Determinants of Neonatal, Infant and Child Mortalities in Iran: A Systematic Review.

Background: Children mortality is considered as one of the main indicators of population development and health, while most of the children's deaths are preventable. This study systematically reviewed the determinants of children mortality in Iran. Methods: This systematic review was conducted to summarize all the factors associated with children mortality in three age groups; Neonate (0-28 d), Infant (28 d-1 yr old) and children (<5 yr old), based on the PRISMA guideline. Many of the electronic international and national databases, in addition to hand searching of reference of selected articles, grey literature, formal and informal reports and government documents were screened to identify potential records up to Jan 2022. We included all studies that identified determinants of child mortality in any province of Iran or the whole country, without any restriction. Results: Overall, 32 studies were included, published between 2000 and 2022, of which 23 were cross-sectional and 15 published in Farsi language. The associations between several risk factors (n=69) and the child mortality were examined. Among the identified factors, 'birth weight', 'mother's literacy', 'socioeconomic status', 'delivery type', 'gestational age', 'pregnancy interval', 'immaturity', 'type of nutrition', and 'stillbirth' were the most important mentioned determinants of child mortality in Iran. Conclusion: Appropriate interventions and policies should be developed and implemented in Iran, addressing the main identified associated factors, resulting from this review study, with the aim of minimizing preventable child deaths, based on their age categories.

The relationship between meaning of life, perceived social support, spiritual well-being and pain catastrophizing with quality of life in migraine patients: the mediating role of pain self-efficacy.

BACKGROUND: Migraine is a neurological disease that has several physical and psychological complications, which is characterized by disability and impaired quality of life. AIMS: The aim of this study was to explore the mediating role of pain self-efficacy in the relationship between meaning of life, perceived social support, spiritual well-being and pain catastrophizing with quality of life in migraine sufferers. The relationship between these factors with quality of life (QOL) was not fully explored in migraine patients. METHOD: This study was a correlational study of structural equations. Therefore, 300 patients with migraine who referred to one of the specialized neurological treatment centers in Zanjan in 2021 were recruited based on the inclusion criteria. Patients also completed the World Health Organization Quality of Life Scale (WHOQOL-BREF), Meaning in Life Questionnaire, Multidimensional Scale of Perceived Social Support, Spiritual Well-Being Scale, Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire. Finally, the hypotheses were then analyzed with correlation coefficient and path analysis method by using SPSS-26 and LISREL-10.2 programs. RESULTS: The results of the present study showed that pain self-efficacy has a mediating role in the relationship between meaning of life and quality of life (B = 0.015), perceived social support with quality of life (B = 0.022), spiritual well-being with quality of life (B = 0.021), as well as pain catastrophizing with quality of life (B = - 0.015). CONCLUSION: According to the results of this study, by considering the role of self-efficacy of pain, it is possible to develop the programs to strengthen and improve the meaning of life, perceived social support, spiritual well-being and also reduce pain catastrophizing, in order to improve the quality of life of patients with migraine.

Medical radiation workers' knowledge, attitude, and practice to protect themselves against ionizing radiation in Tehran Province, Iran.

BACKGROUND: Medical radiation workers are potentially at a risk of unwanted ionizing radiation exposures. This study assessed the radiation protection knowledge, attitude, and practice (RP-KAP) of health-care workers who are occupationally exposed to radiation regarding protecting themselves from radiation. MATERIALS AND METHODS: This study was cross-sectional in design and was carried out in 16 hospitals affiliated to the Tehran University of Medical Sciences between May and September 2014. Total health-care workers who were occupationally exposed to radiation comprising 670 individuals were included in the study based on census sampling method. In total, 413 individuals consented to complete an anonymous 32-item questionnaire comprising single best choice questions with a numerical value assigned to each correct answer. Each set of RP-KAP questions was scored and categorized as poor, medium, and good. The effect of independent variables for prediction of RP-KAP was explored using linear regression analyses. RESULTS: A significant number of participants had poor RP-knowledge (78.9%), RP-attitude (70.7%), and RP-practice (32.4%). Based on linear regression analyses, it was found that field of study (ß = 0.1, P = 0.001), marital status (ß = -0.14, P = 0.01), and level of education (ß = 0.2, P < 0.001) were the predictors of higher RP-knowledge. In-service RP-training (ß = 0.1, P = 0.04) was associated with an increased RP-attitude. Being a woman (ß = 0.2, P < 0.001) and longer years of experience with radiation (ß = 0.2, P < 0.001) were significantly related to better practice. CONCLUSION: In-service training with appropriate qualified and up-to-date materials based on radiation workers' educational needs and approved protocols and guidelines is recommended.

Association between upper extremity musculoskeletal disorders and mental health status in office workers.

BACKGROUND: Musculoskeletal Disorders (MSDs) can lead to potential adverse consequences for individuals and their organizations, and in various research, its relationship to physical and mental health of workforce has been studied. OBJECTIVE: The purpose of this study was to determine the prevalence of MSDs of upper extremities among office workers and its association with mental health status. METHODS: In this cross sectional study, 1488 out of 1630 office workers completed the Standardized Nordic Musculoskeletal Disorders Ques-tionnaire and General Health Questionnaire (GHQ-28) (response rate = 91.3%). RESULTS: Upper extremity MSDs were reported in 410 (27.5%) office workers, including 269 (18.1%) shoulder, 79 (5.3%) elbow and 207 (13.9%) hand/wrist symptoms. Based on GHQ-28, 254 (17.1%) participants were found to be at risk of developing a psychiatric disorder that were observed in 26.7% of workers with MSDs symptoms. Shoulder (p < 0.001), elbow (p < 0.001) and hand/wrist (p < 0.001) MSDs were associated with poor mental health. Among the four GHQ-28 subscales (somatic symptoms, anxiety/insomnia, social dysfunction, and depression), anxiety/insomnia was strongly correlated with shoulders (P < 0.001), elbows (P = 0.002), and hands/wrists (P < 0.001) symptoms. CONCLUSION: Office workers with upper extremity MSDs were more likely to be experiencing mental distress. This indicates a need for greater emphasis on preventive programs at workplace to support their psychological well-being.

THE RELATIONSHIP BETWEEN HOFSTEDE ORGANIZATIONAL CULTURE AND EMPLOYEES JOB BURNOUT IN HOSPITALS OF TEHRAN UNIVERSITY OF MEDICAL SCIENCES 2014-2015.

OBJECTIVE: Organizational culture plays a supportive role in modification of structure and implementation of new management systems. So, the management of organizational culture with cultural elements recognition plays an important role in improving the efficacy and effectiveness of the organization. On the other hand, the health sector requires healthy and motivated practitioners and staff to achieve these goals. Job burnout as a response to environmental stressors causes some changes in attitude and behavior towards work and work environment, and factors such as organizational culture effect on it. This study aimed to clarify the relationship between organizational culture and employee's burnout. MATERIAL AND METHODS: This is a descriptive and cross-sectional study. The study population included all clinical staff (physicians and nurses) and nonclinical (administrative and financial) in hospitals affiliated to Tehran University of Medical Sciences in 2014-2015. Among them, 387 participants were selected using simple stratified random sampling. In order to collect the required data, the Maslach Burnout Inventory (1981) and Hofstede's organizational cultural questionnaire (1988) were used. Also Cronbach's alpha obtained 0.836 and 0.913 for them, respectively. In order to analyze the data, the Kolmogorov-Smirnov test, multiple regression, independent t-test and binomial test were performed using SPSS 20. RESULTS: Results showed that organizational culture in studied population were masculine, collectivism with high uncertainty avoidance and relatively equitable power distance. Mean score for emotional exhaustion was (31.4) and most of participants 315 (40.6%) had average emotional exhaustion. Mean score for depersonalization was (21.16) and most of participants 315 (82.1%) had high depersonalization. Mean score for personal accomplishment was (30.02) and most of participants 280 (73.2%) had high personal accomplishment. Multiple correlation coefficient showed that there is a significant relationship between the components of organizational culture including masculinity/femininity, individualism/collectivism, uncertainty avoidance and power distance with job burnout (r=0.305, p>0.001). R(2) also showed that 9.3 percent of the variance of job burnout is related to the mentioned factors. CONCLUSION: The overall result is that some staff health issues rooted in their culture; so, the organizational culture assessment by hospital managers to plan and goals achievement is essential. If necessary, improving organizational culture, creating a healthy environment, enhancing tolerance and individual adjustment and stress control can help to reduce staff burnout.

Radiation Protection Knowledge, Attitude and Practice (RP-KAP) as Predictors of Job Stress Among Radiation Workers in Tehran Province, Iran.

BACKGROUND: In recent years, much attention has been paid to occupational stress, but relatively little or no research has been conducted on the influence of knowledge, attitude, and practice of radiation protection (RP-KAP) on job stress among radiation workers. OBJECTIVES: This study aims to assess job stress among health care workers in Iran who are occupationally exposed to radiation in order to determine the effects of KAP on self-protection against radiation on their job stress. MATERIALS AND METHODS: The population in this descriptive cross-sectional study comprised 670 healthcare workers, including 428 staff with a degree in radiology and 242 other medical personnel who were working in 16 hospitals affiliated with Tehran University of Medical Sciences (TUMS) in Tehran, Iran. The census method was used to sample the workers. In total, 264 staff with a degree in radiology and 149 other medical personnel completed the job content questionnaire (JCQ) and the RP-KAP questionnaire from May to November 2014. RESULTS: The prevalence rate of job stress was 22.5% based on calculation formulas and possible scores on the JCQ. Sex, RP-knowledge, attitude, practice, and in-service training predicted 41.8% of the variance in job stress. According to the results of the binary logistic regression, workers with higher scores on knowledge (OR = 0.82, 95% CI: 0.75 - 0.90), attitude (OR = 0.71, 95% CI: 0.63 - 0.82), and practice (OR = 0.78, 95% CI: 0.72 - 0.86) and those who had participated in training programs had significantly lower rates of job stress (OR = 0.51, 95% CI: 0.28 - 0.93). CONCLUSIONS: The effects of RP knowledge, attitude, and practice on job stress were significant. In order to reduce job stress in radiation environments, ongoing training programs related to self-care and protection principles are recommended.

Risk Factors for Upper Extremity Musculoskeletal Disorders Among Office Workers in Qom Province, Iran.

BACKGROUND: The identification of the risk factors for musculoskeletal disorders (MSDs) is the first step in designing effective preventive interventions. OBJECTIVES: To investigate the association between individual, organizational, physical, and psychological factors and upper extremity MSDs (i.e., shoulder, elbow and hand/wrist). MATERIALS AND METHODS: In this cross-sectional study, the study population was comprised of office workers from Qom Province, Iran. Of the 1630 Iranian office workers who were selected via a random multistage cluster sampling method, 1488 completed a comprehensive data collection form designed to investigate the individual, organizational, physical, and psychological factors related to MSDs (response rate: 91.3%). RESULTS: The predictors of shoulder MSDs in the past 12 months were uncomfortable sitting posture (ß = 0.42, P = 0.04), limited rest breaks (ß=0.73, P = 0.012), and no access to adjustable desks (ß = 0.43, P = 0.018). Working on a computer for more than five hours (ß = 0.61, P = 0.004) and an uncomfortable sitting posture (ß = 0.79, P = 0.001) predicted hand/wrist symptoms. CONCLUSIONS: Various risk factors in the workplace may contribute to MSDs in different upper extremities. Preventive interventions should hence include ergonomic and office equipment modifications.