Shiraz E-Medical Journal

In Collaboration with Health Policy Research Center, Shiraz University of Medical Sciences

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Shiraz e Medical Journal is an open-access monthly publication by the health policy research center at Shiraz University of Medical Sciences as an Organization. The journal publishes original research articles, review articles, meeting reports, mini-reviews, and letters on all aspects of health sciences with special emphasis on public health. A full list of the types of articles can be found in the Help menu of the journal.

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Now showing 1 - 20 of 1225
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    Quetiapine and Hyper Sexuality
    (Brieflands, 2025-03-31) Seyede Maryam Naghibi; Seyed Hamzeh Hosseini; Mahla Asheghhosseini
    Context: Sexual dysfunction is identified as a routine side effect following antipsychotic consumption; however, different medications present significant differences. Objectives: This study aimed to report a schizoaffective bipolar-type case of hypersexuality following quetiapine therapy and to systematically review the available instances of the association between hypersexuality and quetiapine. Methods: Cases of hypersexuality after taking quetiapine were searched without time restriction until November 16, 2022, under the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guideline. The terms "Compulsive sexual behavior", "Hypersexuality", "Sexual addiction", "Libido", "Compulsive sexual disorder", "Sexual compulsivity", "Hypersexual", and "Quetiapine" were searched in PubMed, Scopus, and ISI Web of Knowledge databases. All case reports and case series were included. Extracted data include authors, year, age, sex, underlying diseases, medication types, medication dose, the effect of medication, and treatment trends. Results: Alongside the present case in this study, six studies, including seven cases, reported the relationship between hypersexuality and quetiapine. Four hypersexual cases improved by adding quetiapine to their treatment panel. On the other hand, similar to the present case in this study, three cases indicated hypersexuality after quetiapine consumption; one of them was treated after 4 - 6 weeks without dosage change, and others achieved improvement following dosage reduction. Conclusions: Although some evidence reported improvement in hypersexuality following quetiapine consumption, an increased sexual drive has also been observed after taking quetiapine. These findings may present the dual role of quetiapine in sexual functioning, suggesting more attention to underlying disease, dosage, and medication interactions.
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    Phenomenology of Family Support in Gender Dysphoria
    (Brieflands, 2025-02-13) Fahime Akhlaghi Buzani; Zanireh Salimi; Reza Bidaki; Zohreh Mahdianpour
    Background: The present study aimed to investigate the phenomenology of family support in the experiences of transsexual individuals and to address gaps in understanding minority experiences in Iran. Methods: This qualitative study involved a statistical population of 15 individuals with gender dysphoria, nominated by the Tehran Institute of Psychiatry. Purposive sampling was employed to select participants of varying ages to achieve data saturation. Interviews were conducted, and the text was analyzed using Colaizzi's phenomenological analysis method. The research questions focused on significant life events and turning points, particularly the stage of gender reassignment surgery. Results: The categories extracted include: "Conditions that influence one's experience of being transsexual", "transsexuals influence on aspects of one's life", "one's experiences of transsexual phenomena", "one's reaction to perceiving one's transsexual", "a person's family reaction when they found out their child is transsexual", "a person's family's reaction to his or her gender change surgery", "family behavior and reaction after surgery", "a person's reaction to family behavior after surgery", and "one's action on surgery and the impact of that action on his or her family's attitudes". Conclusions: These extracted categories provide a framework to evaluate the future turning points in the lives of transsexual individuals, specifically focusing on gender reassignment surgery.
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    The Future of Children Oral Health: Key Trends in Pediatric Dentistry
    (Brieflands, 2025-02-15) Fatemeh Jahanimoghadam
    This article does not have an abstract.
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    Comparing the Effect of Stellate Ganglion Block and Gabapentin on the Post Mastectomy Pain Syndrome
    (Brieflands, 2008-04-01) H Hoseinzade; Ata Mahmoodpoor; D Agamohammadi; S Sanaie
    Background: The reported incidence of post mastectomy pain syndrome following surgery for breast cancer varies considerably with reports from as low as 4-6% to as high as 100%. This pain can be severe enough to interfere with sleep and performance of daily activities. Post mastectomy pain syndrome is a neuropathic pain condition that can follow surgical treatment for breast cancer. The purpose of this study is to evaluate the effect of stellate ganglion block with gabapentin on post mastectomy pain. Materials and Methods: Sixty patients referred from department of oncology and surgery to pain clinic were allocated to two groups. In group A stellate ganglion block was performed with 8ml bupivacaine 0.25%. In group B, patients were treated with gabapentin 900mg per day in three divided doses. Drug dose was increased if necessary until eight weeks. Pain score and quality of life were determined. Data were collected before treatment, 48 hours and every 15 days after treatment until three months. Results: Pain scores at 48 hours after treating were higher in group B than group A and lower at one week, one month and three months after treatment which were statically significant. (P Conclusion: In our study gabapentin was used as an ideal treatment technique for chronic pain following breast surgery.
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    Value of Core Needle Biopsy as the First Diagnostic Procedure in the Palpable Breast Masses
    (Brieflands, 2008-10-01) F Karimian; A Aminian; E Hashemi; AP Meysamie; R Mirsharifi; A Alibakhshi
    Background: Breast core needle biopsy (CNB) provides enough tissue for histopathologic diagnosis and is considered a reliable method for establishing preoperative tissue diagnosis. The purpose of this study is to evaluate CNB as the first diagnostic step instead of excisional biopsy in palpable breast masses. Materials and Methods: In this prospective study, patients with palpable breast mass who underwent CNB were enrolled. Based on pathology report, patients with malignant lesions revealed by CNB were immediately candidate for surgery and those who had benign lesions were followed up to 3 years. Results: 112 females with palpable breast mass were enrolled in the study. In 103 (91.9%) of cases first attempt CNB provided adequate sample tissue. CNB detected malignant lesion in seventy eight (69.6%) patients. All (100%) malignant CNB reports were confirmed at surgery specimen pathology. In 34 (30.4%) patients CNB revealed benign lesion. At the end of 3 years follow up period, 25 (73%) of these patients underwent open biopsy leading to the detection of 1 (3%) malignant tumor. Overall, according to the gold standard defined as positive surgical biopsy or positive follow-up, sensitivity of CNB was calculated as 98.7% (95% CI, 94.1-100%) and its accuracy was 99.1% (95% CI, 97.4-100%). The specificity of the CNB procedure was 100%. Conclusion: These findings suggest that the malignancy detection power provided by CNB may be weighed equal to that of open biopsy. Therefore, we propose CNB as the first choice in diagnostic evaluation of palpable breast mass especially for those in accessible sites and in experienced hands.
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    Stapled Hemorrhoidopexy, Initial Experience in Iran.
    (Brieflands, 2009-01-01) R Azizi; MM Danesh-Pageuh; L Zahedi-Shoolami
    Purpose:: we report initial experience of stapling hemorrhoidopexy in Iran. Methods:: Forty-nine patients with symptomatic hemorrhoids were treated in three medical centers; 29 with Procedure for Prolapse and Hemorrhoids (P.P.H) (Ethicon Endo-surgery), and 20 with Straightforward Trans Anal Mucohemorrhoidectomy (STRAM-kit) (Tyco Healthcare, Norwalk, US). Patients were prospectively evaluated for postoperative pain, anorectal functional status, morbidity and postoperative complications. The follow up period was at least 6 months. Results:: Forty-nine patients were evaluated. The mean age of the patients was 49.3 years. There were 23(46.9%) males and 26(53.1%) females. The median duration of symptom was 7.5 years. No mortality was reported. Urinary retention was the most common complication. Three patients had delayed bleeding. Postoperative pain was classified as painless, mild, moderate and severe. 39 cases (79.6%) had a mild to moderate pain relieved by an Acetaminophen tablet or NSAID. Thirty-six patients (73.5%) were fully satisfied with the operation result. All patients except one (99%) had returned to their normal functional life and their normal activity within 48 hours post-operation. Conclusion:: Stapled hemorrhoidopexy is a safe effective procedure with low complication, minimal postoperative pain and early recovery.
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    Health-Related Quality of Life in Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis Compared to the Healthy Population in Shiraz, Iran
    (Brieflands, 2017-03-01) Negar Darvish; Negin Hadi; Elham Aflaki; Khadijeh Salehi Rad; Ali Montazeri
    Background: Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are chronic and complex autoimmune diseases, involving multiple organs. Therefore, quality of life (QoL) in SLE and RA patients can be affected. The current study aimed to compare SLE and RA patients with the healthy population in terms of health-related QoL (HRQoL) in Shiraz, Iran. Methods: The present cross sectional, analytical study was performed on 100 SLE patients, 100 RA patients, and 200 healthy controls, who were referred to the rheumatology clinics (Motahari and Hafez clinics) of Shiraz University of Medical Sciences. Demographic data including age, gender, educational level, and disease duration were evaluated. The Persian-translated version of 36-item short-form health survey (SF-36) was used as a tool for evaluating HRQoL. For statistical analysis, Pearson’s correlation test, t-test, and ANOVA were performed, using SPSS. Results: Comparison of SLE and RA patients with healthy controls showed that the control group obtained higher scores in 8 subscales of SF-36 questionnaire. Based on the findings, RA patients had the lowest scores between the groups. Age and disease duration had a significant negative linear correlation with HRQoL, while educational level had a significant positive linear correlation with HRQoL. Nevertheless, there was no significant correlation between gender and HRQoL. Conclusions: HRQoL was lower in RA patients in comparison with the SLE group. In fact, RA patients, who suffered from body pain and disability, obtained lower scores in both physical and mental domains. Therefore, promoting the patients’ health literacy, as an empowerment strategy, plays a key role in improving HRQoL.
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    The Shiraz Adult Respiratory Disease Study, a Population-Based Survey: Rationale, Design and Methods
    (Brieflands, 2017-04-30) Seyed Masoom Masoompour; Hamideh Mahdaviazad; Seiyed Mohammad Ali Ghayumi; Mehrab Sayadi
    Background: Despite preventable and curable nature of chronic obstructive respiratory diseases (CORDs), these are still remains as a growing problem, both in developed and developing countries. One of the major reasons for this ignorance is lacking of precise information on the prevalence of CORDs and their major determinants. Objectives: This protocol study aimed at providing a population-based data for the prevalence of CORDs and exploring its socioeconomic determinants in adult population of Shiraz, Iran. Methods: This adult respiratory disease study was designed as a cross sectional survey among urban and suburban population of Shiraz, Iran, during August to December 2015. The local ethics committee of Shiraz University of Medical Sciences authorized the protocol, which adhered to the tenets of the declaration of Helsinki (1975). The study included more than 6,000 noninstitutionalized inhabitants older than 20 years, from the 9 municipal districts of Shiraz city. The sample consisted of 0.5% of the 1,219,237 total inhabitants in the survey area. The sample selection was based on the stratified random sampling method proportionate to the number of municipal districts and strata. After obtaining official permissions, trained interviewers visited the selected homes and completed the data collection form and main questionnaire. Following the completion of recruitment and an initial analysis process, we called and invited the participants with the COPD diagnosis score more than 19.5 to pass the spirometry test in the clinic. The main questionnaire that covered respiratory symptoms was developed from prior validated questionnaires that had been used in several studies. Data were analyzed using the SPSS software version 15.0 (SPSS Inc, Chicago, Illinois, USA). A P-value of less than 0.05 was considered as statistically significant. Results: In this protocol study, we shared our standard protocol considering perfect selection of the study samples and precise examination procedure with effective quality assurance strategies. Conclusions: We anticipate that future reports from the Shiraz adult respiratory disease study would estimate the prevalence of CORDs and their related determinants in the community. Moreover, it will identify patients who should be targeted by respiratory disease prevention programs.
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    Teaching Evidence-Based Medicine (EBM) to Undergraduate Medical Students through Flipped Classroom Approach
    (Brieflands, 2018-02-28) Mohammad Mahdi Sagheb; Mitra Amini; Mahboobeh Saber; Mohsen Moghadami; Parisa Nabiei; Roya Khalili; Rita Rezaee; Leila Bazrafcan; Ali Asghar Hayat
    Introduction: Medical students should be trained about the fundamental skills of evidence- based medicine (EBM) during undergraduate medical education curriculum. This article introduces an innovative model for initiation and development of a flipped classroom for teaching EBM to sixth- year undergraduate medical students in Shiraz Medical School, affiliated to Shiraz University of Medical Sciences. Methods: After conducting needs assessment and setting objectives for the program, blended leaning format and flipped classroom strategy were used. A student satisfaction measurement form was designed to evaluate the flipped classroom based on a 5-point Likert scale. The validity of the questionnaire was determined by experts, and the reliability of the questionnaire was 0.86 after a pilot study. We also used the questionnaires based on Berlin questionnaire to measure students’ knowledge, attitude, and practice about the EBM course in a pre- and posttest design. The validity and reliability of the questionnaire had been approved in our previous study. Also, the result of a summative examination after finishing the course was used as a measure of course goal achievement. Results: A total of 280 medical students on their sixth year of study participated in the flipped classroom in 6 different rotations. A total of 266 (95%) students passed the course and only 14 (%5) failed. The results of posttest scores based on the EBM domains revealed that the best result was obtained in teaching clinical questions’ format (patient, intervention, comparison, and outcome). The lowest posttest scores were in the domain of biostatistics. The overall quality of flipped classroom was reported well by the students. The students stated that the ability to apply knowledge and skills in managing patients were developed in this course. Discussions: In our experience, flipping classroom was a practical and essential activity to educate a large number of medical students about EBM. We acknowledge that the development of deep learning is instructors’ responsibility and that implementing blended learning and flipping classroom can facilitate students’ knowledge and skills about this important topic. We hope that other medical schools all over the world use the flipped classroom discussed in this article to redesign their classrooms in such a way that enables students to develop necessary skills and get involved in deep learning. This will improve the health of the society in the near future.
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    Teaching Evidence-Based Medicine (EBM) to Undergraduate Medical Students through Flipped Classroom Approach
    (Brieflands, 2018-02-28) Mohammad Mahdi Sagheb; Mitra Amini; Mahboobeh Saber; Mohsen Moghadami; Parisa Nabiei; Roya Khalili; Rita Rezaee; Leila Bazrafcan; Ali Asghar Hayat
    Introduction: Medical students should be trained about the fundamental skills of evidence- based medicine (EBM) during undergraduate medical education curriculum. This article introduces an innovative model for initiation and development of a flipped classroom for teaching EBM to sixth- year undergraduate medical students in Shiraz Medical School, affiliated to Shiraz University of Medical Sciences. Methods: After conducting needs assessment and setting objectives for the program, blended leaning format and flipped classroom strategy were used. A student satisfaction measurement form was designed to evaluate the flipped classroom based on a 5-point Likert scale. The validity of the questionnaire was determined by experts, and the reliability of the questionnaire was 0.86 after a pilot study. We also used the questionnaires based on Berlin questionnaire to measure students’ knowledge, attitude, and practice about the EBM course in a pre- and posttest design. The validity and reliability of the questionnaire had been approved in our previous study. Also, the result of a summative examination after finishing the course was used as a measure of course goal achievement. Results: A total of 280 medical students on their sixth year of study participated in the flipped classroom in 6 different rotations. A total of 266 (95%) students passed the course and only 14 (%5) failed. The results of posttest scores based on the EBM domains revealed that the best result was obtained in teaching clinical questions’ format (patient, intervention, comparison, and outcome). The lowest posttest scores were in the domain of biostatistics. The overall quality of flipped classroom was reported well by the students. The students stated that the ability to apply knowledge and skills in managing patients were developed in this course. Discussions: In our experience, flipping classroom was a practical and essential activity to educate a large number of medical students about EBM. We acknowledge that the development of deep learning is instructors’ responsibility and that implementing blended learning and flipping classroom can facilitate students’ knowledge and skills about this important topic. We hope that other medical schools all over the world use the flipped classroom discussed in this article to redesign their classrooms in such a way that enables students to develop necessary skills and get involved in deep learning. This will improve the health of the society in the near future.
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    Correlation Between Anxiety Disorders and Asthma Severity Indices in Asthmatic Children
    (Brieflands, 2023-06-30) Mahsa Rekabi; Parisa Honarpisheh; Mahboobeh Karimi-Galougahi; Vahab Rekabi; Maryam Vasheghani; Narges Eslami; Samin Sharafian; Hooman Sharifi; Alireza Mahdaviani; Mahboubeh Mansouri; Sasan Vasegh; Armin Shirvani; Paniz Pourpashang
    Background: Anxiety and depression in patients with asthma have been linked to frequent exacerbations, increased use of healthcare resources, and poor asthma control. Objectives: In the current study, we examined the correlations between asthma and symptoms of depression/anxiety in adolescents with asthma referred to Masih Daneshvari and Mofid hospitals during 2020 - 2021. Methods: The current observational, cross-sectional study was conducted by administering the Spence Children Anxiety Scale and a demographic information checklist among 105 subjects. Asthma severity was measured using forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity (FVC), the number of short-acting β-2 agonists used per week or month, the number of night awakenings per week or month, having asthma symptoms in daily activities, the number of asthma attacks needing oral corticosteroids per year, and the number of disease exacerbations per week or month. Data were analyzed, and the correlation between the variables was investigated through linear regression and ordinal logistic regression. Results: Patients with a mean age of 11.3 ± 2.5 years showed a mean overall anxiety score of 14 ± 9 out of 114. There was a significant negative correlation between the overall score of anxiety disorders and FEV1 and FEV1/FVC (P < 0.001). There was also a direct correlation between the overall score of anxiety disorders and the frequency of using β-2 agonists, the number of night awakenings, interference with normal functions, and exacerbation frequency (P < 0.001). Conclusions: Our findings indicated a significant association between anxiety disorders and asthma in children. Considering the high prevalence of asthma in Iran than the global average, studying the underlying mechanisms of anxiety and psychological and environmental variables in children with asthma can aid in developing effective psychological therapies.
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    The Impact of Radiofrequency Waves on Male Infertility: A Systematic Review
    (Brieflands, 2020-12-06) Leili Darvish; Azadeh Amraee; Marjan Akhavan Amjadi; Zahra Atarodi Kashani; Masoumeh Ghazanfarpour; Nasibeh Roozbeh; Fatemeh Abdi
    Context: As the use of cellphones and other electronic devices increases, concerns about the possible effect of radiofrequency waves on health are growing. Long-term use of the cellphone may have negative effects on sperm quality. Objectives: The purpose of this research was to examine men's infertility due to the effect of radiofrequency waves. Methods: In this systematic review, language restrictions were not considered in searching the databases. Cochrane Library, Google Scholar, PubMed, EMBASE, ProQuest, CINAHL, Science Direct, MEDLINE, and Scopus were used to obtain the data from them. All data were scanned from the year 2000 until 2019. Papers selected for retrieval were evaluated by the Newcastle-Ottawa and CONSORT scales. Results: A total of 14 articles that met the inclusion criteria were ultimately assessed. Motile sperm, sperm vitality and membrane integrity, morphology, volume, total sperm count, sperm concentration, and sperm fertility were found to be influenced by radiofrequency waves. Conclusions: The results showed that RF has detrimental effects on semen parameters and due to an increase in RF wave use currently and its role in male infertility, giving information to men about adverse complications of RF is necessary. Further studies are needed to design the less harmful devices.
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    A Constructive Blended Approach to Ethical Reasoning: The Impact on Medical Students’ Reflection and Learning
    (Brieflands, 2020-05-11) Leili Mosalanejad; Amir-Mohammad Ebrahimi; Mansour Tafvizi; Nahid Zarifsanaiey
    Background: Teaching medical ethics is currently one of the most essential parts of medical education. Objectives: The present study aimed to design a blended learning program based on a constructive approach to ethical reasoning and determine its effect on the students’ reflection and learning. Methods: This quasi-experimental, single-group, pretest-posttest study was conducted on 35 students who took the medical ethics course in a university of medical sciences. Case studies were presented to the students in a discussion forum, and the main concepts in question were then addressed through interactive lectures and group discussions. Data were collected using the Self-Reflection and Insight scale (SRIS) developed by Grant et al. to assess reflection, with 20 items in three domains. The students’ ethical reasoning was assessed using multiple-choice and open-ended questions and the Objective Structured Clinical examination (OSCE). The relationships between the tests were assessed by calculating the correlation between them. The results of the multiple-choice questions were compared with those of students in the previous year (with the same teacher and content), using the independent t-test. Results: Assessing the mean scores before and after the intervention showed a significant increase in the students’ reflection in all three domains, including the need for self-reflection, encouraging reflection, and insight after the intervention. The findings also showed a significant relationship between the students’ final scores and their virtual round and OSCE scores (P < 0.05). In the final theoretical test, the students’ mean scores were significantly higher than those of students in the previous year (P < 0.001). Conclusions: The proper use of technology with a blended learning approach can help improve the students’ quality of learning and reasoning.
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    Freeze-Dried Dentin Derivative Signal as a Factor for Differentiation of Human Dental Pulp Stem Cells: An In Vitro Study
    (Brieflands, 2024-10-31) Maryam Jalili Sadrabad; Hamid Reza Sameni; Sam Zarbakhsh; Raheb Ghorbani; Amin Naghipoor; Alireza Jarahi; Azra Mohiti
    Tissue engineering is an emerging field in dentistry, and stem cell research has shown promise in regenerating new tissue. The three essential components for tissue engineering are stem cells, scaffolds, and growth/differentiation factors. Numerous studies have been conducted in regenerative medicine, and more recently in regenerative dentistry, utilizing different signals. In a pioneering study, dentin derivative signal (DDS), which was self-administered, was used as a differentiation factor for dental pulp stem cells to promote dentinogenesis in vitro. The study demonstrated that DDS can stimulate dental pulp stem cells to differentiate into other dental tissues, such as dentin.
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    Six-Minute Walk Distance in a Healthy Middle-Aged Iranian Population
    (Brieflands, 2022-08-31) Mohammad Javad Fallahi; Behnam Ein-Mozaffari; Behnam Dalfardi
    Background: The predictive equation of the six-minute walk test designed for one population cannot reliably be used for another population. Despite introducing multiple prediction equations, there is no local such equation for our country, Iran, presently. Methods: In this cross-sectional study, we included 116 (65 males) healthy Iranian adult subjects to measure six-minute walk distance (6MWD), define influential factors, and formulate a native predictive equation. All the studied cases aged between 20 to 50 years old. We performed 6MWT according to the guideline of American Thoracic Society. Results: The mean value of 6MWD was 629.98 ± 81.38 meters, (ranged 421 to 729). On average, men walked 114.29 meters more than women that was statistically significant. Moreover, 6MWD had a direct correlation with subjects’ height (r = 0.627, P < 0.001); however, it had an inverse correlation with their age (r = -0.303, P < 0.001) and weight (r = -0.218, P = 0.019). Multiple regression equation derived this formula: 6MWD = 485.25 – (99.42 × sex male = 0, female = 1) + (2.791 × height cm) – (1.614 × weight) – (1.273 × age year), which explained 61% of variability. We observed that most other countries’ predictive equations could not be reliably applied to our population. Conclusions: In this study, we measured 6MWD in a healthy middle-aged Iranian population and proposed a native predictive equation, which might trigger further research and application of this simple and inexpensive test in our country.
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    Healthy Aging from the Perspective of Older Adults: A Descriptive Qualitative Study
    (Brieflands, 2024-02-29) Tayebeh Saki; Fatemeh Rashidi; Mehdi Mamene; Hamed Azadi; Arman Azadi
    Background: Healthy aging is an important concept developed by the World Health Organization with the aim of enhancing the health of older adults, highlighting the positive aspects of aging, and reinforcing their social roles. Objectives: Since the concept of healthy aging can be interpreted differently by older adults in various societies, this study aimed to explore the perspectives of Iranian older adults regarding healthy aging. Methods: A qualitative descriptive design and content analysis was employed to gather data from 15 purposively selected community-dwelling older adults aged over 60 years in Ilam and Khuzestan provinces, Iran. Semi-structured interviews were conducted and analyzed following Graneheim and Lundman's (2004) content analysis guide. Results: Five main themes and 16 subthemes emerged. These 5 main themes include social participation, mental health, a healthy lifestyle, maintenance of functional ability, and adequacy of economic status. Conclusions: Based on the results, healthy aging is a multidimensional concept. It is recommended that health policy-makers and providers of elderly healthcare services take these factors into account when planning and delivering services aimed at promoting the health of older adults.
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    The Pattern of Medication Use Amongst a Migrant Population Residing in Southern Iran: A Population-Based Study
    (Brieflands, 2021-04-30) Marziyeh Zare; Saba Afifi; Iman Karimzadeh; Mohammad Salehi-Marzijarani; Leila Zarei; Kamran Bagheri Lankarani; Alimohammad Sabzghabaee; Mahtabalsadat Mirjalili; Fariba Ahmadizar; Payam Peymani
    Background: Iran has welcomed a large population of immigrants and refugees, which has led to new demands and priorities in many aspects of life, such as healthcare services. Objectives: For the first time in Southern Iran, in Shiraz City, population-based research was conducted on the patterns of medication use in native non-Iranian residents. Methods: The present cross-sectional study was conducted amongst Shiraz citizens from 2017 to 2018. The population consisted of 43 migrants. Data were collected using a multipart data form. All statistical analyses were performed using SPSS. Results: A total of 43 Afghan migrants were included in the study. Most of them were female (72.1%), aged under 40 years (67.4%), and homemaker (62.8%) with an education level of non-completed high school diploma (97.7%). The majority of the subjects did not have insurance or family physician coverage (93%), and 85.7% got medications without prescription. The three most common medications used by the subjects were iron supplements, acetaminophen, and cold medicines. Conclusions: Iran is now hosting Afghan nationals as one of the largest population of refugees in the world. The health conditions of the Afghan population need more attention in order to improve the health status of their community in Iran.
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    The Correlation Between Self-Expression and High-Risk Behaviors in Students
    (Brieflands, 2024-10-31) Forugh Aleebrahim; Saeed Soleimani; Mohammad Javad Tarrahi
    Background: The increase in high-risk behaviors (HRBs) is recognized as a serious threat to the health of societies. Self-expression is one of the social skills that can have a positive effect on controlling some risky behaviors. Objectives: This study aimed to investigate the correlation between self-expression and HRBs among newly arrived students at Isfahan University of Medical Sciences. Methods: In this cross-sectional study, 402 students (166 males and 236 females) were recruited from Isfahan University of Medical Sciences in 2020. They were selected using a multi-stage random sample and answered questions from the self-expression questionnaire and the high-risk behavior questionnaire. Various statistical indicators were utilized, such as mean, standard deviation (SD), t-test for comparison between the two gender groups, ANOVA for the mean difference between three age groups, and a Pearson correlation matrix to examine the correlations between all components of HRBs. Additionally, the Pearson test and regression analysis were employed. Results: A significant negative correlation was found between the self-expression score and HRBs (r = -0.56, P < 0.001). The mean score of HRBs was 15.33 ± 18.047. The mean score of self-expressions in male students was significantly lower than that of female students (74.51 ± 16.33 vs. 80.36 ± 14.30). The most common HRBs were related to smoking, hookah use (mean = 7.53 ± 8.75), and suicidal ideation (mean = 3.11 ± 3.93). Conclusions: It accentuates the significance of incorporating self-expression interventions in educational and health programs to foster healthier behaviors and promote mental health among this vulnerable population. Further research is warranted to explore additional factors influencing the link between self-expression and HRBs among university students.
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    Health Policy-Making Requirements to Attain Universal Health Coverage in the Middle-Income Countries: A Brief Report
    (Brieflands, 2018-10-31) Hassan Joulaei; Mohammadreza Heydari
    Background: The middle-income countries (MICs) target universal health coverage through varieties of policies. However, they face many struggles such as socio-economic and political problems along with flawed policy-making process. Objectives: The current study aimed at presenting a very brief situational analysis of the health policy making and its outcomes in the MICs and accordingly some strategic suggestions to improve this process. Methods: The current brief review study was conducted on the existing evidence on challenges of health policy-making in MICs and its combating solutions. To search literatures, an unlimited time review was conducted in medical databases with predefined keywords. To classify the barriers and their solutions, the current study employed the World Health Organization (WHO) health systems framework; i.e. six building blocks. Results: Reviewing literatures conducted the researchers to the main challenges of health policy-making process in the MICs including poor governance, imperfect health information system, weak resource management, piecemeal plan instead of inclusive national plan, low efficiency, and equitable outcome of their public policies. Conclusions: To improve health policy-making process in MICs, a wide variety of strategies is applicable. These strategies are: (1) Replacing passive problem-solving approach with an active informed-policy making; (2) Preparing a master plan based on sustainability and reality, prediction power of the future events, and active participation of all stakeholders; (3) establishing a health system with focus on primary health care, service leveling, referral system, and integrated and quality care; (4) Effective health interventions, reducing corruption, managed use of private beside the public sector, and improvement of their contracting systems, equitable distribution of all resources, and establishing and/or strengthening health technology assessment (HTA) Committee; (5) Reinforcing the role of governance to control health market, community involvement, and mandatory health attachment to all policies.