Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1216 1224 EN Nariman Yermek 1. Academy of Public Administration under the President of the Republic of Kazakhstan, Institute of Management, Astana, Kazakhstan 2. Central Asian Institute for Medical Research, Astana, Kazakhstan Ane Tynyshbayeva Academy of Public Administration under the President of the Republic of Kazakhstan, Institute of Management, Astana, Kazakhstan Zarina Bilyalova Central Asian Institute for Medical Research, Astana, Kazakhstan Dulat Turebayev 1. Central Asian Institute for Medical Research, Astana, Kazakhstan 2. Astana Medical University, Astana, Kazakhstan Gulnur Igissinova 1. Central Asian Institute for Medical Research, Astana, Kazakhstan 2. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan Rustem Moldagali 1. Central Asian Institute for Medical Research, Astana, Kazakhstan 2. Kokshetau Higher Medical College, Kokshetau, Kazakhstan Karina Kozhakhmet 1. Central Asian Institute for Medical Research, Astana, Kazakhstan 2. Higher School of Medicine at Ualikhanov University, Kokshetau, Kazakhstan Kulsara Rustemova 1. Central Asian Institute for Medical Research, Astana, Kazakhstan 2. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan Zhansaya Telmanova Central Asian Institute for Medical Research, Astana, Kazakhstan Ivan Shishkin 1. Central Asian Institute for Medical Research, Astana, Kazakhstan 2. Higher School of Medicine at Ualikhanov University, Kokshetau, Kazakhstan Nurbek Igissin 1. Central Asian Institute for Medical Research, Astana, Kazakhstan 2. Research Institute of Life and Health Sciences at Ualikhanov University, Kokshetau, Kazakhstan 2025 02 17 2025 06 02 Background: Cancer is a major public health challenge in Kazakhstan, with significant regional disparities in incidence and access to care. The Akmola Region faces socioeconomic and healthcare barriers affecting oncology outcomes. We examined the role of state policy in addressing cancer trends and proposed evidence-based interventions. Methods: A retrospective descriptive and analytical study was conducted using cancer incidence data from 2009 to 2023, obtained from the Ministry of Health of Kazakhstan. Age-standardized rates (ASRs) were calculated using the WHO guidelines. Joinpoint regression analysis was applied to assess trends. Social factors, including income and access to care, influenced cancer rates. Rural areas faced notable disparities in oncology services. Results: Over 15 years, 26,625 new cancer cases were recorded, with 48.9% in men and 51.1% in women. The most prevalent cancers were breast (11.8%), colorectal (9.5%), and gastric (8.8%). A decline in cancer incidence occurred in 2020, likely due to healthcare service disruptions during COVID-19. Social factors like income and care access shaped cancer rates. Rural areas faced notable disparities. Conclusion: Strengthening state policies is crucial for reducing the cancer burden. Recommendations include expanding screening programs, improving healthcare infrastructure, and addressing regional inequalities through intersectoral collaboration. Implementing evidence-based strategies and integrating global best practices can enhance oncology care and reduce disparities. https://ijph.tums.ac.ir/index.php/ijph/article/view/38203 https://ijph.tums.ac.ir/index.php/ijph/article/download/38203/8573

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1118 1131 Liang Zhang School of Foreign Studies, China University of Political Science and Law, Changping District, Beijing, 102249, China 2024 11 23 2025 01 21 Background: A meta-analysis study was conducted to measure how to forecast the effect of treatment of hypokinetic dysarthria in Parkinson's-disease with speech and language therapy. Methods: Until October 2024, a comprehensive literature research was conducted, and 1665 related studies were reviewed.  The 14 selected studies encompassed 948 participants with hypokinetic dysarthria in Parkinson's disease.  The odds ratio (OR) mean difference (MD) and 95% confidence intervals (CIs) were used to look at the outcome of treatment of hypokinetic dysarthria in Parkinson's disease with speech and language therapy using dichotomous or continuous methods with a fixed- or random-effects model. Results: In individuals with hypokinetic dysarthria in Parkinson-disease, speech and language therapy had significantly higher sound pressure level, phonation (MD, 7. 51; 95% CI, 3. 81-11. 20, p<0. 001), reading (MD, 8. 83; 95% CI, 4. 96-12. 69, p<0. 001), monologue (MD, 4. 28; 95% CI, 2. 47-6. 10, p<0. 001), and picture description (MD, 3. 64; 95% CI, 1. 78-5. 50, p<0. 001), and lower Voice Handicap Index (MD, -5. 61; 95% CI, -9. 05- -2. 17, p=0. 001) compared to control treatment. Conclusion: In individuals with hypokinetic dysarthria in Parkinson's disease, speech and language therapy had significantly higher sound pressure level, phonation, reading, monologue, and picture description, and lower Voice Handicap Index compared to control treatment. To validate these finding more studies are required, caution is needed when interpreting these results, since many comparisons had a limited number of selected studies. https://ijph.tums.ac.ir/index.php/ijph/article/view/37283 https://ijph.tums.ac.ir/index.php/ijph/article/download/37283/8564

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1320 1322 Yasemin Ozkaya Department of Family Medicine, Izmir City Hospital, Izmir, Turkey Merve Turan Karabağlar Family Health Center No., Izmir, Turkey Busra Emir Department of Biostatistics, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey Demet Alaygut Department of Pediatric Diseases, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey Dilek Orbatu Department of Pediatric Diseases, Behcet Uz Pediatric Diseases and Surgery Training and Research Hospital, Iz-mir, Turkey Kayı Eliacik Department of Pediatric Diseases, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey 2024 10 21 2024 11 18 No Abstract. Not have abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/36989 https://ijph.tums.ac.ir/index.php/ijph/article/download/36989/8584

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1225 1232 Milorad Stojadinovic 1. Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia 2. Department of Nephrology, University Clinical Center Serbia, Belgrade, Serbia Radica Zivkovic Zaric 1. Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia 2. Department of Clinical Pharmacology, University Clinical Center Kragujevac, Kragujevac, Serbia Dejan Petrovic 1. Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia 2. Department of Nephrology, University Clinical Center Kragujevac, Kragujevac, Serbia Aleksandra Kezic 1. Department of Nephrology, University Clinical Center Serbia, Belgrade, Serbia 2. Department of Internal medicine, Medical Faculty, University of Belgrade, Belgrade, Serbia Milan Radovic 1. Department of Nephrology, University Clinical Center Serbia, Belgrade, Serbia 2. Department of Internal medicine, Medical Faculty, University of Belgrade, Belgrade, Serbia Svetlana Jovicic Pavlovic Department of Nephrology, University Clinical Center Serbia, Belgrade, Serbia Ivana Mrdja Department of Nephrology, University Clinical Center Serbia, Belgrade, Serbia Lara Hadzi Tanovic Department of Nephrology, University Clinical Center Serbia, Belgrade, Serbia Violeta Knezevic 1. Department of Nephrology, University Clinical Center Vojvodina, Novi Sad, Serbia 2. Department of Internal Medicine, Medical Faculty, University of Novi Sad, Serbia Dejan Pilcevic 1. Department of Nephrology, Medical Military Academy, Belgrade, Serbia. 2. Department of Internal Medicine, Medical faculty of the Military Medical Academy, University of defense in Belgrade, Serbia Tamara Jemcov 1. Department of Internal Medicine, Medical Faculty, University of Belgrade, Belgrade, Serbia 2. Department of Nephrology, General Hospital Zemun, Belgrade, Serbia Marija Karapandzic Department of Nephrology, General Hospital Zemun, Belgrade, Serbia Slobodan Jankovic 1. Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia 2. Department of Clinical Pharmacology, University Clinical Center Kragujevac, Kragujevac, Serbia 2024 07 11 2024 12 23 Background: Increasing healthcare spending is a significant issue, with the aging population contributing to a rise in patients needing renal replacement therapy. The cost of peritoneal dialysis (PD) is substantial, particularly in upper-middle-income countries like Serbia. We aimed to identify the direct costs and influencing factors of treating peritoneal dialysis-associated peritonitis (PD associate peritonitis) in Serbia. Methods: A retrospective observational study was conducted on consecutive patients admitted due to PD-associated peritonitis in five tertiary care hospitals across Serbia in 2019-2022. The primary outcome was total cost of hospitalization. Potential predictors were determined using generalized linear model with a gamma probability distribution and a log link function. Results: The study included 122 patients. The average total cost per patient was 1131.90±1538.67 USD, with the cost of hospitalization (348.17 ± 361.52 USD) and antibiotics (294.94±465.88 USD) being the most significant. The length of hospitalization (P<0.001) and treatment outcome (P<0.001) were found to be significant predictors of the total cost. Conclusion: The costs of treating PD associate peritonitis in Serbia are substantial, with each additional day of hospitalization significantly increasing the cost. The importance of patient and doctor education about infection prevention is underscored by the health consequences and the lengthy, expensive treatment when an infection occurs. https://ijph.tums.ac.ir/index.php/ijph/article/view/36049 https://ijph.tums.ac.ir/index.php/ijph/article/download/36049/8574

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1132 1141 Rosita Yuliandari Doctoral Program of Public Health, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia Chatarina Wahyuni Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia Fariani Syahrul Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia Hari Notobroto Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia Mochammad Qomaruddin Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia Soedarsono . Sub-Pulmonology Department of Internal Medicine, Faculty of Medicine, Universitas Hang Tuah, Surabaya, Indonesia 2024 08 16 2024 10 11 Background: Despite the significant efforts in tuberculosis (TB) management, TB case detection remains a challenge in developing countries. Traditional methods such as Directly Observed Treatment Short-course (DOTS) have often underperformed, necessitating the implementation of the public-private mix (PPM) strategy in recent decades. However, varied PPM models yielded varied results across different countries. Hence, this systematic review assesses the effectiveness of various PPM models and seeks innovative strategies to enhance TB detection. Methods: A systematic search was conducted using PubMed, Scopus, Embase, and Web of Science up to August 2024. Studies evaluating the efficacy of PPM models on TB case detection in developing countries were pooled. From the initial 731 potential studies, a total of 10 studies were finally included in this systematic review. Results: The review identified a variety of PPM interventions, including mass campaigns, mobile screening units, home-based tracking, and digital CXR examination. These approaches significantly raised tuberculosis detection rates compared to control groups or previous years. Notably, private sector involvement and novel approaches, such as application-based tracking in Vietnam and mobile vans equipped with digital X-rays in India, yielded favorable results. However, the variation in effectiveness rate underscored the importance of personalized approaches based on local contexts.    Conclusion: PPM models, especially those with innovative techniques, significantly enhance TB case detection. Scaling up and modifying these strategies to various country circumstances is critical to meeting global TB reduction targets. https://ijph.tums.ac.ir/index.php/ijph/article/view/36390 https://ijph.tums.ac.ir/index.php/ijph/article/download/36390/8565

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1323 1324 Duygu Ayhan Başer Department of Family Medicine, University of Hacettepe, Ankara, Türkiye 2025 03 08 2025 06 02 No Abstract. Not abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/38426 https://ijph.tums.ac.ir/index.php/ijph/article/download/38426/8585

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 493 494 Seji Ahn 1. Division of Sport Science, Incheon National University, Incheon, Republic of Korea 2. Sport Science Institute, Incheon National University, Incheon, Republic of Korea 3. Health Promotion Center, Incheon National University, Incheon, Republic of Korea 4. Functional Rehabilitation Biomechanics Laboratory, Incheon National University, Incheon, Republic of Korea Seoungeun Lee Department of Nursing, Kyung-In Women’s College, Incheon, Republic of Korea Kyoungkyu Jeon 1. Division of Sport Science, Incheon National University, Incheon, Republic of Korea 2. Sport Science Institute, Incheon National University, Incheon, Republic of Korea 3. Health Promotion Center, Incheon National University, Incheon, Republic of Korea 4. Functional Rehabilitation Biomechanics Laboratory, Incheon National University, Incheon, Republic of Korea 2022 07 26 2022 09 02 No Abstract No Abstract  No Abstract  https://ijph.tums.ac.ir/index.php/ijph/article/view/29413 https://ijph.tums.ac.ir/index.php/ijph/article/download/29413/8177

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 367 375 Jeonga Kwon Department of Elementary Education, Korea National University of Education, Cheongju, Korea Yeon Taek Kwon Department of Sports Science, Hongik University, Sejong, Korea 2023 11 29 2024 01 30 Background: We investigated whether physical activity, subjective body image, and perceived stress were linked to watching Mukbang and Cookbang broadcasts among Korean adolescents. Adolescents mainly watch Mukbang and Cookbang shows through media platforms such as YouTube and Instagram. Methods: We examined data on 51,743 Korean adolescents who participated in the Korea Youth Risk Behavior Survey in 2022. Data were evaluated using frequency, chi-square, and multivariate logistic regression analyses. Specifically, the relationship between watching Mukbang and Cookbang broadcasts and physical activity participation, subjective body image, and perceived stress was evaluated through a multivariate logistic regression analysis after adjusting for covariates such as sex, age, school type, and residential area. Results: The results showed that among Korean adolescents, watching Mukbang and Cookbang broadcasts was significantly related to the negative effects of feeling fatter and more stressed and the positive effect of greater participation in physical activities (possibly to combat feeling fat) (P<0.05). In other words, this study confirms that watching Mukbang and Cookbang broadcasts has the simultaneous effect of increased physical activity participation in conjunction with negative subjective body images.  Moreover, it increased perceived stress in adolescents. Conclusion: Adolescents must be better educated about Mukbang and Cookbang broadcasts and their negative impact on subjective body image and perceived stress (as well as their positive impact on physical activity). Such education can help prevent these shows from creating negative teenage habits that can continue into adulthood. These results can be used as basic data for health education and policies that warn about the potential negative effects of such programs.   https://ijph.tums.ac.ir/index.php/ijph/article/view/33916 https://ijph.tums.ac.ir/index.php/ijph/article/download/33916/8162

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 280 292 EN Seyed Gholamreza Noorazar Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran Mohammadreza Mirzaei Department of Persian Medicine, Faculty of Traditional Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Parinaz Kalejahi Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran 2022 11 10 2023 07 05 Background: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with a complex etiology. Stimulants as a first-line treatment are not effective in some cases. In this study, we conducted a systematic review to evaluate the efficacy of traditional Persian Iranian medicine (TIM) for children and adolescents with ADHD. Methods: Data were collected mainly from PubMed, Google Scholar, Web of Science, ProQuest, and Scopus databases until Dec 2022. The keywords related to ADHD, traditional Persian medicine (TPM), and (TIM) were searched. Two reviewers independently screened 714 abstracts and eventually, eight trials were included in the systematic reviews. Changes in the severity of ADHD symptoms were considered based on the validated cutoff on recognized rating scales as the result of the effect of TIM on ADHD. Results: Interventions included herbal extracts of Passiflora incarnate, whey protein, Ginkgo biloba, Crocus sativus L, sweet almond syrup, and horse milk. In all studies, except G. biloba, there was evidence of a reduction in the severity of ADHD. Low evidence could be found for G. biloba. Conclusion: Herbal and traditional remedies are an efficient and safe solution to alleviate the symptoms of ADHD. In future studies, TIM as a complementary therapy may be useful to alleviate ADHD symptoms, especially in children who are resistant to stimulant medications.   https://ijph.tums.ac.ir/index.php/ijph/article/view/30315 https://ijph.tums.ac.ir/index.php/ijph/article/download/30315/8154

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 376 386 Haiyan Zhang Zhongjing Institute of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou city, Henan Province, China Quan Qiu Zhongjing Institute of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou city, Henan Province, China Qingya Li Zhongjing Institute of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou city, Henan Province, China Long Feng Department of Pathogenic Organism Biology, Henan University of Chinese Medicine, Zhengzhou city, Henan Province, China Dongyang Li Zhongjing Institute of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou city, Henan Province, China Miao Zhang Zhongjing Institute of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou city, Henan Province, China Juan Wang Zhongjing Institute of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou city, Henan Province, China Suna Ma Zhongjing Institute of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou city, Henan Province, China Liran Xu Zhongjing Institute of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou city, Henan Province, China 2023 07 03 2023 11 01 Background: We aimed to distinguish the different Chinese medicine (CM) syndromes of acquired immune deficiency syndrome (AIDS) patients at the proteomics level. Methods: We collected AIDS patients diagnosed with different CM syndromes from Weishi County, Kaifeng City, Henan Province, China, including Qi-deficiency syndrome (named QD group) and dampness-heat syndrome (named DH group). Healthy people were collected as controls from Weishi County, Kaifeng city, Henan Province, China. The plasma from three groups were labeled with ITRAQ, LC/MC was used for protein quantitative analysis. Finally, sequence search and cluster analysis were performed. Results: Overall, 27 different proteins were found. Three proteins were up-regulated and 2 proteins down-regulated in the QD group, 11 proteins up-regulated and 13 proteins down-regulated in the DH group. Compared with DH group, there were 7 different proteins in QD group, among which 5 proteins were down-regulated and 2 proteins were up-regulated. When the target protein of DH group was up-regulated, the protein of HC group was down-regulated correspondingly. Conclusion: The significance analysis and clustering of protein results showed that DH group was significantly different from QD group and HC group at the protein level (P<0.05). However, the QD group could not be effectively distinguished from the HC group. AAT, PF4, C-reactive protein and c4bp may be used as potential biomarkers in DH group. Mass spectrometry based on feature selection can be used to classify different CM syndromes. https://ijph.tums.ac.ir/index.php/ijph/article/view/32542 https://ijph.tums.ac.ir/index.php/ijph/article/download/32542/8163

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 293 304 Qiusha Li School of Public Health, Shandong Second Medical University, Shandong, China Zixuan Zhao School of Public Health, Shandong Second Medical University, Shandong, China Chunxiao Yang School of Public Health, Shandong Second Medical University, Shandong, China Zhongming Chen School of Management, Shandong Second Medical University, Shandong, China Wenqiang Yin School of Management, Shandong Second Medical University, Shandong, China 2023 06 12 2023 08 16 Background: The elderly represents the population group with the highest rate of sedentary behavior. Sedentary behavior has an adverse impact on the elderly, which might be related to depression. Methods: We queried PubMed, EMBASE, Web of Science, and MEDLINE to collect literature data. The odds ratio (OR) and corresponding 95% confidence interval (CI) were adopted for the pooled measurements. Sub-group analyses were conducted through stratified meta-analyses based on study design, depression indicator, adjustment for physical activity, sedentary behavior indicator, and type. Sensitivity analyses were performed to test the robustness of the results, and publication bias was assessed through a funnel plot. Results: Seven cross-sectional studies and five cohort studies were included in our meta-analysis. The overall pooled OR was 1.38 (95%CI: 1.16–1.65; P < 0.01), which indicated that sedentary behavior was positively associated with depression in older adults. Sub-group analysis showed that different study designs, depression indicators, sedentary behavior indicators, adjustment for physical activity, sedentary behavior indicator, and type produced different results. In the cross-sectional studies (OR = 1.45, 95%CI: 1.15–1.84), CES-D scale (OR = 1.54, 95%CI: 1.13–2.10), self-reported (OR = 1.39, 95%CI: 1.04–1.87), watching TV (OR = 1.75, 95%CI: 1.02–3.02), and not adjusted for physical activity (OR = 1.37, 95%CI: 1.14–1.65) groups, there was a strong correlation between sedentary behavior and depression in the elderly. Conclusion: Sedentary behavior is asSedentary behaviorsociated with depression in the elderly. As a preventive strategy, we should consider reducing their sedentary time and appropriately increasing physical activity. https://ijph.tums.ac.ir/index.php/ijph/article/view/32277 https://ijph.tums.ac.ir/index.php/ijph/article/download/32277/8155

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 387 396 Slavica Djordjevic 1. Department of the High School of Health, Academy of Applied Studies Belgrade, Belgrade, Serbia 2. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Igor Dimitrijevic 1. Department of the High School of Health, Academy of Applied Studies Belgrade, Belgrade, Serbia 2. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Katarina Boricic Institute of Public Health of Serbia, Dr. Milan Jovanović Batut“, Belgrade, Serbia Snezana Radovanovic 1. Department of Social medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia 2. Institute for Public Health Kragujevac, Kragujevac, Serbia 3. Center for Harm Reduction of Biological and Chemical Hazards, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Ivana Simic Vukomanovic 1. Department of Social medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia 2. Institute for Public Health Kragujevac, Kragujevac, Serbia Olgica Mihaljevic Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Sofija Jovanovic Faculty of Medicine, University Belgrade, Belgrade, Serbia Nevena Randjelovic 1. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia 2. University Clinical Center Kragujevac, Center for Internal Oncology, Kragujevac, Serbia Ana Lackovic Health Center "Dr Milutin Ivković" Palilula, Belgrade, Serbia Snezana Knezevic 1. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia 2. Health Center Kraljevo, Kraljevo, Serbia Veroslava Stankovic 1. Department of the High School of Health, Academy of Applied Studies Belgrade, Belgrade, Serbia 2. Faculty of Medical Sciences, University of Nis, Kruševac, Serbia Marija Sorak Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Verica Jovanovic Institute of Public Health of Serbia, Dr. Milan Jovanović Batut“, Belgrade, Serbia 2023 11 26 2024 01 30 Background: Approximately 2.3 million female breast cancer cases were identified globally in 2020, resulting in 685,000 fatalities among women. Serbia too experiences a high breast cancer burden. Effective reduction of breast cancer incidence and mortality necessitates strategic measures encompassing the implementation of cost-effective screening technology. However, various impediments to screening implementation persist. We aimed to estimate the impact of socioeconomic factors on breast cancer screening in Serbia. Methods: Data from the 2019 National Health Survey of the population of Serbia was. The research was a descriptive, cross-sectional analytical study by design, on a representative sample of the population of Serbia. Data from women aged 15+ yr were used to examine the demographic and socioeconomic factors associated with breast cancer screening inequalities. Results: In Serbia the age group of women who predominantly participated in organized breast cancer screening (39.5%) were the ones aged 65+ yr. Women with a secondary education were 2.1x more likely to undergo a screening exam voluntarily (57.5%), compared to women with a higher education background (26.6%). When considering marital and financial circumstances, married/unmarried women from an affluent financial category exhibited a notably higher frequency of self-initiating a mammography (73% and 48.5%) in comparison to those financially struggling (27.6%). Conclusion:  Strong support is imperative for countries to establish prevention and early detection programs for cancer. https://ijph.tums.ac.ir/index.php/ijph/article/view/33872 https://ijph.tums.ac.ir/index.php/ijph/article/download/33872/8164

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 305 312 Negin Soltani Department of Sports Biomechanics, Central Tehran Branch, Islamic Azad University, Tehran, Iran Ali Fatahi Department of Sports Biomechanics, Central Tehran Branch, Islamic Azad University, Tehran, Iran 2023 11 25 2024 01 30 Background: Deviation of the foot from the normal posture affects the function of the foot and lower limb and causes lower limb injuries in normal people and athletes. Flat feet or flatfoot deformity are usually associated with pain in the foot area and a decrease in the normal function of the foot, which can negatively affect the sports ability of athletes. Therefore, we aimed to investigate the abnormality of flat feet from training, exercise to therapeutic interventions. Methods: Articles were identified by searching five databases: PubMed, Scopus, Google Scholar, Science Direct, and Gate & Pasteur from 2000 to 2022. The keywords were selected specifically and correctly and all the researches and articles related to the title of the article were searched and found. This research was also searched in Persian databases that this database, included: Irandoc, Mag Iran and Noormagz. Results: Finally, 30 studies met the criteria for entering this study, selected and used to conduct this study. Conclusion: By using the results obtained in the research, which include corrective exercises and therapeutic interventions, especially the use of orthoses and various medical insoles, it is possible to help in the treatment and improvement of this anomaly. https://ijph.tums.ac.ir/index.php/ijph/article/view/33858 https://ijph.tums.ac.ir/index.php/ijph/article/download/33858/8156

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 397 403 EN Xiaowen Hou School of Public Health, Shenyang Medical College, Shenyang, 110034, China Jiaqi Zheng School of Public Health, Shenyang Medical College, Shenyang, 110034, China Jiajun Zhang School of Public Health, Shenyang Medical College, Shenyang, 110034, China Lin Tao School of International Education, Shenyang Medical College, Shenyang, 110034, China Kaiwen Cen School of Public Health, Shenyang Medical College, Shenyang, 110034, China Ying Cui School of Public Health, Shenyang Medical College, Shenyang, 110034, China Ji Wu School of Public Health, Shenyang Medical College, Shenyang, 110034, China 2023 05 10 2023 08 12 Background: Ischemic stroke (IS) is the leading cause of disability and mortality worldwide. Low-density lipoprotein cholesterol (LDL-C) levels hadno potential risk on ischemic stroke. However, higher LDL-C levels were closely related to IS. Based on two antagonistic viewpoints, a Mendelian randomization (MR) study was designed to evaluate the causal effects of LDL-C levels on IS. Methods: Datasets of LDL-C levels and ischemic stroke were acquired from genome-wide association studies (GWAS). Weighted median method was conducted for main analysis, and MR-Egger and inverse-variance weighted (IVW) methods were performed for auxiliary analyses. Heterogeneity and pleiotropic tests were utilized to confirm the reliability of this study. Results: A total of 359 single nucleotide polymorphisms (SNPs) were associated with LDL-C levels (P < 5 × 10−8) and 337 SNPs were available in ischemic stroke with eliminating outliers. LDL-C levels were significantly associated with ischemic stroke (OR = 1.104, 95%CI = 1.019 - 1.195, P = 1.52 × 10-2). MR-Egger and IVW showed directionally similar estimates (MR-Egger: OR = 1.120, 95%CI = 1.040 - 1.207, P = 3.12 × 10-3; IVW: OR = 1.120, 95%CI = 1.064 - 1.178, P = 1.17 × 10-5). Conclusion: LDL-C levels had causal effects on IS, providing insights into the design of future interventions to reduce the burden of ischemic stroke. https://ijph.tums.ac.ir/index.php/ijph/article/view/31975 https://ijph.tums.ac.ir/index.php/ijph/article/download/31975/8165

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 313 322 EN Yan-Li Niu Endocrinology Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China Ye Zhang Endocrinology Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China Zhi-Yong Song Endocrinology Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China Chuan-Zhi Zhao Endocrinology Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China Yun Luo Endocrinology Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China Yan Wang Endocrinology Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China Jing Yuan Emergency Department, Luodian Hospital, Baoshan District of Shanghai, Shanghai, China 2023 06 03 2023 08 14 Background: We systematically reviewed and analyzed the efficacy and safety of insulin degludec/insulin aspart (IDegAsp) versus biphasic insulin aspart 30 (BIAsp 30) in patients with type 2 diabetes (T2D). Methods: We used computers to search the Embase, PubMed, Clinical Trials, and the Cochrane Library database, and collected randomized controlled trials (RCTs) on the treatment of IDegAsp versus BIAsp 30 in T2D patients. The research period was from the establishment of the database to May 19, 2023. We used Review Manager 5.20 statistical software for systematic meta-analysis. Results: We included 8 RCTs with 2281 participants. IDegAsp was better to BIAsp30 in improving fasting plasma glucose (FPG) levels (P<0.001) and reducing the endpoint daily average insulin dose (P<0.01). Furthermore, compared with BIAsp30, IDegAsp significantly reduced the risk of nocturnal hypoglycemic events (P<0.001). However, there was no significant difference in the improvement of body weight change (P=0.99), glycosylated hemoglobin (P=0.50), the overall risk of hypoglycemic events (P=0.57) and adverse events (P=0.89) between the two groups. Conclusion: Compared with BIAsp30, IDegAsp could significantly reduce FPG levels, insulin dosage, and the risk of nocturnal hypoglycemic events in T2D patients, without increasing the overall risk of adverse events. https://ijph.tums.ac.ir/index.php/ijph/article/view/32189 https://ijph.tums.ac.ir/index.php/ijph/article/download/32189/8157

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 404 413 Qiong Jia School of Design and Art, Shenyang Jianzhu University, Shenyang, China Heyao Wang School of Design and Art, Shenyang Jianzhu University, Shenyang, China Dalin Sun School of Design and Art, Shenyang Jianzhu University, Shenyang, China 2023 12 19 2024 01 30 Background: Anxiety is a common mental health problem among adolescents that substantially increases the risk of anxiety disorder. Depression in adulthood and is a high-risk factor leading to suicide. We aimed to explore effective anxiety intervention methods in view of the annual rising detection rate of anxiety in adolescents. Methods: We enrolled 150 volunteers with mild anxiety or above (anxiety scale≥50 points) from 1015 adolescents between March and May 2023 in four communities in Shenyang, Liaoning Province and Nantong, Jiangsu Province in China. The participants were randomly divided into the experimental and control groups, comprising 73 and 74, respectively. The experimental group was given 2-month psychological intervention based on behavior change wheel (BCW) theory, whereas the control group was given no intervention. Results: The average anxiety score of the participants 46.57 ± 14.19, with 40.4% having anxiety symptoms. Anxiety was statistically correlated with self-evaluation of physical condition, family relationship, and grades (P < 0.05). The depression and anxiety score of the experimental group was significantly lower than that of the control group (P < 0.001). Conclusion: Anxiety has become a common phenomenon among adolescents. Self-evaluation of physical condition, family relationship, and grades are the focus of intervention for individuals with anxiety. The intervention method proposed in this study can effectively reduce the level of anxiety and depression in adolescents, providing a new perspective for formulating anxiety intervention strategies for adolescents. https://ijph.tums.ac.ir/index.php/ijph/article/view/34058 https://ijph.tums.ac.ir/index.php/ijph/article/download/34058/8166

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 323 334 EN Maliheh Ghobadi Department of Health Management, Policy, and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran Anahita Behzadi Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Asma Sabermahani Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran 2022 10 22 2023 06 15 Background: Clinical practice guideline (CPGs) are highly valuable in enhancing healthcare efficiency as they lead to the selection of the best medical methods and reduction of their costs. Nevertheless, implementing CPGs in practice can be quite challenging, as they require alterations at individual, organizational, and health system levels. Therefore, we aimed to identify the outcomes, barriers, and facilitators associated with CPG implementation. Methods: We conducted an extensive search using Web of Science, PubMed, Scopus, Embase, and various non-English databases to gather quantitative, qualitative, and review studies on the implementation of CPGs from Jan 1, 1990, to Dec 26, 2022. Our analysis focused on the outcomes, barriers, and facilitators of CPG implementation, which categorized into four groups: policy-making, health system and hospitals, professional experts, and clinical guidelines. Results: After conducting a thorough review of 37 studies, the most significant outcomes were found to be reduced costs and enhanced quality of care. However, certain challenges, such as inadequate support, insufficient education, high work pressure, tight schedules, and a lack of unified and clear guidelines, hindered these improvements. To overcome these barriers, it is essential to prioritize effective leadership, improve work conditions, allocate necessary resources, create a structured framework for the guidelines, and simplify their content to fit the clinical circumstances. Conclusion: It is crucial to identify the outcomes and barriers associated with implementing CPGs to enhance professional performance, elevate the quality of care, and foster patient satisfaction. Developing effective strategies hinges on this awareness.   https://ijph.tums.ac.ir/index.php/ijph/article/view/30173 https://ijph.tums.ac.ir/index.php/ijph/article/download/30173/8158

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 414 424 Maja Milosevic Markovic Department of Public Health, School of Dental Medicine, University of Belgrade, Belgrade, Serbia Milan Petrovic Clinic for Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia Milan Latas Clinic for Psychiatry, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia Igor Djordjevic Clinic for Prosthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia Srdjan Milovanovic Clinic for Psychiatry, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia Svetlana Jovanovic Department of Public Health, School of Dental Medicine, University of Belgrade, Belgrade, Serbia 2022 08 03 2023 04 07 Background: Oral squamous cell carcinoma (OSCC) has numerous physical, psychosocial and financial implications, which significantly affect patients' quality of life. We aimed to determine the health-related quality of life (HRQoL) and identify quality of life (QoL) predictors in patients with OSCC. Methods: We included 64 consecutive patients aged 40 to 80 yr treated for OSCC from Jan to Dec 2021. Health-related QoL was evaluated using the 30-item Cancer Quality of Life Questionnaire (QLQ-C30) and the 35-item Head and Neck Cancer-Quality of Life Questionnaire (QLQ-H&N35). The demographic questionnaire and clinical parameters were also presented. Results: The functioning scale in the QLQ-C30 questionnaire with the lowest average score was Global health status. The mean QLQ-C30 summary score (80.92 ± 10.4) was higher than the Global health status score (50.5 ± 22.2). In the QLQ-H&N35 questionnaire, the symptoms with highest scores were weight loss, dry mouth, and social eating. Linear regression analysis demonstrated that Global health status score was associated with education level [β-coefficient = 19.33 (95% CI: 10.7-24.9, P=0.004], alcohol consumption [β-coefficient=10.04 (95% CI: 4.5-14.8), P=0.023] and invasive surgical procedure [β-coefficient=22.75 (95% CI: 15.0-30.5), P=0.002]. The QLQ-C30 summary score was associated with living alone [β-coefficient= -20.05 (95% CI: −29.91-(−10.21), P=0.018], smoking status [β-coefficient=4.35 (95% CI: 1.8-6.91), P=0.043] and alcohol consumption [β-coefficient =4.59 (95% CI: 1.99-7.19), P=0.037]. Conclusion: We found several significant predictors of worse perception of HRQoL among patients with OSCC, which may be useful for specific prevention and treatment in order to achieve better QoL.   https://ijph.tums.ac.ir/index.php/ijph/article/view/29466 https://ijph.tums.ac.ir/index.php/ijph/article/download/29466/8167

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 335 347 Mohammed Muneer Alareqi School of Public Health, Lanzhou University, Lanzhou, China Lina Alshoaibi School of Stomatology, Lanzhou University, Lanzhou, China Yanli Liu School of Public Health, Lanzhou University, Lanzhou, China Sushma Dhital School of Public Health, Lanzhou University, Lanzhou, China Benzhong Zhang School of Public Health, Lanzhou University, Lanzhou, China 2022 05 14 2023 01 31 Background: In humanitarian crises, water, sanitation and hygiene interventions are critical for the survival of people. However, strong evidence-based information is still limited. In order to describe the quantity and quality of current evidence, we conducted an evidence gap map provides a visual overview, highlighting areas lacking evidence. Methods: According to developed inclusion and exclusion criteria, a systematic literature search was conducted to find related systematic reviews and meta-analyses. The databases, including PubMed, Web of Science, SCOPUS and Cochrane were searched using search strings from 2000 until 2021. Characteristics of the included reviews were extracted and summarized. Two persons evaluated methodological quality independently using the AMSTAR tool. Invite a third person to solve any discrepancies. Results: This study revealed seven systematic reviews, including one meta-analysis. One study was of high quality, four of medium, and two of low quality. A total of 272 primary studies were included with a median value of 38.8 (range, 6-106) which deeply analyzed for data extraction. Cross-sectional, case-control, and qualitative case studies were the most used study designs. Diarrheal diseases were the most reported outcomes representing 46% of the impact evaluations. Cholera outbreaks account for 43% of a crisis context. The research gaps were insufficient reporting of some interventions with related outcomes and the geographical distribution of current evidence. Conclusion: There is a limitation in current evidence represented by a lack of high-quality and experimental studies investigate the impact of water, sanitation and hygiene (WaSH) interventions on health and behavioral outcomes in humanitarian sittings.   https://ijph.tums.ac.ir/index.php/ijph/article/view/28742 https://ijph.tums.ac.ir/index.php/ijph/article/download/28742/8159

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 425 432 Gulshara Berdeshova Department of General Hygiene, West Kazakhstan Medical University named after M. Ospanov, Aktobe, Kazakhstan Aiman Mussina Department of Public Health and Epidemiology, Astana Medical University, Nur-Sultan, Kazakhstan Lyazat Orakbay Department of Public Health, Kazakh-Russian Medical University, Almaty, Kazakhstan Aidana Tolegenova Department of Health Policy and Management, Kazakh National Medical University named after S.D. Asfendiyarov, Al-maty, Kazakhstan Saya Zhorabek Department of Health Policy and Management, Kazakh National Medical University named after S.D. Asfendiyarov, Al-maty, Kazakhstan Assel Amanova Department of Public Health and Hygiene, Astana Medical University, Nur-Sultan, Kazakhstan Shynar Kulbayeva Department of Clinical Disciplines, Kokshetau University named after Sh. Ualikhanov, Kokshetau, Kazakhstan 2022 10 31 2023 04 26 Background: We aimed to study the rate and trends of the incidence of chronic cardiovascular diseases in urban and rural areas of the northern regions of the Republic of Kazakhstan (RK) from 2015 to 2020. Methods: The retrospective data were analyzed using modern methods of biomedical statistics. We used the Electronic Register of Dispensary Patients (2015-2020), where we conducted a retrospective study and trend calculations. The study included patients with chronic cardiovascular diseases (CVD) (according to the International Classifier of Diseases-10, the following nosologies were identified: I25 chronic coronary heart disease and its nosological forms (I25.0-I25.9), and patients by age categories, consisting of dispensary registration in polyclinics of the northern region of the RK. Results: For 2015 - 2020 in the northern region (urban and rural) of RK, 12,315 patients were registered, who were on dispensary records for the chronic CVD. This amounted to 87.3% of urban residents, and 12.7% of rural residents. The share of patients with chronic CVD in the northern region of the republic by age groups had a bimodal growth pattern with the first peak at the age of 60-74 (40.4%) and the second - at the age of 45-59 (37.7%). Conclusion: This study notes an increase in chronic CVD, both in urban and rural areas of the northern region of the RK. This once again proves the need for the development, implementation and use of modern tools in the provision of medical services to cardiological patients at the outpatient level, taking into account the characteristics of the northern regions of our country. https://ijph.tums.ac.ir/index.php/ijph/article/view/30270 https://ijph.tums.ac.ir/index.php/ijph/article/download/30270/8168

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 433 442 Mohammad-Reza Mohajeri-Tehrani Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Seyyed Amirsina Alemzadeh Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Abbaszadeh Marzbali Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Sadaf Nasserisina Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Hosnan Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Ameneh Naghghash Thalassemia Department, Torfeh Hospital, Shahid Beheshti University, Tehran, Iran Amir Ali Hamidieh Pediatric Stem Cell Transplant Department Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran Maryam Behfar Pediatric Stem Cell Transplant Department Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran Fariba Mohseni Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Hoda Rashidian Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Sara Shirazi Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Maryam Aboee-Rad Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Mostafa Qorbani Non-Communicable Diseases Research Center, Alborz University of Medical Science, Karaj, Iran Bagher Larijani Thalassemia Department, Torfeh Hospital, Shahid Beheshti University, Tehran, Iran Zohreh Hamidi Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran 2022 12 06 2023 03 29 Background: Beta-thalassemia major patients frequently have endocrinopathies. We tried to determine relation between demographic and transfusion factor and endocrinopathies. Methods: Major beta-thalassemia patients (n=114 cases), 3–38 yr of age, entered this study. Female to male ratio was 51/63. Children (less than 20 yr) formed 57% of participants. Information about bone mineral density (BMD) and hormonal and biochemistry blood evaluation including fasting blood sugar (FBS), ferritin, triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH), luteinizing hormone (LH) and follicle-stimulating hormone (FSH), testosterone (males), and estradiol (females) entered data sheet. Results: Sex and ferritin level showed no significant correlation with above disorders. Age significantly correlated to short stature, diabetes, low BMD at femur and neck (P, 0.031, 0.008, 0.009 and <0.001, respectively). The risk of short stature had increased in 12 yr and older patients 7.71 times than younger patients (P= 0.008). The risk of diabetes had increased in 35 yr and older patients 26.25 times than younger patients (P= 0.03).  The risk of Z-score ≤ -2 in femoral region has increased in 19 yr and older patients 5.84 times than younger patients (P= 0.002). The risk of Z-score ≤ -2 in spinal region has increased in 14 yr and older patients 17 times than younger patients (P= 0.007). Conclusion: The main factor related with endocrinopathies was age. The correlation between age and short stature, diabetes and low BMD was positive. Therefore, we recommend early monitoring of thalassemia patients (in their late childhood and early teenage) for these complications.   https://ijph.tums.ac.ir/index.php/ijph/article/view/30593 https://ijph.tums.ac.ir/index.php/ijph/article/download/30593/8169

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 2 2024 01 30 443 452 EN Morvarid Zarif-Yeganeh Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran