Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 03 1883 1893 Youngoh Bae 1. Sungkyunkwan University, Suwon 16419, Republic of Korea 2. Korean Armed Forces Capital Hospital, Seongnam, 13487, Republic of Korea Suho Jang Sungkyunkwan University, Suwon 16419, Republic of Korea Woonyoung Jeong Sungkyunkwan University, Suwon 16419, Republic of Korea Jisoo Tak Sungkyunkwan University, Suwon 16419, Republic of Korea Seung Won Lee 1. Sungkyunkwan University, Suwon 16419, Republic of Korea 2. Kangbuk Samsung Hospital, Seoul, 03181, Republic of Korea 2025 03 30 2025 06 07 Background: Comprehensive and updated data on the prevalence, incidence, mortality, and disability rates of musculoskeletal (MSK) and headache disorders in Asia are scarce. We aimed to analyze the trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) related to these disorders from 1990 to 2021. Methods: We assessed the burden of MSK and headache disorders across Asia utilizing data from the Global Burden of Disease study. We evaluated the trends in DALYs, mortality, incidence, and prevalence and their changes over time. Correlations with the sociodemographic index were examined to determine potential influencing factors. Results: In 2021, MSK and headache disorders accounted for 120 million DALYs (95% uncertainty interval: 72.5–182.3 million), reflecting a 94% increase since 1990. Furthermore, mortality increased by 138% over the same period. Lower back pain was the leading contributor to DALYs (36.9 million), followed by migraine (25.4 million) and knee osteoarthritis (7.4 million). From 1990 to 2021, DALYs due to osteoarthritis and gout increased by 15% and 170%, respectively. DALYs due to rheumatoid arthritis (RA) remained stable, although RA-related mortality increased by 117%. Age-standardized rates exhibited minimal variation, with the highest burden observed in individuals aged 50–54 years and a higher prevalence among females. Conclusion: MSK and headache disorders were leading causes of disability in Asia, with significant increments in both DALYs and mortality over the past three decades. These trends underscore the urgent need for targeted prevention and management strategies, particularly for high-burden conditions like lower back pain, migraine, and osteoarthritis. https://ijph.tums.ac.ir/index.php/ijph/article/view/38659 https://ijph.tums.ac.ir/index.php/ijph/article/download/38659/8645

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 03 1808 1819 Seif Khalfan 1. Food Safety and Health Research Centre, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China 2. Faculty of Health and Allied Sciences, Zanzibar University, Tunguu, Zanzibar Tanzania Jeremie Minani Faculty of Health and Allied Sciences, Zanzibar University, Tunguu, Zanzibar Tanzania Sultan Muki Faculty of Health and Allied Sciences, Zanzibar University, Tunguu, Zanzibar Tanzania Fatma Said Ministry of Health, Zanzibar, Tanzania Dennis Lyakurwa Department of Curative Services, Ministry of Health P.O.Box 743, Dodoma, Tanzania Bo Zhang Food Safety and Health Research Centre, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China 2024 12 15 2025 03 11 Background: The prevalence of obesity and overweight globally has increased to epidemic proportions, representing a substantial burden on health systems. The consumption of high-energy-density but low-nutritional-value food, known as fast food, has been linked to the obesity epidemic. This review aimed to quantify the association between fast food consumption and overweight/obesity in individuals aged ten years and above. Methods: We followed the PRISMA-P 2020 guidelines. To identify studies, English databases, including PubMed, Web of Science, Scopus, Science Direct, and DOAJ, were searched. The search strategy focused on terms and inclusion criteria. After quality assessment, data were analyzed using SPSS software. Results: Thirteen studies out of 665 screened indicate a significant positive association between fast food consumption and obesity or overweight (OR 2.979 [1.748-5.078]). Heterogeneity analysis revealed substantial variability across studies (Q = 119.497, P < 0.0001; I² = 92.47%), suggesting true differences beyond chance with the random-effects model showed a stronger association compared to the fixed-effects model (OR 2.979 vs. OR 1.929). Sensitivity analysis demonstrated variations based on sample size. Publication bias of the included studies was done using Egger’s and Begg’s tests. Conclusion: The analysis revealed the effect of fast food consumption on weight status varied among demographic subpopulations. The review also provides further justification for interventions to encourage healthier dietary choices and reductions in consumption of fast food, both of which, in turn, are aimed at tackling the obesity epidemic. https://ijph.tums.ac.ir/index.php/ijph/article/view/37530 https://ijph.tums.ac.ir/index.php/ijph/article/download/37530/8639

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 2035 2036 Seungeun Park Dable, Hanam-si, Korea Taemin Song Graduate School of Industry & Environment, Gachon University, Seongnam, Korea Jae-Hyun Park Department of Social and Preventive Medicine, School of Medicine, Sungkyunkwan University, Suwon, Korea 2024 10 30 2025 01 21 Not abstract. No Abstract.   https://ijph.tums.ac.ir/index.php/ijph/article/view/37064 https://ijph.tums.ac.ir/index.php/ijph/article/download/37064/8659

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 03 1894 1905 EN Zhuanping Zeng 1. Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China 2. Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangdong Pharmaceutical University, Guangzhou 510006, China 3. School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510006, China Jiao Guo 1. Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China 2. Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education of China, Guangdong Pharmaceutical University, Guangzhou 510006, China 3. School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510006, China 2025 01 27 2025 05 07 Background: Pre-diabetes mellitus (PDM) is considered a precursor stage of type 2 diabetes mellitus (T2DM) and serves as an early warning sign for the disease. However, most studies only analyze the risk factors of T2DM, ignore the exploration of PDM.  Methods: Here 28,208 patients with T2DM were selected from 5 cities in the Pearl River Delta, Guangdong Province, China in 2017. Then a 1:1 matched case-control study was conducted according to the matching conditions. Finally, 28208 patients with PDM and 28208 patients with normal glucose tolerance (NGT) were matched, and when multiple subjects were matched, the same subjects in the region were preferredOrdered multiple logistic regression was used to analyze the influencing factors of T2DM and PDM. When analyzing the relationship between overweight, obesity, smoking, and T2DM, factors such as age, education level,  exercise were adjusted. Results: Overweight, obesity (OR=1.427, 95%CI:1.388~1.468; OR=1.829,95%CI:1.753~1.908) and smoking (OR=1.161,95%CI:1.113~1.212) were risk factors for the onset of T2DM by ordered multiple logistic regression. There was an additive interaction between overweight obesity and smoking in the developing of T2DM. Moreover, there were 0.196(0.051~0.341) relative excess risk due to the additive interaction, 9.1% (2.0%-16.1%) of T2DM exposed to both risk factors was attributable to the additive interaction, and the risk of T2DM in overweight and obese smokers was 1.203(1.004-1.402) times as high as the sum of risks in the participants exposed to a single risk factor too. Conclusion: Overweight obesity and smoking are the risk factors for the onset of T2DM. https://ijph.tums.ac.ir/index.php/ijph/article/view/37981 https://ijph.tums.ac.ir/index.php/ijph/article/download/37981/8646

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 03 1820 1830 Zahra Bayat Jozani Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran Zohreh Mahmoodi Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran Amirhossein Takian 1. Department of Global Health, Center of Excellence for Global Health (CEGH), School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2. Department Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 3. Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran Seyedeh Tahereh Mirmolaei Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran 2025 01 18 2025 05 08 Background: This scoping review aimed to identify intermediary Social Determinants of Health (SDH) affecting access to reproductive health services among Afghan migrant women, emphasizing the challenges in achieving equitable health service access for this vulnerable population. Methods: To ensure methodological rigor, the PRISMA checklist was followed. The inclusion criteria comprised quantitative studies addressing access to reproductive health services among Afghan migrants. Articles were retrieved from SCOPUS, Web of Science, and PubMed databases, as well as through manual reference checks, covering the period from Jan 2000 to Mar 2025. Data extraction was guided by the World Health Organization's SDH framework, with a specific focus on intermediary determinants such as healthcare quality, behavioral and psychosocial factors, and social networks. Results: From an initial pool of 628 articles, 18 met the eligibility criteria. The most frequently reported intermediary SDH was the quality and condition of healthcare services. Other common factors included behavioral aspects, social capital and cohesion, and psychological well-being. These determinants were consistently linked to disparities in access to reproductive health services. Conclusion: Effective access to reproductive health services among Afghan migrant women hinges on addressing both structural and intermediary SDH. The influence of these factors is context-specific, and tailored interventions are needed. Notably, the supportive role of non-governmental organizations and community-based social support systems should be prioritized to enhance reproductive health outcomes in migrant population. https://ijph.tums.ac.ir/index.php/ijph/article/view/37868 https://ijph.tums.ac.ir/index.php/ijph/article/download/37868/8640

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 2037 2039 Keita Wagatsuma 1. Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Nii-gata, Japan 2. Institute for Research Administration, Niigata University, Niigata, Japan 2024 12 10 2025 01 21 No Abstract. Not Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/37474 https://ijph.tums.ac.ir/index.php/ijph/article/download/37474/8660

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 1906 1916 Mirjana Nedovic Vukovic 1. Center for Health System Evidence and Research in Public Health, Institute of Public Health of Montenegro, Podgorica, Montenegro 2. Faculty of Medicine, University of Montenegro, Podgorica, Montenegro Milos Bojic 1. Faculty of Medicine, University of Montenegro, Podgorica, Montenegro 2. Center for Plastic and Reconstructive Surgery, Clinical Center of Montenegro, Podgorica, Montenegro Marina Jaksic 1. Faculty of Medicine, University of Montenegro, Podgorica, Montenegro 2. Department of Laboratory Diagnostics, Institute for Children's Diseases, Clinical Center of Montenegro, Podgorica, Montenegro Mileta Golubovic 1. Faculty of Medicine, University of Montenegro, Podgorica, Montenegro 2. Center for Pathology, Clinical Center of Montenegro, Podgorica, Montenegro Marko Vukovic 1. Faculty of Medicine, University of Montenegro, Podgorica, Montenegro 2. Clinic of Urology, Clinical Center of Montenegro, Podgorica, Montenegro 2025 10 04 Background: Prostate cancer is the fifth leading cause of cancer-related death among men worldwide, with an estimated 375,304 deaths in 2020 and a mortality rate of 7.7 deaths per 100,000. It stands as the leading cause of cancer mortality in 48 countries. We aimed to analyze the prostate cancer mortality trend in Montenegro for the period 1990-2018 using regression techniques. Methods: The data concerning prostate cancer mortality in Montenegro from 1990 to 2018 was collected. Mortality rates were age-standardized to the World Standard Population for estimating both overall and gender-specific trends. The joinpoint, linear and Poason regression were applied for trend assessment. Results: In Montenegro, during the period from 1990 to 2018, 1,184 individuals died from prostate cancer. The average annual number of deaths was 40.8, with an average age-standardized rate of 8.3. For the period 1990-2018, rates statistically significantly increased on average by 2.4% annually [AAPC (95%CI)=2.4% (1.4-3.4); P<0.001]. An increase in mortality rates was observed among individuals aged 65-74 by 1.1%, which was not statistically significant (P=0.452), and among those aged 75-84 by 2.7%, which was statistically significant [AAPC (95%CI)=2.7% (1.3-4.1); P<0.001]. Almost 50% of all deaths occurred in men aged 75-84, and nearly a third in the age group 65-74. Conclusion: The rising trend in prostate cancer mortality indicates the need for more effective prevention, screening, early diagnosis, and treatment measures for prostate cancer in Montenegro with special focus on older men. https://ijph.tums.ac.ir/index.php/ijph/article/view/41008 https://ijph.tums.ac.ir/index.php/ijph/article/download/41008/8647

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 03 1831 1841 Javad Barzegari National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran Farid Abolhasani Shahreza National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran 2024 11 11 2025 07 08 Background: Since its inception in 2005, Iran’s Family Medicine Program has faced persistent challenges in implementing an effective referral system, limiting its potential to optimize healthcare delivery and reduce hospital overcrowding. This scoping review synthesized evidence from 31 studies (2005–2022) to identify and categorize systemic challenges within Iran’s referral system. Methods: In 2023, a systematic search of English and Persian databases (e.g., PubMed, SID, Magiran) identified studies on referral system challenges. Data were thematically analyzed and mapped to six WHO domains: governance, financing, human resources, equipment, information systems, and service delivery. Results: Key challenges include: Governance: Fragmented policies, weak oversight and lack of enforceable referral protocols. Financing: Delayed payments to physicians and restrictive insurance tariffs disincentivize compliance. Service Delivery: Public distrust in family physicians, low reverse referral rates, and poor specialist feedback. Technology: Reliance on paper-based referrals and fragmented electronic records. Human Resources: Rural specialist shortages (0.5 per 10,000 in Iran vs. 4.2 in urban areas) drive bypassing of primary care. Conclusion: Iran’s referral system struggles reflect systemic deficiencies in governance, financing, and infrastructure. Successful reforms require multi-level interventions: digitizing referrals, incentivizing compliance through blended payment models, and rebuilding public trust via awareness campaigns. Lessons from countries like South Korea (differential copayments) and the UK (Shared Care models) highlight pathways for integration. Without urgent action, the Family Medicine Program risks perpetuating inefficiencies and inequities in Iran’s healthcare system. https://ijph.tums.ac.ir/index.php/ijph/article/view/37175 https://ijph.tums.ac.ir/index.php/ijph/article/download/37175/8641

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 2040 2041 EN Meric Odemis Faculty of Sports Sciences, Alanya Alaaddin Keykubat University, Alanya, Antalya, Türkiye Halil Çobanoğlu Faculty of Sports Sciences, Alanya Alaaddin Keykubat University, Alanya, Antalya, Türkiye Eren Akdag Faculty of Sports Sciences, Akdeniz University, Antalya, Türkiye 2025 02 18 2025 04 07 Not abstract. No Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/38219 https://ijph.tums.ac.ir/index.php/ijph/article/download/38219/8662

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 1917 1925 EN Xueling Xin Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, No.175 Shandong Road, Shibei District, Qingdao, Shandong 266033, People’s Republic of China Jing Jia Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, No.175 Shandong Road, Shibei District, Qingdao, Shandong 266033, People’s Republic of China Hongrui Zhai Qingdao Municipal Centre of Disease Control and Prevention Wencheng Wang Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, No.175 Shandong Road, Shibei District, Qingdao, Shandong 266033, People’s Republic of China Zhaohai Meng Huangdao District Center for Disease Control and Prevention, No.567 Lingshanwan Road, Huangdao District, Qingdao, Shandong 266400, People’s Republic of China Litao Sun Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, No.175 Shandong Road, Shibei District, Qingdao, Shandong 266033, People’s Republic of China Xia Wang Shibei District Center for Disease Control and Prevention, No.3 Deping Road, Shibei District,Qingdao, Shandong 266033, People’s Republic of China Liyan Dong Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, No.175 Shandong Road, Shibei District, Qingdao, Shandong 266033, People’s Republic of China 2024 03 14 2025 02 18 Background: Hand, foot and mouth disease (HFMD) is a common infection disease among children, which is caused by human enterovirus (EV) family. The absence of cross-protection against different EV sub-types, makes HFMD reinfection common. Thus, we aimed to explore the epidemiological characteristics and influencing factors of HFMD reinfection in Qingdao City. Methods: Data on HFMD cases from 2014 to 2022 were obtained from National Infectious Surveillance System. Logistic regression analysis was used to assess the independent risk factors of HFMD reinfection. Results: A total of 78422 HFMD cases were enrolled. Of these, 2041 cases were classified as reinfection, corresponding to the reinfection rate of 2.60%. The median time interval between the primary infection and secondary infection was 12.75 (IQR=12.24) months. The seasonal peak of reinfection occurred from June to August each year. Multivarite logistic analysis showed that male, younger age, scattered children, severe cases, hospitalization, and EV71 infection were risk factors for HFMD reinfection. The proportion of patients infected with EV71 in the primary infection cases was higher than that in non-reinfection cases (OR=1.83, 95%CI=1.29-2.60). Conclusion: Boys aged 5 years and below, especially those with severe cases and first infected with EV71 are more prone to reinfection. Therefore, authorities should implement targeted health education and intervention strategies to reduce the reinfection rate among vulnerable population. https://ijph.tums.ac.ir/index.php/ijph/article/view/34888 https://ijph.tums.ac.ir/index.php/ijph/article/download/34888/8648

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 03 1842 1856 EN Akram Gazerani 1. Department of Operating Room, Faculty of Nursing and Midwifery, Neyshabur University of Medical Sciences, Neyshabur, Iran 2. Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran Zahra Sadat Manzari Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Eesa Mohammadi Nursing Department, Faculty of Medical Sciences Tarbiat Modares University, Tehran, Iran Mahnaz Amini Division of Sleep Medicine, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Tayebeh sadat Manzari Department of Cardiovascular, School of medicine, Mashhad University of Medical Sciences, Mashhad, Iran Zahra Dalir Department of Medical -Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran 2024 03 10 2024 08 31 Background: Poorly sleeping is a common problem for heart failure patients and can significantly decrease their quality of life. Among heart failure patients, the widespread issue of poor sleep quality can lead to a diminished quality of life. The present study aimed to review systematically the evidence focused on the determinants of sleep quality factors in heart failure patients. Methods: We conducted a comprehensive search for observational studies in both English- and Persian-language databases from Feb 1991 to Jan 2023. The search strategy included keywords such as "sleep quality" and "heart failure" and risk factors. All screening and extraction steps were carried out by two researchers. Results: The initial search yielded 10,357 articles. After screening, 37 studies (30 cross-sectional studies, 1 longitudinal study, 2 correlational studies, 1 prospective observational study, 2 case‒control studies and 1 descriptive-analytical study) were included. We categorized the identified factors as demographic, habits and lifestyle, medication use, and psychological. The Pittsburgh Sleep Quality Index (PSQI) is the most commonly used sleep quality assessment tool. Conclusion: Mental health-related and lifestyle factors such as depression, fatigue, female sex, and high BMI play important roles in disrupting sleep quality. In addition, it is necessary to develop new assessment tools for sleep quality specified for HF patients. https://ijph.tums.ac.ir/index.php/ijph/article/view/34868 https://ijph.tums.ac.ir/index.php/ijph/article/download/34868/8642

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 2040 2041 Nader Aghakhani Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran Béatrice Marianne Ewalds‑Kvist 1. Department of Psychology, Stockholm University, Stockholm, Sweden 2. Division of Psychology, University of Turku, Turku, Finland Sina Aghakhani Department of Law, Faculty of Humanities Sciences, Islamic Azad University of Tehran, West Branch, Tehran, Iran Babak Alishahihesar School of Nursing and Midwifery, University of Vienna, Vienna, Austria Pedram Abolfathpour School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran 2025 01 06 2025 01 21 No Abstract. Not Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/37722 https://ijph.tums.ac.ir/index.php/ijph/article/download/37722/8663

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 1926 1937 Dilara Canbay Özdemir Pursaklar County Health Department, Ankara, Turkey Duygu Ayhan Başer Department of Family Medicine, Medical Faculty, Hacettepe University, Ankara, Turkey İzzet Fidancı Department of Family Medicine, Medical Faculty, Hacettepe University, Ankara, Turkey Arzu Demircioğlu Karagöz Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey Merve Özdemir Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey 2025 04 27 2025 07 08 Background: To assess the effect of different treatment protocols on anthropometric measures, lipid profile, and weight-related quality of life amid the pandemic. Methods: A single-blind randomized controlled trial was conducted at Hacettepe University's Family Medicine outpatient clinics in Ankara, Turkey, in 2022. Participants were stratified into three groups: intervention, control-1, and control-2. The intervention group received a calorie-restricted diet, exercise program, and follow-up calls every 15 days. Control-1 received the same plan with a single follow-up at week 4. Control-2 received general dietary and exercise advice and regular follow-up calls every 15 days. Outcomes were measured at baseline and 12 weeks, including quality of life assessed with the Turkish IWQOL-Lite scale. Results: We 153 participants, with 51 individuals per group. At the 12th week, all groups exhibited significant improvements in weight, BMI, waist circumference, fat mass, and quality of life scores. The intervention group demonstrated improvements in physical function, self-esteem, work, and total quality of life score compared to baseline (P<0.001). Conclusion: Developing and adhering to a personalized exercise and diet plan is crucial for maintaining a healthy lifestyle, even during a pandemic. https://ijph.tums.ac.ir/index.php/ijph/article/view/38922 https://ijph.tums.ac.ir/index.php/ijph/article/download/38922/8649

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 03 1857 1869 Hossein Moameri Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran Mojtaba Norouzi 1. Department of Biostatistics and Epidemiology, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran 2. Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran Ghulam Raza Mohammadyan 1. Department of Biostatistics and Epidemiology, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran 2. HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Sahar Salehi Department of Biostatistics and Epidemiology, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran Shoboo Rahmati Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran 2024 12 02 2025 05 18 Background: eHealth has proven effective in changing health-related behaviors and overcoming barriers to HIV care. This systematic review and meta-analysis aimed to review the effect of eHealth on HIV Pre-Exposure Prophylaxis (PrEP). Methods: A systematic review and meta-analysis was conducted in international databases without a time limit until August 2024 to identify studies evaluating the effectiveness of eHealth interventions for PrEP among key populations. This search strategy used a combination of keywords related to "eHealth”, “HIV”, and "pre-exposure prophylaxis". A random effects model was used to compute the pooled measure of association (relative risk). The results were combined using a random-effects model for meta-analysis. The I2 index was also used to measure heterogeneity between the studies. Results: Twelve articles involving 3,578 participants were included in the meta-analysis. The findings showed that using websites had a positive effect on PrEP (RR=1.90, 95% CI: 1.30-2.79). Moreover, e-health interventions had the greatest effect on PrEP uptake among female sex workers (FSWs) (RR=2.27, 95% CI: 1.62-3.17). Furthermore, e-health demonstrated a notable effect on PrEP uptake (RR=1.90, 95% CI: 1.30-2.79), particularly in studies with follow-up less than six months (RR=1.85, 95% CI: 1.19-2.09). Additionally, studies conducted in the United States reported the most significant effect of e-health on PrEP (RR= 1.71, 95% CI: 1.38-2.11; I² = 0.41%). Conclusion: eHealth interventions have the potential to improve the effectiveness of PrEP among key populations. Integrating e-health interventions with comprehensive healthcare services and providing continuous support can improve PrEP uptake, adherence, and retention in the future. https://ijph.tums.ac.ir/index.php/ijph/article/view/37382 https://ijph.tums.ac.ir/index.php/ijph/article/download/37382/8643

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 2044 2045 Reza Abdollahi Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran Mir Hossein Ahmadi Nursing Instructor, Khalkhal School of Medical Sciences, Khalkhal, Iran 2025 01 27 2025 08 10 No Abstract. Not Abstract.   https://ijph.tums.ac.ir/index.php/ijph/article/view/37983 https://ijph.tums.ac.ir/index.php/ijph/article/download/37983/8664

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 1938 1953 Zaiqin Ling Department of Tuberculosis, Shandong Public Health Clinical Center, Shandong University, Jinan, 250013, China Muhammad Naeem 1. College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China 2. Department of Basic Sciences (Pharmacology), University of Veterinary and Animal Sciences, Lahore, Pakistan (Narowal Campus- 51600) 2024 12 03 2025 02 18 Background: The present study addresses the development of a novel subunit vaccine (SV) to combat tuberculosis (TB). Methods: The research used immunoinformatics to develop a subunit vaccine with 7 MHC-I, 3 MHC-II, and 7 B-cell epitopes joined by AAV, GPGPG, and KK linkers. It involved Mtb protein Rv0577 and PADRE sequence as an adjuvant. TLR2 binding affinity (Kd, nM) was determined through PRODIGY. In-silico evaluations determined allergenicity, antigenicity, and physicochemical properties. The vaccine was presented in an AAVDj/8 system, intracellular expression was verified, and the copy number was identified using qPCR and qRT-PCR. Results: The web tools confirmed the stability, non-allergenicity, and high immunogenicity of the vaccine (0.5673 < 0.4). PRODIGY tool depicted good SV-TLR2 binding (ΔG = -8.8 kcal/mol, Kd = 330 nM) with 59 intermolecular contacts, indicating possible TLR2 activation. Indirect immunofluorescence showed the expression of intracellular proteins. Viral titers, determined by 10-fold serial dilution up to 10³, showed a detectable titer, and copy numbers (10⁹/mL–10¹¹/mL) proved productive viral replication and significant vaccine effectiveness. Conclusion: This comprehensive methodology, from epitope selection to in-vitro testing, establishes a robust foundation for further exploring and advancing this SV.  https://ijph.tums.ac.ir/index.php/ijph/article/view/37410 https://ijph.tums.ac.ir/index.php/ijph/article/download/37410/8650

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 03 1870 1882 Meghdad Rahati Department of Health Management, Khomein University of Medical Sciences, Khomein, Iran Zahra Sakeni Kashan University of Medical Sciences, Kashan, Iran Abdolhosein Kalantari Department of Sociology, Faculty of Social Science, Tehran University, Tehran, Iran Masoud Etedali Department of Nursing, Khomein University of Medical Sciences, Khomein, Iran Alireza Ganjipour Department of Clinical Sciences, Khomein University of Medical Sciences, Khomein, Iran Ali Valinejadi Department of Health Information Technology, Khomein University of Medical Sciences, Khomein, Iran 2024 09 29 2025 06 01 Background: Organizational health literacy (OHL) plays a crucial role in improving patients’ understanding and engagement in hospital care. Despite its importance, little is known about the comprehensive dimensions of OHL from a managerial perspective. This study aimed to identify key dimensions that can influence OHL in hospital settings to enhance patient care. Methods: A scoping review was conducted to examine studies published from 2012-2024 regarding OHL in hospitals. Relevant studies were identified using a structured search strategy across multiple databases, including PubMed, Scopus, and Web of Science. Overall, 39 articles were selected after screening, and content analysis was performed using MAXQDA-10. The review adhered to the PRISMA guidelines for scoping reviews. Results: The analysis identified six core dimensions of OHL: (i) leadership and management, (ii) policy and strategy formulation, (iii) human resources, (iv) organizational resources (including financial, physical, and informational), (v) processes, products, and services, and (vi) results. These dimensions were further categorized into 21 subcategories. Each dimension outlines essential components for improving hospital OHL, such as leadership support, staff training, communication strategies, and resource allocation. Additionally, the study highlights the role of technology, including electronic health literacy, in improving organizational performance. Conclusion: By addressing the key dimensions that influence organizational health literacy in hospitals, hospital administrators can enhance patient understanding of healthcare services, improve safety and satisfaction levels, and foster a culture of health literacy. The provided framework offers a valuable management approach for integrating OHL into hospital operations, potentially leading to more informed and health-literate patient communities. https://ijph.tums.ac.ir/index.php/ijph/article/view/36769 https://ijph.tums.ac.ir/index.php/ijph/article/download/36769/8644

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 1954 1964 Pınar Hamurcu Department of Nutrition and Dietetics, Faculty of Health Sciences, Istinye University, Istanbul, Türkiye 2024 03 04 2025 05 09 Background: This study aimed to examine the relationship between nutritional status assessed by the diet quality index with physical activity, sleep, and quality of life among young adults. Methods: This descriptive, cross-sectional research utilized a sample of 700 university students enrolled in the 2021–2022 academic year at a private university's Faculty of Health Sciences in Istanbul, Türkiye. Data were collected using face-to-face interviews with Information Form, Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire (IPAQ), World Health Organization Quality of Life-Short Form-Turkish Version (WHOQOL-BREF-TR) and 24-Hour Food Consumption Record. The dietary quality of the participants assessed via Diet Quality Index-International (DQI-I). Results: The study revealed inadequate diet quality among young adults, with a mean DQI-I score of 33.08±7.03. According to PSQI assessment, 85.3% of them had impoverished sleep quality, and according to IPAQ assessment, 23.3% of them were physically inactive. In comparing participants' characteristics with DQI-I, a positive correlation observed between age and both DQI-I-Total (P=0.017) and Variety sub-dimension (P=0.027). Furthermore, statistically significant differences identified between Moderation sub-dimension and economic situation (P=0.032), as well as between Variety sub-dimension and sleep duration (P=0.044). No statistically significant association found between diet quality and either sleep quality or physical activity levels (P>0.05). However, a significant relationship observed solely between Variety sub-dimension and social relationship sub-dimension of WHOQOL-BREF-TR (P=0.033). Conclusion: This study observed a significant correlation between dietary diversity and quality of life, whereas no significant correlation observed between diet quality and sleep quality, physical activity level, or quality of life. https://ijph.tums.ac.ir/index.php/ijph/article/view/34811 https://ijph.tums.ac.ir/index.php/ijph/article/download/34811/8651

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 1965 1974 Mihael Djacic Special Psychiatric Hospital “Dr Slavoljub Bakalović”, Vrsac, Serbia Snezana Radovanovic Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Nebojsa Zdravkovic Department of Medical statistics and informatics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Vladislava Stojic Department of Medical statistics and informatics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Stefan Milojevic 1. Faculty of Business Economics, EDUCONS University, Serbia 2. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Albert Darijan Department of the High School of Health, Academy of Applied Studies Belgrade, Belgrade, Serbia Stefani Lazin Synapse Center Vrsac, Vrsac, Serbia Ilija Glisic TIM-D MEDICAL Specialist Clinic, Leskovac, Serbia Milos Stepovic Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Tatjana Boskovic Matic Department of Neurology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia 2025 05 15 2025 08 10 Background: The importance of the role of nurse technicians lies in the fact that they are becoming the main providers of health care for psychiatric patients, in addition to providing them with appropriate care. We aimed to examine predictors of quality of life of nurse technicians caring for psychiatric patients. Methods: The sample consisted of 260 nurse technicians caring for psychiatric patients at the Special Hospital for Psychiatric Diseases "Dr Slavoljub Bakalović" in Vršac and the Special Hospital for Psychiatric Diseases in Kovin, Serbia. The following instruments were used in the study: a questionnaire to collect sociodemographic characteristics, the World Health Organization Quality of Life Self-Assessment Questionnaire – Short Version, the Depression Anxiety Stress Scales, the Brief Resilience Scale, and the Fatigue Assessment Scale – FAS Serbian and the Zarit Stress Interview. Results: On the physical and mental aspects of the quality of life of medical technicians, the greatest negative impact is the physical aspect of fatigue (P=0.036) and anxiety (P=0.017), and the positive impact is the number of household members (P=0.001). On the environmental aspect of the quality of life, the greatest negative impact is the burden of caregivers (P=0.000). Conclusion: Due to unique working environment of care-giving medical nurses, the quality of life has become very considering aspect. Fatigue, stress, anxiety can have a cumulative effect of those individuals, and lead to the burnout syndrome.   https://ijph.tums.ac.ir/index.php/ijph/article/view/39122 https://ijph.tums.ac.ir/index.php/ijph/article/download/39122/8652

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 1975 1984 Zhen Su Sports and Military Training Department, Zhijiang College of Zhejiang University of Technology, Shaoxing, China Ziqiang Zhang Department of Fundamental Courses, Zhejiang Changzheng Vocational & Technical College, Hangzhou, China Xiaolei Zhan Sports and Military Training Department, Zhijiang College of Zhejiang University of Technology, Shaoxing, China Xi Xiao Continuing Education College, Zhejiang University of Technology, Hangzhou, China 2025 07 11 2025 09 30 Background: Short-video addiction is prevalent among adolescents and threatens their development. This study aimed to examine the relationships among physical exercise, self-control, subjective emptiness, and short-video addiction in adolescents and the underlying mechanisms. Methods: A total of 889 adolescents were recruited from 3 middle schools in Zhejiang Province, China. Data collection was conducted from April to June 2025 using a questionnaire. Results: The mean score of short-video addiction in adolescents was 3.01; physical exercise was negatively correlated with short-video addiction (r=−0.626, P<0.001); self-control (effect=−0.106, 95% CI [−0.175, −0.047]) and subjective emptiness (effect=−0.360, 95% CI [−0.492, −0.260]) mediated the relationship between physical exercise and short-video addiction; and the chain mediation model shaped by self-control and subjective emptiness had a statistically significant effect (effect=−0.064, 95% CI [−0.115, −0.025]). Conclusion: Physical exercise contributes to mitigating short-video addiction in adolescents by enhancing self-control and alleviating psychological emptiness. Relevant interventions should integrate physical activities to improve adolescents’ self-management abilities, satisfy their psychological needs, and lay a foundation for the prevention and treatment of this addictive behavior. https://ijph.tums.ac.ir/index.php/ijph/article/view/39859 https://ijph.tums.ac.ir/index.php/ijph/article/download/39859/8653

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 1985 1995 Rukiye Sumeyye Bakici Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Türkiye Necati Emre Sahin Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Türkiye Seyma Toy Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Türkiye Zulal Oner Department of Anatomy, Faculty of Medicine, İzmir Bakırçay University, İzmir, Türkiye 2024 07 13 2025 06 01 Background: This study aimed to examine the relationship between hand types and somatotypes of healthy young individuals. Materials: Overall, 312 volunteering individuals (152 F, 160 M) from Karabük University (Karabük, Türkiye), between the ages of 17 and 35 years were included in this prospective study. The somatotypes of the individuals were measured using a previously formed Excel template based on the Heath-Carter method. Factor analysis and clustering analysis were conducted with the 17 parameters measured. Results: The mean body mass index of female participants was 21.23±3.30 kg/m2, while that of males was 23.48±3.52 kg/m2. When the somatotypes of individuals were examined, 5 different groups were found to be balanced: ectomorph, endomorphic mesomorph, mesomorph endomorph, mesomorphic endomorph, and central. As a result of these factors, it was concluded that there were 4 hand types: short palm short finger, long palm long finger, wide hand long finger, narrow hand short finger. The distribution of hand types between somatotype groups, the result that endomorphic mesomorph group had long palm long finger and wide hand long finger, while balanced ectomorph group had narrow hand short finger was found to be statistically significant (x2=55.817; df=12, P<0.05). Conclusion: The difference between somatotypes was not only in body types, but also in hand anthropometry. We believe that the fact that these results can be used as anatomical data in product design, ergonomics, and preliminary design of interfaces for young individuals in the Turkish population will contribute to experts interested in this field. https://ijph.tums.ac.ir/index.php/ijph/article/view/36076 https://ijph.tums.ac.ir/index.php/ijph/article/download/36076/8654

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 1996 2004 Anqi Zhong The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China Shihan Liu Department of Otorhinolaryngology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China Lingli Zhang Department of Otorhinolaryngology, Central Hospital Affiliated to Chongqing University of Technology, Chongqing, China 2024 11 24 2025 02 18 Background: Childhood intelligence is a critical developmental milestone influenced by genetic and environmental factors. The interplay between intelligence and vestibular function, which is increasingly recognized for its relevance to cognitive abilities, has not been extensively studied. This study aims to investigate the potential association between childhood intelligence and vestibular dysfunction. Methods: Utilizing a two-sample Mendelian randomization (MR) approach, we analyzed data from publicly available genome-wide association studies (GWAS) of European ancestry. Genetic instruments were selected based on GWAS significance, independence, and F-statistics. We employed MR Egger, Weighted median, Inverse variance weighted (IVW), Simple mode, and Weighted mode methods for robustness checks. Results: Our analysis identified a significant inverse association between childhood intelligence and the risk of vestibular dysfunction (IVW: OR= 0.907, 95% CI = 0.843 - 0.976, p= 0.009). The MR Egger intercept test did not indicate horizontal pleiotropy, and heterogeneity analysis suggested consistency in the results. Conclusion: The study provides preliminary evidence of a negative correlation between childhood intelligence and vestibular dysfunction risk, suggesting that higher intelligence may be associated with a lower likelihood of vestibular issues. This finding underscores the importance of vestibular function in cognitive development and offers insights for early intervention strategies. https://ijph.tums.ac.ir/index.php/ijph/article/view/37298 https://ijph.tums.ac.ir/index.php/ijph/article/download/37298/8655

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 2005 2014 Khadijeh Saeidi Department of Biochemistry, Faculty of Biological Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran Mehdi Hedayati Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Molecular Biology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Monireh Movahedi Department of Biochemistry, Faculty of Biological Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran Maryam Sadat Daneshpour Department of Biochemistry, Faculty of Biological Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran 2024 07 30 2025 03 16 Background: Medullary thyroid cancer (MTC) is a rare neuroendocrine malignancy, accounting for 5-10% of all thyroid cancer cases. The precise molecular processes driving MTC remain largely elusive. We aimed to conduct a pilot study analyzing plasma metabolic profiles of MTC patients to uncover disruptions in metabolic pathways that may contribute to MTC tumorigenesis. Methods: Proton nuclear magnetic resonance (1H-NMR) spectroscopy was performed to screen metabolic changes in plasma samples from MTC patients (n=16) and healthy subjects (n=12). Multivariate and univariate analyses were applied using MetaboAnalyst and SIMCA software. Results: A total of 30 compounds were identified, of which three metabolites—glycerol, isobutyric acid, and valine—showed significant differences between MTC patients and the control group (P<0.05). Conclusion: The findings from this study contribute to the current understanding of MTC metabolism and suggest that the NMR-based metabolomics approach can provide a metabolic pattern of MTC, potentially improving diagnostic procedures. https://ijph.tums.ac.ir/index.php/ijph/article/view/36196 https://ijph.tums.ac.ir/index.php/ijph/article/download/36196/8656

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 2015 2023 Niloofar Harati Department of Psychology and Educational Sciences, ST.C, Islamic Azad University, Tehran, Iran Nahid Hosseinabbasi Department of Nursing and Midwifery, Ahv. C., Islamic Azad University, Ahvaz, Iran Zahra Marzban Raad Department of Gynecology Surgery, Iran University, Tehran, Iran 2025 05 10 2025 09 25 Background: Human papillomavirus (HPV) is among the most prevalent sexually transmitted infections worldwide. Understanding the psychological contributors to HPV infection is crucial for informing preventive strategies. We examined whether sexual assertiveness, body image shame, and impulsiveness predict HPV infection in women. Methods: In this cross-sectional, predictive correlational study, 119 women aged 18 to 45 who underwent HPV testing in gynecology and oncology clinics in early 2024 were recruited via convenience sampling. Data were gathered using a demographic questionnaire and three standardized instruments: the Hurlbert Index of Sexual Assertiveness (HISA), the Body Image Shame Scale (BISS), and the Barratt Impulsiveness Scale (BIS). Logistic regression analysis was conducted using SPSS version 27. Results: The participants had a mean age of 33.98 years, with 47.89% being single and 52.1% married. Among all participants, 40.3% tested positive for HPV. Body image shame and impulsiveness emerged as significant predictors of HPV infection risk (P < 0.001). External body image shame was identified as the most impactful subscale of body image shame, while cognitive impulsivity showed the strongest influence among the components of impulsiveness. However, the findings revealed no significant association between low sexual assertiveness and the risk of HPV infection (P > 0.05). Conclusion: These findings highlight the role of psychological factors, especially body image shame and impulsiveness, in HPV risk. Integrating related interventions into public health measures like vaccination and screening may improve their effectiveness and enhance women’s sexual health outcomes. https://ijph.tums.ac.ir/index.php/ijph/article/view/39062 https://ijph.tums.ac.ir/index.php/ijph/article/download/39062/8657

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 9 2025 10 04 2024 2034 EN Ali Askari 1. Department of Occupational Health Engineering, School of public Health, Tehran University of Medical Sciences, Tehran, Iran 2. Department of Occupational Health and Safety, OICO, Azar Oilfield Project, Ilam, Iran Ali Salehi Sahlabadi 1. Safety Promotion and Injury Prevention Research Center, Research Institute for Health Sciences and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2. Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Maliheh Eshaghzadeh Department of Nursing, school of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran Mohsen Poursadeghiyan 1. Social Determinants of Health Research Center, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran 2. Department of Occupational Health Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran6. Social Determinants of Health Research Center, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran 7. Department of Occupational Health Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran Gebaeil Nasl Saraji Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2024 07 11 2025 07 17 Background: During driving, drowsiness may happen for a few moments, but its consequences can be terrible. Drowsiness in the driver can be detected in the early stages. Each method used for detecting drowsiness has its own strengths and weaknesses or benefits and flaws. The main contribution of our research was improving Driver Drowsiness Detection (D.D.D) systems. Methods: In accordance with the research objective, it is imperative to address the subsequent inquiries (Q) throughout the process of constructing, testing, and delivering the ultimate D.D.D software model: Q1. What is the methodology employed for constructing the initial model of drowsiness detection software? Q2. How is the initial model of drowsiness detection software tested and refined during the development phase? Q3. What is the operational mechanism of the final model of drowsiness detection software? Results: The results were able to detect different facial conditions (with hair and glasses) with a 92.3 percentage detection rate.  Conclusion: This model could help improve D.D.D systems, and detect drowsiness in different environments and situations. https://ijph.tums.ac.ir/index.php/ijph/article/view/35500 https://ijph.tums.ac.ir/index.php/ijph/article/download/35500/8658