Understanding the Reasons for Sharing Syringes or Needles to Inject Drugs: Conventional Content Analysis.

BACKGROUND: This qualitative study was undertaken with the aim to identify the reasons for sharing syringes or needles among people who inject drugs (PWID) in Iran. METHODS: We used purposive sampling to recruit 4 groups of participants, male PWID (n = 14), female PWID (n = 6), service providers (n = 8), and human immunodeficiency virus (HIV)/addiction experts (n = 9). Data were collected through 2 focus group discussions (FGDs) among male PWID, and semi-structured interviews with female PWID, service providers, and HIV/addiction experts. Using conventional content analysis, themes were extracted for reasons for sharing needles to inject drugs. FINDINGS: We found 13 themes for barriers such as low perceived risk of HIV, high stigma around drug injection and use, low access to harm reduction education and prevention services due to their limited working hours as a well as uneven geographical distribution of services, some structural barriers like incarceration, poverty, and homelessness, and several competing survival needs beyond the injection-related safe behaviors. CONCLUSION: Our study was able to provide the perspectives of both PWID and health care authorities and providers towards several barriers to accessing HIV prevention services that lead to needle sharing among PWID in Iran. These barriers need to be addressed to achieve the target of HIV epidemic control.

A Productive Proposed Search Syntax for Health Disaster Preparedness Research.

OBJECTIVE: To find a proper search strategy to do a systematic review related to preparedness for disasters. METHODS: MeSH and Emtree terms were searched to detect synonyms for two main search terms "disaster" and "preparedness". Expert opinion on the synonyms was examined applying a Google form. The adopted syntax was searched in PubMed and results were sifted. Hand searching in two top key journals was done and sensitivity was calculated. RESULTS: Out of 1120 articles, 122 were included. In PDM journal, 10 articles were included by hand searching, out of which 5 were not spotted in PubMed search with the proposed syntax. In DMPHP journal, 13 publications were included, with 5 not found in PubMed search. Because of human error in hand searching 2 articles were added. CONCLUSION: The proposed syntax in this study achieves a sensitivity of search of 0.6 in PubMed which could be quite applicable for researchers. Moreover, in case only MeSH or Emtree terms were applied in search strategy or where hand searching was not performed, there were a number of articles missed.

Factors influencing the migration of Iranian healthcare professionals: A qualitative study.

BACKGROUND: The migration of healthcare specialists from developing countries has increased in recent years. This has caused a rapid reduction in the access to and quality of healthcare services in such countries. The aim of this study is to evaluate the factors affecting the migration of specialist human resources in Iran's healthcare system. METHODS: This is a qualitative study, which was carried out through semi-structured interviews between 2015 and 2016. For sampling, purposive sampling method with maximum variation sampling was used. Further, data saturation was observed by conducting 21 interviews, and data analysis was performed using the MAXQDA10 content analysis software. RESULTS: Factors affecting the migration of specialists were classified into five key themes, including structural, occupational, personal, socio-political and economic factors. These themes consisted of 12 categories and 50 subcategories. The most important factors affecting the migration of our study population were structural issues, occupational problems, and personal concerns. CONCLUSION: Identification of factors influencing migration is the first step to prevent the migration of specialist human resources. Implementing the recommendations proposed in this study would assist to prevent migration of medical professionals.

The Effect of Empowerment and Educational Programs on the Quality of Life in Iranian Women with HIV.

AIDS affects physical, mental, social, and psychological health status. One of the goals of Health for All in the 21st century is to improve the quality of life. This study is a randomized clinical trial conducted on 120 HIV-positive women. Women were administered assessment questionnaires to be completed during the structured interview. After sample collection, participants were divided randomly into 3 groups by using the table of random numbers, then, respectively, received educational intervention, empowerment program, and routine procedures offered by the center and were followed by refilling the questionnaires 12 weeks after intervention. Depending on the type of data, chi-square, analysis of variance, and paired t test were used, and SPSS version 16 was used for data analysis. The finding showed that knowledge increased after intervention in educational ( P = .02) and empowerment groups ( P = .006); also empowerment group indicated significant difference in psychological ( P = .006) and spiritual ( P = .001) domains and their total quality of life ( P = .004). According to this study, exposing HIV-positive women to empowerment education is effective in improving their quality of life.

Association between polymorphism of GSTP1, GSTT1, GSTM1 and CYP2E1 genes and susceptibility to benzene-induced hematotoxicity.

Occupational exposure to benzene has been associated with leukemia, anemia, leukopenia, and thrombocytopenia. Genetic susceptibility to benzene toxicity in humans may be related to variations in benzene metabolizing genes. The main objective of this study was to ascertain whether polymorphism of GSTP1, GSTM1, GSTT1 and CYP2E1 genes might influence susceptibility to the adverse effects of benzene among employees of a petrochemical plant. In this cross-sectional study, 124 employees of a petrochemical plant who had been occupationally exposed to benzene and had one or more abnormal hematological parameter (cases) and 184 subjects with a similar exposure scenario, free from any abnormal hematological parameters (referent) were studied. Atmospheric concentrations of benzene were measured and GSTM1 and GSTT1 genotypes were evaluated using the multiplex polymerase chain reaction (PCR) technique. Additionally, GSTP1 and CYP2E1 genotypes were determined by PCR- restriction fragment length polymorphism (PCR-RFLP). The frequency of null GSTT1 genotype in cases was significantly higher than that of referent group (32.3 vs. 18.5%, OR 2.1, 95% CI 1.23-3.56, p = 0.004). The mean value of platelets in subjects with null GSTT1 genotype was significantly lower than that of individuals with positive GSTT1 genotype (p = 0.015). Conversely, the mean value of leukocytes was significantly higher in subjects with null GSTM1 genotype as compared to those with positive GSTM1 genotype (p = 0.026). Logistic regression analysis showed that, subjects with null GSTT1 genotype had a significantly higher risk for hematological disorders, as compared to those with positive GSTT1 genotype (OR 2.1, 95% CI 1.23-3.56). Moreover, subjects with both null GSTT1 and GSTM1 genotypes had a significantly higher risk for hematological disorders as compared to subjects with positive GSTT1 and GSTM1 genotypes (OR 2.35, 95% CI 1.14-4.8). The results of this study showed that, individuals carrying null GSTT1 or both null STT1 and GSTM1 genotypes had a higher risk and were more susceptible to benzene-induced hematological disorders.

Factors Influencing Fast-Food Consumption Among Adolescents in Tehran: A Qualitative Study.

BACKGROUND: The consumption of different types of fast food is increasingly growing in all parts of the world, both in developed and developing countries. Because of the changes and transitions in the lifestyle and dietary habits of people, an increasing number of people from different age groups, particularly adolescents and young adults, are inclined toward consuming fast food. OBJECTIVES: The objective of this study was to investigate the factors influencing fast-food consumption among adolescents in Tehran, Iran. PATIENTS AND METHODS: The present qualitative study was conducted in 2012 - 2013 in Tehran, the capital of Iran. To achieve the objective of this study, 42 adolescents were enrolled in this study through a purposive sampling method, and the required data was collected via individual semi-structured in-depth interviews. Data collection and analysis were carried out simultaneously, and the collected data was analyzed via a thematic content analysis and using MAXQDA 10 software. RESULTS: In this study after coding the transcribed interviews, the findings were categorized into three main themes as follows: personal views, social factors, and family factors. Each theme included several categories and subcategories, and the coded sentences and phrases were placed under each category and subcategory. CONCLUSIONS: The results of this study showed that the number of factors promoting fast-food consumption appeared to be more than the inhibiting factors and that the diverse factors at the individual and social level influenced fast-food consumption among adolescents.

The impact of sleep healthy behavior education on the quality of life in the pregnant women with sleep disorder: A randomized control trial in the year 2012.

BACKGROUND: About 79% of pregnant women in the world suffer from sleep disorders. These disorders result from physiological changes during pregnancy, originate from different factors, and can affect pregnant women's quality of life before, during, and after delivery. This study aimed to investigate the effect of sleep healthy behavior education on the quality of life among pregnant women with sleep disorders in the second trimester. MATERIALS AND METHODS: This is a clinical trial conducted on 112 pregnant women with sleep disorders referring to two selected health care centers in Makou affiliated to Urmia University of Medical Sciences during June-Oct 2012. Data collection tools included demographic characteristics questionnaire, Pittsburgh Standard Sleep Quality questionnaire, and World Health Organization, Quality of Life (WHOQOL-BREF) WHOQOL-BREEF questionnaire. Sampling was done by convenient sampling. Firstly, Pittsburg Standard Sleep Quality Questionnaire was completed and the pregnant women with sleep disorders were selected as the subjects. After completion of sampling, the subjects were randomly assigned to two groups of study and control. Education of sleep health behavior was provided in the study group by the researcher during four 1-h sessions. Then, WHOQOL-BREEF and Pittsburg Standard Sleep Quality questionnaire were completed again in two groups in the first follow-up session (1 month after educational intervention) and in the second follow-up session (2 months after educational intervention) held by the researcher. Control group only received conventional prenatal care. The obtained data were analyzed by Chi-square test, independent t-test, Fisher's exact and repeated measure tests through SPSS 18. RESULTS: Mean scores of quality of life showed an increase in 1 and 2 months after intervention in the study group compared to the control group. A significant difference was observed in the QOL in the two groups, 1 month (P < 0.000) and 2 months (P < 0.001) after intervention. CONCLUSIONS: Education of sleep healthy behaviors was effective on the QOL of pregnant women with sleep disorders. The results obtained in the present study can be used to support the pregnant women with sleep disorders and sleep disorders clinics, as well as for administration of prenatal care.

Relationship between Energy Expenditure Related Factors and Oxidative Stress in Follicular Fluid.

BACKGROUND: This study evaluated the impact of body mass index (BMI), total calorie intake and physical activity (PA) as energy expenditure related factors on oxidative stress (OS) in follicular fluid (FF). MATERIALS AND METHODS: This prospective study conducted on 219 infertile women. We evaluated patients' BMI, total calorie intake and PA in their assisted reproduction treatment cycles. Malondialdehyde (MDA) and total antioxidant capacity (TAC) in pooled FF at oocyte retrieval were additionally assessed. RESULTS: There was no relation between OS biomarkers to total calorie intake and PA. The TAC levels in FF adjusted for age, duration of infertility, etiology of infertility, number of used gonadotrophin and PA showed a positive relation to BMI (p=0.001). The number of used gonadotrophin and PA had a negative relation to duration of infertility (p=0.03) and anovulation disorder as an etiology of infertility. The MDA level in FF had a positive association with anovulation disorder as the etiology of infertility (p=0.02). MDA in FF was unaffected by BMI. CONCLUSION: Increasing age, BMI and PA do not affect OS in FF. In women with longtime infertility and those with anovulation disorder as an etiology of infertility, decreased potent antioxidant defense in the follicular microenvironment may contribute to ovarian function. Therefore antioxidant supplements may be beneficial for these groups of women.

Impact of environmental tobacco smoke exposure in women on oxidative stress in the antral follicle and assisted reproduction outcomes.

BACKGROUND: Cigarette smoke contains many oxidants and may alter the human reproduction by inducing oxidative stress (OS) in both active and passive smokers. This study was designed to evaluate the effect of environmental tobacco smoke (ETS) exposure on oxidative stress in the follicular fluid and the assisted reproduction outcomes. MATERIALS AND METHODS: An observational prospective study was carried out on 236 infertile women, who underwent assisted reproduction cycles. The ETS exposure was assessed using self-reported ETS exposure and the cotinine level in follicular fluid. To evaluate the OS in follicular fluid (FF) malon-di-aldehyde (MDA) and total antioxidant capacity (TAC) were measured. The number of retrieved oocytes, rate of metaphase II stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were considered as the assisted reproduction outcomes. The results were adjusted for age, body mass index, duration, and etiology of infertility; P-values less than 0.05 were considered significant. RESULTS: The MDA and TAC levels in FF were not related to the self-report number of the weekly ETS exposure and cotinine levels in FF. Also, the number of retrieved oocytes, MII stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were not related to the cotinine level and weekly ETS exposure. However, in women whose cotinine levels in FF were lower and equal/above 3.5 ng/ml, the number of retrieved oocytes was higher (12.63 ± .71 vs. 9.28 ± 1.11, P = 0.01). The relationship between the MDA level and cleavage rate (Beta = -18.5, confidence interval-34.9 and-2.1, P < 0.05) was negatively significant and the relationship between the MII stage rate with TAC (Beta = 0.02, confidence interval 0.01 and 0.04, P < 0.05) was positively significant. CONCLUSION: The ETS exposure may alter the assisted reproduction success by influencing the number of available oocytes. Although, the OS in a follicular environment affect the ability of oocytes to reach the specific cleavage stages at appropriate time intervals, it does not mediate poor-assisted reproduction outcomes due to ETS exposure.

Knowledge translation for research utilization: design of a knowledge translation model at Tehran University of Medical Sciences.

INTRODUCTION: The present study aimed to generate a model that would provide a conceptual framework for linking disparate components of knowledge translation. A theoretical model of such would enable the organization and evaluation of attempts to analyze current conditions and to design interventions on the transfer and utilization of research knowledge. METHODS: This research, performed in 2006-2007 at the Tehran University of Medical Sciences (TUMS), utilized two distinct methodologies: a narrative review to identify existing knowledge transfer models and frameworks and focus group discussions to determine the views and opinions of researchers and decision makers regarding barriers to knowledge translation within the health system. RESULTS: A knowledge translation cycle is described, with five domains: knowledge creation, knowledge transfer, research utilization, question transfer, and the context of organization. DISCUSSION: The knowledge translation cycle offers a theoretical basis for identifying basic requirements and linking mechanisms in the translation of knowledge for research utilization.