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BACKGROUND: The importance of data quality whether in collection, analysis or presenting stage is a tangible and undeniable scientific fact and the main objects of researches implementation. Objective: This paper aims at explaining the main problems of the Iranian scientific papers for providing better data in the field of national and sub-national prevalence, incidence estimates and trends of obesity and overweight. METHODS: To assess and evaluate papers, we systematically followed an approved standard protocol. Retrieval of studies was performed through Thomson Reuters Web of Science, PubMed, and Scopus, as well as Iranian databases including Irandoc, Scientific Information Database (SID), and IranMedex. Using GBD (Global Burden of Diseases) validated quality assessment forms to assess the quality and availability of data in papers, we considered the following four main domains: a) Quality of studies, b) Quality report of the results, c) Responsiveness of corresponding authors, and d) Diversity in study settings. RESULTS: We retrieved 3,253 records; of these 1,875 were from international and 1378 from national databases. After refining steps, 129 (3.97%) papers remained related to our study domain. More than 51% of relevant papers were excluded because of poor quality of studies. The number of reported total population and points of data were 22,972 and 29 for boys, and 38,985 and 47 for girls, respectively. For all measures, missing values and diversities in studies' setting limited our ability to compare and analyze the results. Moreover, we had some serious problems in contacting the corresponding authors for complementary information necessary (Receptiveness: 17.9%). CONCLUSION: As the present paper focused on the main problems of Iranian scientific papers and proposed suggestions, the results will have implications for better policy making. [ABSTRACT FROM AUTHOR]

Aging causes the reduction in physical and physiological strength and an increase in the odds of affliction with chronic physical and mental diseases ultimately affecting the quality of life (QoL). So far, several primary studies have been conducted on the impact of religious-spiritual education and care on the QoL of the elderly. However, to the best of our knowledge, a study that compiles and represents these findings in a published paper is lacking. Therefore, the current study conducted a systematic review and meta-analysis to investigate the effect of religious-spiritual education and care on the QoL of the elderly population. To access studies related to the aim of the study, SID, MagIran, IranMedex, IranDoc, Embase, PubMed, Scopus, Web of Science, and Google Scholar databases were searched. The search was done using relevant and validated keywords with MeSH/Emtree without time limitations until December 2021. The qualitative appraisal of the papers was done using the JBI checklist. To estimate the heterogeneity of studies, I2 index was used, and to combine the data and carry out a meta-analysis, Random Effects model was used. In the primary research, 1065 studies were found. The omission of the redundant cases led to a total number of 12 papers with a sample size of 317 in the intervention group and 321 in the control to be included in the meta-analysis. After the intervention, the mean score of QoL showed a significant increase by 1.42 ± 0.31 with a Confidence Interval of 95% (P<0.001). Meta-regression results showed that the increase in the year of conducting the study, and the number of intervention sessions, that the standardized mean difference had a decreasing trend, and that with the increase in the average age of the elderly, there was a rising trend (P<0.001). Therefore, it seems that the application of religious-spiritual education and care could be part of a program to improve the QoL of the elderly. [ABSTRACT FROM AUTHOR]

Objective: Antiplatelet drugs, such as Aspirin and Clopidogrel (Plavix) are effective in the primary prevention of thromboembolic events. They are commonly used to reduce the risk of recurrence of thromboembolism. The body's hemostatic system responds differently to these drugs in different people. Resistance testing for aspirin and Clopidogrel is now recommended before starting antiplatelet therapy. Methods: A systematic literature search was performed on May 12, 2021, using the medical search engines PubMed, Scopus, and Web of Science, and the local databases SID and Magiran. After data extraction, a meta-analysis was performed using Comprehensive Meta-Analysis (CMA2) software. The I2 statistic was used to measure heterogeneity between estimates. Results: Among the 949 papers, Clopidogrel resistance was assessed in 136 patients and Aspirin resistance in 400 patients. The prevalence of Aspirin resistance was found to be 52.1% and the prevalence of Clopidogrel resistance was found to be 20.5%. Conclusion: It seems that in Iran, the issue of Aspirin and Clopidogrel resistance is suboptimally addressed. This pattern could also occur in other developing countries in the Middle East region. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is an autoimmune-associated pathology with an articular inflammatory basis. RA is diagnosed by severe pain, movement restriction, fatigue, anxiety, depression, and sexual disorder (SD). This pathology can potentially reduce the quality of life and cause many problems. The electronic databases of PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar search engine were systematically searched for the papers reporting the prevalence of SD in patients with RA (by August 2023). Following paper collection and data extraction, the Random Effects model was used to perform the data analysis (CMA, v.2). The heterogeneity of studies was assessed using I2 index. Following the assessment of 53 eligible studies with a sample size of 9,174 cases, the overall prevalence of SD in RA patients was 32.4% (95% CI:24.4–41.6). Also, the prevalence of SD in RA females and males was 36.5% (95% CI: 26.4–48) and 23.5% (95% CI:12.6–39.4), respectively. Based on the findings, the prevalence of SD among RA individuals was found relatively high; thus, the application of measures seems necessary to prevent sexual disorders in RA cases. These strategies are useful for health policymakers. [ABSTRACT FROM AUTHOR]

Background: The Lidcombe Program is a stuttering treatment approach for children between the ages of 3 and 6 years. Most papers about the Lidcombe Program, however, are based on studies conducted in native English-speaking countries. The aim of this paper is to systematically review the delivery and implementation of the Lidcombe Program in non-native English-speaking countries. Summary: A resource search was conducted between October and November 2019. Scopus, PubMed, ASHA, Cochrane Library, ERIC, Google Scholar, and SpeechBITE databases and reference lists of relevant papers were searched for the identification process. Joanna Briggs Institute tools were used for the appraisal of the studies. The search yielded 8 studies conducted in non-native English-speaking countries. The Lidcombe Program is efficacious in non-native English-speaking countries when delivered to both preschool and young school age children who stutter. It is reported to be delivered with minor changes and challenges. The number of weekly clinic visits and the total time needed to reach zero or near-zero stuttering levels with the Lidcombe Program can be up to 3 times greater in non-native English-speaking countries than in native English-speaking countries, mostly due to the increased time needed to introduce the parental verbal contingencies. Key Messages: Speech and language therapists practicing in non-native English-speaking countries are encouraged to use the Lidcombe Program for both preschool and young school age children who stutter, although this can take more time than that reported in native English-speaking countries. Further investigation to explore the therapy process with children and parents in non-native English-speaking countries is needed. [ABSTRACT FROM AUTHOR]

Objective According to the World Health Organization (WHO), more than 1 billion people (approximately 15% of world population) live with disability. Also, about half of these people lack access to healthcare facilities. Therefore, providing timely healthcare services, especially rehabilitation, is of great significance for these people. The goal of the study was to determine the objectives and policies in the field of rehabilitation in middle- and high-income countries and compare them with Iran. Materials & Methods Based on available databases, a comprehensive review of documents, papers, and books was performed in the field of rehabilitation related to high- and middle-income countries. Results Due to a lack of coordinated services, inappropriate access, unplanned distribution, unclear service delivery levels, neglect of health promotion and prevention levels, lack of a transparent referral system, unclear insurance system, and weak financial resources, the need for a national program with a service integration approach is strongly felt. The review of the rehabilitation programs and documents in other countries help us to design a conceptual framework of the rehabilitation service model, which is based on three principles: Removing barriers and developing access to healthcare services and programs; strengthening and developing rehabilitation using technology, community-based support, and rehabilitation services; and promoting comparable international data collection on disability and supporting research on disability and related rehabilitation services. Conclusion The national rehabilitation program, with a service integration approach, provides a good platform for fair access to rehabilitation services for all people with disability. In this program, the health system is the most important reference to meet these needs. Therefore, it is suggested that this program pursue three main objectives: Fair promotion of the healthcare services of rehabilitation for recipients, improving the response to the needs of rehabilitation service recipients, and reducing the financial and social risks of service recipients. [ABSTRACT FROM AUTHOR]

Background: Alloimmunization is an immune response against foreign antigens which introduced into the body through transfusion, pregnancy, or transplantation. This phenomenon is a big challenge in patients, which require regular transfusions. In the current study, we tried to have a comprehensive review on the status of alloimmunization in Iran. For this purpose, we searched for papers investigating alloimmunization in transfusion-dependent patients and also in patients with no regular transfusions who are candidate for surgery or who need blood. Methods: We searched PubMed, Google Scholar, SID, and MAGIRAN databases using the following keywords: "blood transfusion," "alloimmunization," "alloantibodies," "irregular antibodies," "red cell antibodies," and "Iran." No limitation for the date of publication and language of the papers was defined. All the identified records were then screened for the relevance and duplication. Results: A total of 22 papers were included in this study. All of the studies were conducted from 1999 to 2016 and providing alloimmunization data from different cities all over of Iran. In general, the results showed that the most prevalent alloantibodies are anti-Kell (anti-K antigen) and anti-Rh system, mainly anti-E, anti-D, anti-C, and anti-c. Conclusion: Anti-Kell and anti-Rh antibodies are the most prevalent antibodies responsible for alloimmunization in Iranian population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nurses experience many job tensions, which lead to job burnout. The consequences of nurses' job burnout include absenteeism, reduced quality of patient care, interpersonal conflicts with colleagues, physical and mental problems, reluctance to provide care with patients, and quitting the job. OBJECTIVE: The present study aimed to investigate the prevalence of job burnout among nurses in Iran using a meta-analysis method. METHOD: The study was conducted through a meta-analysis method based on the PRISMA checklist. An unlimited search was conducted until 2020 to access the Persian and English papers in national databases, including Medlib, SID, Iranmedex, and Magiran, and databases including Cochrane, Science-Direct, PubMed, Scopus, and Web of Science. The keywords were "job burnout, nurse, and Iran." The data were searched and extracted by two researchers independently. All analyses were performed using version 2.0 of the Comprehensive Meta-Analysis (CMA) software. RESULTS: The prevalence of job burnout was investigated in 14 papers with a sample size of 2271 individuals with an average age of 31.44 years old, and a confidence interval of 55% (44–66%). Fars province, with 89.2%, had the highest, and Zanjan province, with 25.9%, experienced the lowest prevalence of job burnout. The overall prevalence of job burnout was 44% in males and 66% in females so that the highest prevalence was in women. CONCLUSION: The prevalence of job burnout in nurses was high in some areas of Iran. A special attention by managers is needed in this field because of the several roles played by the nurses in the healthcare system and the improvement of public health. Implementation of plans to reduce the job burnout and to improve the mental health of nurses by reducing work hours, giving more opportunities to them to express their opinion(s) in amount of salary and benefits, and creating better working conditions are recommended. [ABSTRACT FROM AUTHOR]

BACKGROUND: Work-related musculoskeletal disorders (WRMSDs) and ergonomic risk factors are very common in bakery workers. OBJECTIVE: The purpose of this study is to (1) assess the prevalence of musculoskeletal disorders among bakers because they use automated machines or traditional baking, and (2) to determine the strategies to prevent musculoskeletal disorders in bakers. METHODS: A systematic review of PubMed, Scopus, and Web of Science was conducted from the beginning to February 4, 2022, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Mesh keywords and phrases were used to execute the search strategy. Information on MSDs and ergonomic risk factors in bakery workers was collected. Two reviewers worked independently on study selection, data extraction, and paper quality ranking. RESULTS: This study identified 14 papers from seven countries. Although the prevalence of MSDs in bakery workers has been studied, only a handful of them have been studied ergonomic risk factors, and the findings have been very limited. The association between different risk factors and MSDs seemed significant compared to many other occupational diseases. The traditional bread-baking system and lack of mechanization may increase the risk of MSDs in bakery workers. CONCLUSION: WRMSDs for bakery workers have been less studied than other occupational diseases. Our systematic review found several significant relations between the factors influencing the prevalence of MSDs. This study also showed the comparison of traditional and modern cooking systems with diseases of the upper limbs, shoulders, and back pain as possible fields for future research. [ABSTRACT FROM AUTHOR]

Objective: Infertility influences various emotional, psychological, social, and relational aspects of women's lives. By employing a systematic review on the papers published in this field, this study aimed to identify the consequences of infertility on psychological and social health of women in Iran. Method: This was a descriptive study, conducted through a systematic review according to the directions denoted by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) in 2018. To investigate the entirety of the published studies on the sociopsychological consequences of women's infertility in Iran, various databases, including Comprehensive Human Science Portal, Scientific Information Databases (SID), Magiran, National Library and Archives of I. R. IRAN, Noormags, MEDLIB, Science Direct, Google Scholar, Medline, and ProQuest, were explored for the studies published between 1991 and 2018. The selected papers were evaluated according to the content analysis method. Results: Out of the 53 papers investigated, 27 were published in domestic journals (51%), while the remaining 26 papers were published in international journals and were in English (49%). The results revealed that sociopsychological consequences of women's infertility are categorized in 6 main categories: (1) quality of life, (2) depression, (3) anxiety, (4) social support, (5) violence, and (6) sexual function. Conclusion: The results of this study can be used to design psychocognitive interventions and assist women in decreasing the emerging psychological pain and pressure. [ABSTRACT FROM AUTHOR]

Context: During the COVID-19 pandemic and challenges, medical education with insight toward training competent students with a global vision has highlighted the necessity of a robust approach toward sustainable development (SD) on internationalization. Inevitable transformations in medical education and its internationalization component due to the COVID-19 pandemic have not yet been investigated. Accordingly, the objective of this study was to assess the current situation and propose the operational framework of internationalization for medical education with a global vision toward SD. Evidence Acquisition: A critical review was conducted on English papers extracted from Google Scholar, Scopus, PubMed, and Elsevier databases using the following search terms: Sustainable development, operational approach, educational environment, management strategies, internationalization, and COVID-19. Boolean operators were used to eliminate inappropriate hits with a focus on research goals. Ineligible studies were excluded by screening titles and abstracts. The knowledge management was applied to the related findings of the internationalization of medical education components. Results: Evidence presents a new order of internationalization components of internal and external dimensions with an educational paradigm shift to virtual programs. Assessing these dimensions indicated the requirement of implementing SD. The suggested pathway should initiate from the internal institution dimensions (facilities and budget component with generating income), followed by the external institution dimensions (sociocultural element and nation-building). Conclusions: The COVID-19 pandemic has forced educational institutions to shift to virtual education. The designed framework highlights educational activities toward virtual education and earning income, empowering faculties, and meeting social needs in medical education to achieve SD. [ABSTRACT FROM AUTHOR]

Objective: In this systematic review, we aimed to evaluate the existing strategies and interventions in domestic violence prevention to assess their effectiveness. Method: To select studies, Pubmed, ISI, CINAHL, PsycINFO, Cochrane, Scopus, Embase, Ovid, Science Direct, ProQuest, and Elsevier databases were searched. Two authors reviewed all papers using established inclusion/ exclusion criteria. Finally, 18 articles were selected and met the inclusion criteria for assessment. Following the Cochrane quality assessment tool and AHRQ Standards, the studies were classified for quality rating based on design and performance quality. Two authors separately reviewed the studies and categorized them as good, fair, and poor quality. Results: Most of the selected papers had fair- or poor-quality rating in terms of methodology quality. Different intervention methods had been used in these studies. Four studies focused on empowering women; 3, 4, and 2 studies were internet-based interventions, financial interventions, and relatively social interventions, respectively. Four interventions were also implemented in specific groups. All authors stated that interventions were effective. Conclusion: Intervention methods should be fully in line with the characteristics of the participants. Environmental and cultural conditions and the role of the cause of violence are important elements in choosing the type of intervention. Interventions are not superior to each other because of their different applications. [ABSTRACT FROM AUTHOR]

Candidiasis is one of serious problems in immunosuppressed patients, including HIV patients. Candida albicans is a fungi causing different humans diseases. Immunosuppression is a hallmark of HIV infection, and its' deficiency can introduce complications through impairment of immune cells, such as CD4+ lymphocytes. The aim of the current review was to investigate the importance of candidiasis co-infection in HIV Iranian patients. In addition, it focused on prognosis, prevention, and management of candidiasis since this infection could have a large scale of mortality in people living with HIV and AIDS (PLWHA). For the current systematic review, multiple electronic bibliographic databases were searched, including PubMed, EMBASE, Scopus, Web of Science, Google Scholar, and Iranian databases from 1 January 2011 until 24 February 2020. Majority of articles (n = 11) investigated oral and oropharyngeal candidiasis (OPC) with a prevalence range of 16.5% to 43.82% in HIV-positive patients. Apart from oral candidiasis, one reference also evaluated vagina, nail, and skin candidiasis. C. albicans isolates were the most prevalent species, with a 34.42%, 52.2%, and 82.2% frequency rate in three studies, while in other papers, there was a fluctuation in C. albicans prevalence. Candidiasis is the most prevalent opportunistic infection in AIDS patients. Due to high prevalence rate of oropharyngeal candidiasis, routine screening of HIV patients is recommended. Since CD4+ T cells count decreased in HIV patients, periodic examinations are necessary. Fluconazole is most commonly used azole to treat Candida due to its mechanism; however, anti-fungal prophylaxis needs more investigation to reduce mortality and morbidity associated with mucosal candidiasis. [ABSTRACT FROM AUTHOR]

Background: Health systems around the world have their own unique challenges. Today, competence in clinical leadership is often seen as more important than clinical competence. Given the important role of physicians in health systems, how do they acquire clinical leadership competencies? In this research, valid scientific articles were reviewed for insight. Methods: In this research, databases including Science Direct, ProQuest, PubMed, SCOPUS, and Emerald, as well as Google Scholar, the Scientific Information Database, and Magiran for Iranian articles were searched for valid evidence-based English and Persian articles published between 2010 and 2018 using combination of keywords such as "physician," "leadership," and "competency" singly and in combination with the terms "AND" and "OR" as research strategy. Studies that focused on "physicians leadership competency" were selected. Search results were limited to the years 2010-2018. After reviewing the papers, 18 relevant articles were selected. Results: In the first phase, 350 articles were selected and after careful examination, 18 papers were approved at the final stage. It was found that education and leadership development courses are the most important factor for enhancing managerial competencies for physicians. It should be noted that the researchers found that in Iran research on competence in clinical leadership has also been less relevant than others. Conclusion: It is imperative that managers and planners of medical curricula design courses to develop management skills for physicians. In the post-graduate period, for physicians' continuing education, courses that address applied management and leadership should be identified and included in the continuing education curricula to address the real needs of the country's health systems. Leadership development programs can also be useful as projects to be modeled with the help of the world's top medical universities. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Firefighters, as the first responders to disasters, are exposed to dangerous and stressful situations and experience high job stress due to the nature of their work, affecting various physical and mental health dimensions. The aim of this study was to assess job stress in Iranian firefighters by systematic review. MATERIAL AND METHODS: PRISMA guideline was used to conduct the present study. Data resources of SID, Magiran, Scopus, PubMed, ISC, Web of Science, and Google Scholar were searched. Conference papers and the reference list of retrieved articles were screened to identify additional studies. Literature searches were conducted in both Persian and English without any time limit until the end of 2020. RESULTS: Initially, 147 studies were identified, and finally 13 eligible studies were systematically reviewed. In this study, 2378 Iranian firefighters were studied. Most of the studies had cross-sectional designs. CONCLUSIONS: The results of the present study showed that most Iranian firefighters are exposed to job stress, influencing other life aspects such as quality of life, job satisfaction, etc. As appropriate interventions can reduce job stress, providing firefighters with adequate training at the beginning of employment and also with in-service training, it is possible to reduce their job stress. [ABSTRACT FROM AUTHOR]

Aim: This systematic review and meta-analysis evaluated the subtyped Blastocystis sp. isolated from humans in Iran. Background: Blastocystis sp. is an anaerobic intestinal protozoan that infects humans as well as domestic and wild animals, i.e. mammals, amphibians, reptiles, and arthropods. Methods: A comprehensive search for papers published before April 2022 was undertaken utilizing English and Persian databases. The following MeSH keywords were used in the electronic search: (Blastocystis sp.) AND (molecular OR subtype) AND (prevalence OR epidemiology) AND Iran. The quality of the included studies was evaluated. Thereafter, a random-effects meta-analysis was conducted to estimate the pooled prevalence and odds ratios regarding the included studies. Results: A total of 32 studies comprised of five case-control studies and 27 cross-sectional studies met the eligibility criteria. The overall pooled prevalence of subtyped Blastocystis sp. in Iran was estimated to be 10% (95% confidence interval: 6 to 15%). Eight subtypes of Blastocystis sp. (ST1-ST7 and ST9) were identified in our study, of which ST3 was the most common subtype (0.04); 0.02-0.07). The difference in subtypes between two case and control groups in reported studies was not significant, but the odds ratio of infection by ST3 (0.98; 95% CI, 0.30 to 3.20) was higher in cases. Conclusion: The current systematic review showed that with the exception of ST8 and ST12, all human Blastocystis sp. subtypes reported in the world are found in different parts of Iran. [ABSTRACT FROM AUTHOR]

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Background and Objectives: Road traffic injuries (RTIs) are the most frequent public health problem in Iran. The present study reviewed the methodology of the RTI articles using the Haddon matrix evidence. Materials and Methods: PubMed, Scopus, Web of Science, ProQuest, and Persian national databases, including SID, Magiran, and IranDoc, were searched for the articles published from March 21, 2009, to October 21, 2020. The search process was done by two independent reviewers. The quality of the articles was assessed based on the Scopus index of journals. Results: Nine-hundred and fourteen articles were included in this review study, which mostly focused on RTIs in Iran and precrash and postcrash prevention approaches. The methodological approach was cross-sectional in 487 (53.2%) articles and merely 5 (0.54%) articles were randomized clinical trial (RCT) papers. RCT studies focused on the human factor in the precrash phase. Research center evidence indicated that the Safety Promotion and Injury Prevention Research Centers mainly focused on human and environmental factors. However, the Trauma Research Center of Kashan and Sina Trauma and Surgery Research Center of Tehran often addressed vehicles. Conclusion: The RTIs studies in Iran often followed a cross-sectional methodology and used a precrash prevention approach. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B infection can be transmitted both vertically and horizontally. Although the universal neonatal vaccination and catch up vaccination of teenagers along with targeted vaccination of at risk population have decreased the prevalence of HBV infection in Iran dramatically, there is still risk of vertical transmission with subsequent chronic liver disease and hepatocellular carcinoma. This study aims to estimate the prevalence of latent HBV infection among Iranian pregnant women using meta-analysis method. Data Sources: Papers written in Persian or English were identified during a comprehensive search within five national and four international main databases. Study Eligibility Criteria and Participants: Studies reported the HBV infection prevalence among Iranian pregnant women and provided enough quality scores were selected for this meta-analysis. Methods: After a systematic review of national and international databases, duplicated and irrelevant studies were excluded. Standard error of the infection prevalence was calculated based on the binomial distribution. Because of the significant heterogeneity observed among the results, random effects model was applied to combine the results of the primary studies. Moreover, sensitivity analysis and meta-regression models were used to detect the sources of this heterogeneity. Results: At final step of the systematic search, 18 papers entered into the meta-analysis investigating 24853 pregnant women. Prevalence of HBV infection among Iranian pregnant women was estimated as 1.2% (95% confidence interval: 0.9 - 1.6). Among different risk factors assessed, only familial history in four studies out of five relevant evidences was statistically significant. Conclusions: HBV infection prevalence among Iranian pregnant women is low and familial history is its major determinant. [ABSTRACT FROM AUTHOR]

Background: The aim of this review was to explore hospital socio-natural disaster resilience by identifying: studies assessing structural and non-structural aspects of building resilience; components required to maintain a safe and functional health facility; and if the checklists used were comprehensive and easily performed.Methods: A review systemic approach using PRISMA was taken to search the literature. The search focused on articles that discuss hospital disaster resilience. This includes assessments and checklists for facility structural and non-structural components.Results: This review identified 22 articles describing hospital assessments using checklists containing structural and non-structural elements of resilience. These studies identified assessments undertaken in ten countries, with eight occurring across Iran. A total of seven differing checklists were identified as containing aspects of structural or non-structural aspects of building resilience. The World Health Organization (WHO) has authored three checklists and four others were developed independently.The structural resilience domain includes building integrity, building materials, design standards, and previous event damages as important elements to determine resilience. Within the internal safety and resilience domains, 11 differing elements were identified as important to non-structural or internal infrastructure resilience. These included the safety of power, water, telecommunication, medical gas supply, and medical equipment resupply systems.Independent evaluation methods were reported in the majority of articles, with a small number highlighting the benefits of both self-evaluation and independent review processes. Implementation of training programs to evaluators was mentioned in three papers with the assessor's knowledge and understanding of all checklist elements being highlighted as important to the validity of the evaluation.Conclusion: The review identified the assessment of hospital resilience as important for management to determine areas of vulnerability within the hospital's infrastructure and to inform improvement strategies. Assessment criteria must be comprehensive, highlighting structural and non-structural aspects of facility infrastructure. These assessments are best done as a multi-disciplinary collective of experts, involving hospital employees in the journey. This collaborative approach provides a key educational tool for developing disaster capacity, engaging ownership of the process, and the resulting improvements.The on-going development of health facility and wider health system resilience must remain a key strategic focus of national governments and health authorities. The development of standardized procedures and guidelines must be embedded into daily practice. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Denture stomatitis is the common form of oral candidiasis, which is seen in the form of diffused inflammation in the areas covered by dentures. Many primary studies report the prevalence of denture stomatitis and candida albicans among patients in the Iranian population; therefore, using meta-analysis is valuable for health policy makers. Purpose: The purpose of the present study is to determine the prevalence of denture stomatitis and candida albicans in Iran. Materials and Method: Using relevant keywords, national and international databases were searched. After limiting the search strategy and deleting the duplicates, the remaining papers were screened by examining the title and abstract. In order to increase the sensitivity of search reference lists of papers were examined. Finally the index of heterogeneity between studies was defined using Cochran test (Q) and Isquared (I2). According to heterogeneity, the random effects model was used to estimate the prevalence of denture stomatitis and candida albicans in Iran. Result: The prevalence of denture stomatitis in 12 studies, and the prevalence of candida albicans in patients with denture stomatitis have been reported in 6 studies. The number of sample under investigated and its age range among primary studies included meta- analysis was 2271 individuals and 32.7 till 87.5 years respectively. The prevalence of denture stomatitis in preliminary studies imported to a meta-analysis varied from 1.9% to 54.6%, and its rate in Iran using the meta-analysis was estimated 28.9 % (CI 95%: 18.2-39.6). Also the overall prevalence of candida albicans in patients with denture stomatitis in Iran was estimated 60.6% (CI 95%:50.1-71.2). Conclusion: This study showed that the prevalence of denture stomatitis and candida albicans among patient infected denture stomatitis is relatively significant in Iran.. [ABSTRACT FROM AUTHOR]

Objective: Having cosmetic breast implants increases a woman's chance of suicide, which is now a global challenge. This systematic review evaluated the possible risk of suicide among women who undergo cosmetic breast implants. Method: This meta-analysis was done based on Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). In the current systematic review and meta-analysis, we systematically searched for all articles written in both English or Persian that estimated the prevalence of suicidal ideation in women who had cosmetic breast implants. We systematically searched different databases, including MEDLINE (PubMed), Web of Science, Embase, Cochrane, Library ProQuest, Scopus, and Google Scholar, from inception to March 2021. There was also a search for references. Suicidal ideation, a suicide plan, or suicide attempts were the outcomes. In order to determine the total pooled prevalence of suicidal ideation, we utilized a random-effects model. To examine the risks of bias in each study, we applied the Joanna Briggs Institute Critical Appraisal method. Results: We identified 218 citations in our initial search. After omitting duplicated citations and excluding irrelevant studies according to the title and abstract selection, 42 studies were chosen for the full text analysis. Finally, 11 research, examining a total of 324,332 women were incorporated into the systematic review and critical appraisal assessment. Eight of these studies were found to be eligible for meta-analysis. The frequency of suicide in women with cosmetic breast implant was 0.2% (95% CI: 0.1% to 0.4%; P < 0.001) (Q-value: 168.143, I2:95.83). Most of the included studies had moderate quality. Conclusion: There might be a correlation between cosmetic breast implants and suicide risk, which could be stronger in the presence of a history of mental illnesses. The evidence about the possible effects of breast implants on the risk of suicide is still inconclusive, and there is a need for future well-designed studies on this topic. [ABSTRACT FROM AUTHOR]

Evaluation of programs and determining its challenges to improve and implement reforms is essential in a healthcare system. A primary healthcare program was conducted since 1984 in Iran and faces various challenges after several decades of its life. The aim of this study is to evaluate Iran's primary healthcare program and determine its challenges and weaknesses. In the present systematic review study, the published articles related to Iran's primary healthcare were searched and collected from Iranian databases (SID, Magiran, Noormags and Irandoc) and international databases (Pubmed, Scopus, Web of Knowledge and Google Scholar). The Iranian grey literature was also explored. In total, from 336 papers identified, 25 papers were deemed relevant after the step-by-step review of articles and removal of non-related articles. The results of this study show that primary healthcare in Iran has different challenges and weaknesses. Most of these challenges and weaknesses relate to the structure and process of primary healthcare. The Iranian primary healthcare system has achieved many successes in community health promotion, but today, because of social, economic, political and environmental changes, it does not meet the needs of the people; therefore, this system requires structural reforms. [ABSTRACT FROM AUTHOR]

Background: Various interventions have been undertaken in Iran to promote evidence-informed health policy-making (EIHP). Identifying the challenges in EIHP is the first step toward strengthening EIHP in each country through the design of tailored interventions. Therefore, the current study was conducted to synthesize the results of earlier studies and to finalize the list of barriers to EIHP in Iran.Methods: To identify the barriers to EIHP in Iran, two steps were taken: a systematic review and policy dialogue. To conduct the systematic review, three Iranian databases and PubMed, Health Systems Evidence (HSE), Embase, and Scopus were searched. The reference lists of included papers and documentation from some local organizations were hand-searched. Upon conducting the systematic review, given the significance of stakeholders in clarifying the problem of EIHP, policy dialogue was used to complete the list previously extracted and to do advocacy. Selection criteria for the stakeholders included influential and informed individuals from knowledge-producing, knowledge-utilizing, and knowledge-brokering organizations. Semi-structured interviews were held with three important absent stakeholders.Results: Challenges specific to Iran that were identified included the lack of integration of the health ministry and the medical universities, lack of ties between health knowledge utilization organizations, failure to establish long-term research plans, neglect of national research needs at the time of recruiting human resources in knowledge-producing organizations, and duplication and lack of coordination in routine data obtained from surveillance systems, disease registration systems, and censuses. It seems that some challenges are common across countries, including neglecting the importance of inter- and intra-disciplinary studies, the capacity of policy-makers and managers to utilize evidence, the criteria for evaluating the performance of policy-makers, managers, and academic members, the absence of long-term programmes in knowledge-utilizing organizations, the rapid replacement of policy-makers and managers, and lack of use of evaluation studies.Conclusions: In this study, we tried to identify the challenges regarding EIHP in Iran using a systematic review and policy dialogue approach. This is the first step toward determining the best interventions to improve evidence-informed policy-making in each country, because these challenges are contextual and need to be investigated contextually. [ABSTRACT FROM AUTHOR]

Background and Objectives Transfusion of platelet has become one of the main treatments for thrombocytopenic patients to reduce the severity and frequency of bleeding consequences. Failure to attain the desired level of platelets in a patient following platelet transfusion is defined as platelet refractoriness. The purpose of present paper is to review and study the mechanisms involved in the formation of platelet refractory. Materials and Methods This article reviews the effective factors present in platelet recipients and donors, and considers the characteristics of platelet products that may have impacts on platelet refractoriness. The search is conducted through scientific databases including Science Direct, PubMed, Medline, SI, Scopus, and Ma iran by the keywords “Platelet Refractory”, “Alloantibody”, “HLA”, “Platelet Transfusion” and their Persian equivalents. Finally out of about 130 related articles, 97 articles were used for the review. Results Generally, platelet refractoriness occurs in two ways including immunologic and nonimmunologic. The immunologic way is due to alloimmunization against alloantigens as a result of contact with human leukocyte antigens (HLA), Human Platelet Antigens (HPA). Non immunologic conditions such as fever, spleen enlargement and use of certain medications are responsible to 80% of platelet refractory incidence. Conclusions Identification of different features and mechanisms in platelet refractoriness including immunologic and non-immunologic factors have an important role in control, prevention and management of the disease. [ABSTRACT FROM AUTHOR]

Background Healthcare workers (HCWs) are at risk of acquiring blood-borne infections such as hepatitis B, hepatitis C, and human immunodeficiency virus through needlestick injuries (NSIs). We aimed to investigate the prevalence of needlestick injuries and other related indicators among HCWs in Iran through a systematic review and meta-analysis. Methods We searched various databases until the end of May 2023 for studies reporting the prevalence of NSIs among healthcare workers in Iran. We used a random model with 95% confidence intervals (CIs) to analyse the data and the Joanna Briggs Institute (JBI) tool to evaluate the quality of included studies. We conducted and reported the study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results We included 87 studies in the analysis and found that 47% (95% CI = 42-52, I2 = 98.9%) of Iranian HCWs experienced NSI. NSIs were most frequently related to syringe needles (58%; 95% CI = 52-65, I2 = 96.8%) and most often caused by recapping (30%; 95% CI = 22-38, I2 = 98.5%). In this study, 56% (95% CI = 45-67, I2 = 98.6%) of HCWs with NSIs did not report their injury. Moreover, the prevalence of NSIs the highest in the morning shift (0.44; 95% CI = 0.36-0.53, I2 = 97.2%), emergency unit (0.20; 95% CI = 0.16-0.24, I2 = 93.7%), and intensive care unit (0.20; 95% CI = 0.16-0.24, I2 = 94.3%). Conclusions To reduce the high prevalence of NSIs, HCWs, especially those in emergency departments, should use safety equipment. Healthcare managers should provide a calm and stress-free environment for HCWs, educate them on safety principles and standards, and support experienced HCWs with NSIs. [ABSTRACT FROM AUTHOR]

purpose of this study was to synthesize the evidence related to the leadership and management competencies in healthcare organizations through the best-fit method. Methods: A systematic review of literature published between 2000 and 2020 was performed to identify studies focusing on confirming and/or identifying the competency requirements of hospital managers. The best-fit framework synthesis method was used to map the identified competencies and associated behavioral items against the validated management competency assessment program (MCAP) management competency framework. Results: Twelve studies were identified for inclusion in the review. The mapping of the identified competencies and behavioral items generated a competency model for hospital managers that can apply for different healthcare context. The new competency model includes the following seven core leadership and management competencies: evidence-informed decision-making, operations, administration and resource management, knowledge of healthcare environment and the organization, interpersonal, communication qualities and relationship management, leading people and organisation, enabling and managing change, and professionalism. Conclusion: This review and the mapping of the competencies identified in previous studies against the validated MCAP framework has resulted in the recommendation for an extended leadership and management competency framework for health service managers. It provides guidance for the formulation of training and development directions for the health service management workforce in a different healthcare context. [ABSTRACT FROM AUTHOR]

Heart valve disease (HVD) affects 2.5% of the US population and one million individuals aged 65 years and older in the UK. Given its burden, the aim of the present review was to assess the cost-effectiveness of heart valve replacement with mechanical versus biological prosthesis in HVD patients. We performed a systematic search in various electronic databases from January 1990 to June 2019. Five out of 542 articles were entered into the study, from which 2 papers were subsequently excluded not meeting the minimum number of items of the CHEERS checklist. Quality-Adjusted Life Year, Life Years Gained, and the Incremental Cost-Effectiveness Ratio (ICER) regarding the type of replaced heart valve were extracted and reported. Studies were conducted in three different countries (Iran, France, and USA). ICER ranged from $1253 in Iran to €54,634 in France. Survival rate of mitral mechanical versus biological valves at 10 and 20 years was 72.9% versus 76.0% and 51% versus 30%, respectively. Survival rate at 20 years in patients undergoing atrial valve replacement was 20%. Ten- and 20-year death rates for biological valves were higher with respect to mechanical prosthesis (15.5% versus 8.4% at 10 years), with this difference becoming more relevant at 20 years (36.9% versus 13.9%). Due to higher ICER, mortality rate, and lower success rates in the long term for biological prostheses compared to mechanical ones, these appear to be more suitable for older patients (aged ≥ 70 years). [ABSTRACT FROM AUTHOR]

A systematic review was conducted to gain a more nuanced understanding of similarities and distinctions across countries in the development of executive functions (EF). The review includes 26 studies, with child and adolescent participants, that were published between 2006 and 2018. Both similarities and differences within developmental patterns of EF are identified across different countries. Across countries, bilingual children are shown to outperform their monolingual peers. Task improvement with age is not consistently reported in all studies, with no linear effects apparent in children from developing countries or regions. Gender differences on EF measures also vary between countries. Girls perform better than boys on EF tasks and parent and teacher ratings of EF in both Western and East Asian samples. Yet, in Iran and Tanzania, boys receive higher EF scores. From preschool age through adolescence, East Asians outperform Western counterparts on direct assessment measures of EF. However, strong discrepancies can be found between measures of direct EF assessment and parent and teacher ratings of children's EF. Chinese parents rate their children's EF as lower compared with parents from other countries. The role of contextual factors explaining differences in EF development is discussed. Highlights: This paper presents the first systematic review on the topic of cross‐national variation in children's EF development.A clearly defined conceptual framework regarding EF facets and analysis of a wide age span underpin this review.From preschool age through adolescence, East‐Asian children outperform their Western counterparts on direct assessment measures of EF. [ABSTRACT FROM AUTHOR]

Background and Aim Among the plants with multiple healing properties and a long and common history of use in Iranian traditional medicine, is dog-rose plant with the scientific name of “Rosa canina” that belongs to the Rosaceae family. This study aimed to review the effectiveness of Rosa canina in treatment of different body organs and tissues and emphasizes its therapeutic mechanism. Methods & Materials This is a review study. About 176 papers published from 2010 to 2018 were extracted from PubMed, Science Direct, Scopus, Google Scholar, Ovid, MagIran, and SID databases using related keywords and entered into study. Ethical Considerations Ethical issues (including plagiarism, misconduct, data fabrication, falsification, double publication or submission, redundancy) have been completely observed by the authors. Results Different studies had indicated the importance of Rosa canina as a medicinal plant protecting liver, lowering glucose and lipid levels, and having antioxidant and anti-inflammatory properties. The highest flavonoid activity in the Rosaceae family is related to Rosa canina. The use of herbal extracts in the treatment of common diseases, such as diabetes, fatty liver, urinary tract and Alzheimer's, has been recommended. Conclusion High qualitative and quantitative diversity of effective ingredients, ease of access, absence of adverse effects of consumption and endemic nature of Rosa canina plant make it necessary to use it for the control and treatment of common human diseases. [ABSTRACT FROM AUTHOR]

Objective: Workplace violence is one type of occupational hazards that is increasingly growing worldwide. In the health system, one of the important groups subject to workplace violence is emergency medical services (EMS) personnel, who provide emergency services for patients and casualties as the first responders. The aim of this study was to determine the prevalence of workplace violence and its different types among Iranian EMS personnel. Method: This study was conducted based on PRISMA guideline for systematic review and meta-analysis. The data were extracted from Scopus, PubMed, Web of Science, Google Scholar, SID and MagIran databases using Persian and English keywords. The search was conducted up to December 2018 without any limitation in publication year. The qualities of selected papers were assessed by STROBE checklist. I2 index was used to evaluate heterogeneity, and random effects model was used in meta-analysis. Data were analyzed using Stata14. Results: A total of 9 studies entered the meta-analysis. The total sample size was 1257 Iranian EMS personnel, with an average age of 32.21 ± 2.01 years. The prevalence of physical, verbal, and cultural workplace violence among EMS personnel was 36.39% (CI 95%:27.29-45.50, P<0.001, I2 = 90.8%), 73.13% (95% CI=68.64-77.62, P=0.013, I2 = 62.7%), and 16.51% (95% CI =3.49- 29.53, p<0.001. I2 = 94.7%), respectively. Conclusion: Considering the high prevalence of workplace violence among EMS personnel in Iran, more studies should be conducted to determine the underlying causes of EMS staff workplace violence in Iran. Training violence prevention methods as well as assigning national protective rules are highly suggested. Insufficient studies on Workplace violence among EMS personnel in Iran and high heterogeneity were the limitations of this study. [ABSTRACT FROM AUTHOR]

Background: The high prevalence of malocclusion is a public health problem in the world and the third priority in oral care. Numerous primary studies have presented reports on the prevalence of malocclusion among Iranian children. In combination, the results of these studies using meta-analysis are highly valuable for health policy-making. Similarly, this study aimed at determining the prevalence of different types of malocclusion among Iranian children. Materials and Methods: Using relevant keywords, national and international databases were explored. After narrowing down the search strategy and leaving out the duplicates, the remaining articles were screened based on titles and abstracts. To increase search sensitivity, reference lists of the papers were examined. To identify unpublished articles and documentations, a set of negotiations were done with the people involved and research centers. Finally, the heterogeneity index between the studies was determined using Cochran (Q) and I2 tests. According to the results of heterogeneity, the random effects model was used to estimate the prevalence of malocclusion in Iran. Results: In total, 25 articles were included in the meta-analysis process. The prevalence of dental malocclusion was estimated in 28,693 Iranian children aged 3-18 years. The total prevalence of Class I, II, and III malocclusion was 54.6% (46.5-62.7), 24.7% (20.8-28.7), and 6.01% (4-7.1), respectively. The prevalence of Class I, II, and III malocclusion was 44.6% (32.9-56.2), 21.5% (18.01-25.1), and 4.5% (3.2-5.9) in boys and 48.8% (36.8-60.8), 21.5% (16.9-25.1), and 5.5% (3.9-7.1) in girls, respectively. Conclusion: This study showed a high prevalence of malocclusion among Iranian children. Also, the results indicated that the prevalence is higher in girls. [ABSTRACT FROM AUTHOR]

Introduction. Low birth weight is an important indicator of the health of babies. A low birth weight is a leading health problem and a major reason for death in newborns. This study targeted to assess the relationship between maternal and infant factors and low birth weight in Iran through a systematic review and meta-analysis. Methods and Materials. This paper was a systematic review and meta-analysis of the relationship between maternal/ infant factors and low birth weight based on the published research papers conducted in Iran. To achieve this goal, two trained researchers independently elicited all the relevant articles by using the appropriate keywords and their combinations in SID, Madlib, Iranmedex, Irandoc, Google Scholar, Pubmed, ISI, Scopus and Magiran databases. The results of the study were combined with SPSS 20 and STATA software. Results. In the initial stage, 25 more relevant articles out of 46 papers were selected. The gestational age with less than 37 weeks and prenatal care had the most (CI: 27- 14. 53, OR: 19.81) and the least (CI: 1.86, OR: 1.5) effect on the low birth weight in newborns, respectively. Conclusion. This study showed that there is a significant relationship between the low birth weight and multiple births, preeclampsia, maternal weight gaining during pregnancy, baby's gender, and pregnancy age. Hence, controlling the factors above in mothers during pregnancy by the health authorities could lead to the birth of infants with a healthy weight and consequently the number of infants with low birth weight will decrease. [ABSTRACT FROM AUTHOR]

Background: Improving the ethical competencies of nursing students, as an important dimension of professional competence, is a primary objective of nursing education. Thus, this study aimed to explore a guide for codes of ethics for the development of ethical competence among nursing students in the healthcare system of Iran. Methods: This is a systematic review and meta-synthesis of qualitative studies conducted in the healthcare system of Iran. The review included studies published between January 1, 2000 and March 2024. We conducted a comprehensive search in various international and national databases, including Web of Science, PubMed, Embase, PsycINFO, Cochrane Library, CINAHL, Scopus, Barakatns, MagIran and SID. Initially, 86 qualitative studies were identified, and after a meticulous screening process, 39 studies were carefully reviewed. Finally, 10 qualitative studies were selected for analysis. The meta-synthesis employed an interpretive approach by thematic synthesis. Results: Based on our results, four main themes and 10 categories, along with summarized codes, were extracted as crucial elements of the codes of ethics for the professional competence of Iranian nursing students. The main themes identified were knowledge, standards, experiences, and attitudes (KSEA). Conclusions: The concept of codes of ethics for developing professional competencies in Iranian nursing students was detected as a multidimensional concept with four major areas. By emphasizing the rights of clients and the standardization of nursing practice, this set of ethical codes can contribute to preventing clinical errors and legal issues at hospitals and educational settings. Furthermore, it fosters a positive environment that encourages professional behaviors among nursing students. Nursing students, as future nurses, should apply codes of ethics when facing emerging ethical challenges. Nurse educators have a crucial role in providing students with the necessary preparation and guidance during their professional socialization process in nursing schools. [ABSTRACT FROM AUTHOR]

Acceptance and commitment therapy (ACT) for obsessive–compulsive disorder (OCD) has been found efficacious in randomized clinical trials (RCTs), but the two widely known RCTs were conducted within the United States with predominantly White samples. Research that evaluates treatments like ACT for OCD outside the typical Western cultures is needed. The current scoping review summarizes the key characteristics and findings from 18 RCTs that evaluated ACT for OCD in Iran. These RCTs are largely unknown in the broader scientific literature despite representing the vast majority of ACT for OCD trials, in part because the majority are published in Persian. The preponderance of RCTs treated participants in groups, and most protocols did not include exposure exercises. Of 18 trials, 5 were single sex. Use of selective serotonin reuptake inhibitors (SSRIs) was common with all participants on stable doses at pretreatment in many of the trials. Methodological quality was low to medium. ACT was inconsistent against nontraditional comparison conditions, slightly favorable to empirically validated treatments, and favorable compared with the waitlist and SSRIs. The process of change data indicated that ACT increased the psychological flexibility more than cognitive behavior therapy or SSRIs. These results highlight that findings on ACT for OCD from Western populations replicate and generalize to individuals in Iran. These findings also offer insights gained from studying ACT in Iran and significantly expand the literature based on ACT for OCD that can be integrated into scholarship by all researchers. [ABSTRACT FROM AUTHOR]

Purpose: The aim was to critically appraise, synthesise and present the evidence of medication errors amongst hospitalised patients in Middle Eastern countries, specifically prevalence, nature, severity and contributory factors. Methods: CINAHL, Embase, Medline, Pubmed and Science Direct were searched for studies published in English from 2000 to March 2018, with no exclusions. Study selection, quality assessment (using adapted STROBE checklists) and data extraction were conducted independently by two reviewers. A narrative approach to data synthesis was adopted; data related to error causation were synthesised according to Reason's Accident Causation model. Results: Searching yielded 452 articles, which were reduced to 50 following removal of duplicates and screening of titles, abstracts and full-papers. Studies were largely from Iran, Saudi Arabia, Egypt and Jordan. Thirty-two studies quantified errors; definitions of 'medication error' were inconsistent as were approaches to data collection, severity assessment, outcome measures and analysis. Of 13 studies reporting medication errors per 'total number of medication orders'/ 'number of prescriptions', the median across all studies was 10% (IQR 2–35). Twenty-four studies reported contributory factors leading to errors. Synthesis according to Reason's model identified the most common being active failures, largely slips (10 studies); lapses (9) and mistakes (12); error-provoking conditions, particularly lack of knowledge (13) and insufficient staffing levels (13) and latent conditions, commonly heavy workload (9). Conclusion: There is a need to improve the quality and reporting of studies from Middle Eastern countries. A standardised approach to quantifying medication errors' prevalence, severity, outcomes and contributory factors is warranted. [ABSTRACT FROM AUTHOR]

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Purpose Protecting households against financial risks of healthcare services is one of the main functions of health systems. The purpose of this paper is to provide a pooled estimate of the prevalence of catastrophic healthcare expenditures (CHE) among households in Iran.Design/methodology/approach Both international (PubMed, Scopus and Clarivate Analytics (previously known as the Institute for Scientific Information)) and Iranian (Scientific Information Database, Iranmedex and Magiran) scientific databases were searched for published studies on CHE among Iranian households. The following keywords in Persian and English language were used as keywords for the search: "catastrophic healthcare costs," "catastrophic health costs," "impoverishment due to health costs," "fair financial contribution," "prevalence," "frequency" and "Iran" with and without "health system". The I2-test and χ2-based Q-test suggested heterogeneity in the reported prevalence among the qualified studies; thus, a random-effects model was used to estimate the overall prevalence of CHE among households in Iran.Findings A total of 24 studies with a cumulative sample of 301,097 households were included in the study. The estimated pooled prevalence of CHE among households was 7 percent (95 percent confidence interval: 6–8 percent). Meta-regression analysis indicated that the prevalence of CHE was inversely related to the sample size (p<0.05). The results did not suggest a significant association between the prevalence of CHE and the year of data collection.Originality/value The findings revealed that the prevalence of CHE among Iranian households is significantly higher than 1 percent, which is the goal set out in Iran's fourth five-year development plan. This warrants further policy interventions to protect households from incurring CHE in Iran. [ABSTRACT FROM AUTHOR]

Background: No systematic review has explored the causes of and factors associated with maternal mortality in the context of Iran. This study reviewed determinants and causes of maternal mortalities during pregnancy, delivery and the puerperium using the International Classification of Diseases-Maternal Mortality (ICD-MM), introduced by the World Health Organization. Methods: A systematic electronic search of all the studies that identified causes and/or determinants of maternal deaths in any part of Iran or in the whole country were included, without any restriction of time or language of studies. To identify the studies to include in this study, a combination of hand searching and bibliographies was also conducted. These sources and citations yielded a total of 653 articles; nevertheless, only 29 articles met the inclusion criteria, hence, required data were extracted, summarized, and grouped together from these papers and are reported in the tables. Results: Amongst the 29 studies published between 2003 and 2017 in Iran, 24 studies were cross-sectional. Overall, 4633 deaths were reviewed, and 2655 (58%) of the cases included the data on the causes of death generally. According to the ICD-MM, a total of 69.9, 20.6, and 5.2% of the mortalities were due to direct, indirect and unspecified causes respectively and 4.3% of the causes were not clear in several studies. The leading direct and indirect causes of death were identified as hemorrhage (30.7%) and hypertensive disorders (17.1%) and circulatory system diseases (8.1%) respectively. Several factors including gravidity, type of delivery, socio-economic status of mothers, locations of birth, death and maternity care venues were found in the original studies as the most important determinant of maternal mortalities in Iran. Conclusions: This study, provided an updated summary of evidences on the causes and determinants of maternal death in Iran, which is critically important for the development of interventions and reduction of the burden of maternal mortality and morbidities. [ABSTRACT FROM AUTHOR]

Acute bacterial meningitis (ABM) is one of the most severe infectious diseases, causing neurologic sequel, and a case fatality rate of 20-30%. The aim of this paper was to summarize the main causes of ABM in Iran. We searched the data for relevant articles using meningitis, etiology, and Iran as search terms. We found 23 papers for inclusion in the review that focused specifically on the ABM, addressing etiology and acute meningitis. Finally, during the 23 years, a total of 18163 cases were recorded, and 1074 cases of which met the criteria for bacterial meningitis. The most common agent associated with bacterial meningitis was S. pneumoniae, followed by H. influenzae, Enterobacter spp., N. meningitidis, and group B streptococcus. The total incidence of ABM during 1991 to 2002 was higher than during 2003-2013. S. pneumoniae still remains a main cause of bacterial meningitis. For improved outcomes, studies are needed to further clarify the etiology of meningitis in Iran, explore simple, accurate, and practical diagnostic tools as PCR, and investigate the most appropriate specific and supportive interventions to manage and prevent meningitis as vaccination. [ABSTRACT FROM AUTHOR]

Background: A substantial growth has been reported in Iran's health research output over the last recent decades, throughout the times of economic, social, and political instability. This study reviewed the existing literature to provide a better understanding of the evolution of Iran's health research system over this period.Methods: A narrative review of studies addressing health research system (HRS) in Iran was performed. The search strategy and categorization of the retrieved data was informed by the HRS framework of the World Health Organization (WHO). This framework proposes four functions for HRS: (i) stewardship; (ii) financing; (iii) creating and sustaining resources; and (iv) producing and using research. Searches in MEDLINE through PubMed (using MeSH terms) complemented with semantic searches through PubMed and Google Scholar were conducted.Results: After removing the duplicates, 805 articles were retrieved, of which 601 were irrelevant, and 204 were reviewed.Conclusions: Iran has made substantial progress in different components of its HRS over the last few decades, such as starting a discourse surrounding health research ethics, priority-setting, and placing monitoring mechanisms while increasing the capacity for conducting and publishing research. However, there is still room for improvements, or even a need for fundamental changes, in several components, such as regarding increasing the research budget and improving the funding allocation mechanisms; improving the education curriculum; and promoting the use of evidence. The findings emphasized that improvement of HRS functions requires addressing context-specific problems. This review provides essential lessons to share with other low- and middle-income countries and international organizations, eg, the WHO. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to assess the quality of Iranian university libraries.Design/methodology/approach This first systematic review and meta-analysis were based on the PRISMA guidelines by searching in national and international databases from 2003 to January 2017 with standard Persian and English keywords. Data searching, extracting and quality appraising were completed by two researchers, independently. Any unexpected documents were assessed by a third expert researcher. Data were extracted in accordance with the “Strength of the Reporting of Observational Studies in Epidemiology” checklist after the final selection of appraised documents. Random effects size based on Cochrane test and I2 were used for combining the obtained results from different studies together by considering the heterogeneity of studies.Findings Based on the meta-analysis conducted in 25 (6.42 percent) included studies, the total sample size was estimated. According to three dimensions of LibQUAL, findings of current information control, affect of service and the library as a place were estimated as 5.37 [CI95%: 5.02, 5.73], 6.91 [CI95%: 5.56, 6.26], and 5.46 percent [CI95%: 5.2, 5.73], respectively. Also, mean of service adequacy and superiority gap are equal to 0.07 [CI95%: −0.22, 0.36] and −2.06 [CI95%: −2.89, −1.23], respectively. There was a significant correlation between three dimensions of service quality and service superiority gap of LibQUAL and geographical regions of Iran (p<0.01). Also, a significant correlation was found between the gaps of services and three aspects of LibQUAL model and published years through a meta-regression test (p<0.01).Practical implications The results obtained from the present study showed that users are relatively satisfied with the quality of services provided by Iranian university libraries. An improvement in the quality of library services can promote the scientific level of universities.Originality/value The results of the present systematic review and meta-analysis study demonstrate a vital connection between primary research studies and decision-making for policymakers in Iranian university libraries to increase quality services. [ABSTRACT FROM AUTHOR]

Background/Objectives. This paper seeks to identify the prevalence of Phenylketonuria (PKU) in Arab countries, Turkey, and Iran. The study reviewed the existence of comprehensive national newborn screening programs and reported consanguinity rates. Methods. A computer based literature search was conducted using relevant keywords to retrieve studies conducted on PKU. A total of 34 articles were included. Prevalence was categorized based on the type of screening method used for PKU diagnoses. Results. The prevalence of classical PKU diagnosed through a comprehensive national newborn screening program ranged from 0.005% to 0.0167%. The highest prevalence was reported in Turkey at 0.0167%, whereas the lowest prevalence was reported in the UAE, 0.005%. Conclusion. The findings of this review emphasize the need for the establishment of more efficient reporting systems in these countries that would help measure Disability-Adjusted Life Year (DALY) in order to estimate the overall societal burden of PKU. [ABSTRACT FROM AUTHOR]

Background: Peptic ulcer is a prevalent problem and symptoms include epigastria pain and heartburn. This study aimed at investigating the prevalence and causes of peptic ulcers in Iran using systematic review and meta-analysis. Materials and Methods: Eleven Iranian papers published from 2002 to 2016 are selected using valid keywords in the SID, Goggle scholar, PubMed and Elsevier databases. Results of studies pooled using random effects model in meta-analysis.The heterogeneity of the sample was checked using Q test and I2 index. Results: Total sample size in this study consist of 1335 individuals with peptic ulcer (121 samples per article). The prevalence of peptic ulcers was estimated 34% (95% CI= 0.25 - 0.43). The prevalence of peptic ulcers was 30% and 60% in woman and man respectively. The highest environmental factor (cigarette) has been addressed in 30% (95% CI= 0.23-0.37) of patients. The prevalence of Helicobacter pylori was estimated in 62% (95% CI= 0.49-0.75) of patients. Conclusion: The results of this study show that prevalence of peptic ulcers in Iran (34%) is higher that worldwide rate (6% to 15%). There was an increasing trend in the prevalence of peptic ulcer over a decade from 2002 to 2016. [ABSTRACT FROM AUTHOR]

Background: Evidence-based nursing (EBN) is an approach to make effective clinical decisions based upon personal clinical expertise and patient preferences and values in combination with the most current and relevant research and evidence available on the topic. This approach uses the evidence-based practice (EBP) as a foundation. In spite of extensive training in EBN for nursing students in Iran, appropriate articles have not been summarized suitably as to EBN's effectiveness. The present study aimed to systematically review the effectiveness of EBN education on the knowledge, skills, and attitudes of nursing students in Iran. Methods: For a systematic review on the topic, different searching methods were applied by searching on the following key words: training, learning, evidence-based nursing, nursing education in B.A. course, nursing students, workshop, knowledge, attitudes, skills, Iran. Their English equivalents were included. Databases that were searched included SID, Magiran, Medlib, Iranmedex, PubMed, Google Scholar, and CINAHL. We included studies that had recruited undergraduate nursing students, articles that had the key words in the titles, all studies conducted in Persian and English up to 2016, and the studies which used at least one educational intervention for evidence-based teaching. Results: Based on the results of automated and manual database searches of over 313 papers, 143 articles were eliminated by studying their titles based on not reporting teaching EBM to undergraduate nursing students, and 160 articles were removed based on content. In all, eight articles were related to the topic of the present study, indicating that EBN education promotes knowledge, attitudes, and skills of nursing students. Conclusion: This study found that EBN educational methods can promote knowledge, attitudes and skills in undergraduate nursing students, but the review does not reach a conclusion as to the advisability of one strategy. [ABSTRACT FROM AUTHOR]

Objective: Delirium is a brain dysfunction syndrome. In most cases, this syndrome is neither diagnosed accurately nor treated properly. The incidence of delirium by itself increases hospitalization period, mortality rate and the cost in health spectrum. If appropriate attempts are not made to treat this complication, the outcomes could become worse. Thus, the present study aimed at conducting a review on medications which are prescribed to treat delirium and establishing a general view on their advantages and disadvantages. Method: By searching Google Scholar, PsycINFO, Scopus, and PubMed databases as well as hand searching in key journals, data were collected without time and language limitation. After collecting the data, comparing the similar or contradictory information, and sorting them, the views of specialists were inquired and duly received via email. By acquiring consensus of opinions, the secondary manuscript was written in a narrative review form. Discussion: This narrative review paper aimed at providing a general view on defining delirium, the pathologic factors that create it, and treating this syndrome based on its development. Authentic evidence regarding delirium management was reviewed and a treatment strategy was suggested for Iranian patients. [ABSTRACT FROM AUTHOR]

Background: Q fever is endemic in Iran, thus, we conducted a systematic review and meta-analysis on epidemiology of Coxiella burnetii among humans and animals in Iran. Materials and Methods: A systematic search was performed to identify all articles reporting C. burnetii prevalence in Iranian humans or animals, published from January 2000 to January 2015. Data from articles were extracted, and a pooled estimate of prevalence with corresponding 95% confidence interval (CI) was calculated using random effect method. Results: In this review, 27 papers were identified. The pooled seroprevalence of Q fever in animals was 27% (CI 95%: 23%-32%). The prevalence was 33% (CI 95%: 22%-45%) in goats, 27% (CI 95%: 21%-32%) in sheep, and 17% (CI 95%: 5%-28%) in cattle. The bacterial DNA was detected in 5% (95% CI: 3%-9%) of milk samples, and it was higher in cattle (10%; 95% CI: 6%-16%) than sheep (2%; 95% CI: 0-7%) and goats (4%; 95% CI: 0-12%). Conclusion: C. burnetii DNA or its antibody has been frequently detected among ruminants. Since these animals can transmit the infection to humans, Q fever could be a potential health problem in Iran. [ABSTRACT FROM AUTHOR]

Objective: Activating mutation in Ubiquitin-specific peptidase (USP8) is identified to enhance cell proliferation and adrenocorticotropic hormone (ACTH) secretion from corticotroph pituitary adenoma. We investigated the USP8 variant status in a population of Iranian people with functional corticotroph pituitary adenoma (FCPA). Moreover, a systematic review was conducted to thoroughly explore the role of USP8 variants and the related pathways in corticotroph adenomas, genotype-phenotype correlation in USP8-mutated individuals with FCPA, and the potential role of USP8 and epidermal growth factor receptor (EGFR) as targeted therapies in PFCAs. Methods: Genetic analysis of 20 tissue samples from 19 patients with PFCAs was performed using Sanger sequencing. Moreover, a systematic literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, web of Sciences, and Cochrane databases were searched. The last search was performed on 20 September 2023 for all databases. Results: In our series, we found two somatic mutations including a 7-bp deletion variant: c.2151_2157delCTCCTCC, p. Ser718GlnfsTer3, and a missense variant: c.2159 C > G, p. Pro720Arg (rs672601311) in exon 14. The Systematic review indicated USP8 variant in 35% of corticotroph adenomas, with the highest frequency (25%) in 720 code regions, p. Pro720Arg. Data regarding the impact of USP8 mutational status on clinical characteristics and outcomes in FCPAs are inconsistent. Moreover, Pasireotide as well as inhibitors of EGFR such as Gefitinib and Lapatinib, as well as USP8 inhibitors including -ehtyloxyimino9H-indeno (1, 2-b) pyrazine-2, 3-dicarbonitrile, DUBs-IN-2, and RA-9 indicated promising results in treatment of corticotroph adenomas. Conclusion: Although the USP8-EGFR system has been identified as the main trigger and target of corticotroph tumorigenesis, more precise multicenter studies are required to yield more consistent information regarding the phenotype-genotype correlation and to develop effective targeted therapies. [ABSTRACT FROM AUTHOR]