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   Table of Contents - Current issue
October-December 2020
Volume 7 | Issue 4
Page Nos. 159-220

Online since Friday, November 27, 2020

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The strategies of the preventing induced demand for medicine prescription: A qualitative study p. 159
Azam Mohamadloo, Ali Ramezankhani
Aims: The purpose of the present qualitative study was to investigate strategies of preventing induced demand for medicine prescription through in-depth interviews with various stakeholders (physicians, pharmacists, faculty members, and patients). Materials and Methods: For data gathering, we used in-depth interviews with a purposive sample of 20 participants who were selected according to their experience. Interviews were transcribed, analyzed, and identified, and the key themes were named and coded with a sample of quotation. We used content analysis to analyze the interviews. All authors participated in the analysis process to avoid bias and receive an agreement. Results: In the process of data analysis, all the strategies of preventing induced demand for prescription of medicine were elicited from the data analysis and were classified into two themes: Health education program and stewardship in the health system with 12 categories and 37 subcategories. Some strategies include promoting pharmaceutics' health literacy; developing, implementing, and evaluating policies to prevent induced demand for prescription of medicine; reforming the education system and medical research; development of health information; reforming the health system structure; reforming the monitor and control system in the health system; observing patients' rights charter; and reforming the insurance companies. Conclusion: The present study provides evidence that confirms the induced demand is preventable. Hence, we recommend that stockholders consider the strategies to preventing induced demand for the prescription to prevent unnecessary prescriptions of medicines and the consequences.
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Biomedical waste management practices in health centers in Chandigarh, India p. 165
Meenu Kalia, Naveen Krishan Goel, Ravi Rohilla, Dinesh Walia, Navpreet Singh
Background: Any waste, which is generated during the diagnosis, treatment, or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biological products, is defined as biomedical waste (BMW). The World Health Organization states that 85% of hospital is nonhazardous. Ten percent of the remaining waste is infectious and 5% is noninfectious but hazardous wastes. Thus, about 15%–35% of hospital waste is regulated as infectious waste. Aim: The aim of this study is to assess the awareness, attitude, and practices of medical officers and paramedical workers regarding BMW management. Materials and Methods: The present study was conducted in the dispensaries of Chandigarh city. The study participants included the medical officers and paramedical health workers working in the public health set up. Results: The knowledge of medical officers and paramedical workers regarding needle stick injury was 84.3% and 73.3%, respectively. 31.2% of doctors and 36.7% of paramedical workers had received training for BMW management, whereas 65.6% of doctors and 66.7% of paramedical workers had received hepatitis B immunization. Gloves and mask were most common protective devices used among doctors (68.8% and 53.1%) and paramedical workers (68.9% and 33.3%), respectively. Handwashing facility was present in all centers (100%) in Chandigarh. Knowledge regarding the disposal of radioactive waste was poor among all levels of health-care workers (28.1% among medical officers and 5% paramedical workers). Conclusion: The gap exists between the knowledge and practices of segregation of BMW. The importance of training regarding BMW management needs to be emphasized. Training of paramedical workers should be held at regular intervals.
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Impact of titanium dioxide particles on adsorption properties of HZSM-5 zeolite for toluene treatment p. 170
Hasan Asilian Mahabadi, Maryam Farokhzad, Mohammad Sharif Hosseini, Elham Yahyaei, Razieh Janizadeh
Introduction: Today, a variety of catalysts were used for the removal of the volatile organic compound in work environments. Zeolites are frequently used as catalyst and catalyst base because of their desirable characteristics. HZSM-5 attracts the attention of air pollution researchers in recent years. The aim of this study is to investigate the adsorption properties of HZSM-5/titanium dioxide (TiO2) catalyst. Materials and Methods: A dynamic system was used for producing 42 ppm of toluene in 250C, 5% humidity, and environment pressure. For determination of adsorption capacity, 42 ppm of toluene with the flow of 0.5 L/min passed through the reactor containing 1 g of the HZSM-5/TiO2catalyst which was coated within 3%, 5%, and 8% of TiO2using impregnation method. For determination of the catalyst characteristics, different analyses of X-ray diffraction, Brunauer Emmett Teller (BET), Fourier transform infrared, and scanning electron microscope were used. Results: Adsorption capacity was 22.3, 23.81, 38.06, and 28.88 mg/g for HZSM-5, HZSM-5/Tio23%, HZSM-5/Tio25% and HZSM-5/Tio28%, respectively. The specific surface was 298.8 m2/g for HZSM-5 and 212.8, 189.3, and 185.1 m2/g for 3%, 5%, and 8% HZSM-5/TiO2catalyst, respectively. Results indicated that the breakthrough time increases by increasing in weight percent of TiO2. Adsorption isotherm was identified as type I, based on International Union of Pure and Applied Chemistry (IUPAC) classification. Conclusion: The integration of TiO2particles with HZSM-5 created a photocatalyst with desirable properties that include high adsorption capacity and long breakthrough time to maintain a high amount of toluene vapors, which lead to better removal efficiency.
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Baseline and post-intervention surveys of the prevalence of HIV in an African Rural population and women in the brothel p. 176
Ali Johnson Onoja, Felix Olaniyi Sanni, Paul Olaiya Abiodun, Imam Adamu, Sheila Onoja, John Shaibu
Backgrounds: HIV remains a major global public health challenge despite all efforts to end the endemic since the 1980s. This study is aimed to determine the baseline and postintervention HIV prevalence among female sex workers (FSW) and in the population of Bonny Island. Materials and Methods: The study is a quantitative study involving the general population of the Bonny Kingdom and the FSW in baseline and postintervention surveys. Blood samples were collected and tested for HIV. Data were analyzed with SPSS version 25. Results: A total of 1104 blood samples were tested for HIV in both surveys. The baseline HIV prevalence was 4.5% and 1.8% in the postintervention. The prevalence ratio of baseline/postintervention was 2.5 (confidence interval [CI] 1.2–5.8; P = 0.011). HIV prevalence was 4.5% in both males and females in the baseline survey as compared to 1.9% and 3.8% in postintervention. The HIV prevalence ratio in females was 3.8 (CI: 1.0–21.1, P = 0.025), but no significant difference was observed among males. Baseline HIV prevalence was 7.0 among age 25–34 years and 0.5% in postintervention with a prevalence ratio of 12.9 (CI: 2.0–54.9; P < 0.001). The highest prevalence in the baseline survey was observed among FSW (14.0%) and 1.2% in the postintervention with a prevalence ratio of 14.3 (CI: 2.2–60.3; P < 0.001). HIV prevalence was significantly higher among FSWs aged 25 or more, full time, had more than one client and have spent over a year in sex work (P < 0.05). Conclusion: The reduction in the prevalence of HIV seen at the postintervention survey could be attributed to the 3 years of interventions. However, the intervention programs should be sustained and ever scaled up to prevent, control of HIV.
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Dramatic changes in multiple sclerosis prevalence in Iran: A descriptive study in ten regions of Iran p. 182
Manizhe Pakdel, Anna Hedstrom, Nilufar Marufi, Elham Hooshmand, Ali Akbar Mohammadi, Reza Marashi, Neda Khosh Kholgh, Vahid Kazemi Moghaddam
Background and Objectives: The prevalence of multiple sclerosis (MS) differs between different regions of Iran. This study aimed to investigate changes in prevalence and incidence rates of MS in ten ethnic and cultural zones of Iran set by the Ministry of Health and Medical Education. Materials and Methods: Information on MS incidence and prevalence was obtained from the national registry of MS during the study period 2006–2013. Demographic data were acquired from the Statistical Centre of Iran. Results: A rising trend of MS prevalence was observed in Iran, and overall, the prevalence of MS increased by 3.67% per year. The highest prevalence rates of MS, and the most dramatic increase in MS prevalence, occurred in the central areas of Iran. However, during the 7-year period, the prevalence gradually increased also in southern and western areas. Conclusion: The prevalence and incidence of MS have been rapidly increasing in all regions of Iran, especially from central to western and southern regions.
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Cognitive functioning, self-esteem, and body image in breast cancer survivors p. 187
Shreya Manot, Susmita Halder
Context: Breast cancer is a chronic disease in which cells in breast tissue multiply uncontrolled, typically resulting in a lump. India has a predominant young population, and women in the age group of 30–50 being diagnosed with breast cancer is on the rise. Their survival rates are also rising, owing to the treatment regimens which commonly include chemotherapy. Breast cancer survivors have the challenge of dealing with side effects of treatment such as cognitive impairment, along with alterations in the appearance – breast asymmetry, changes in skin texture and sensitivity, impacting self-esteem and body image. Aim: The present study aims to explore the cognitive functioning, self esteem, and body image of women with a history of breast cancer. Settings and Design: The present study is a cross-sectional, comparative study conducted on breast cancer survivors in an urban area of Kolkata, who were selected using purposive sampling method. Subjects and Methods: A total of sixty females – thirty breast cancer survivors and thirty normal counterparts, aged 30–50 years, were included. Neuropsychological tests, Rosenberg Self Esteem Scale, and Body Image Scale were administered. Statistical Analysis: Descriptive and inferential statics were computed using SPSS 20 software. Results: The results of the study show the presence of significant difference between the two groups. Conclusion: Thus, with a rise in the number of breast cancer survivors, it becomes imperative to understand the negative impact of the various treatments and provide timely interventions, thereby ensuring better quality of life and adequate psychological and emotional support for them.
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Using the sisterhood method to determine the maternal mortality ratios in six local governments of Ondo State, Nigeria p. 192
Ali Johnson Onoja, Simon Peterside Onuche, Felix Olaniyi Sanni, Sheila Iye Onoja, Theophilus Umogbai, Paul Olaiya Abiodun, Shehu Busu Mohammed
Background: Maternal mortality is a major global health challenge and very common in sub-Saharan Africa and usually occurs due to complications during pregnancy and childbirth. This study aimed to determine the maternal mortality ratio (MMR) in six local government areas (LGAs) of Ondo State using the sisterhood method. Methodology: The study was a cross-sectional descriptive survey of women in the reproductive age group 15–49 years. Data related to maternal mortality were collected in March 2017 using the indirect sisterhood method. A structured questionnaire was used to collect data and was analyzed using IBM-SPSS version 25.0 software. Results: The average MMR in the 6 LGAs was 950 per 100,000 live births with a range of 584–1183 per 100,000 live births. Akoko South had the least MMR of 584 per 100,000 live births, Ondo West had 782 per 100,000 live births, Irele had 982 per 100,000 live births, Owo had 782 per 100,000 live births, Akure South had 1386 per 100,000 live births, and Ile-Oluji had the highest MMR of 1183 per 100,000 live births. The lifetime risk of dying a maternal death ranged from 0.03 to 0.07, with Ile-Oluji South having the highest risk. The greatest risk of dying a maternal death was found among adolescents and young adults aged 15–39 years with a peak at 20–24 years. Conclusion: This study found high MMR in Ondo State, with adolescents and young adults aged 15–39 years being at the highest risk. This calls for consistent interventions to minimize maternal deaths in the state and in Nigeria.
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Knowledge, attitude of health-care workers and effect on patients-seeking health-care services in Ado, Ekiti State, during coronavirus disease-2019 pandemic: A pilot cross-sectional survey p. 198
Mary Alaba Aderibigbe, Augustine Anayochukwu Onyeaghala, Emmanuella Ogechi Onyeaghala
Aims: This study was aimed to assess the knowledge of coronavirus disease-2019 (COVID-19) pandemic and document its effect on accessing health-care services among individuals living in Ado, Ekiti State, Nigeria. Materials and Methods: The study was a cross-sectional pilot survey. Respondents consisted of 100 randomly selected individuals of different socioeconomic, educational, and age groups. The questionnaire consisted of 10 questions. It was distributed online. The survey lasted from June 10 to 28, 2020. Results: Sixty percent (60%) of respondents were males and 40% females. Knowledge and belief that COVID-19 was real were high (94%). Fifty–seven percent (57%) of respondents had need for healthcare, but did not visit health-care facility (HCF), 17 (17%) visited and 26 (26%) had no need to visit. Of the 57 (57%) who did not visit HCF, they attributed it to various reasons-health care workers (HCW) would think they have COVID-19, 8 (19%); HCW would not be at the facility 16 (37%) and lockdown 19 (44%). The 12 (48%) who visited HCF reported that HCWs attended to them, 9 (36%) were neither attended to nor referred and 4 (16%) referred. Forty–six percent (46%) reported many have died at home due to inability to access HCF and others had varying opinions. Conclusion: This study has shown that knowledge and belief on COVID-19 among residents in Ado was high. However, limitation due to the lockdown could have great effects on access to health-care services and the disposition of HCWs to attend to those who may be in need of health care.
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Sexual schemas and high-risk sexual behaviors in female students: The mediating role of cognitive emotion regulation p. 203
Somayeh Zarea, Qasem Ahi, Shahram Vaziri, Fatemeh Shahabizadeh
Aims: The present study aimed to investigate the mediating role of cognitive emotion regulation (CER) strategies in the relationship between sexual schemas and high-risk sexual behaviors (HRSBs). Materials and Methods: In a descriptive-correlational study, a sample of 426 persons were selected from all female students at Islamic Azad University of Shiraz using random cluster sampling during 2018–2019. The research instruments were High-Risk Sexual Behavior Questionnaire, CER Questionnaire, and Sexual Self-Schema Scale. Data were analyzed using SPSS software and LISREL software using structural equation modeling. Results: The findings revealed that there is a significant relationship between sexual schemas with HRSBs and CER. Furthermore, there is a significant relationship between CER and HRSBs. The relationship between sexual schemas and HRSBs was mediated by CER. This model has a good fit for the data. Conclusions: The results indicate the mediating role of CER strategies in the relationship between sexual schemas and HRSBs. Therefore, it seems necessary for specialists, therapists, and planners to consider the role of these variables when working with students, especially in counseling and treatment centers.
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Workload and quality of working life in shift and nonshift workers of a water and wastewater contracting company in 2018 p. 210
Reza Yeganeh, Nastouh Khanjani Fashkhami, Zabiolah Damiri, Mehrdad Kamrani, Ali Asghar Khajevandi, Seyed Hojat Mousavi Kordmiri
Background: Workload is one of the most important factors leading to the occurrence of work-related injuries that can have impacts on quality of working life (QoWL). Therefore, the purpose of this study was to compare workload and QoWL in shift and nonshift workers of a water and wastewater contracting company. Materials and Methods: In this cross-sectional study, workload and QoWL for all workers of a water and wastewater contracting company were investigated. Fifty-one shift workers and 38 daytime workers completed NASA Task Load Index (TLX) as well as QoWL Scale by Van Laar et al. The data were analyzed by R software. Results: The results showed that physical demands of NASA-TLX in shift workers were higher than those in daytime ones. Among the dimensions of QoWL Scale, only the difference between the average scores for home–work interface was significant in a way that the conditions for the group of shift workers were more favorable. Conclusions: The results of this study showed that the volume of work and the quality of work in shift and nonshift workers are not significantly different and One reason is that the shift group had 12 hours more work and 24 hours more rest. The correlation between the dimensions of workload and QoWL demonstrated that increased workload would lead to a decline in QoWL.
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Dangerous driving behaviors among professional drivers of Kashan p. 215
Fahimeh Karamali, Hossein Akbari, Hamid Reza Saberi, Alireza Dehdashti, Mohammad Hossein Ziloochi, Mojtaba Behzadi, Masoud Motalebi Kashani
Aims: Underlying psychological causes of road accidents needs to be more identified in Iran. According to studies, human errors are the most effective factor of driving accidents. The purpose of this study was to identify dangerous driving behaviors among professional drivers in Kashan. Materials and Methods: Data for this descriptive cross-sectional study were collected in Occupational Medicine Center of Kashan, Truckers Cooperative, and Aran and Bidgol Kavir Steel Company during autumn 2017 and winter 2018. Demographic information and Driving Behavior Questionnaire were completed. Data were analyzed using Chi-square and one-way ANOVA tests by SPSS version 16. Results: Studied drivers included 61 (20.1%) bus, 95 (31.4%) truck, and 147 (48.5%) trailer drivers aged 43.15 ± 10.29 with 19.48 ± 11.34 years of driving experience. Fifty-nine drivers (19.5%) had at least one accident; of them, 10 (17%) resulted in death. Seventy-two drivers (23.7%) received up to 20 penalties. There was a significant relationship between type of vehicle and age, work experience, number of working days per week, average driving speed, and smoking. There was a statistically significant relationship between slip and accident (P = 0.007). Penalties in bus drivers were significantly related to mistake (P = 0.026) and slips (P = 0.027). There was a statistically significant relationship between penalty and risky violations (P = 0.002), slips (P = 0.002), highway violations (P = 0.003), mistake (P = 0.029), and general behavior (P = 0.001) in trailer drivers. Conclusion: Assessing driving behavior and screening procedures when selecting professional drivers can reduce the incidence of accidents.
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