of 1080 clinical nurses were selected from 5 cities located in Iran. The original version of the MSCS was translated into Persian and the psychometric properties of MSCS were assessed using COSMIN criteria. The exploratory factor analysis (EFA) showed that the factor loading of the 36 items was between 0.72-0.87, all of which were significant. The confirmatory factor analysis (CFA) fitted the data well (χ2/df = 7, RMSEA = 0.01, CFI = 0.96, NFI = 0.95, and TLI = 0.97). The reliability of the instrument was assessed in terms of its internal homogeneity where the Cronbach's alpha of the whole instrument was found to be 0.96. The Persian version of MSCS for nurses possesses satisfactory validity and reliability. Thus, nurse managers can use this instrument to measure medication safety competence in nurses.

Socioeconomic inequalities in prevalence, awareness, treatment and control of hypertension: evidence from the PERSIAN cohort study.

BACKGROUND: Elevated blood pressure is associated with cardiovascular disease, stroke and chronic kidney disease. In this study, we examined the socioeconomic inequality and its related factors in prevalence, Awareness, Treatment and Control (ATC) of hypertension (HTN) in Iran. METHOD: The study used data from the recruitment phase of The Prospective Epidemiological Research Studies in IrAN (PERSIAN). A sample of 162,842 adults aged > = 35 years was analyzed. HTN was defined according to the Joint National Committee)JNC-7(. socioeconomic inequality was measured using concentration index (Cn) and curve. RESULTS: The mean age of participants was 49.38(SD = ± 9.14) years and 44.74% of the them were men. The prevalence of HTN in the total population was 22.3%(95% CI: 20.6%; 24.1%), and 18.8%(95% CI: 16.8%; 20.9%) and 25.2%(95% CI: 24.2%; 27.7%) in men and women, respectively. The percentage of awareness treatment and control among individuals with HTN were 77.5%(95% CI: 73.3%; 81.8%), 82.2%(95% CI: 70.2%; 81.6%) and 75.9%(95% CI: 70.2%; 81.6%), respectively. The Cn for prevalence of HTN was -0.084. Two factors, age (58.46%) and wealth (32.40%), contributed most to the socioeconomic inequality in the prevalence of HTN. CONCLUSION: The prevalence of HTN was higher among low-SES individuals, who also showed higher levels of awareness. However, treatment and control of HTN were more concentrated among those who had higher levels of SES, indicating that people at a higher risk of adverse event related to HTN (the low SES individuals) are not benefiting from the advantage of treatment and control of HTN. Such a gap between diagnosis (prevalence) and control (treatment and control) of HTN needs to be addressed by public health policymakers.

Spanish Flu in Tehran from 1918 to 1920.

The Spanish flu spread from September 23, 1918 to 1920. This disease was one of the historical catastrophes in Iran, and a large number of people in Tehran were infected. Evidence also shows that 5000-10000 out of the 250000 infected people died in Tehran over three years. Besides, an increase was detected in the prevalence of other diseases such as pericarditis, orchitis, mastoiditis, meningitis, optic neuritis, paralysis of the palate, mania, cholera, and dysentery. Overall, five percent of the city were destroyed, and the population and economic development were severely damaged. This study aims to evaluate the importance of the history of local medicine in Tehran, the spread of Spanish flu, World War I, and presence of Russian, Ottoman, and British troops in Iran during the flu outbreak. The critical role of Britain in artificial famine, malnutrition, and drug embargo was assessed, as well.

Prevalence of drug use, alcohol consumption, cigarette smoking and measure of socioeconomic-related inequalities of drug use among Iranian people: findings from a national survey.

BACKGROUND: Drug use can lead to several psychological, medical and social complications. The current study aimed to measure and decomposes socioeconomic-related inequalities in drug use among adults in Iran. METHODS: This was a cross-sectional study The PERSIAN Cohort is the largest and most important cohort among 18 distinct areas of Iran. This study was conducted on 130,570 adults 35 years and older. A structured questionnaire was applied to collect data. The concentration index (C) was used to quantify and decompose socioeconomic inequalities in drug use. RESULTS: The prevalence experience of drug use was 11.9%. The estimated C for drug use was - 0.021. The corresponding value of the C for women and men were - 0.171 and - 0.134, respectively. The negative values of the C suggest that drug use is more concentrated among the population with low socioeconomic status in Iran (p < 0.001). For women, socioeconomic status (SES) (26.37%), province residence (- 22.38%) and age (9.76%) had the most significant contribution to socioeconomic inequality in drug use, respectively. For men, SES (80.04%), smoking (32.04%) and alcohol consumption (- 12.37%) were the main contributors to socioeconomic inequality in drug use. CONCLUSIONS: Our study indicated that drug use prevention programs in Iran should focus on socioeconomically disadvantaged population. Our finding could be useful for health policy maker to design and implement effective preventative programs to protect Iranian population against the drug use.

Socioeconomic gradient in physical activity: findings from the PERSIAN cohort study.

BACKGROUND: The level of socioeconomic-related inequality in physical activity in Iran is largely unknown. This study investigates socioeconomic-related inequality in poor-physical activity (PPA) among Iranian adults. METHODS: A total of 129,257 adult participants enrolled in the PERSIAN (Prospective Epidemiological Research Studies in IrAN) Cohort were included in this study. Physical activity of adults was measured using metabolic equivalent rates (METs). Physical activity less than 41 METs/hour/day was considered PPA. The Concentration index (C) was used to quantify socioeconomic-related inequality in PPA. Moreover, the C was decomposed to identify the relative contribution of explanatory variables to inequality in PPA. RESULTS: There were significant regional variations in physical activity level among Iranian adults (29.8-76.5%). The positive value of C (0.098, 95% CI = 0.092 to 0.104) suggested that the higher concentration of PPA among higher socioeconomic status (SES) adults in Iran which was consistently observed in all cohort sites. CONCLUSIONS: The higher prevalence of PPA among Iranian adults, especially, women and older adults, warrant further public health attention. Since PPA is concentrated more among the high-SES population in Iran, strategies for the promotion of physical activity should focus more on economically well-off population.

Socioeconomic Inequalities in Gastroesophageal Reflux Disorder: Results from an Iranian Cohort Study.

BACKGROUND Despite progress in the health indexes in recent years, health inequalities remain as a global challenge within and between regions and countries. This study is the first to quantify the socioeconomic inequity in gastroesophageal reflux disease (GERD) using the concentration index. METHODS In this cross-sectional study, we used baseline data (7012 subjects) from the Fasa Cohort Study (the Southern Iran). The principal component analysis was used to construct socioeconomic status of the participants. The concentration index and concentration curve were used to measure socioeconomic-related inequality in GERD. Decomposition of concentration index was also done to identify the contribution of each explanatory variable to the wealth-related inequality in GERD prevalence. RESULTS The prevalence of GERD was 16.9% (95% CI: 15.9-17.7%). The overall concentration index for GERD was 0.093 (95% CI: 0.062-0.166]. Correspondingly, this figure for men and women were 0.116 (95% CI: 0.062-0.171%) and 0.091 (95% CI: 0.044-0.137%), respectively. The main contributors of socioeconomic-related inequality in GERD prevalence were socioeconomic status (64.4%), alcohol drinking (29%), and age (8.4%). CONCLUSION GERD is significantly more concentrated among richest people. There was significant socioeconomic inequality in GERD according to some individual factors. These inequalities need to be addressed by policy makers to identify the vulnerable subgroups and to reduce the disease burden in the community.

Concurrent assessment of calpain and caspase3 activities in brains of mice with acetaminophen-induced acute hepatic encephalopathy.

To develop pharmacological therapy for acute hepatic encephalopathy (AHE), understanding the molecular basis for cell injury is essential. Excitotoxic neural cell injury mediated by calpain as a post- receptor mechanism has been proposed as a player in neuronal injury in AHE. Concurrent assessment of Calpain and Caspase3 activities in the brain of AHE mice in acetaminophen- induced mourine model was performed. After induction of AHE by acetaminophen in mice, the model was confirmed by histopathological, biochemical and behavioural studies. The brains were removed, western blot analysis was done and the relative activity of calpain and caspase was estimated and compared to control group calpain but not caspase 3 activity was significantly increased in the AHE group compared to the control brains. Experimentally, this finding is the first to report. Increased calpain activity in liver has been previously reported. To translate both finding it can be suggested that calpain inhibition can be an investigational intervention in saving lives in AHE. To confirm the results, besides more advanced toxicodynamic studies on acetaminophen, the results should be confirmed in other models of AHE in future.

The PERSIAN Cohort: Providing the Evidence Needed for Healthcare Reform.

In the past, communicable diseases caused the highest mortality in Iran. Improvements in socioeconomic status and living standards including access to safe drinking water, along with the inception of Health Houses in the 1980s, have changed disease patterns, decreasing the spread of and deaths from infectious and communicable diseases. The incidence and prevalence of non-communicable diseases (NCD), however, have now increased in Iran, accounting for nearly 80% of deaths and disabilities. Without interventions, NCD are predicted to impose a substantial human and economic burden in the next 2 decades. However, Iran's health system is not equipped with the necessary policies to combat this growth and must refocus and reform. Therefore, in the year 2013, the Ministry of Health and Medical Education funded a well-designed nationwide cohort study-Prospective Epidemiological Research Studies in IrAN (PERSIAN)-in order to assess the burden of NCD and investigate the risk factors associated with them in the different ethnicities and geographical areas of Iran. The PERSIAN Cohort, which aims to include 200000 participants, has 4 components: Adult (main), Birth, Youth and Elderly, which are being carried out in 22 different regions of Iran. Having an enormous dataset along with a biobank of blood, urine, hair and nail samples, the PERSIAN Cohort will serve as an important infrastructure for future implementation research and will provide the evidence needed for new healthcare policies in order to better control, manage and prevent NCD.