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Background: Each of the Coronavirus disease 2019 (COVID-19) vaccines has its characteristics that can affect their effectiveness in preventing hospitalization and patient mortality. The present study aimed to determine the effectiveness of COVID-19 vaccines, including whole-virus, protein-based, and vector-based on COVID-19 infection, hospitalization, and mortality. Methods: The current cohort study was conducted using the data of all people who received at least two doses of each type of COVID-19 vaccine from March 2020 to August 2022 in Khorasan Rzavi province. Quantitative data were characterized using measures of central tendency and dispersion, while the risks of infection, hospitalization, and mortality were assessed for each type of vaccine. Logistic regression was employed to evaluate the effect of various vaccine types on infection rate, hospitalization, and mortality while adjusting for other independent variables. Results: In this study, over 2 million vaccinated individuals had received at least two doses of the COVID-19 vaccine. Whole-virus vaccines, which had an infection rate of 3%, a hospitalization rate of 1.4%, and a mortality rate of 0.2%, were the most effective vaccines. The study also identified several factors associated with an increased risk of COVID-19 infection, hospitalization, and mortality, including kidney disease, cardiovascular disease, respiratory issues, age, sex, diabetes, olfactory dysfunction, fever, chills, body mass index (BMI), and the type of vaccine. Conclusion: This study highlights the substantial impact of COVID-19 vaccination in reducing infection, hospitalization, and mortality rates in Iran. The results support the use of whole-virus and vector-based vaccines as more effective options for preventing COVID-19 outcomes. The study also emphasizes the importance of considering various factors, including medical history and side effects, when evaluating the effectiveness of different vaccine types. The findings of this study can inform public health policy and vaccination strategies in Iran and other countries. [ABSTRACT FROM AUTHOR]

Background: Workplace violence has always been a serious challenge in health care systems. It reduces employees’ satisfaction and productivity, and increases the potential for adverse medical events. This study aimed to determine the prevalence and predictors of workplace violence among hospital clinical staff. Methods: This cross-sectional study was conducted on 140 hospital care staff including nurses and paramedics in 2022. The standard questionnaire of WHO on workplace violence in health sector was used to collect data. To describe the quantitative variables, the mean and standard deviations were utilized, and for analyzing the data, multiple logistic regression model was used. The analysis was performed using SPSS 26. Results: The results showed that 47.9% of the participants experienced verbal violence at least once in the past year, and 19.3% experienced sexual violence. Regarding the perpetrators of violence, except for physical violence, colleagues accounted for the highest. Most physical violence cases against the clinical staff were perpetrated by one of the patient’s family members. Gender, marital status, and years of work experience were determined as predictors of workplace violence. Married male employees with limited work experience were disproportionately at risk of workplace violence. Conclusion: Hospital clinical staff were exposed to all kinds of violence, especially verbal violence. Training personnel on the management of workplace violence and enhancing their communication skills and determining the scope, and predictors of workplace violence can help healthcare managers reduce the violence and its complications. [ABSTRACT FROM AUTHOR]

Although bread is the principal food in most countries, polycyclic aromatic hydrocarbons (PAHs) may be present and pose a potential risk to consumers. The aim of this review is to provide a comprehensive report on the concentration and health risks associated with PAHs in bread around the world. Various databases, such as Scopus, PubMed, Science Direct, and Google Scholar, were searched from their beginnings until December 2023 for this systematic review, which included 34 potentially relevant articles with data relating to 1057 bread samples. Utilizing a multilevel regression modeling approach, the study evaluated various factors such as fuel type, bread type, and geographical location. Following the initial evaluation, in 26.47% and 20.28% of all studies, the levels of Bap and PAH4 were higher than the permissible limit values, respectively. Based on the isomer ratios, 55.88% of the studies associated the presence of PAHs in bread samples with pyrogenic/coal combustion sources. According to the carcinogenic risk results, bread consumers in all studies have been exposed to moderate or high levels of carcinogenicity. The most significant risk levels are associated with the consumption of bread in Egypt, Kuwait, Iran, and India. Moreover, meta‐regression analysis demonstrated significantly higher toxicity equivalent quotient and cancer risk mean values in bread baked using fossil fuels compared to other sources (p <.05). The high concentrations of PAHs, especially Benzo[a]pyrene, in bread pose a serious public health risk. Stringent regulations and monitoring are crucial to reduce contamination. Further research is necessary to develop safe processing methods to remove PAHs in bread. [ABSTRACT FROM AUTHOR]

Objective: The impact of self-efficacy and health literacy skills on pregnant women's adherence to urinary tract infection (UTI) preventive behaviors is inadequately investigated. Thus, the present study explored whether an educational intervention based on self-efficacy and health literacy skills managed to improve UTI preventive behaviors among pregnant women. Methods: A quasi-experimental study was conducted from January to July 2021 among pregnant women residing in Mashhad, Iran. To this aim, 110 pregnant women at a gestational age of 12–18 weeks were randomly assigned to a control (n = 55) and an intervention group (n = 55) and completed all questionnaires during the intervention and the 3-month follow-up. The intervention group received the full training program, comprising six 2-hourly training sessions. Results: Most women were from low-income families (69.1%), were housewives (74.5%) with high school education or lower (63.6%). The theory-based intervention had a significant effect (P < 0·05) on UTI preventive behavior outcomes (i.e., clothing habits, nutrition, urination, health, and sexual behaviors) in the intervention group compared with the control group after intervention, and in their variation from baseline to follow-up in all scores. Conclusions: An educational intervention based on health literacy skills and self-efficacy could be an effective theory-based intervention to improve UTI preventive behaviors and reduce recurrent UTI and complications. [ABSTRACT FROM AUTHOR]

Introduction: This study, of significant importance to healthcare professionals, policymakers, researchers, and organizations involved in child healthcare and malnutrition in Afghanistan, aimed to estimate the out‐of‐pocket expenditure (OOPE) in patients under 5 years old with severe malnutrition in a children's hospital in Herat Province, Afghanistan. Method: This study employed a meticulously designed cross‐sectional descriptive‐analytical approach with practical results. The research population consisted of families with malnourished children under 5 who were referred to Herat Children's Hospital. Data was collected using a comprehensive standard World Health Organization questionnaire to gather demographic information from children in Herat. A carefully selected convenience sampling method was used, with 300 referring patients participating in face‐to‐face interviews with the supervisors of these children. After obtaining personal consent and coordinating with health officials, interviews were conducted with the caregivers of children under 5 who suffered from severe malnutrition. The data was then analyzed using robust descriptive statistics, quantitative variables, mean and standard deviation, frequency, and relative frequency. Multiple regression analysis was used to determine the factors that most influenced direct payments from patients' pockets, ensuring the reliability and validity of the findings. Results: The results showed that OOPE in both households with seven and less than seven people and more than seven people was 68%. The findings indicated that among the residents of Herat referred to the studied hospital, these people spent 54% of the treatment costs directly out of pocket. In contrast, people in the rural areas of Herat pay 69% of the treatment costs to receive medical services straight out of pocket. The critical point is that 93% of the families have incurred catastrophic expenses to treat their children suffering from severe malnutrition. The research revealed that the patient's location and the education level of the head of the household were the most significant factors affecting out‐of‐pocket payments by patients. Conclusion: Increasing OOPE in rural Afghanistan poses a significant obstacle to equitable healthcare services and access to appropriate medicines. To support the goal of universal healthcare coverage, geographic imbalances, and broad health financing options must be addressed. Strengthening insurance coverage and more government assistance can significantly reduce these patients' out‐of‐pocket payments. [ABSTRACT FROM AUTHOR]

Patient satisfaction is essential to the patient-centered approach in health services delivery, but little is known about satisfaction with physiotherapy services in Afghanistan. This study evaluated patients' satisfaction with physiotherapy services and related factors in this country. This study was conducted on 420 recipients of a physiotherapy center in Afghanistan. A questionnaire was used to collect data that measured satisfaction in 4 dimensions: treatment process, logistics, organizational factors, and overall. The scale of the questionnaire was 5-point Likert. The highest possible score was 100. Statistics methods included Spearman's correlation coefficient, Mann-Whitney and Kruskal-Wallis tests for univariate analysis, and Linear Regression for multivariate analysis. The average overall satisfaction score was 84.82 ± 13.24. Among the demographic variables, the relationship between education level and overall satisfaction score was significant. The findings of the linear regression model showed that the 3 dimensions of satisfaction, including the treatment process, logistics, and organizational factors, had statistically significant relationships with overall satisfaction. The level of satisfaction was high in all dimensions. To maximize satisfaction, reducing waiting time and better communication with patients, as components of logistics and organizational factors, are suggested. Patients also need to receive feedback from physiotherapists that are an essential components of the treatment process dimension. [ABSTRACT FROM AUTHOR]

Background: The human body changes during life, but research on how sociodemographic characteristics and physical activity (PA) related to all aspects of body image are still unclear and there is conflict in the relevant results. This study aims to examine gender-specific body image perception and physical activity in relation to BMI and sociodemographic characteristics among health employees who worked in health and medical care centers. Methods: The study was a population-based cross-sectional survey of 170 health employees (55 men and 115 women) in Binaloud, Iran. Participants completed a self-administered questionnaire, which consisted of a self-administered Multidimensional Body-Self Image Questionnaire (MBSRQ) and stages of change scales. The full version of Marcus-TTM based on the stages of physical activity changes was used based on 5 items related to regular physical activity behavior and intentions. Results: There were no significant differences between men and women in total body image score, body area satisfaction, and attitude. Disease orientation (p = 0.02) and health orientation (p = 0.05) were the only significant differences between men and women. The number of children, level of education, BMI, and PA had a stronger influence on body image concerns and body dissatisfaction. PA and 7 of the 10 subclasses of MBSRQ (appearance evaluation, fitness evaluation, fitness orientation, health evaluation, health orientation, and illness orientation) showed a significant difference (P<0.05) between participants in the five TTM stages. Conclusion: The ideal body image and body satisfaction may differ by the number of children, level of education, gender, BMI, and PA. Evidence from this study supports that participants' stages of change affect their physical activity and body image perception. This result suggests a need for conducting work/home place intervention to promote adults' body image perception and body area satisfaction based on the usage-specific stage under consideration. [ABSTRACT FROM AUTHOR]

Background: Recently, the pandemic of coronavirus disease 2019 (COVID-19) is a new emerging universal challenge in infectious epidemic disease management. Even today, with access to vaccines, the most effective intervention is behavioral intervention, and as new types emerge, it continues to be significant. The goal of the present study was to promote preventive behaviors during the coronavirus pandemic among oil factory workers using the health belief model (HBM). Methods: A total of 138 onshore shift workers (69 control and 69 case group) were randomly chosen from the two sites of oil fields in southern Iran. Data collection tools were demographic characteristics questionnaire, COVID-19 knowledge questionnaire, HBM questionnaire, and prevention behaviors questionnaire. The Whatsapp application was used to educate the intervention group. Workers completed questionnaires at baseline, after the intervention, and three months after the educational program. Data analyses were done using SPSS software, version 24. Results: Except for knowledge and cues to action, there were significant interactions between time and group for HBM constructs and behavior (P≤0.05). Furthermore, there were significant changes in all variables between follow-up and baseline in the intervention group (P≤0.05). The linear regression indicated that the perceived benefit (ß=0.48, P=0.001) and self-efficacy (ß=0.40, P=0.001) were the most effective factors in preventive behavior, respectively. Conclusion: The results showed that efficient education based on the HBM and emphasizing enhancing knowledge and preventive behavior adoption can prevent individuals from developing COVID-19 and its complications. Considering that the perceived benefits and self-efficacy were the strongest predictor of behavior, attention to these constructs in educational interventions, especially among oil factory shift workers studied, who are at risk of COVID-19 and without enough knowledge, can provide better outcomes related to COVID-19 preventive behaviors. [ABSTRACT FROM AUTHOR]