Executive and hierarchical models for participatory response to health emergencies in the workplace: Lessons from COVID-19.

Introduction: Workplaces are high-risk environments for epidemic transmission, and the COVID-19 pandemic has highlighted the significant impacts that health emergencies can have on both the healthcare system and the economy. This study presents executive and hierarchical models for participatory response to health emergencies in the workplace, with a focus on COVID-19. Methods: The study was conducted in three phases. Content analysis of interviews with 101 stakeholders and national documents was used to identify key themes and dimensions for an executive model. A focus group discussion and review of international documents were then used to refine and expand the executive and hierarchical models. The alignment and trustworthiness of the final models, as well as feedback, were gathered from 117 informants working in various workplaces. Results: The executive model highlighted that context understanding, management commitment, and participation play critical roles in developing tailored prevention and response plans, and adequate support is necessary for successful plan implementation. Monitoring and review processes should be established to ensure proper functioning. The hierarchical model emphasizes the need for collaborative efforts from various stakeholders to effectively implement pandemic prevention and participatory response plans. Conclusion: Overall, the executive and hierarchical participatory models presented in this study provide a framework for effectively controlling pandemics and other health emergencies in the workplace, enhancing both health resilience and the sustainability of economic activities.

Exploration roles and responsibilities of trade unions in preventing and responding to emergencies against epidemics: The case of COVID-19.

BACKGROUND AND AIM: The coronavirus disease 209 (COVID-19) pandemic has been affecting various strata of society including different guilds. Each of these segments has its role to play in controlling epidemics. Accordingly, this study aimed to explore trade unions' roles and responsibilities in the prevention and emergency response to epidemic, including the COVID-19 pandemic. MATERIALS AND METHODS: The present qualitative research was conducted using directed content analysis. Participants were selected by a purposeful sampling method. Data were collected through semistructured interviews and field notes and validated through Lincoln and Guba's (1985) evaluative criteria. Data were analyzed by MAXQDA software. RESULTS: Data analysis, constant comparison, and class integration provided a total of seven main themes, which were extracted into four domains of Plan, Implementation, Review, and Action. The main themes were categorized into the dimensions of each domain, so that the Plan domain included three dimensions of union/guild contexts, leadership and staff participation, and planning. The Implementation domain included two dimensions of support and operations. The Assessment domain had a performance evaluation dimension, and the Action domain was made up of an improvement dimension. CONCLUSION: Relying on their organizational and social capacities, trade unions can facilitate the leadership and participation of employees and communities for appropriate policies and making resilient decisions to control epidemics and other roles and responsibilities related to health.

Smear grading at initial treatment association with treatment outcomes among new smear positive pulmonary tuberculosis patients: A retrospective study.

Introduction: Tuberculosis (TB) is one of the most challenging diseases in diagnosis, treatment and control. We aimed to assess the association of the initial grading of Mycobacterium Sputum Smear (MSS) on the outcomes of TB treatment. Materials and methods: In a retrospective study, data of 418 positive pulmonary smear patients were retrieved from the TB registration system in Iran during 2014 to 2021. Patients' data included demographic, laboratory and clinical information and were recorded in our checklist. The grading of Mycobacterium Sputum Smear (MSS) at the initial treatment was assessed based on World Health Organization (WHO) guidelines. Chi-square test was used to assess the relationship between tuberculosis treatment outcomes and Mycobacterium grade at initial treatment in SPSS. Results: The mean age of cases was 51.19 ± 22.29 years old and varied between 14 and 95 years. Laboratory results showed that the rate of 1-9, 1+,2+ and 3+ Mycobacterium tuberculosis was 17.7%, 44.3%, 19.4% and 18.7%, respectively. The rate of cure, death and treatment failure in patients was 87.1%, 6.9%, and 1.2%, respectively. The highest mortality rate (11.5%) occurred in patients with 3+ and the lower rate of cure was 79.5% in this group. Moreover, by increasing the Mycobacterium grade the rate of transferred out and lost to follow up from treatment increased (p = 0.024). Conclusion: High smear grading of sputum is inversely associated with lower curing and on-time treatment. Moreover, by increasing the Mycobacterium grade at initial treatment, treatment failure and lost to follow up increased Therefore, improvement the health system and patient-diagnosis and screening programs is necessary to on-time diagnosis and facilitate the treatment process.

Health literacy among Iranian adults: findings from a nationwide population-based survey in 2015.

BACKGROUND: Health literacy is one of the most important determinants of noncommunicable diseases prevention. Health literacy is associated with elevated risks for poorer access to care, adverse health outcomes, and increased hospitalization and health costs. AIMS: This study aimed to determine the level of health literacy among the general adult population in the Islamic Republic of Iran. METHODS: Using a cross-sectional study during 2014-2015 with a multistage cluster sampling approach, we administered a pilot-tested standardized questionnaire to assess different domains of health literacy (i.e., reading, comprehension, communication/decision-making and Interpretation/judgment skills, individual and social empowerment, health information access and health information use) among 8439 (3935 males) individuals aged 18-60 years. Data were collected through face-to-face interviews. Descriptive statistics and multivariable linear regression method using SPSS (20) were applied to identify the factors associated with health literacy among Iranian adults. RESULTS: The mean health literacy level was 10.2±3.8 (out of 20). Only 18% (95% confidence interval [CI]: 17.15-18.78) of the participants had adequate health literacy, while 45.7% (95% CI: 44.64-46.78) had inadequate, and the 36.3% (95% CI: 35.21-37.33) had moderate health literacy. In the adjusted linear regression model, education level (the smallest ß = 4.35, P < 0.001), age (ß = 0.01, P = 0.002), female sex (ß = 0.45, P < 0.001), residency in rural areas (ß = 0.26, P < 0.001) and having permanent job (ß = 1.03, P < 0.001) were significantly associated with more health literacy. CONCLUSION: Our findings highlighted that the Iranian adult population has an insufficient level of health literacy, which calls for comprehensive education planning to improve the levels, with special attention to certain subpopulations (e.g. illiterate populations) and domains (e.g. individual empowerment).

Knowledge, risk perception, and behavioral intention about hepatitis C, among university students.

INTRODUCTION: Hepatitis C virus (HCV) infection is a major complex public health problem. Different resources have proved that healthcare workers more than the general population are at a risk of infection. Therefore, medical field students, due to the future occupational hazards, are included in the risk group. AIM: The purpose of the study was to evaluate the level of knowledge, public and individual risk perception, and behavioral intention about HCV, among medical sciences students of the Isfahan University of Medical Sciences. SETTINGS AND DESIGN: This is a descriptive-analytical study that was conducted among 457 students of the Medical Sciences in the Isfahan University of Medical Sciences. MATERIALS AND METHODS: The data was collected using a questionnaire. Sampling was done randomly. STATISTICAL ANALYSIS USED: The data was analyzed using the SPSS18 software and statistical tests of Pearson, Spearman, T- test, and the analysis of variance (ANOVA); P < 0.05 was considered significant. RESULTS: Four hundred and fifty-seven students (41.8% male and 58.2% female) in 29 fields of study (six categories) participated in this research. The mean age was 21.55 ± 2.6 years. The mean and standard deviations of the students' knowledge was 3.71 ± 2.9 (out of 8), and the behavioral intention to accruing information and performance of preventive actions related to HCV was 11.52 ± 3.16 (out of 20). Public risk perception was 20.1 ± 3.5 (out of 30); and personal risk perception was 6.96 ± 1.8 (out of 10). The ANOVA test showed that public perception of the risk among students of different academic fields was different (F = 1.52, P < 0.05). CONCLUSIONS: According to the low knowledge of students of Medical Sciences in the Isfahan University of Medical Sciences about HCV, it was recommended that the University Policymakers design an educational intervention about it, in order to minimize the chances of being infected.