Socioeconomic inequality in violent behaviors, life dissatisfaction, and self-rated health in pediatric population: the CASPIAN-V study.

BACKGROUND: Bullying, being a victim of violent behaviors, life satisfaction (LS) and self-rated health (SRH) in children and adolescents, all have consistently been recognized as vital factors in school performance and future individual life. METHODS: This cross-sectional data secondary study was a part of the fifth Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease (CASPIAN-V) in 2015. A total of 14,400 students 7-18 years and their parents living in 30 provinces in Iran were studied. A validated questionnaire of the World Health Organization on Global School-based Health Survey (WHO-GSHS) was used to measure the outcomes and socioeconomic variables. Family's socioeconomic status (SES) was determined using principal component analysis (PCA). The crude and adjusted odds ratios (95% confidence interval (CI)) were estimated using multiple logistic regressions for each outcome. RESULTS: A total of 14,274 students completed the study, of whom 50.6% were boys. Overall, the prevalence of bullying, being a victim, life dissatisfaction (LDS), and poor SRH among students was 35.6, 21.4, 21.1, and 19.0%, respectively. In multiple-logistic regression analysis (Adjusted OR, (95%CI), students with an illiterate father and mother (1.60, (1.25-2.04), 1.28, (1.03-1.61), unemployed father (1.58, (1.29-1.81)), and one-parent family (1.32, (1.05 - 1.64) had a higher odd of Poor-SRH. Besides, a family size larger than four members (1.14, (1.03-1.25), and low-SES (1.35, (1.15-1.56), and illiteracy of the mother (1.64, (1.30-2.08) had a direct association with LDS. Mother illiteracy also increased the odds of bullying (1.77, (1.45-2.16) and being a victim (1.58, (1.26-1.98). CONCLUSIONS: Some socioeconomic variables can be proposed as the statistically significant attribution of bullying and being a victim, LDS, and Poor-SRH in children and adolescents.

Early childhood development in Iran and its provinces: Inequality versus average.

BACKGROUND: Early childhood development is influenced by family socioeconomic status in such a way that socioeconomic deprivation might be accompanied with adverse outcomes in early development of a child. This study aimed to assess early childhood development based on average and also based on the distribution of socioeconomic inequality in Iran and its provinces. METHODS: Using data from provincially representative Multiple Indicator Demographic and Health Survey (2010), we developed a suitable latent class approach to construct a proxy of socioeconomic status. A composite index of early childhood development was used. We assessed inequality in early childhood development using the concentration index method. RESULTS: At province level (n = 30), the highest and lowest averages of early childhood development were 13.60 (SD = 2.99) and 5.81 (SD = 3.29), respectively. Concentration indices indicated pro-rich inequality in early childhood development at national and provincial level. The concentration index of early childhood development was 0.087 (95% CI = 0.085-0.0098) in Iran. Moreover, the consistent positive values of the concentration indices revealed that early childhood development inequality favored best-off children in all provinces. However, early childhood development was disproportionally distributed among provinces and rated 0.016 to 0.149. CONCLUSIONS: Iranian children in more prosperous households reported higher early childhood development compared with those in poor households at national and provincial level. It is vital to consider inequality in addition to average level of childhood development across Iranian provinces to reach a more comprehensive understanding of childhood development for public policy action in the country.

Assessment of women's empowerment: An exploratory study to develop a valid and reliable Persian-version tool.

Lack of a valid and reliable women's empowerment tool was reported by previous studies in Iran. The authors of this paper, accordingly, intended to fill this gap by developing a valid questionnaire. 600 women in Dezful city, southeast of Iran, took part in the study in 2014-2015. Multistage sampling method was used to recruit the participants. Our exploratory factor analysis revealed that 18 items of the model loaded on 4 factors. Internal consistency of the questionnaire was suitable as Cronbach's alpha coefficient was 0.77. Considering high validity and shortness of the questionnaire, it can be used as a trustful and comprehensive tool to measure women's empowerment in future studies.

Content analysis of family physician plan using social marketing approach: Qualitative- document analysis.

BACKGROUND: The family physician plan formed at the heart of the health system can play a vital role in the results and the optimal cost of resources. Social marketing is a process that uses the basics and principles of commercial marketing in the field of health to develop and implement a health plan. This study seeks to analyze the documents related to the program from the perspective of social marketing components. MATERIALS AND METHODS: This qualitative document analysis study was conducted in 2021 by reviewing the documents and content of the texts related to family physician plan. The obtained data were analyzed by the directed content analysis method after extraction and collection. RESULTS: The results showed the identification of social marketing components in the family physician plan. However, the two most essential parts of "insight" and "behavior theory," which address the underlying issues in an intervention, were not found in the analyzed documents and texts. CONCLUSION: It is necessary to use a coherent and appropriate approach to revise and develop the family physician plan. To resolve the current challenges and problems of the family physician plan, the application of components and the social marketing approach that addresses all the required aspects of a health plan is a suitable model and approach.

Challenges of patient handover process in healthcare services: A systematic review.

BACKGROUND: The patient handover process is in fact a valuable and essential part of the care processes in the hospitals. This can be a factor in increasing the quality and effectiveness of medical care. Incorrect and incomplete handover can increase the percentage of errors and cause serious problems for patients. The aim of this study was to identify the handover challenges concerning safety and quality of health services. MATERIALS AND METHODS: A systematic review was conducted according to the Preferred Reporting Item for Systematic Reviews and Meta-analyses guideline. The key words "challenges of patient handover" or "challenges of patient handoff" were used in combination with the Boolean operators OR and AND. The ProQuest, Ovid, Doaj, Magiran, SID, Scopus, Science Direct, PubMed, and ISI were searched. RESULTS: A total of 263 articles were extracted, and 20 articles were selected for final review. The results of selected articles indicated that there are various challenges such as communication, noncoordination, nonuse of checklist, poor management, time management, and other things. These studies reported that communication was the main challenge of handover process. CONCLUSIONS: Hospitals try to provide a lot of services to the patients and other customers in a safe and healthy environment. Lack of communication among the incoming and outgoing nurses in handover process is one of the main causes of reduced safety and quality of services and patient dissatisfaction.

Decomposition of passive smoking inequality in Iranian children and adolescents: the CASPIAN-V Study.

To investigate the socioeconomic inequality in passive smoking in Iranian children and adolescents. Through a multistage random cluster sampling method, a representative sample of 14,400 school students, aged 6-18 years, were enrolled from urban and rural areas of 30 provinces of Iran. Using a non-linear principal component analysis (NLPCA), the correlated variables were summarized as socioeconomic status (SES). Normalized concentration index (NCI) was used to measure inequality in passive smoking at national and regional SES levels. We decomposed total socioeconomic inequality in passive smoking into explanatory variables to identify the main contributors of inequality in passive smoking in the population studied. Data of 12,327 students and parents were complete for the current study. The response rate was 85.6% (50.9% boys, 71.2% urban residents). About 44% of Iranian students were exposed to passive smoking. The NCI for passive smoking at a national level was - 0.043 (95% confidence interval - 0.035, - 0.012), indicating that passive smoking was more concentrated among poorer children and adolescents. This inequality was statistically significant at a national level and in all regions except for regions with lower middle- and lowest SES levels. Considering the decomposition analysis, the household SES (63%), mothers' educational level (37%), fathers' educational level (29%), and school type (18%) made the largest positive contribution to inequality in passive smoking of children and adolescents. Passive smoking was distributed unequally among Iranian children and adolescents; it was more concentrated among socioeconomically disadvantaged families. Public health policies attentions should be given to reduce passive smoking among low SES children and adolescents living with illiterate or low-educated parents.

Socioeconomic determinants of health-care and emotional needs among Iranian older adults in Isfahan.

INTRODUCTION: The main aim of this study was to explore the socioeconomic determinants of health-care and emotional needs among older adults. MATERIALS AND METHODS: In this cross-sectional study, 350 older adults were randomly selected from five geographical regions in Isfahan, 2016. A self-administered checklist was employed to collect health-care and emotional need data among older adults residing day-care centers. Data were analyzed using logistic regression through STATA/SE (version 14). RESULTS: The highest proportion of older adults lived with income 285-855 USD monthly and insured by social security insurance. Illiteracy, loneliness, and low level of income were more prevalent among female older adults than male ones. The emotional needs of single/widow (odds ratio [OR] = 0.299), divorced (OR = 0.133) older people, not having children (OR = 0.811) or grandchildren (OR = 0.684), and illiterates (OR = 0.689) were discovered to be lower than their counterpart groups. As the elderly got older, their health-care needs were met more. Older adults covered by military insurance have their health-care needs met as much as 21% (OR = 1.215) greater than social security insurance. CONCLUSIONS: Regarding health-care needs, economic and monetary factors are still important in meeting this type of needs as well as education and social insurance. While regarding emotional needs, nonmonetary and noneconomic factors, including social network, are important determinants for the satisfaction of emotional needs.

Irritable bowel syndrome is concentrated in people with higher educations in Iran: an inequality analysis.

OBJECTIVES: Like any other health-related disorder, irritable bowel syndrome (IBS) has a differential distribution with respect to socioeconomic factors. This study aimed to estimate and decompose educational inequalities in the prevalence of IBS. METHODS: Sampling was performed using a multi-stage random cluster sampling approach. The data of 1,850 residents of Kish Island aged 15 years or older were included, and the determinants of IBS were identified using a generalized estimating equation regression model. The concentration index of educational inequality in cases of IBS was estimated and decomposed as the specific inequality index. RESULTS: The prevalence of IBS in this study was 21.57% (95% confidence interval [CI], 19.69 to 23.44%). The concentration index of IBS was 0.20 (95% CI, 0.14 to 0.26). A multivariable regression model revealed that age, sex, level of education, marital status, anxiety, and poor general health were significant determinants of IBS. In the decomposition analysis, level of education (89.91%), age (-11.99%), and marital status (9.11%) were the three main contributors to IBS inequality. Anxiety and poor general health were the next two contributors to IBS inequality, and were responsible for more than 12% of the total observed inequality. CONCLUSIONS: The main contributors of IBS inequality were education level, age, and marital status. Given the high percentage of anxious individuals among highly educated, young, single, and divorced people, we can conclude that all contributors to IBS inequality may be partially influenced by psychological factors. Therefore, programs that promote the development of mental health to alleviate the abovementioned inequality in this population are highly warranted.