Arian Azadnia

Objectives: The study aimed to investigate the mental health status of women with female genital mutilation/cutting (FGM/C) and compare it with that of a similar group of women without FGM/C.Methods: A case–control study was carried out in 2018 among 122 women with FGM/C and 125 women without FGM/C who had been referred to one of the general health service centres in Kermanshah Province, western Iran. The 28 item General Health Questionnaire (GHQ-28) was used to collect data on participants’ mental health. A multivariate logistic model with odds ratios (ORs) was used to determine the relationship of independent variables with the outcome variable, mental health status.Results: The mean age of the FGM/C and control groups was 35.7 (standard deviation [SD] 8.6) and 31.3 (SD 7.2) years, respectively. According to the GHQ-28 questionnaire, 65.6% (n = 80) of the FGM/C group and 52% (n = 65) of the control group had symptoms of a mental health disorder; the difference between the groups was statistically significant (p = .03). The prevalence of severe depression in the FGM/C group was significantly higher than in the control group (p = .021). Multivariate logistic regression showed that having a history of FGM/C (adjusted OR 1.79; 95% confidence interval [CI] 1.05, 3.05) and being in employment (adjusted OR 3.46; 95% CI 1.23, 9.74) had a significant effect on presentation with symptoms of a mental health disorder (p < .05).Conclusion: Women who suffer from FGM/C are more vulnerable to mental health disorders such as depression.

Purpose The purpose of this paper is to investigate the prevalence of medication errors (MEs) and the factors affecting them among nurses of hospitals affiliated to Kurdistan University of Medical Sciences (KUMS) in 2016. Design/methodology/approach This is a cross-sectional and descriptive-analytic study. In total, 503 nurses were selected using census method from six hospitals affiliated to KUMS. A self-constructed questionnaire was employed to collect information on nurses’ socio-demographic characteristics (6 items), the prevalence and type of MEs (21 items) and their perceptions about the main causes of MEs (40 items). Data were collected from August 15 to October 15, 2016. In addition, nonparametric and linear regression tests were used to describe the descriptive statistics and analyze the data. Findings The response rate was 73 percent and the monthly reported MEs per nurse was 6.27±11.95. Giving medication at non-scheduled time (28.4 percent), giving multiple oral medications together (22.4 percent) and giving painkillers after operation without physician’s prescription (15.3 percent) were three types of repetitive MEs, respectively. Gender, work experience, and having a second job affected the total number of MEs. “Long and unconventional nursing shifts,” “changing the dosage of medications for patients under observation due to multiple consultations and different doctors’ orders” as well as “failure to give feedback about the causes of errors to nurses by supervisors” were the three prioritized factors for MEs. Originality/value There is a need to reduce MEs in order to improve patient safety. It seems that in order to reduce MEs, systemic and managerial reforms such as reducing the working hours and workload of nurses, giving feedback about the causes of MEs to nurses, and using initiatives to reduce the stress in nurses are necessary.

BACKGROUND: Heart failure (HF) is the most common cardiovascular reason for hospital admission, particularly among patients older than 60 years old. Heart failure with reduced ejection fraction (HFrEF) comprises approximately 50% of all heart failure cases. Home-based cardiac rehabilitation (HBCR) is an alternative option to enhance the participation rate in cardiac rehabilitation (CR) interventions for patients who are not able to attend center-based cardiac rehabilitation (CBCR). The purpose of this review is to clarify the extent to which present studies of HBCR align with the core components defined by both the European Society of Cardiology (ESC) and the British Association for Cardiac Prevention and Rehabilitation (BACPR). METHODS: A critical review was conducted through four databases, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews, to identify randomized controlled trials up until June 2022. We scrutinized the commonalities between BACPR and ESC and developed a list of standards. The risk of bias was assessed using the RoB 2 tool. RESULTS: Among the 87 papers selected for full-text screening, 11 studies met the inclusion criteria. Six papers possessed a high proportion of fidelity to essential standards, four studies had a medium alliance, and one intervention had a low level of alliance. CONCLUSION: Overall, the majority of included studies had medium to high alignment with standards and core components. However, a need for more attention to long-term strategy as an important standard is revealed. Rapid identification and initial assessment are the most met standards; however, lifestyle risk factor management and long-term outcomes were recognized as the least met standards.

Purpose Health is one of the most basic human rights. This study aims to examine the pattern of unmet health services needs and barriers to use health services among people with disabilities. Design/methodology/approach This cross-sectional study was conducted among people with disabilities in Sanandaj, the capital of a less economically developed province in western Iran in 2020. In total, 548 samples were selected using random sampling, and data were collected using a questionnaire. Chi-square test and Fisher's exact test were used to examine the relationship between independent variables including demographic variables and dependent variables. Statistical tests were performed using STATA software package. Findings About 64% and 23% of participants needed outpatient and inpatient services, respectively. The gap between the perceived need and using health services for outpatient and inpatient services was reported to be 55% and 30%, respectively. The main reasons for not seeking the required health care were “insufficient coverage of costs by insurance” and “lack of physical access.” Having supplementary insurance and better economic status were significantly correlated with using outpatient care and having supplementary insurance and type of disability had a significant relationship with using inpatient care. Originality/value There was a big gap between the perceived need, seeking for and receiving health services in people with disabilities. Designing and implementing appropriate interventions to reduce barriers on the way of transforming, the need for health services into demand in the population of people with disabilities should be on the agenda of policymakers and relevant managers in the country.

Aflatoxins are fungal toxins with carcinogenic, mutagenic, and teratogenic properties. Aflatoxin M1 (AFM1) is resistant to autoclave, pasteurization temperature, and other food preservation procedures. The present study aimed to measure and compare the levels of AFM1 in 84 raw milk samples collected during six successive months, including 36 samples from a dairy factory and 48 samples from four major local dairy distribution centers. The day of sampling was selected randomly. AFM1 levels were measured using the ELISA assay. In distribution centers number one, two, three, and four, the levels of AFM1 were higher than the permissible limits in 33%, 25%, 8.3%, and 25% of the samples, respectively. Furthermore, the level of AFM1 in 19.44% of the factory samples was higher than the permissible limits in the United States. The mean AFM1 concentration in distribution centers number one, two, three, and four and the dairy factory was 0.0344, 0.243, 0.19, 0.301, and 0.175, respectively. The results of one-way analysis of variance (ANOVA) indicated no significant difference in the mean concentration of AFM1 with (P=0.279). According to the results, it is recommended that more preventive actions be taken in order to control the AFM1 content of livestock feeds and consumed milk in Kurdistan University, Iran.