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Background: Health services utilization, as one of the mechanisms of the health system, guarantees a healthy life and improves well-being for everyone. Aims: The aim of this study was to identify factors affecting the use of outpatient health services among women. Methods/designs: This scoping review examined the studies related to outpatient health services utilization (OHSU) and its determinants among women. This review was conducted on English language studies published between 2010 and 2023 (All searches were conducted on 20 January 2023). Studies available in databases such as Web of Science, MEDLINE (PubMed), Scopus, Wiley library, Proquest, and Google Scholar were searched manually. Selected keywords and their equivalents were used to search for related articles in each database. Results: A total of 18 795 articles were identified, of which 37 met the inclusion criteria. Findings showed that age, marital status, level of education, employment status, income level, socioeconomic status, rape experience, health insurance, health status, ethnicity, living in rural areas, quality of services, area of residence, having a purpose in life and access to health services affect OHSU among women. Conclusions: The results of the present review showed that in order to achieve the universal goals of health services coverage and health service utilization, it is necessary for countries to provide insurance coverage to the maximum number of people. Also, policies should change in favor of the elderly, poor and low-income, low-educated, rural, ethnic minority, and chronically ill women and provide them with free preventive health services.

The present study aimed to investigate the effect of social determinants and socio-demographic factors on driving among older adults living in Tehran, Iran. This cross-sectional study was conducted on 1280 older adults in Tehran in 2020. The participants were randomly selected from people aged 60 years and above. Data were collected using a questionnaire. Multiple logistic regression was employed to estimate the effects of socio-demographic characteristics on driving status among older persons. Data analysis was performed by SPSS 23.0. The driving among older adults was found to be 33.3% while it was 70.6% among the older adults with a driver's license. There was a significant relationship between internet use, gender, health status, education level, loneliness and driving status (p

The present study aimed to determine the association between drug type, risk behaviors and non-fatal overdose among people who use drugs (PWUD). We searched for studies in English published before February 1, 2021, on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on the factors associated with non-fatal overdose among PWUD. After reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes (PICO) criteria. After a detailed assessment of over 13,845 articles, a total of 49 studies met the eligibility criteria. We found that non-injection opioid use, heroin injection, cocaine use, concurrent use of buprenorphine and benzodiazepines, benzodiazepine use, incarceration, injecting drugs, and duration of injecting were associated with greater odds of non-fatal overdose among PWUD. The findings of the current meta-analysis support the requirement to improve suitable harm reduction strategies for drug users, such as peer-based overdose management, and further focusing on the need to balance the current emphasis on enforcement-based responses to illegal drug use with health-related interventions.

There is scattered evidence of the impact of workplace interventions in improving employees' physical activity. This systematic review was performed to evaluate the strategies of workplace interventions and their effectiveness, as reported in primary studies.Primary experimental trials, both randomized controlled trials (RCTs) and non-RCTs, which examined interventions to increase healthy adult employees' physical activity were included in this review. Studies in English or Persian published between 2009 and 2019 with access to full text of resources were considered. Google Scholar, PubMed, Web of Science, Scopus and Cochrane Library, ProQuest (Thesis) and World Health Organization Clinical Trial Registration Databases and Persian databases such as SID, Magiran, IranMedex, Irandoc were searched. All the stages of review were conducted based on PRISMA. RoB and ROBINS-I were used to assess the risk of bias of the primary studies.Thirty-nine studies, with a total of 18 494 participants, met the inclusion criteria. Of these, 22 were RCTs, 17 were non-RCTs. Effective interventions were reported in 15 RCTs and 14 non-RCTs. Four main strategies of interventions were identified, consisting of motivation and support; monitoring and feedback; information and education; and activity. Thirteen different behavior change techniques (BCT) were identified with self-determination theory (SDT) being the most frequent behavior change theory used.It seems that a multi-strategy intervention that one of the strategies of which is physical activity in the workplace (Activity), the use of behavioral change theories, especially SDT, may be indicative of a more effective intervention. It is recommended that BCTs be considered when designing physical activity interventions.

We assessed the prevalence, sociodemographic variables, mental health condition, and type of drug use associated with suicide behaviors among patients with substance use disorders (SUD). Studies in English published from January 1, 1995 to December 31, 2020 were searched on PubMed, Scopus, Cochrane and Web of Science to identify studies on variables associated with suicidal behaviors (ideations and attempts) among patients with SUD. After reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes (PICO) criteria: (i) population: patients with SUD; (ii) intervention: suicide behaviors in the past year; (iii) comparator: SUD who had not suicide behaviors; (iv) outcome: suicide ideations or attempts in the last year; and (v) study type: cross-sectional, cohort, and case-control studies. Out of 10,810 articles, 48 studies met eligibility criteria. Our findings showed a pooled prevalence rate of suicide ideations of 35% (95% CI, 22% 48%) and suicide attempts of 20% (95% CI, 17% 23%) in the last year among patients with SUD. Smoking, previous history of sexual abuse, depression, and alcohol and cannabis use disorders were significantly associated with suicide ideations. Study findings also showed that being female, smoking, history of physical and sexual abuse, depression and alcohol, cannabis, cocaine, amphetamine use disorders, and polysubstance abuse were significantly associated with suicide attempts among patients with SUD. These findings have implications for developing prevention programs. Appropriate initiatives for reducing the risk of suicide behaviors like systematic assessments of changes in drug use pattern at the emergency departments or at other key health providers may be more broadly implemented. Motivational therapy to improve help-seeking, increased information on adverse consequences of heavy substance use, and crisis plan resolutions to face suicide behaviors could also be consolidated.

Background: Sexually transmitted infections are one of the most important public health problems and have serious consequences for female sex worker. The aim of this study was to investigate the prevalence of STIs among sex workers and to identify high-risk behaviors affecting STIs.Methods: In this cross-sectional study, 898 women sex workers were studied in 21 provinces of Iran from October 2016 to March 2017. The required information was collected through self-report and completing a questionnaire. Simple and multiple logistic regression was used with 95% significance level. To identify risk factors for sexually transmitted diseases.Results: The prevalence of STIs was 41.8%. Multiple logistic regression results showed that the odds of getting STIs in FSW over the age of 35was 5.6 times higher than FSWs 18-24 years (AOR = 5.65, 95% CI: 1.035, 30.90), and the odds of getting STIs in FSWs with imprisonment was 3 times higher in FSW without imprisonment (AOR = 3.00, 95% CI: 1.04, 8.62), Also odds of getting STIs in FSWs who used injectable drugs was 17.2 times higher in FSW who did not take injectable drugs (AOR = 17.21, 95% CI: 2.54, 116.59). But self-perceived risk of HIV was borderline (AOR = 3.81, 95% CI: 0.97, 14.93),Conclusion: The findings of this study can provide evidence for designing and implementing for risk reduction interventions for FSWs.

Objectives: Increasing care needs for the elderly are an important concern for different countries, especially those with an aging population. It is important for health policy making to have knowledge of the factors affecting the use of health services in the elderly to identify the potential problems and develop appropriate interventions for improving utilization and increasing access to health services. This study aims to investigate the barriers and facilitators of the outpatient health service use in the elderly Methods & Materials: In this systematic review, studies in English published from 1996 to 2019 were searched in Web of Science, PubMed and Scopus databases using PRISMA guidelines and related keywords. After eliminating duplicate and irrelevant articles, the quality of remaining articles was evaluated by two evaluators independently, based on STROBE checklist. Narrative synthesis method was used to combine the data Results: Forty-four eligible studies were included for the review. The determinants of the health service use were divided into three categories of predisposing factors (e.g. age, gender, marital status, ethnicity), enabling factors (e.g. income, insurance coverage, education level, employment status, social network, social support), and need factors (e.g. having chronic disease, self-assessed health status, severity of disease, number of diseases, comorbid diseases, physical disability, unhealthy lifestyle). Findings showed that age >80 years, ethnic minority, being unemployed and retired, low educational level, small and limited social network, and physical disability were the barriers to using outpatient health services, while being female, married, having insurance, social support, having a companion during a disease, having children, high income level, and shorter distance to the health care centers were the facilitators of using outpatient health services in the elderly Conclusion: A group of factors are associated with the outpatient health service use by the elderly. These factors include predisposing, enabling, and need-related factors according to Andersen’s behavioral model of health service use. Interventions to increase the use of health services by the elderly should be based on these factors, and should be taken into account by the policymakers to reduce the burden of health services caused by diseases.

Background: Substance use is one of the most important health problems in the world, few studies have looked at the social determinants of substance use. Therefore, the purpose of this study was to...

Background Vaccination is a key intervention to prevent COVID-19. Many vaccines are administered globally, yet there is not much evidence regarding their safety and adverse effects. Iran also faces this challenge, especially as data regarding the Sputnik V vaccine is sparse. Therefore, the aim of this study is to determine the adverse effects of the most commonly used vaccines in Iran. Methods Using a retrospective cohort study design, 6600 subjects aged 18 years or older who had received two doses of any of the three COVID-19 vaccines (Sinopharm, AstraZeneca, and Sputnik V) were selected using a random sampling method between March and August 2021. Subjects were asked about any adverse effects of the vaccines by trained interviewers via telephone interview. Vaccine-related adverse effects in individuals during the first 72 h and subsequently following both doses of the vaccines were determined. The demographic variables, type of administered vaccine, adverse effects, and history of the previous infection with COVID-19 were collected. Descriptive statistics (mean, standard deviation) and analytical statistics (Chi-squared and Wilcoxon tests) were performed at a 95% significance level using STATA software version 15 (STATA Corp, College Station, TX, USA). Results From 6600 participants, 4775 responded (response rate = 72.3%). Of the participants, 1460 (30.6%) received the AstraZeneca vaccine, 1564 (32.8%) received the Sinopharm vaccine and 1751 (36.7%) received the Sputnik V vaccine. 2653 participants (55.56%) reported adverse effects after the first dose and 1704 (35.7%) after the second dose. Sputnik V caused the most adverse effects with 1449 (82.7%) vaccine recipients reporting symptoms after the first or second dose, compared with 1030 (70.5%) for AstraZeneca and only 585 (37.4%) for the Sinopharm vaccine. The most common adverse effects after the first dose were fatigue (28.37%), chill/fever (26.86%), and skeletal pain (22.38%). These three adverse effects were the same for the second dose, although their prevalence was lower. Conclusions In this study, we demonstrate that the Sputnik V vaccine has the highest rate of adverse effects, followed by the AstraZeneca and Sinopharm vaccines. COVID-19 vaccines used in Iran are safe and there were no reports of serious adverse effects.

Background: Injection of drugs is one of the most serious health problems among Iranian living with HIV/AIDS. The injection of drugs, accounting for the transmission of more than two-thirds of HIV infections. HIV remains a major concern around the world and is expected to be the third leading cause of mortality worldwide. Thus, the aim of this study was to explore the predictors of injection drug use in the elderly patients living with HIV/AIDS. Methods: This was a cross-sectional study executed in Tehran City, Iran, in 2018. A total of 160 individuals aged 60 years and older with HIV from different counseling centers were selected by convenience sampling. Data were collected using questionnaires including a positive state of mind, coping, social support, and a checklist of demographical variables. Bivariate analysis and multiple logistic regression using SPSS software version 21.0 were employed to determine factors associated with drug injection. The statistical tests were performed with a significance level of 5% (p≥0.05). Results: The study participants’ mean(SD) age was 65.6(±6.6) years. In total, 33 people (20.6%) of the samples reported injection drug use. The frequency of injection drug use was greater among men (AOR: 2.28, 95% CI 2.2-22.8; p=0.010), those reporting a monthly income of ≥30000000 Rials (AOR: 31.56, 95% CI 2.95-338; p=0.004), subjects with past experience of drug use (AOR: 7.11, 95% CI 2.18-23.2; p=0.001), those with ≥2 years past from their HIV diagnosis (AOR: 4.04, 95% CI 1.12-14.58; p=0.033), and those living with more than two people in one residential place (Household size AOR: 5.9, 95% CI 1.64-21.24; p=0.007). Conclusion: It seems that the design and implementation of harm reduction programs among the elderly with HIV/AIDS who inject drugs are essential and should be considered as an agenda of policymakers and health professionals.

Background: The human life value is among the most important challenges of the health economic evaluation. This limitation has reduced the feasibility of applying the cost-benefit method in evaluations of health interventions and policies. Using the human capital approach and discounted value of future earnings, the present study calculated the human capital of different age groups. Methods: The required data were obtained using “income and expenditures of Iranian households” data in 2015 from the Statistical Center of Iran, which included the information on 19380 urban households. Results: According to the calculation of human capital, the maximum value of a statistical life year in the highincome group was related to the age group of 30-34 yr old (223,286 US$ equals to 9378 million Iranian Rials). The lowest value in all three groups of high, medium and low income is related to the age group of 85 and older. In addition, the economic value of statistical life year for men has been calculated as higher than that of women, however, in older age groups, the human capital of both genders have been converging. Conclusion: The economic value of life for young people aged between 20 to 30 yr was higher than other demographic groups. The findings of the research help to provide a more accurate base for the cost-benefit analysis of health and social policies. Considering the economic value of the statistical life for different age groups may change policy priorities in areas related to health and life of human beings.