ABSTRACT
Purpose: To assess knowledge and preventive practices about osteoporosis among elementary school teachers of Bandar-Abbas in 2020. Materials and Methods: In this cross-sectional study, the schools were selected using simple random sampling, and the teachers were invited to fill out an online questionnaire. The knowledge section of the questionnaire assessed general knowledge and knowledge regarding risk/protective factors, nutrition, and physical activity. The preventive practices section assessed dietary habits using a food frequency questionnaire, asking about 16 items in six groups, intakes of which were compared to the recommendations of the Iranian food pyramid. This section also assessed physical activity using the International Physical Activity Questionnaire. Results: Totally, 377 school teachers with a mean [standard deviation (SD)] age of 38 (6.7) participated in this study. The level of overall knowledge of 128 (33.9%) teachers was high, 222 (58.9%) moderate, and 27 (7.2%) low. The median [interquartile range (IQR)] intakes of fruits [2 (1-2)] and meats/eggs [1.7 (1.4-2.2)] were adequate, while those of dairy products [1.5 (0.9-2.3)], nuts/legumes [0.5 (0.2-1.1)], and vegetables [0.3 (0.1-1)] were inadequate. The median (IQR) intakes of tea/coffee [1 (0.6-2)] and cola [0.1 (0-0.3)] were considered limited. The physical activity level of 121 (32.1%) teachers was high, 124 (32.9%) moderate, and 135 (35%) low. Conclusion: Knowledge of the teachers about osteoporosis was moderate, and their preventive practices were somewhat adequate concerning dietary habits and moderate concerning physical activity.
ABSTRACT
Background: Payments to physicians by the pharmaceutical industry are common, but recent evidence shows that these payments influence physician prescribing behavior in the form of increased prescription of brand-name drugs, expensive and low-cost drugs, increased prescription of payer company drugs, etc. Considering that these payments increase drug costs for patients and health systems, there is a public interest in controlling them. Therefore, this study aimed to identify and propose policy options for managing physician-pharmaceutical industry interactions in the context of Iran's health system. Methods: In the first phase, a systematic search was conducted to identify relevant policies and interventions in Web of Science, PubMed, and ProQuest databases from 2000 to 2022. Then, the opinions of the research team and an expert group (physicians, health policy and transparency experts, and industry representatives) were used to categorize the interventions and propose policy options along with their advantages, disadvantages, and implementation considerations. Results: In the search, 579 articles were retrieved, and 44 articles were found suitable for the final analysis. Twenty-nine interventions and strategies were identified, and based on these; Five policy options were identified: prohibition, restriction, physician self-regulation, voluntary industry disclosure, and mandatory industry disclosure. Conclusion: The proposed policies in our study include advantages, challenges, and implementation considerations based on up-to-date evidence that can help policymakers use them to manage COI in physician-pharmaceutical industry interactions in Iran's health system. A combination of measures seems to help manage COI: firstly, using self-regulating physicians and industry to institutionalize transparency, and in the next step, implementing mandatory industry disclosure policies and establishing restrictions on some financial interactions.
