Estimation of the wastage rate of MMR and pentavalent vaccines in open and closed vials in three western provinces of Iran.

BACKGROUND: Vaccine wastage is one of quality indicators of immunization program and high vaccine wastage will increase overall costs and impede efforts towards a more efficient and sustainable program. We aimed at estimating of the wastage rates of Measles-Mumps-Rubella (MMR) and pentavalent (diphtheria-tetanus-pertussis-hepatitis B -Haemophilus influenza type b) vaccines in different vaccine vial sizes. STUDY DESIGN: Multicentre descriptive study using existing data. METHODS: This study was in three provinces (Hamadan, Kermanshah and Kordestan) of Iran including 131,135 populations with 2,548 under-1years children. Twenty-seven health facilities were selected randomly from nine districts in three provinces of western part of Iran. Six-months data including vaccination and vaccine stock records collected from April to September 2017. Finally, number of opened vials and number of target population vaccinated were collected and data were analysed to estimate the wastage rates in both unopened and opened vials of both antigens. RESULTS: The wastage rate for combined MMR 2-dose and 5-dose opened vials for three provinces was 29%(Hamadan 18%, Kermanshah 14% and Kordestan 52%). The wastage rate for combined pentavalent single-dose and 10-dose vials for three provinces was 17% (in Kordestan33%, 11% Kermanshah 11% and Hamedan 3%). The total average of pentavalent single-dose and 10-dose vials wastage rate was 5% and varied 13% for urban and 3% for rural areas. The average of discarded unopened vials wastage rate in all facilities for MMR was 3.9% (3.2% for MMR 2-dose vial and 10.2% for MMR 5-dose vial). This rate was 1.7% for pentavalent total (1.9% for single dose vial and 0.4% for 10 dose vial). CONCLUSION: The vaccine wastage rates in Iran are in line with other countries and lower than the suggested rate based on WHO policies for multi-dose vials. The wastage rates were different for in provinces, districts and health facilities. The MMR total wastage rate in rural is higher than those in urban areas. However, the pentavalent total wastage rate was higher in urban area.

Skin Cancer Prevention: Psychosocial Predictors of Sunscreen Use in University Students.

Skin cancer has the most prevention potential among all cancers. Sunscreen use is an effective method in reducing the risk prevalence of skin cancer. The aim of this study was to determine the cognitive determinants of sunscreen use among university students based on the health belief model (HBM). This cross-sectional study was conducted among 301 university students in the west of Iran. Students were randomly selected to participate voluntarily in the study. Participants filled out a self-administered questionnaire. Data were analyzed by SPSS version 16 using appropriate statistical tests including correlation and logistic regression at 95% significance level. Our results indicated 44.2% of participants reported had always sunscreen use. Among the HBM constructs, cues to action with odds ratio estimate of 1.146 (95% CI 1.061, 1.239) and perceived self-efficacy with odds ratio estimate of 1.131 (95% CI 1.036, 1.234) were the more influential predictors on always sunscreen use. Female students and high levels of mother's education were significant predictors of sunscreen use. It seems these findings are useful in planning health promotion programs aimed at increasing self-efficacy for sunscreen use.

Correction to: Skin Care Prevention: Psychosocial Predictors of Sunscreen Use in University Students.

The article Skin Cancer Prevention: Psychosocial Predictors of Sunscreen Usein University Students, written by Mehdi Mirzaei-Alavijeh, Hassan Gharibnavaz and Farzad Jalilian, was originally published electronically on the publisher's internet portal (currently SpringerLink) on July 23, 2019 with open access.

Measuring Beliefs Related to Colorectal Cancer Screening Behavior among Iranian Middle-Aged and Elderly: a Psychometric Study

The annual fecal occult blood test is a very important method for colorectal cancer early detection through screening. Our aim was to assess psychometrics of instrument measuring beliefs related to fecal occult blood test uptake among Iranian middle-aged and elderly, based on the theory of planned behavior. This cross-sectional study was performed on 150 middle-aged and elderly who were randomly selected to participate voluntarily in Kermanshah, in the west of Iran. The studied constructs included attitude, subjective norms, perceived behavior control, and behavior intention. Data were analyzed with SPSS software (ver. 21.0). The mean age of the respondents was 59.1 years [SD: 6.73], in the range from 50 to 73. All of the loads of the exploratory factorial analysis were larger than 0.4. KMO was calculated as 0.756. Overall, four factors under investigation accounted for 82% of the variance in the hypothesized model. Cronbach's alpha for the measured constructs of attitude, subjective norms, perceived behavior control, and behavior intention were 0.92, 0.88, 0.70 and 0.88, respectively. Our findings indicated the final scale to be adequately reliable and valid for measurement of these constructs for prediction of fecal occult blood test uptake among Iranian middle-aged and elderly.

Effectiveness of Coping Skills Education Program to Reduce Craving Beliefs among Addicts Referred To Addiction Centers in Hamadan: A Randomized Controlled Trial.

BACKGROUND: One of the most important factors affecting relapse of addiction is craving beliefs of substance use. The goal of the present study was assessment of the effectiveness of coping skills education program to reduce craving beliefs among opium addicts. METHODS: In a randomized controlled trial, during September 2011 to August 2012, 70 opium addicted men referred to the Behavioral Disorders and Substance Abuse Research Center in Hamadan, western Iran were assigned to intervention group (receiving coping skills education program) and control groups. The study information was analyzed using SPSS software. RESULTS: Regarding craving beliefs for continuing drug use, the two groups had similar scales at the beginning of interventional program, while the level of these beliefs was significantly reduced in the intervention group (P= 0.002), but not in the control group (P= 0.105). Also, a significant correlation was also revealed between taking advantage of the educational program and increase awareness of the signs of relapse in the intervention group (P=0.003) that was not revealed in the control (P= 0.174). On the other hand, executing coping skills education program led to reducecraving beliefs and improve knowledge towards signs of relapse. CONCLUSION: Our findings demonstrate positive impact of coping skills education program after detoxification process on decrease of craving beliefs among opium addicts.

Validity and Reliability of the Iranian Version of the HIV/AIDS Stigma Instrument-PLWHA (HASI-P).

BACKGROUND: HIV/AIDS disease has remained highly stigmatized all over the world even though the increasing accessibility of its treatment. This study was designed to adapt the HIV/AIDS Stigma Instrument (HASI) to the Iranian People Living with HIV/AIDS (PLWHA). METHODS: Translation -back translation of the scale into Persian was done. Then, the validity and reliability of the instrument were evaluated. The validity of the translated scale was assessed in three ways: evaluating its linguistic validity, assessing its content validity by a panel of nine experts, and exploring its construct validity by factor analysis. The internal con-sistency of the translated scale was evaluated by Cronbach's Alpha. RESULTS: HASI showed a good Content Validity Index (CVI value >0.75) and Content Validity Ratio (CVR >0.78). The internal consistency of the instrument regarding the total score was α=0.89. The three stigma sub-scales that were dis-tancing and blaming (8 items, α=0.87), fear (3 items, α=0.82), and discrimination (5 items, α=0.83). CONCLUSION: This article reports the development and validation of a new measure of stigma, i.e. HIV/AIDS Stigma Instrument in PLWHA (HASI-P), and pro-vides evidence to support its content validity and internal consistency.