Economic inequalities in decayed, missing, and filled first permanent molars among 8-12 years old Iranian schoolchildren.

BACKGROUND: First permanent molars (FPM) play an important role in the masticatory function and oral health. This study aimed to assess the economic inequalities of FPM health indices among schoolchildren in the northeast of Iran. METHODS: A total of 4051 children aged 8-12 years old were included in the analyses of this cross-sectional study in 2015. Economic status was measured using the principal component analysis on home assets. Concentration index (C) was used to measure economic inequality in FPM health indices, and its contributing factors determined by Wagstaff decomposition technique. RESULTS: The prevalence of having decayed, missing, and filled FPMs among children was 40.9% (95% CI: 38.8-43.0), 1.2% (95% CI: 0.8-1.6%), and 7.8% (95% CI: 6.7-8.9%), respectively. Missing FPM was generally more concentrated among low-economic children (C=-0.158), whereas, filled FPM was more concentrated on high-economic children (C = 0.223). Economic status, mother education, having a housekeeper mother, and overweight/obesity, contributed to the measured inequality in missing FPM by 98.7%, 97.5%, 64.4%, and 11.2%, respectively. Furthermore, 88.9%, 24.1%, 14.5%, and 13.2% of filled FPM inequality was attributable to children's economic status, father education, residence in rural areas, and age, respectively. CONCLUSION: There is a significant economic inequality in both missing and filled FPM. This inequality can be attributed to the economic status of individuals. To reduce FPM extraction, it is important to target low-income and rural children and provide them with FPM restoration services. Additionally, it is necessary to provide training to less-educated parents and housekeeper mothers to address the observed inequalities.

Socioeconomic inequalities in employees' health-enhancing physical activity: Evidence from the SHAHWAR cohort study in Iran.

BACKGROUND: Increasing level of physical activity (PA) among working population is of particular importance, because of the high return of investment on employees' PA. This study was aimed to investigate socioeconomic inequalities in Health-Enhancing Physical Activity (HEPA) among employees of a Medical Sciences University in Iran. METHODS: Data were extracted from the SHAHWAR Cohort study in Iran. Concentration index (C) and Wagstaff decomposition techniques were applied to determine socioeconomic inequality in the study outcomes and its contributors, respectively. RESULTS: Nearly half of the university employees (44.6%) had poor HEPA, and employees with high socioeconomic status (SES) suffered more from it (C = 0.109; 95% CI: 0.075, 0.143). Also, we found while poor work-related PA (C = 0.175; 95% CI: 0.142, 0.209) and poor transport-related PA (C = 0.081, 95% CI: 0.047, 0.115) were more concentrated among high-SES employees, low-SES employees more affected by the poor PA at leisure time (C = -0.180; 95% CI: -0.213, -0.146). Shift working, and having higher SES and subjective social status were the main factors that positively contributed to the measured inequality in employees' poor HEPA by 33%, 31.7%, and 29%, respectively, whereas, having a married life had a negative contribution of -39.1%. The measured inequality in poor leisure-time PA was mainly attributable to SES, having a married life, urban residency, and female gender by 58.1%, 32.5%, 28.5%, and -32.6%, respectively. SES, urban residency, shift working, and female gender, with the contributions of 42%, 33.5%, 21.6%, and -17.3%, respectively, were the main contributors of poor work-related PA inequality. Urban residency, having a married life, SES, and subjective social status mainly contributed to the inequality of poor transport-related PA by 82.9%, -58.7%, 36.3%, and 33.5%, respectively, followed by using a personal car (12.3%) and female gender (11.3%). CONCLUSIONS: To reduce the measured inequalities in employees' PA, workplace health promotion programs should aim to educate and support male, urban resident, high-SES, high-social-class, and non-shift work employees to increase their PA at workplace, and female, married, rural resident, and low-SES employees to increase their leisure-time PA. Active transportation can be promoted among female, married, urban resident, high-SES, and high-social-class employees and those use a personal car.

Validity of the Persian version of the Munich ChronoType Questionnaire (MCTQIR).

PURPOSE: Currently, the most useful questionnaire for determining the chronotype is the Munich ChronoType Questionnaire (MCTQ). It determines chronotype based on sleep-wake behavior on workdays and work-free days and uses the mid-sleep time on free days (MSF), corrected for accumulated sleep debt over the work week to classify chronotype (MSFsc). Our study aimed at validating Persian version of the MCTQ. METHODS: Participants completed the Persian version of the MCTQ, reduced Morningness-Eveningness Questionnaire (rMEQ), Epworth sleepiness scale (ESS), and demographic characteristics. RESULTS: The study sample was comprised of 250 Iranian men and women (mean age 34 years, age range 30 to 58 years, 113 men). Results showed that there is a significant negative relationship between the components of MCTQ and rMEQ, and the strongest relationship related to the MSF index. The results also showed that MCTQ parameters were not significantly related to the ESS scale. Cut-off values of MSFsc for chronotype categories were determined by inter-quartile range (Q25% = 3.44, Q50% = 4.68, and Q75% = 5.75). CONCLUSIONS: Like the MCTQ in other languages, the Persian version of the MCTQ is a reliable tool for assessing chronotype.

The Impact of COVID-19 Pandemic on Physical Activity Levels Among Health Care Workers: Longitudinal Results From the SHAHWAR Study.

OBJECTIVE: The aim of the present study was to investigate physical activity (PA) changes during the COVID-19 pandemic among health care workers. METHODS: In a follow-up study, staff PA was compared before and during the COVID-19 pandemic. Logistic regression model was used to determine the related factors with PA changes. RESULTS: Total PA (MET minutes a week) among participants (n = 449) showed a statistically significant decrease during the pandemic compared with before the pandemic: 3785.5 ± 2237.09 versus 2363 ± 2452.90, P < 0.0001. Although transport-related PA decreased in medical and administrative department staff (3851 ± 22.83.4 vs 2446.7 ± 2477.6, P < 0.0001 and 3593.8 ± 2094.3 vs 2122.6 ± 2373.8, P < 0.0001, respectively), the decrease was associated with employment in the administrative and nonshift sectors with odds ratios of 2.37 (1.38 to 4.08) and 2.04 (1.28 to 3.26), respectively. CONCLUSION: Promoting PA at home and leisure is especially recommended to achieve the recommended PA levels.

Effect of psychosocial interventions on risky driving behaviours among offender drivers by using simulated and real driving: study protocol for a non-randomised controlled trial.

BACKGROUND: Risky driving behaviour including anger while driving has led to millions of global road traffic crashes, thousands of mortalities and injuries. These losses are much more in middle-income countries, such as Iran. This paper explains methods of data collection in a controlled trial study for evaluating the effect of psychosocial interventions on risky driving by using simulated and real driving. METHODS: This non-randomised controlled trial study will include 180 offender drivers. They will refer to the simulation laboratory by traffic police after their driving licences were suspended. At baseline, all participants will fill five questionnaires including demographic, Driving Anger Scale, Driving Anger Expression Scale, Spielberger's Anger and Manchester Driving Behavioural, and then they will be tested with a driving simulator. Afterwards, they will be allocated to one of three-intervention training arms (mindfulness, meta-cognition and social marketing) or a control arm without any training. Risky driving behaviours will be assessed in three follow-ups after intervention. The primary outcome of interest will be driving offences, recorded by traffic police in two time points: at 6 months and 1 year after the intervention. DISCUSSION: This study examines the effect of three interventions in reducing driving offence. The results can end in a new therapeutic training or a new legislation that should be added to current obligatory training for getting driving licence and can lead to long-term safe driving among Iranian drivers. Future research is recommended to study the cost-effectiveness of these interventions in actual driving in Iran. TRIAL REGISTRATION NUMBER: UMIN000039493.

COVID-19 epidemic effects on sleep quality among health sector workers: A follow up study.

Health care workers (HCWs) were vulnerable to sleep disturbances in normal circumstances. Poor sleep quality (PSQ) is common during the coronavirus disease 2019 (COVID-19) epidemic. The aim of this study is evaluation of sleep quality among healthcare workers during COVID-19 epidemic in a cohort study. In a follow-up study, we assessed sleep quality in 453 Iranian HCW participants in late-April 2021, after approximately 8 weeks of the epidemic of COVID-19. In order to compare the sleep quality in the two time intervals, during and before COVID-19, we used the recorded data of the same group of participants who were enrolled in a study named SHAHWAR (SHAhroud Health care Workers Associated Research) cohort that is focused on the health of HCWs who work at the Shahroud university of medical sciences. Data collection process in the SHAHWAR study started on October 2, 2019 and continued until February 19, 2020. Our results showed sleep quality worsened among shift-workers during COVID-19 outbreak; however, it was improved among non-shift staff. Sleep quality was more likely to be worsening if HCWs had shift-working roles [OR: 1.84(1.11-3.06), and if they experienced death in their families [OR: 5.06(1.60-12.80)]; however, having a paramedical role was a protective effect [OR: 0.52(0.27-092)], for poor quality sleep. Sleep quality worsened during the epidemic among HCWs. A greater impact, in terms of higher PSQI index, in this group of workers was seen in shift working staff.

Predictors of Self-Reported Compliance with COVID-19 Preventive Guidelines: A Quantile Regression Model.

The research used an online, convenience cross-sectional sample of adults aged ≥18 years old recruited from Shahroud County, Northeast of Iran. We measured the contribution of multiple determinants for association with behavioral compliance, at the time of the COVID-19 pandemic. The compliance score measured with this questionnaire can be within a range of 5 and 100. Compliance was bounded between 19 and 80 that has been distributed J-shape, so quantile logistic regression model has been fitted for that. Variables related to people's knowledge, including self-reported knowledge and following the news related to COVID-19, were the two main factors that accompanied behavioral compliance at all of its levels in the period of pandemic.

The Effects of Inhalation Aromatherapy Using Lavender Essential Oil on Postoperative Pain of Inguinal Hernia: A Randomized Controlled Trial.

PURPOSE: One of the main problems after inguinal hernia surgery is postoperative pain. The purpose of this study was to examine the effects of aromatherapy with lavender oil inhalation on postoperative pain after inguinal hernia surgery. DESIGN: A randomized controlled design was used. METHODS: Ninety participants were selected and assigned to two groups: the intervention group (n = 45) and the control group (n = 45). The patients in the intervention group inhaled four drops of 2% lavender essential oil with oxygen for 20 minutes. The patients in the control group inhaled only oxygen. Postoperative pain was measured 0 minutes after being transferred to the surgery ward, and then 2 hours, 6 hours, and 24 hours after surgery using the visual analog scale. FINDINGS: In comparison to the control group, levels of pain severity in the intervention group were significantly lower in four stages of measurements (P < .001). Also, in all stages, measurements showed significant statistical differences within the groups (P < .001). CONCLUSIONS: Aromatherapy with lavender essential oil helped decrease postoperative pain after inguinal hernia surgery.

Sleep Improvement Effect on Sexual Life Quality Among Rotating Female Shift Workers: A Randomized Controlled Trial.

BACKGROUND: Poor sleep quality consequences among shift working nurses are well recognized. AIM: To investigate the impact of sleep improvement on sexual quality of life. METHODS: The study was a parallel randomized controlled trial, conducted among 120 female nurses in 2 educational hospitals in the Northeast of Iran, Shahroud. Using random blocks of four, 120 eligible participants were randomly assigned to study groups. Data collecting tools included a demographic data questionnaire, Pittsburgh Sleep Quality Index to assess sleep quality, and the survey of sexual quality of life-female and Sexual Self-Efficacy Questionnaire to evaluate level of sexual quality of life and sexual self-efficacy, respectively. The intervention consisted of 3 weekly sleep intervention sessions that lasted from 90 to 120 minutes. OUTCOMES: The study's primary and secondary outcomes were sleep quality, and the level of sexual self-efficacy and sexual quality of life, respectively. RESULTS: By 3-month follow-up, the loss to follow-up rate was 5.9%. The mean sleep quality score was 7.61 ± 2.26 in the recruited participants. Following the intervention, the sleep quality score showed statistically significant differences compared to the control group [mean difference (CI 99.98%), -1.89 (-2.40, -1.38)]. Participants in the intervention group showed modest increases in both measures; sexual self-efficacy [mean difference (CI 99.98%), 8.82 (6.83, 10.81)] and sexual quality of life [mean difference (CI 99.98%), 19.64 (18.08, 21.20)]. CLINICAL IMPLICATIONS: These findings suggest that sleep improvement could promote the sexual quality of life among shift working nurses. STRENGTHS & LIMITATIONS: Strengths of this study include the use of a validated outcome measure. Focusing the study on female nurses and the small size of the study population are the limitations. CONCLUSION: Improved sleep showed an impact on sexual quality of life among rotating female shift workers. Khastar H, Mirrezaie SM, Chashmi NA, et al. Sleep Improvement Effect on Sexual Life Quality Among Rotating Female Shift Workers: A Randomized Controlled Trial. J Sex Med 2020;17:1467-1475.

Effects of reviewing childbirth scenarios on choice of delivery type: a randomized controlled trial.

OBJECTIVE: The incidence of cesarean section (CS) was estimated as about 48% between 2000 and 2012 in Iran. This study was conducted to assess the effects of reviewing written childbirth scenarios on the selection of delivery method. MATERIALS AND METHODS: This randomized controlled trial was conducted in Shohada Women's Hospital in Behshahr, Mazandaran, Iran, from May to December 2015. A total of 223 women at 28 to 32 weeks of gestation were randomly allocated into three groups; the standard care (control), theory of planned behavior (TPB)-based education, and TPB education plus additional support via written childbirth scenarios (scenario). Participants were assessed at baseline (weeks 28-32) and intervention (week 37 of pregnancy) periods. Both intervention groups (TPB and scenario groups) participated in three learning sessions that were based on TPB, whereas the control group received routine care service. RESULTS: The frequencies of normal vaginal delivery (NVD) in the scenario, TPB, and control groups were 73.2%, 58.5%, and 45.7%, respectively (p=0.004). The results showed that the relative risks of CS decision in the scenario and TPB groups in comparison with the control group were both 0.87 and statistically significant (p=0.018 and p=0.013, respectively). The relative risk of choosing CS after the removal of obligatory CS cases in the scenario group compared with the control was 0.85. CONCLUSION: Written childbirth scenarios that contain information on NVD and CS as additional support are effective educational tools for reducing CS rates.

The effects of psychosexual counseling on sexual quality of life and function in Iranian breast cancer survivors: a randomized controlled trial.

BACKGROUND: Considering different dimensions of life, special sex life for survivors of breast cancer (BC) is important because their life expectancy has increased. OBJECTIVE: We designed this study to improve the sexual function, satisfaction and quality of sexual life. METHODS: In a randomized controlled clinical trial study, from a total 286 breast cancer survivors (BCS), 118 women enrolled to the study. After providing informed consent, the participants were randomly assigned either to the intervention group or to the waitlist control group. The intervention consisted of six weekly psychosexual counseling sessions that lasted from 90 to 120 min. Data were collected by the demographic and clinical forms, Beck Depression Inventory, Female Sexual Function Index (FSFI), Larson Sexual Satisfaction Questionnaire and sexual quality of life-female (SQOL-F) questionnaire. RESULTS: Mean age of patients in control and intervention groups were 43.8 ± 6.6 and 44.84 ± 6.7, respectively. More than 65% of the patients in the both groups were either normal or showed a low level of depression. Sexual function (FSFI) scores and sexual quality of life (SQOL-F), showed a significant statistic differences after intervention (P < 0.001 in both tools). Sexual satisfaction (Larson) has showed improvement in some subclasses, however, change in total score was not statistically significant (P = 0.073). CONCLUSIONS: The psychosexual intervention program was effective in improving sexual function and quality of sexual life among BCS. This intervention has clinical significance as it provided an opportunity for the women to discuss their sexual issues.

Diagnostic Accuracy of Rapid Ultrasound in Shock (RUSH) Exam; A Systematic Review and Meta-analysis.

OBJECTIVE: To perform a diagnostic accuracy of the rapid ultrasound in shock (RUSH) to diagnose the etiology of undifferentiated shock in patients presenting to the emergency department (ED). METHODS: We searched the Medline via PubMed, Scopus, and ISI Web of Knowledge till July 2017. Two independent reviewers screened studies for eligibility. Our study analysis is planned in accordance with the guidelines for meta-analysis of diagnostic studies. In the systematic search, of 397 references, 295 were excluded on the basis of the title and abstract. For the remaining 102 articles, the full text was retrieved and critically reviewed. After the selection process, five papers were included. RESULTS: The pooled estimate of all data showed that the RUSH protocol exhibited high sensitivity (0.87, 95% Confidence Interval (CI): 0.80-0.92, I2 = 46.7%) and specificity (0.98, 95% C. I.: 0.96-0.99, I2 = 30.8%). The AUC for SROC, a global measure of the RUSH protocol performance, was 0.98 ± 0.01, indicates the high accuracy of the test. Positive and negative likelihood ratios reported from the studies ranged from 9.83 to 51.32 and 0.04 to 0.33, respectively. The pooled estimate of all data showed that the RUSH protocol exhibited high positive likelihood ratio (19.19, 95% C. I.: 11.49-32.06, I2 = 14.1%) and low negative likelihood ratio (0.23, 95% C. I.: 0.15-0.34, I2 = 18.4%). CONCLUSION: This meta-analysis suggests that RUSH protocol has generally good role to distinguish the states of shock in patients with undifferentiated shock referred to the emergency department.

Incidence and Residual Risk of HIV, HBV and HCV Infections Among Blood Donors in Tehran.

Estimation of residual risk is essential to monitor and improve blood safety. Our epidemiologic knowledge in the Iranian donor population regarding transfusion transmitted viral infections (TTIs), is confined to a few studies based on prevalence rate. There are no reports on residual risk of TTIs in Iran. In present survey, a software database of donor records of Tehran Blood Transfusion Center (TBTC) was used to estimate the incidence and residual risk of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections, by applying the incidence rate/window period (IR-WP) model. A total of 1,207,155 repeat donations was included in the analysis and represented a mean of 8.4 donations per donor over 6 years. The incidence amongst repeat donors was estimated by dividing the number of confirmed seroconverting donors by the total number of person-years at risk. The residual risk was calculated using the incidence/window period model. Incidence rate and residual risk for HBV, HCV and HIV infections were calculated for total (2005-2010) and two consecutive periods (2005-2007 and 2008-2010) of the study. According to the IR-WP model, overall residual risk for HIV and HCV in the total study period was 0.4 and 12.5 per million units, respectively and for HBV 4.57/100,000 donations. The incidence and residual risk of TTIs, calculated on TBTC's blood supply was low and comparable with developed countries for HIV infection but high for HCV and HBV infections. Blood safety may therefore be better managed by applying other techniques like nucleic acid amplification tests.