Understanding determinants related to farmers' protective measures towards pesticide exposure: A systematic review.

OBJECTIVE: Pesticide poisoning is the main cause of adverse effects and mortality worldwide. Protective measures can reduce the intensity of the effects of pesticides on the health of farmers. Numerous cross-sectional studies have been conducted on the determinants of performing protective measures to reduce exposure to pesticides, but there is no systematic study that comprehensively examines the impact of these factors. Therefore, the aim of this study is to identify existing studies on the determinants of effective protective measures to reduce exposure to pesticides among farmers. METHODS: In this systematic review, studies were obtained from PubMed, Web of Science and Scopus databases using a search strategy that covered articles from the first years of database design to April 20, 2023. The inclusion and exclusion criteria were based on the PICOs criteria. The study included cross-sectional studies that measured the implementation of protective measures using objective or valid subjective tools. The data were extracted and analyzed based on several criteria and ecological levels. The Ecological Model of Health Behavior was used to classify the determinants that affect the performance of protective behaviors. The National Heart, Lung and Blood Institute (NHLBI) has developed a quality assessment tool for studies. RESULTS: A total of 39 studies were ultimately selected for inclusion in this analysis. Many of these studies were conducted in developing countries. The most important factors that have an impact on protective measures include a variety of socio-demographic characteristics (age, gender, level of education, income, farming experience, experience of using pesticides), individual level (knowledge, attitude, risk perception, intention), interpersonal level (subjective norms), organizational level (education), and public policy level (government attention, health costs, governmental extension services). The quality of most studies was fair. CONCLUSIONS: Research indicates that several factors influence the use of personal protective equipment and safe behaviors when handling pesticides. These include farmers' education level, knowledge, and attitudes towards safety measures. Environmental factors such as access to information, extension services, training programs, and media coverage can also help minimize exposure to pesticides.

Factors related to medication adherence in patients with hypertension in Iran: a systematic review study.

OBJECTIVES: This study aimed to review the available studies of the factors in Iranian hypertensive patients' adherence to drug treatment. METHODS: Four Persian databases and seven English databases were searched. The articles, which were published from 2000 to 2022 in Persian and English and examined the adherence to drug treatment in the Iranian population of adults with high blood pressure, were reviewed. Based on the primary examination, 31 of the initial 1062 articles met the inclusion criteria and were included in the analysis. The evidence, which was provided by the examined articles, was summarized and discussed using the 5-dimensional framework of adherence to long-term treatments, which was developed by WHO. RESULTS: The factors that significantly correlated with adherence to drug treatment in the examined studies were: (1) factors that were related to the health team or the health system: patients' satisfaction with their doctor-patient relationship; (2) factors that were related to the conditions: the number of concomitant diseases, high quality of life and the implementation of effective interventions; (3) factors which were related to the treatment: long duration of illness, short intervals between the visits, duration of treatment, lower numbers of drugs, and the patient's blood pressure control; and (4) factors that were related to the patient: self-efficacy, health literacy, social support, locus of control, illness perception, beliefs, attitude, knowledge, and cues to action. CONCLUSION: It is possible to draw definite conclusions about the factors which affect adherence to drug treatment in patients with high blood pressure because most of the relevant studies have been cross-sectional. Therefore, in the future, valuable results can be obtained by conducting more studies that preferably use objective instruments for assessing adherence to drug treatment.

Interventions to prevent road traffic injuries among pedestrians: a systematic review.

Road traffic injuries (RTIs) are a serious public health problem and are an important cause of disability and death worldwide. A significant proportion of traffic injuries and fatalities are among pedestrians. Reviewing and evaluating related interventions can be a practical step to implementing appropriate methods to prevent RTIs among pedestrians, a highly vulnerable group of road users.The search of articles was conducted in the electronic databases of Scopus, PubMed, ISI, Safety Lit, and CDC. Other papers were also reviewed using forward citation and backward citation. The search strategy was for studies examined from the first years of database creation until January 10, 2021, in all languages in journals with matched judgment according to the type of population, type of interventions, comparators, and results. Joanna Briggs Institute (JBI) checklists were used to determine articles' quality and assess possible biases depending on the type of study.The initial search resulted in finding 16,272 abstracts. Finally, 25 studies, including 17 randomized clinical trials (RCTs) studies, seven studies pretest/post-test interventions (PPI), and one study controlled pretest/post-test interventions (cPPI) met the inclusion criteria. Among these preventive interventional studies, 20 studies were conducted in high-income countries, three were in lower middle-income countries, one study was in upper middle-income country, and only one study was conducted in a low-income country. Most interventional studies in the field of prevention of RTIs (15 studies) had an educational/behavioral approach, designed to change pedestrian behavior and the use of this approach was also effective in improving pedestrian behavior. The legislation/law enforcement approach was used in one study and two studies used an engineering/technology approach. In studies with an engineering approach after engineering reforms, pedestrian injuries in children decreased by 37.5%. In seven studies, multifaceted interventions were used. The interventional studies that used this approach were able to improve pedestrian safe behavior.The majority of studies were based on educational/behavioral approaches and pedestrians' behavior improved notably. In addition, the majority of interventional studies were conducted in countries with high income levels. Therefore, programming for preventive interventions to attenuate RTIs is highly important in low/middle-income countries to reduce the risk of injury to vulnerable road users. These findings can be applied by policy-makers to develop educational, engineering, environmental, and law enforcement interventions and attenuate injuries sustained by pedestrians.