Impact of Covid-19 pandemic lockdown on the urban litter and clean environment index.

Changing the level of pollution in the urban environment is one of the consequences of Covid-19. Litter are one of the most important urban pollutants affected by the Covid-19 pandemic. In this research, the pollution level of urban areas during the Covid-19 pandemic was investigated by studying the urban environment. To this end, the protocol of observation and counting was used and litter were studied in two groups including common litter and Covid-19 related litter in Yasuj, Iran. The results were interpreted based on the clean environment index (CEI). The time of observation was selected based on the peak of the disease and the decline in the incidence rate. The results showed that on average, at the peak of the disease, the density of the litter was reduced by 19% compared to the low lockdown related to Covid-19. The CEI on average was 4.76 at the peak of the disease that was interpreted in the clean status, while the CEI on average was 5.94 at the low lockdown related to Covid-19 so interpreted in the moderate status. Among urban land uses, recreational areas with a difference of more than 60% showed the greatest impact caused by Covid-19, while in commercial areas this difference was less than 3%. The effect of Covid-19 related litter on the calculated index was 73% in the worst case and 0.8% in the lowest case. Although Covid-19 decreased the number of litter in urban areas, the emergence of Covid-19 lockdown related litter was a cause for concern and led to increasing the CEI.

Health care workers' mental health in the face of COVID-19: a systematic review and meta-analysis.

BACKGROUND: Healthcare workers are leading the way in treating patients with coronavirus disease 2019 (COVID-19). Due to the high levels of psychological stress, this group is more likely to experience psychological issues. These psychological problems in healthcare providers include depression, anxiety, insomnia, stress and post-traumatic stress disorder (PTSD). The goal of this systematic review and meta-analysis was to find out how common these problems were in the face of COVID-19. METHODS: On 20 February 2022, systematic searches were conducted in the PubMed, Cochrane Library, Scopus, EMBASE, Science Direct, Web of Science and ProQuest databases. Two authors selected articles based on search keywords. As a last step, articles about the prevalence of psychological problems among healthcare workers in the face of COVID-19 were looked at and analysed for five different outcomes. RESULTS: The initial search yielded 18,609 articles. After reviewing the titles, abstracts and full texts of the articles, 44 were chosen for the final analysis and 29 were subjected to a meta-analysis. Insomnia, anxiety, depression, PTSD and stress are among the psychological issues faced by healthcare workers. Furthermore, the highest pooled prevalence of depression, anxiety, insomnia, PTSD and stress was 36% (95% confidence interval (CI) 24-50%), 47% (95% CI 22-74%), 49% (95% CI 28-70%), 37% (95% CI 19-59%) and 27% (95% CI 6-69%). CONCLUSIONS: In this meta-analysis, insomnia was found to be the most common mental health problem, followed by anxiety, PTSD, depression and stress in healthcare workers in the face of the COVID-19 pandemic. Generally, the pooled prevalence of these mental health problems was higher among physicians, nurses and older staff in the subgroup analysis. As a result, health policymakers and managers of the health care system should think about effective interventions to promote mental health, paying particular attention to these two groups.Key pointsStudies conducted in China reported more mental problems than in other countries.Health policymakers and health system managers should hold training programs to promote healthcare workers' mental health with a particular focus on more vulnerable groups.The prevalence of PTSD, stress, anxiety, depression and insomnia were higher among physicians, nurses and older staff.Health systems at both national and local levels have to take older physicians, nurses and healthcare providers into consideration while designing interventions.

Identification and Prioritization of Critical Factors Affecting the Performance of Iranian Public Hospitals Using the Best-Worst Method: A Prospective Study.

Background: In the ever-changing healthcare environment, policymakers and managers need a comprehensive evaluation system to accurately identify and prioritize factors affecting hospital performance. The present study aimed to identify and rank critical factors affecting hospital performance using the best-worst method (BWM). Methods: A cross-sectional study was conducted during 2016-2019 to identify and prioritize factors affecting the performance of Iranian public hospitals using the BWM. Initially, the content validity ratio (CVR) was used to screen the identified factors. Then, using a linear programming formula, a pairwise comparison between the best/worst criterion with all other identified criteria was performed. Results: The most important internal factor was efficiency, and its associated indicators were mainly related to financial factors. Among all external factors, the most prominent were economic, legal, and political factors, which were negatively affected by budgeting policies and the payment system. A megatrend was also identified in the form of a national health insurance system as well as a shift from employer-based to government-subsidized insurance coverage. Conclusion: External factors (economic and political) had a greater impact on the performance of public hospitals than internal factors (efficiency and effectiveness). A preprint of this study was published at https://www.researchsquare.com/article/rs-453223/v1 with doi: 10.21203/rs.3.rs-453223/v1.

Cigarette butts as a super challenge in solid waste management: a review of current knowledge.

Filtered cigarette is the most common type of tobacco used and cigarette butt is the most important environmental consequence of smoking. This study aimed to investigate the cigarette butt management and identify future needs to improve the current situation. The results showed that cigarette butts are the most abundant and widespread hazardous waste in the world. The current form of cigarette butt management has inferior performance that faced waste management systems with serious challenges. The results showed that reducing the littering rate and recycling are known as basic strategies in the management of this hazardous waste. Future studies should focus on reducing cigarette butt pollution and the amount of pollutant leakage from them.

Legal and policy requirements of basic health insurance package to achieve universal health coverage in a developing country.

OBJECTIVES: This study has analyzed the policy-making requirements related to basic health insurance package at the national level with a systematic view. RESULTS: All the documents presented since the enactment of universal health insurance in Iran from 1994 to 2017 were included applying Scott method for assuring meaningfulness, authenticity, credibility and representativeness. Then, content analysis was conducted applying MAXQDA10. The legal and policy requirements related to basic health insurance package were summarized into three main themes and 11 subthemes. The main themes include three kinds of requirements at three level of third party insurer, health care provider and citizen/population that contains 5 (financing insurance package, organizational structure, tariffing and purchasing the benefit packages and integration of policies and precedents), 4 (determining the necessities, provision of services, rules relating to implementation and covered services) and 2 (expanded coverage of population and insurance premiums) sub themes respectively. According to the results, Iranian policy makers should notice three axes of third party insurers, health providers and population of the country to prepare an appropriate basic benefit package based on local needs for all the people that can access with no financial barriers in order to be sure of achieving UHC.

Scoping literature review on the basic health benefit package and its determinant criteria.

BACKGROUND: There are various criteria and methods to develop Basic Health Benefit Package (BHBP) in world health systems. The present study aimed to extract criteria used in health systems in different countries around the world using scoping review method. METHODS: A systematic search was carried out in Cochrane Library, PubMed, Scopus, Science Direct, Web of Science, ProQuest, World Bank, World Health Organization, and Google databases between January and April 2016. Papers and reports were gathered according to selected keywords and were examined by two authors. Finally, the criteria were extracted from the selected papers. RESULTS: The primary search included 8876 papers. After studying the articles' titles, abstracts, and full texts, 9 articles and 14 reports were selected for final analysis. After the final analysis, 19 criteria were extracted. Due to diversity of criteria in terms of number and nature, they were divided into three categories. The categories included intervention-related criteria, disease-related criteria, and community-related criteria. The largest number of criteria belonged to the first category. Indeed, the most widely applied criteria included cost-effectiveness (20), effectiveness (19), budget impact (12), equity (12), and burden of disease (10). CONCLUSION: According to the results, different criteria were identified in terms of number and nature in developing BHBP in world health systems. It seems that certain criteria, such as cost-effectiveness, effectiveness, budget impact, burden of disease, equity, and necessity, that were most widely utilized in countries under study could be for designing BHBP with regard to social, cultural, and economic considerations.

Equity analysis of hospital beds distribution in Shiraz, Iran 2014.

BACKGROUND: One of the important aspects of equity in health is equality in the distribution of resources in this sector. The present study aimed to assess the distribution of hospital beds in Shiraz in 2014. METHODS: In this retrospective cross-sectional study, the population density index and fair distribution of beds were analyzed by Lorenz curve and Gini coefficient, respectively. Descriptive data were analyzed using Excel software. We used Distributive Analysis Stata Package (DASP) in STATA software, version 12, for computing Gini coefficient and drawing Lorenz curve. RESULTS: The Gini coefficient was 0.68 in the population. Besides, Gini coefficient of hospital beds' distribution based on population density was 0.70, which represented inequality in the distribution of hospital bedsamong the nine regions of Shiraz. CONCLUSION: Although the total number of hospital beds was reasonable in Shiraz, distribution of these resources was not fair, and inequality was observed in their distribution among the nine regions of Shiraz.

The decision-making matrix of propensity to outsourcing hospital services in Bandar Abbas, Iran.

OBJECTIVE: To determine the level of managers' propensity for outsourcing the services in hospitals using decision-making matrix. METHODS: The applied, cross-sectional study was conducted at three hospitals affiliated to Bandar Abbas University of Medical Sciences, Iran, in 2013, and comprised managers and employees of four service units: radiology, laboratory, nursing, and nutrition services. Data was collected using two questionnaires and face-to-face interviews. Data was analysed using SPSS 16 and by using decision-making matrix. RESULTS: Of the 122 subjects in the study, 12(9.8%) were managers and 110(90.2%) were other employees. The highest and lowest propensities for outsourcing were related to nutrition (66.6%) and nursing services one (8.33%). The decision-making matrix showed low outsourcing of the nursing, radiology, and laboratory services based on the services' features. However, there were difference between the results obtained from laboratory service decision-making matrix and the propensity for laboratory service outsourcing. CONCLUSIONS: The difference between the results obtained from the matrix and managers' viewpoint can be due to the lack of managers' sufficient attention to the features of hospital services when making decisions on outsourcing them.

Household financial contribution to the health System in Shiraz, Iran in 2012.

BACKGROUND: One common challenge to social systems is achieving equity in financial contributions and preventing financial loss. Because of the large and unpredictable nature of some costs, achieving this goal in the health system presents important and unique problems. The present study investigated the Household Financial Contributions (HFCs) to the health system. METHODS: The study investigated 800 households in Shiraz. The study sample size was selected using stratified sampling and cluster sampling in the urban and rural regions, respectively. The data was collected using the household section of the World Health Survey (WHS) questionnaire. Catastrophic health expenditures were calculated based on the ability of the household to pay and the reasons for the catastrophic health expenditures by a household were specified using logistic regression. RESULTS: The results showed that the fairness financial contribution index was 0.6 and that 14.2% of households were faced with catastrophic health expenditures. Logistic regression analysis revealed that household economic status, the basic and supplementary insurance status of the head of the household, existence of individuals in the household who require chronic medical care, use of dental and hospital care, rural location of residences, frequency of use of outpatient services, and Out-of-Pocket (OOP) payment for physician visits were effective factors for determining the likelihood of experiencing catastrophic health expenditure. CONCLUSION: It appears that the current method of health financing in Iran does not adequately protect households against catastrophic health expenditure. Consequently, it is essential to reform healthcare financing.

Investigation of the preparedness level of the hospitals against disasters in Bandar Abbas, Iran, in 2012.

OBJECTIVE: To determine the preparedness level of hospitals against natural disasters in Bandar Abbas, Iran. METHODS: The cross-sectional, descriptive study was conducted in all the 9 hospitals in Bandar Abbas, Iran, during 2012. The required data was collected using a standard checklist comprising 220 items in 10 areas. It was completed for each hospital using observations and interviews. SPSS 16.0 was used to analyse the data. RESULTS: The overall level of preparedness against disasters in Bandar Abbas hospitals was 38.6%. They were at a poor level in the areas of reception (31.4%), evacuation (28.1%), traffic (33.3%), security (34.6%), communication (30.6%), human resources (38.6%), and commanding and management (20.1%). Areas of emergency services (55.1%), training (53.5%), and logistics (53.5%) were moderate, while none of the areas could score enough to be in the good or very good category. CONCLUSION: Preparedness was poor and hospital administrators should establish necessary technical and communication infrastructures through sufficient budgets to improve weak areas.

Health-related quality of life and its related factors in HIV(+) patients referred to Shiraz Behavioral Counseling Center, Iran in 2012.

BACKGROUND: HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole. Nowadays, using anti-viral medication delays the onset of the disease cycle and increases the patients' life time. From the psychological point of view, however, such patients are faced with a great number of social and cultural limitations which affect various dimensions of their health as well as quality of life. Therefore, the present study aimed to investigate the quality of life and its related factors in HIV patients in Shiraz Behavioral Counseling Center. METHODS: The present analytical cross-sectional study was conducted on 129 HIV patients in Shiraz Behavioral Counseling Center who were selected through convenience sampling. The data were gathered using demographic as well as SF-36 questionnaires and analyzed through T-test, ANOVA, X(2), and Schiff's post hoc test. RESULTS: In this study, the patients' mean score of quality of life was 48.8+14. In addition, the mean scores of males' and females' life quality were 47.7+16.2 and 59.5+20.4, respectively and the difference was statistically significant (p<0.05). The mean difference of the patients' quality of life was also found to be significant based on employment status, marital status, and history of drug abuse (p<0.05), while it was not significant regardin gage, level of education, length of disease, and the distance between the house and the service providing center. CONCLUSION: In comparison to the physical dimension, the HIV-positive individuals' quality of life mean score was lower in the mental dimension. In addition, the mean difference revealed to be significant based on marital as well as employment status. These findings show such patients' needs for psychological support, more psychological interventions, and creation of appropriate job opportunities.