Text analysis of billboards and infographic graphics advertising COVID-19 on promoting preventive behaviors and taking vaccination against the coronavirus pandemic and investigating the opinions of the Iranian adult population.

BACKGROUND: Advertising is one of the most important solutions that health centers and medical services around the world use to try to encourage public opinion to create a positive attitude towards preventive measures and vaccination. This study has been done with the aim of text analysis of billboards and infographics related to promoting preventive behaviors and vaccination against the coronavirus pandemic and providing solutions and models for preventive information and advertising in the field of health. METHODS: The study method in this research is a combination of qualitative and content analysis. Data collection was done in a targeted manner. The sample size includes 33 advertising billboards and infographics. Data collection has been done through searching the sites and websites of health networks and medical education centers in Iran, taking pictures of infographics and billboards in public places, and also receiving archive files of pictures from the public relations of health networks and medical services. The data was collected from February 19, 2020 to December 30, 2022 (the time frame of the pandemic and public vaccination program in Iran). The data was analyzed based on the three-dimensional discourse analysis theory of Fairclough. Then, an online survey about promoting preventive behaviors and vaccination against the coronavirus pandemic in the format of billboards and infographics was designed in SurveyMonkey and its link was provided to the audience through virtual networks and other platforms. The age group of people was selected from 18 to 70 years. Considering that the number of participants should be representative of the entire community under investigation, therefore, based on Cochran's formula, the sample size was equal to 350 people. Finally, users' opinions were analyzed using descriptive statistics. The assessment of validity involved experts in infection control and linguistics. The reliability of the measurement, determined through the Cronbach's alpha internal consistency coefficient, yielded a coefficient of 0.968. RESULTS: The results show that among the four linguistic components of words, syntax, coherence and text structure; "live metaphors", "pronoun "we", "collocation and reference", and "attitude markers" have the most impact on the audience. The frequency percentage of the data shows that these language elements have tremendous power in attracting the audience to perform preventive behaviors. The results show that the language reflects the culture, opinions and needs of people in the society. Also, the results show that encouraging people to perform preventive behaviors should be through the integration of medical information with motivational linguistic factors in order to attract the audience more. CONCLUSIONS: It can be concluded that the use of the appropriate pattern of medical advertising discourse and correct communication strategies, will help public participation in the field of epidemic control. The language of effective health education and health communication during an epidemic must be related to the ways of thinking and speaking of ordinary people. Also, words with metaphorical and ironic meanings have a high potential to influence the health performance of people in society and increase public awareness of health communication. Therefore, using them to create a new value system with the aim of controlling and overcoming the consequences of the epidemic is very effective.

Investigating the tendency to use COVID-19 vaccine booster dose in Iran.

INTRODUCTION: Vaccine hesitancy is recognized as a significant public health threats, characterized by delays, refusals, or reluctance to accept vaccinations despite their availability. This study, aimed to investigate the willingness of Iranians to receive booster shots, refusal rate, and their preferred type of COVID-19 vaccine. MATERIALS AND METHODS: This cross-sectional study was conducted over a month from August 23 to September 22, 2022 using an online questionnaire distributed through WhatsApp and Telegram online communities. The questionnaire assessed participants' intent to accept COVID-19 booster vaccination and had no exclusion criteria. Data analysis involved using SPSS version 16.0, with t-tests and chi-square tests used to assess the bivariate association of continuous and categorical variables. A multivariate logistic regression model was built to examine the association between Health Belief Model (HBM) tenets and COVID-19 vaccination intent. The Hosmer Lemeshow Goodness of Fit statistic was used to assess the model's fit, with a p-value > 0.05 indicating a good fit. RESULTS: The survey was disseminated to 1041 adults and the findings revealed that 82.5% of participants expressed a desire to receive the booster dose. Participants who intended to be vaccinated were generally older (46.4 ± 10.9), mostly female (53.3%), single (78.9%), had received a flu vaccine (45.8%). The findings indicated that the HBM items, including perception of COVID-19 disease, perceived benefits of COVID-19 vaccines, COVID-19 safety/cost concerns, preference of COVID-19 vaccine alternatives, and prosocial norms for COVID-19 vaccination, received higher scores among individuals intending to be vaccinated compared to vaccine-hesitant individuals, with statistical significance (p < 0.05). However, the "COVID-19 risk-reduction habits" item had a higher score but did not reach statistical significance (p = 0.167). CONCLUSION: Factors such as lack of trust in the effectiveness of the vaccine, trust in specific vaccine manufacturers, and concerns about side effects of COVID-19 vaccine are among the most important factors. These findings have implications for national vaccination policies, emphasizing the need for policymakers in the health sector to address these factors as vital considerations to ensure the continuity of vaccination as one of the most important strategies for controlling the pandemic.

"Intention to receive COVID-19 vaccine among healthcare workers: a comparison between two surveys".

BACKGROUND: Considering the importance of intention to receive COVID-19 vaccine among healthcare workers and its role in maintaining their health and inhibiting the epidemic spread of Covid-19, the present study was done to identify the changes in intention to receive COVID-19 vaccine rate in two different time points and it's determinants based on the dimensions of the health belief model among healthcare workers in Iran. METHODS: Two cross-sectional surveys performed to investigate COVID-19 vaccination intent and associated factors based on the health belief model. The first conducted on 1244 participants from August 18 to 23, 2020, and the second on 1514 participants from February 5 to April 29, 2021, both using a questionnaire of intent to accept COVID-19 vaccination. The questionnaire distribution platform in both surveys was similarly, WhatsApp and Telegram social and working virtual groups of HCWs. Data were analyzed with SPSS-16 software for descriptive and analytical statistics. RESULTS: In the first survey, 58.4% (95% CI: 0.55-0.61%) of healthcare workers intended to receive the COVID-19 vaccine, the rate dropped to 45.7% (95% CI: 0.43-0.48%) in the second survey (P < 0.001). The regression analysis indicated six factors that were significantly associated with higher intention to receive COVID-19 vaccine: being a female (OR = 1.84, 95% CI (1.11-3.03)), history of Covid-19 infection (OR = 1.54, 95% CI (1.09-2.18), perceptions of Covid-19 disease (OR = 1.13, 95% CI (1.01-1.28)), perceived benefits of COVID-19 vaccine (OR = 1.34, 95% CI (1.22-1.47)), prosocial norms for COVID-19 vaccination (OR = 1.25, 95% CI (1.21-1.29)), and COVID-19 vaccine safety/cost concerns (OR = 1.25, 95% CI (1.17-1.33)). CONCLUSIONS: Present study showed an undesirable rate of intention to receive COVID-19 vaccine among healthcare workers, especially decreasing over the time, emphasize the need of interventions to promote healthcare workers' intention to receive the vaccine and reduce the spread of COVID-19 disease.

Causes of medical errors and its under-reporting amongst pediatric nurses in Iran: a qualitative study.

OBJECTIVES: To explore the causes of medical errors (ME) and under-reporting amongst pediatric nurses at an Iranian teaching hospital. DESIGN: A qualitative study, based on individual, in-depth, semi-structured interviews and content analysis approach. SETTINGS: The study was conducted at the Pediatric Department of the largest tertiary general and teaching hospital in Shiraz, southern Iran. PARTICIPANTS: The study population was all pediatrics nurses who work at Pediatric Department and they had been trained on ME, as well as methods to report them through the hospital's ME reporting system. Purposive sampling was used by selecting key informants until data saturation was achieved and no more new information was obtained. Finally, 18 pediatric nurses were interviewed. MAIN OUTCOME MEASURE(S): Pediatrics nurses' views on the causes of ME and under-reporting. RESULTS: We found five main factors causing ME and under-reporting: personal factors, workplace factors, managerial factors, work culture and error reporting system. These factors were further classified into proximal and distal factors. Proximal factors had direct relationship with ME and distal factors were contextual factors. CONCLUSION: Causes of ME and under-reporting amongst pediatric nurses are complex and intertwined. Both proximal and distal factors need to be simultaneously addressed using context-specific approaches. Further research on other groups of healthcare workers and using a quantitative approach will be beneficial to elucidate the most appropriate interventions.

Awareness and Observance of Patient Rights from the Perspective of Iranian Patients: A Systematic Review and Meta-Analysis.

BACKGROUND: Recipients of healthcare services have rights, which must be acknowledged and protected. Such rights include observance of acceptable patient physical, mental, spiritual, and social needs guided by commonly accepted rules and regulations. The objective of this study was to conduct a systematic review and meta-analysis of awareness rates and observance of patient rights in Iran from the perspective of the patient. METHODS: In this study, various references such as Medline (PubMed), Scopus, Scientific Information Database (SID), Google scholar, Magiran, and IranMedex were searched (from August to December 2015). Heterogeneity was assessed using the Q statistic. English and Persian search keywords and combinations included terms such as "patient bill of rights, patient rights, Iranian patient bill of rights, and Persian patient rights." A meta-analysis of the primary search sources was accomplished using STATA (version 11.0). RESULTS: Initial review included 20 articles of which 12 assessed observance rates of patient rights and three described service awareness rates of recipients concerning their personal rights. Five articles covered both topics and had an estimated 54.2% coverage based on the results of meta-analysis and the random-effects model with the heterogeneity. CONCLUSION: An Observance rate of patient bills of rights was considered somewhat adequate. However, contradictions in findings noted in this study suggest deficiencies do exist and need to be resolved. There appears a need to better describe and increase awareness rates of healthcare services by patients concerning their own bill of rights.

Medical students' knowledge of indications for imaging modalities and cost analysis of incorrect requests, shiraz, iran 2011-2012.

Medical imaging has a remarkable role in the practice of clinical medicine. This study intends to evaluate the knowledge of indications of five common medical imaging modalities and estimation of the imposed cost of their non-indicated requests among medical students who attend Shiraz University of Medical Sciences, Shiraz, Iran. We conducted across-sectional survey using a self-administered questionnaire to assess the knowledge of indications of a number of medical imaging modalities among 270 medical students during their externship or internship periods. Knowledge scoring was performed according to a descriptive international grade conversion (fail to excellent) using Iranian academic grading (0 to 20). In addition, we estimated the cost for incorrect selection of those modalities according to public and private tariffs in US dollars. The participation and response rate was 200/270 (74%). The mean knowledge score was fair for all modalities. Similar scores were excellent for X-ray, acceptable for Doppler ultrasonography, and fair for ultrasonography, CT scan and MRI. The total cost for non-indicated requests of those modalities equaled $104303 (public tariff) and $205581 (private tariff). Medical students at Shiraz University of Medical Sciences lacked favorable knowledge about indications for common medical imaging modalities. The results of this study have shown a significant cost for non-indicated requests of medical imaging. Of note, the present radiology curriculum is in need of a major revision with regards to evidence-based radiology and health economy concerns.

Picture analysis of billboards and infographic graphics advertising COVID-19 on promoting preventive behaviors and taking vaccination against the Coronavirus disease pandemic.

Today, advertising science is a tool that helps advertisers to design their advertising to meet the needs of the audience. In this regard, knowing and understanding the audience is one of the most important points that advertisers should pay attention to before advertising in order to better attract the audience. This study has been done with the aim of billboards and infographics analysis related to promoting preventive behaviors and vaccination against the Coronavirus disease pandemic and investigating the opinion of the general adult population of Iran. The method used in this research is the qualitative method. In this research, according to the type of data and research goals, Kress and Van Leeuwen's discourse theory method has been used. The sample size includes 36 advertising billboards and infographics. Data collection has been done through searching the sites and websites of health networks and medical education centers in Iran, taking pictures of infographics and billboards in public places, and also receiving archive files of pictures from the public relations of health networks and medical services. The data was collected from February 19, 2020 to December 30, 2022 (the time frame of the pandemic and public vaccination program in Iran). Then, an online survey about promoting preventive behaviors and taking vaccination against the Coronavirus disease pandemic was designed in SurveyMonkey and its link was provided to the audience through virtual networks and other platforms. The assessment of validity involved experts in infection control and linguistics. The reliability of the measurement, determined through the Cronbach's alpha internal consistency coefficient, yielded a coefficient of 0.968. In this study, data analysis was conducted using IBM SPSS Statistics software, version 15.0 (IBM Corp., Armonk, NY, USA). Finally, users' opinions about of billboards and infographics were analyzed using descriptive statistics. The results of component analysis and surveys show that visual components such as «The staring look at the spectator (Demand)¼, «Head-on Shot (inclusion)¼, «Down Shot (Creating a sense of participation for the represented person)¼, «Close-up (intimate/individual relationship)¼, «Level Shot (equality)¼ and «High-Angle Shot (Presenting power)¼ in medical advertising has had a great impact in arousing public opinion to create a positive attitude towards preventive measures and vaccination during the Coronavirus disease epidemic. The results of this research show that in visual communication, visual components play a significant role in creating and maintaining target ideologies. Also, advertising in the field of preventive measures in medical sciences requires certain rules that determine people's culture and the main foundation of their attitude and thinking. Therefore, it is necessary to know such knowledge and learn it by the medical staff to deal with critical situations.

High Post-Infection Protection after COVID-19 among Healthcare Workers: A Population-Level Observational Study.

Background: Even though a few years have passed since the coronavirus disease 2019 (COVID-19) outbreak, information regarding certain aspects of the disease, such as post-infection immunity, is still quite limited. This study aimed to evaluate post-infection protection and COVID-19 features among healthcare workers (HCWs), during three successive surges, as well as the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection, reactivation, re-positivity, and severity. Methods: This cross-sectional population-level observational study was conducted from 20 April 2020 to 18 February 2021. The study population included all HCWs in public or private hospitals in Fars Province, Southern Iran. The infection rate was computed as the number of individuals with positive polymerase chain reaction (PCR) tests divided by the total number of person-days at risk. The re-infection was evaluated after 90 days. Results: A total of 30,546 PCR tests were performed among HCWs, of which 13,749 (61.94% of total HCWs) were positive. Considering the applied 90-day threshold, there were 44 (31.2%) cases of reactivation and relapse, and 97 (68.8% of infected and 1.81% of total HCWs) cases of reinfection among 141 (2.64%) diagnosed cases who experienced a second episode of COVID-19. There was no significant difference in symptoms (P=0.65) or the necessity for ICU admission (P=0.25). The estimated protection against repeated infection after a previous SARS-CoV-2 infection was 94.8% (95% CI=93.6-95.7). Conclusion: SARS-CoV-2 re-positivity, relapse, and reinfection were rare in the HCW population. After the first episode of infection, an estimated 94.8% protection against recurring infections was achieved. A preprint version of this manuscript is available at DOI:10.21203/rs.3.rs-772662/v1 (https://www.researchsquare.com/article/rs-772662/v1).

The management of cytotoxic drug wastes in Shiraz, Iran: an overview of all government and private chemotherapy settings, and comparison with national and international guidelines.

Excessive use of cytotoxic drugs owing to a dramatic increase in malignancy incidence leads to the production of high amounts of cytotoxic wastes. In Iran, management of hazardous wastes has been neglected in recent decades. The aim of this study was to determine the amount of intravenous cytotoxic drug wastes, their collection and disposal status in chemotherapy wards, and to compare the current status with standard guidelines in Shiraz, Iran. This cross-sectional study was performed using data collected during 2 consecutive months, from 22 June to 22 August 2011, in all 13 chemotherapy wards in Shiraz. The amount of prescribed drugs, drugs waste, collection and disposal status of cytotoxic drugs were recorded. We then compared the current status of waste collection and disposal in our samples with our national guideline. The prescription of cytotoxic drugs and the amount of total drugs waste reached approximately 6 and 0.2 kilograms respectively. Total vials volume was calculated to be approximately 1000 l in order to estimate the volume of containers required for the encapsulation method. The results demonstrated that the current status of cytotoxic waste collection and disposal is inappropriate, and none of the facilities under study followed our guidelines perfectly. The adherence to all recommendations and guidelines was poorer in private wards than in government-run ones. The management of cytotoxic wastes is inappropriate and our existing national guidelines are lacking. Suggestions for the best management of cytotoxic waste are revising the existing guidelines, allocating a sufficient budget, training healthcare workers, providing multiple administration options of cytotoxic drugs and accomplishing a surveillance system.

Roadmap to recovery: Implemented and attitude toward school reopening strategies during the COVID-19 pandemic, a scoping review.

The novel coronavirus disease 2019 (COVID-19) has had various financial and life impacts on the world's population. Schools' regular activity and function during the pandemic require balancing the repercussions of suspending in-person education versus health threats. Furthermore, children are one of the prominent victims of the restricted quarantine strategies' effects, which may make them vulnerable to various mental health problems. In this study, we reviewed previously reported strategies and roadmaps regarding the reopening of schools during the COVID-19 pandemic. The following databases were searched from October to December 2021, via multi-step search strategies for "COVID-19," "coronavirus," "school reopening," "roadmaps," "reopening," and "reopening strategies": Google Scholar, PubMed, Scopus, and Web of Science. A total of five papers with roadmaps focusing on reopening schools were included in this study. Fundamental issues and principles of these reviewed roadmaps were: 1) protecting the high-risk students and staff physically and mentally, 2) accelerating the vaccination of essential workers, staff, parents, and students, and 3) improving the COVID-19 testing capacity. Roadmaps for the reopening of the schools should describe some phases and steps for their strategies. Current roadmaps have not mentioned any phases and timelines for this process. Describing some health metrics in the roadmaps for progressing to the next step or returning to the previous ones is also necessary for all roadmaps and should be considered in further studies.

Clinical laboratory waste management in Shiraz, Iran.

Clinical laboratories are significant generators of infectious waste, including microbiological materials, contaminated sharps, and pathologic wastes such as blood specimens and blood products. Most waste produced in laboratories can be disposed of in the general solid waste stream. However, improper management of infectious waste, including mixing general wastes with infectious wastes and improper handling or storage, could lead to disease transmission. The aim of this study was to assess waste management processes used at clinical laboratories in Shiraz, Iran. One hundred and nine clinical laboratories participated In this cross sectional study, Data collection was by questionnaire and direct observation. Of the total amount of waste generated, 52% (by weight) was noninfectious domestic waste, 43% was non-sharps infectious waste and 5% consisted of sharps. There was no significant relationship between laboratory staff or manager education and the score for quality of waste collection and disposal at clinical laboratories. Improvements in infectious waste management processes should involve clearer, more uniformly accepted definitions of infectious waste and increased staff training.

Cost efficiency of the family physician plan in fars province, southern iran.

BACKGROUND: In recent years use of family physicians has been determined as a start point of health system reform to achieve more productive health services. In this study we aimed to assess the cost-efficiency of the implementation of this plan in Fars province, southern Iran. METHODS: This cross-sectional descriptive study was done in 2007 in 18 provincial health centers as well as 224 rural health centers in Fars province. Data were collected using forms, statistics, and available evidence and analyzed by expert opinion and ratio techniques, control of process statistics, and multi indicator decision model. RESULTS: Although in the family physician plan more attention is paid to patients and the level of health training, availability, and equity has improved and the best services are presented, it has not only decreased the costs, but also increased the referrals to pharmacies, laboratories, and radiology clinics and the costs of healthcare. CONCLUSION: Although the family physician plan has led to more regular service delivery, it has increased the patients' referral to pharmacies, laboratories, and radiology centers and more referrals to family physicians. It seems that the possibility of setting regularity in health system can be gained in the following years of the family physician program mainly via planning, appropriate management and organizing correct health plans according to need assessments, and continual supervision on activities, which would happen according to current experiences in this plan.

Cost-Effectiveness of Breast Cancer Screening in Shiraz, Iran.

Background: Breast cancer is the most common cancer in the world, which accounts for 21.4% of all kinds of cancers for women in Iran. However, the treatment of breast cancer is costly and given that the budget devoted to the healthcare sector is limited, the present study aimed to investigate the cost-effectiveness of breast cancer screening for women, who referred to breast clinic located in Shahid Motahari clinic affiliated to Shiraz University of Medical Sciences, Shiraz city, Iran in 2017-2018. Methods: This study is a cross-sectional study analyzing the cost-effectiveness of breast cancer screening versus no screening. The study was conducted on 3500 women, who referred to the breast clinic in Motahari clinic, at 2017-2018 in Shiraz, Iran. The patients were identified and direct costs, which were correlated to cancer breast screening, were calculated based on the patients' records with public tariff per person. Tree age pro 2011 used to analyze cost effectiveness. Results: Based on the results obtained, the expected cost of screening and no screening were 7556 $ppp and 7840 $ppp, respectively. Given their difference in effectiveness (16%), screening was dominant (less costly and more effective) compared to no screening. Tornado diagram showed that the results had the maximum sensitivity to the increase in screening cost. Conclusions: In general, according to the results obtained from the current study, the screening was more cost effective compared with no screening.

Medical Error and Under-Reporting Causes from the Viewpoints of Nursing Managers: A Qualitative Study.

Background: Patient safety as a goal can be achieved by reporting medical errors (ME); however, most errors are never reported. The aim of this study is to explore the causes of ME, and the obstacles in reporting them amongst nurses. Methods: We conducted semi-structural interviews, with 12 nursing managers in the biggest teaching hospital in southern Iran (2015-2016). The interview guide concentrated on the causes of ME and barriers in reporting them. All face-to-face interviews were recorded and transcribed verbatim and analysed using thematic analysis. Results: In this study 4 main themes were extracted for the causes of ME: personal/social characteristics, nonprofessional practice, hospital related factors/organization contextual factors, and poor management. Also, 5 main themes (such as; personal characteristics, fear from reporting, nonprofessional practices, cultural and social factors, and error surveillance system features) were obtained with regards to barriers in reporting. Conclusions: ME can be reduced by improving professional practice and better human resource management. Also, reporting errors can be increased by focusing on cultural and social factors.

COVID-19 Vaccination Acceptance in Iran, a Nationwide Survey on Factors Associated with the Willingness toward Getting Vaccinated.

Background: In the name of extensive vaccine uptake, understanding the public's attitude, perception, and intent toward COVID-19 vaccination is a significant challenge for public health officials. Methods: A cross-sectional survey via an online questionnaire rooted in the Health Belief Model and Integrated Behavioral Model was conducted to evaluate COVID-19 vaccination intent and its associated factors. Factor analysis and multivariate logistic regression were operated to be satisfactory. Results: Among the 4,933 respondents, 24.7% were health care workers, and 64.2% intended to accept COVID-19 vaccination. The adjusted odds (aOR) of COVID-19 vaccination intent was higher for individuals with greater exposure to social norms supportive of COVID-19 vaccination (aOR = 3.07, 95% Confidence Interval (CI) = 2.71, 3.47) and higher perceived benefits of COVID-19 vaccination (aOR = 2.9, 95% CI = 2.49, 3.38). The adjusted odds of vaccination intent were lower for individuals with greater COVID-19 vaccine safety concerns (aOR = 0.28, 95%CI = 0.25, 0.31). Lower vaccination intent was also associated with increasing age ((aOR = 0.99, 95% CI = 0.98, 0.999), female sex (aOR = 0.76, 95% CI = 0.65, 0.88), and working in the health care field (aOR = 0.75, 95% CI = 0.63, 0.9). Conclusions: The odds of COVID-19 vaccination intent were higher three or more times among those with a greater belief in vaccine effectiveness, lower concerns about vaccine safety, and greater exposure to cues to vaccinate, including from doctors. This last finding is concerning as vaccine acceptance was surprisingly lower among health care workers compared to others. The remarkable results of factor analysis and reliability of the questionnaire may encourage local health authorities to apply it to their regional population.

The COVID-19 vaccination acceptance/hesitancy rate and its determinants among healthcare workers of 91 Countries: A multicenter cross-sectional study.

The aim of this study was to investigate the COVID-19 vaccination acceptance rate and its determinants among healthcare workers in a multicenter study. This was a cross-sectional multi-center survey conducted from February 5 to April 29, 2021. The questionnaire consisted of 26 items in 6 subscales. The English version of the questionnaire was translated into seven languages and distributed through Google Forms using snowball sampling; a colleague in each country was responsible for the forward and backward translation, and also the distribution of the questionnaire. A forward stepwise logistic regression was utilized to explore the variables and questionnaire factors tied to the intention to COVID-19 vaccination. 4630 participants from 91 countries completed the questionnaire. According to the United Nations Development Program 2020, 43.6 % of participants were from low Human Development Index (HDI) regions, 48.3 % high and very high, and 8.1 % from medium. The overall vaccination hesitancy rate was 37 %. Three out of six factors of the questionnaire were significantly related to intention to the vaccination. While 'Perceived benefits of the COVID-19 vaccination' (OR: 3.82, p-value<0.001) and 'Prosocial norms' (OR: 5.18, p-value<0.001) were associated with vaccination acceptance, 'The vaccine safety/cost concerns' with OR: 3.52, p-value<0.001 was tied to vaccination hesitancy. Medical doctors and pharmacists were more willing to take the vaccine in comparison to others. Importantly, HDI with OR: 12.28, 95 % CI: 6.10-24.72 was a strong positive determinant of COVID-19 vaccination acceptance. This study highlighted the vaccination hesitancy rate of 37 % in our sample among HCWs. Increasing awareness regarding vaccination benefits, confronting the misinformation, and strengthening the prosocial norms would be the primary domains for maximizing the vaccination coverage. The study also showed that the HDI is strongly associated with the vaccination acceptance/hesitancy, in a way that those living in low HDI contexts are more hesitant to receive the vaccine.

Unhealthy Lifestyle Predisposed Shiraz Healthcare Workers to Metabolic Diseases.

Background: Poor health condition may increase the risk of occupational problems and reduces an organization's productivity. Also, there is a direct, bilateral relationship between occupation and health. Objective: To evaluate the health status of health care workers (HCWs) in the largest tertiary general and teaching hospital in southern Iran. Methods: This cross-sectional study (Sep2014-Dec2016) was conducted on HCWs, who were referred to Prevention and Health Promotion Clinic of Shiraz Namazee hospital. The participants' health status was assessed and after the risk assessments and necessary physical examinations, the laboratory and para clinic tests were requested. Using descriptive and analytical tests, all data were analyzed. Results: Totally, 963 HCWs were enrolled, that 64.4% were women, with mean ± SD age of 35.51 ± 8.9 years. Eighty-eight percent and 77.4% of the participants had history of ergonomic and psychological exposures. Impaired glucose tolerance and abnormal serum cholesterol were seen in 13.6% and 29.9%, respectively. Body mass index was a predictive factor for abnormal blood pressure (OR: 1.12; 95%CI: 1.02-1.22), impaired glucose tolerance (OR: 1.08; 95%CI: 1.01-1.16), and abnormal serum cholesterol (OR: 1.17; 95%CI: 1.10-1.25), respectively. Male gender (OR: 1.83; 95%CI: 1.08-3.03) was a predictive factor for abnormal serum cholesterol. Conclusions: The health status of HCWs is not good enough in Iran. They did not have an appropriate lifestyle. They were exposed to different occupational hazards. The prevalence of chronic diseases was notable. Overweight, obesity, and inactivity were the most important causes of metabolic diseases.

Investigating the epidemiology of methanol poisoning outbreaks: a scoping review protocol.

OBJECTIVE: We aim to identify relevant studies from 2000 to 2020 regarding methanol poisoning outbreaks and map the existing literature with a focus on the epidemiology and global burden of disease. INTRODUCTION: Methanol poisoning occurs in individuals or as an outbreak. Illicit productions are responsible for most methanol poisoning outbreaks; however, there are some occupational, suicidal, and homicidal incidences as well. In methanol poisoning outbreaks, medical facilities get overwhelmed quickly. The current WHO fact sheet dates back to 2014 and there have been no updates since. Based on our preliminary search, it seems that the course of methanol outbreaks has changed. INCLUSION CRITERIA: The study will include peer-reviewed articles and gray papers that focus on the epidemiology of methanol poisoning outbreaks. This review will consider all methanol poisoning outbreak victims without any limitation in geographical, social, cultural, or gender-based demographics. METHODS: A three-step search strategy will be used. First, an initial search will be done in MEDLINE and Scopus to identify key terms. Those key terms will then be searched across included databases (MEDLINE, Scopus, Embase, and Web of Science) and sources for gray literature. In a third step, references and Google Scholar will be searched manually. Two reviewers will screen the titles and abstracts, then full texts for identifying inclusion criteria and data extraction. Disagreements will be resolved by a senior author. Extracted data will be tabulated and mapped. Quantitative data will be reported using descriptive numerical summary analysis.

Resuming Breast Imaging Services in the Aftermath of the COVID-19 Pandemic: Safety and Beyond.

As the Coronavirus disease 2019 (COVID-19) epidemic begins to stabilize, different medical imaging facilities not directly involved in the COVID-19 epidemic face the dilemma of how to return to regular operation. We hereby discuss various fields of concern in resuming breast imaging services. We examine the concerns for resuming functions of breast imaging services in 2 broad categories, including safety aspects of operating a breast clinic and addressing potential modifications needed in managing common clinical scenarios in the COVID-19 aftermath. Using a stepwise approach in harmony with the relative states of the epidemic, health care system capacity, and the current state of performing breast surgeries (and in compliance with the recommended surgical guidelines) can ensure avoiding pointless procedures and ensure a smooth transition to a fully operational breast imaging facility.

Basics of Developing a COVID-19 Reopening Roadmap: A Systematic Scoping Review.

BACKGROUND: The necessity of easing pandemic restrictions is explicit. Due to the harsh consequences of lockdowns, governments are willing to find reasonable pathways to reopen their activities. METHODS: To find out the basics of developing a reopening roadmap, on 6th-10th July 2020, we conducted a systematic search on PubMed, Scopus, and Web of Science to review the databases; and Google by manual to review the grey literature. Two independent authors extracted the data, and the senior author solved the discrepancies. RESULTS: Sixteen documents were included. Data categorized into four sections: principals, general recommendations for individuals, health key metrics, and in-phases strategy. The number of phases or stages differed from three to six, with a minimum of two weeks considered for each one. Health key metrics were categorized into four subsets: sufficient preventive capacities, appropriate diagnostic capacity, appropriate epidemiological monitoring, and sufficient health system capacity. These metrics were used as the criteria for progressing or returning over the roadmap, which guarantees a roadmap's dynamicity. Noticeably, few roadmaps did not mention the criteria that may alter the dynamicity of their roadmap. When some areas face new surges, the roadmap's dynamicity is essential, and it is vital to describe the criteria to stop the reopening process and implement the restrictions again. CONCLUSION: Providing evidence for policymaking about lifting the COVID-19 restrictions seems to be missed in the literature should be addressed more, and further studies are recommended.