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Results in International Journal of Epidemiology and Health Sciences: 49

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, Sarah Cuschieri
International Journal of Epidemiology and Health Sciences, Volume 4, pp 1-14; https://doi.org/10.51757/ijehs.4.2023.697489

Abstract:
Background: Medical research dynamics are complex, and stressors such as the COVID-19 pandemic make them even more so.Aims: The purpose of this article was to assess the impact of COVID-19 on medical students' willingness to become doctors and their goals. It also investigated how COVID-19 affects students' mental health and well-being.Methods: A literature-based anonymous online survey was created to assess students' future career goals, willingness to become doctors, and various aspects of their mental health. There was descriptive and univariate regression analysis.Results: Males enrolled in medical school at a higher rate than females. After the pandemic, a minority of students changed their initial specialty choice, but there was no statistical significance in their willingness to become a doctor (p =0.45). Only students who had long COVID-19 symptoms showed significant variation in their sleep patterns (p =0.01). Female students had significantly higher anxiety levels than male students, with 11.21% (CI95%:6.34 - 18.74) experiencing severe anxiety.Conclusion: Enrolling in medical school is a deeply personal decision that should not be taken lightly. Workplace conditions should be improved in order to attract the next generation of health-care providers. It is thus recommended that medical schools consider establishing a pre-entry course to inform and expose potential medical students to the working lives of doctors. All medical schools must ensure that mental and psychological support is easily accessible and non-stigmatizing.
, Seyyedeh Zahra Hajiasghari
International Journal of Epidemiology and Health Sciences, Volume 4, pp 1-6; https://doi.org/10.51757/ijehs.4.2023.696939

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Introduction: Hospitals may have an adverse effect on the environment. The World Health Organization (WHO) introduced the concept of Green Hospital to reduce these complications while also improving the environment. The purpose of this study was to assess how many hospitals in Qazvin met Green Hospital standards.Methods: This descriptive-observational study was carried out in all of the hospitals in Qazvin that were included in the study via the census sampling method. The standard green hospital questionnaire was used to collect data, which was completed with environmental experts through interviews and document observation. This questionnaire has 96 questions and is divided into eight dimensions: environmental, energy, hazardous materials, water, sewage, greenhouse gas emissions, external water consumption, material, and environmentally friendly purchasing management. Each question is graded on a three-point Likert scale ranging from 0 to 2.Results: This study included nine hospitals. Six were teaching/public (5 teaching hospitals and 1 Social Security Hospital), and three were public. The average ratio of active beds to approved beds was 90%, with private hospitals reaching more than 100% (131%). The mean achievement rates for the first through eighth dimensions were 70.08, 74.07, 74.07, 60.88, 40.87, 27.77, and 31.48, respectively. The overall mean score for meeting Green Hospital standards was 57.46%.Conclusions: Although hospitals achieved higher achievement rates in some dimensions, overall results showed low achievement rates. As a result, their managers and employees must learn how to prevent environmental degradation.
, Joseph Opeyemi Tosin
International Journal of Epidemiology and Health Sciences, Volume 4, pp 1-19; https://doi.org/10.51757/ijehs.4.2023.696940

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Background and Objective: Scientists and world leaders are still trying to understand COVID-19 and its potential global consequences. While there have been some successes, there are still many that remain unknown. This study provides an update report on the virological and immunological distribution and implications of the COVID-19 pandemic around the world from January 28th to February 3rd, 2022..Material and Method: The United Nations geoscheme was used to obtain data from 196 countries and regions around the world. The results were compiled and compared to the values obtained for the United States.Results: When available data was compared to that of the United States, the American continent had a higher mortality comparison factor than infection cases, whereas the European continents had a higher infectious comparison value than mortality value. With the exception of South Africa and Botswana, the African continents appear unconcerned about the value of mortality and infectivity.Conclusion: The new wave and virus variant have caused a resurgence in its global impact. There is a need to understand how Africa has survived all variants of the virus despite having few medical resources.
Zahra Karimi, Zahra Davoodi, Leila Rabiei, Mahnaz Jafari, Mansoureh Kiani Dehkordi, Roy Rillera Marzo,
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2022.254985

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Objective: COVID-19 prevalence is a new and serious threat to public health. The disease has had an impact on nearly every important economic, political, social, and even military aspect of many countries around the world. As a result, the psychological effects of this viral disease on different levels of society's psychological health are critical, necessitating scientific research. This study looked into the possible link between COVID-19 and psychological distress and anxiety in Iran.Methods: The first large-scale global study of psychological distress and anxiety in public society, this cross-sectional (descriptive-analytical) study was based on the participation of people from some Asian countries during the COVID-19 epidemic. Only the results from Iran were presented in this article. This study had 1480 participants and used a standard questionnaire called the COVID-19 Peritraumatic Distress Index (CPDI) with a Cronbach's alpha of 0.82.Results: It was discovered that 1171 (79%) of the participants were female, while 309 (21%) were male. The CPDI Questionnaire yielded a mean score of 54.16±6.13. There was a significant relationship (p=0.0002) between age group and total score of psychological distress and anxiety. The findings revealed a link between anxiety variables and education (p = 0.0001), monthly income (p = 0.008), and gender (p = 0.019).Conclusion: It can be concluded that the majority of study participants were in an unfavorable psychological distress and anxiety situation.
, Kourosh Zarea, Hossein Komeili-Sani, Malek Fereidooni-Moghadam
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2022.254146

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Background: When there is betrayal and disloyalty in a family, the betrayed spouse suffers the most, resulting in mental health disorders and a loss of emotional and behavioral balance. The purpose of this study was to explain the divorce crisis in betrayed spouses.Method: This qualitative research was conducted as a content analysis method in Ahvaz, Iran. Data was gathered through 18 semi-structured interviews with 14 betrayed participants chosen using purposeful sampling. The data was analyzed using the traditional content analysis method.Results: After analyzing the data, three main themes and seven subcategories were identified. Among the themes were divorce issues, with subcategories such as "fear of disclosure," "moving towards divorce," and "fear of consequences, lack of support, and parent household problems."Conclusion: According to the findings, some of the study participants had not forgiven their spouse after discovering their betrayal and had broken up, but others had to ignore their partner's flaws and carry on with their lives for a variety of reasons, including a fear of losing their children, loneliness, and a lack of support. More research in this area is recommended.
, Alice Khachian, Shaghayegh Sedigh, Sona Elyasi, Maedeh Mortezanasab, Ghazal Ghaderi
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2022.254051

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Background and Objective: Leukemia is one of the top five cancers in Iran. Aside from physical issues, the disease causes a variety of social and psychological issues for patients. In this regard, one aspect that cancer may affect is quality of life, which can lead to anxiety. The collaborative care model is a novel nursing model that improves treatment outcomes through collaboration. As a result, the purpose of this study is to look into the impact of a collaborative care model on quality of life and anxiety in leukemia patients.Methods: The current non-randomized clinical trial, which included a control group, was conducted on 60 leukemia patients at Firoozgar and Rasoul Akram hospitals in Tehran (affiliated to Iran University of Medical Sciences). The hospitals were randomly divided into two groups: control and intervention, and patients were chosen at random from each hospital using a convenience sampling method. The collaborative care model was implemented in the intervention group, while no specific measures were taken in the control group. Patients in both groups' quality of life was measured using the Quality-of-Life Questionnaire in Oncology Patients before, one, and two months after the intervention, and their anxiety was measured using the Beck Anxiety Inventory. Both groups completed their questionnaires using a self-report method.Results: In terms of demographic characteristics, there was no statistically significant difference between the two groups (p>0.05). Prior to the intervention, no statistically significant difference in mean anxiety, quality of life, and its dimensions was observed between the two groups (p>0.05). Following the intervention, a statistically significant difference in mean anxiety and quality of life scores was observed between the two groups (p<0.05), indicating a decrease in anxiety and an increase in quality of life among patients in the intervention group.Conclusion: Based on the findings, it appears that the collaborative care model has a positive effect on reducing anxiety and improving quality of life in leukemia patients, and it is preferable to use this model when caring for this group of patients.
, Mahni Rahkar Farshi, Mahnaz Jabraeili
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2022.253999

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Background: Provision of pediatric palliative care is of particular importance. Therefore, this study aims to assess knowledge and attitude of nurses working in pediatric wards about this matter.Methods: The current descriptive study was conducted in 3 hospitals in Tabriz, Iran. The sample consisted of all nurses working in pediatric wards, who were selected through a convenience sampling method. For data collection, a checklist for demographic variables, Palliative Care Quiz for Nursing, and Frommelt Attitudes Toward Care of the Dying Patients were used. Collected data were then analysed using SPSS.Results: Of the total of 247 questionnaires distributed, 220 were returned completely. Most of the participants were female (96.3%). Their mean age was 32 years, and their mean work experience in clinical wards was 7.22 years. The results showed that the mean total scores of nurses’ knowledge and attitude about pediatric palliative care were 10.70±2.83 and 97.90±98.83, respectively.Conclusion: Findings of this study showed that nurses have a good attitude and poor knowledge about pediatric palliative care. Considering the findings of this study as well as the importance of pediatric palliative care, it is necessary to improve nurses’ knowledge about this matter. Further studies are also recommended in this regard.
Ram Prasad Sharma G, Kalpana Sharma, Niki Shrestha
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2022.254050

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Background: When working in Coronavirus Diseases (COVID-19) wards and ICUs, Health Care Workers (HCWs) face numerous physical and psychosocial challenges. The purpose of this study was to look into the difficulties that HCWs face when caring for COVID-19 patients. Method: A qualitative phenomenological study was used, and the study sample included 12 HCWs (8 nurses and 4 doctors) who worked specifically with COVID-19 patients. A semi-structured interview guideline was used for data collection, and Giorgi's method was used for analysis. Results: During the pandemic, HCWs faced numerous challenges while caring for COVID-19 patients in a hospital. HCWs faced five major challenges: (i) increased workload and staff shortages, (ii) mental stress, (iii) social stigma and isolation, (iv) resource scarcity, and (v) a lack of specific skill training. Conclusion: While caring for COVID-19 patients during the pandemic, health care workers faced numerous physical, psychological, and social challenges. As a result, these issues must be addressed in order to provide quality care in the hospital.
, Godwin Somto
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2022.253510

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Background: COVID-19 has claimed the lives of millions of people in Nigeria and around the world during the last two years. It is a recognized global health crisis of our day, as well as a persistent threat to the earth. The goal of this study was to examine the trend and fit an Error Trend and Seasonal (ETS) exponential smoothing and Autoregressive Integrated Moving Average (ARIMA) model to Nigeria's COVID-19 daily fatalities.Methods: A dataset of daily COVID-19 confirmed fatality cases was used in the investigation. Data was acquired from the Nigerian Centre for Disease Control (NCDC) web database between the 10th of July 2020 and the 2nd of December 2021. The ARIMA model and twelve (12) ETS exponential smoothing techniques were investigated using a dataset of COVID-19 pandemic deaths in Nigeria. The ARIMA and ETS exponential smoothing algorithms were evaluated using the Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), Hannan Quinn Information Criterion (HQC), and Average Mean Squared Error (AMSE) selection criteria.Result: The ARIMA (0,1,0) model was the best time series modeling for the coronavirus (COVID-19) epidemic in Nigeria since it had the lowest AIC=2863.51, BIC=2866.90, HQ = 2866.90, and AMSE = 0.55471 values.Conclusion: The ARIMA (0,1,0) model is preferred above the other thirteen (13) competing models based on daily confirmed COVID-19 deaths in Nigeria. This research would assist the Nigerian government in better understanding the pestilence's evolution pattern and providing adequate provisions, prompt mediation, and treatment to prevent additional deaths caused by the virus.
Hulera Usman Kabido, Joseph Fuh Nfongeh, Victor Kolawole Fadayomi, Onyemachi Ifeanyi Adibe, Abdullahi Shuaibu Kabiru, Nafisat Tijjani Dalhat, Yahuza Jibrin Abubakar
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2022.253998

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Background: Due to its persistent nature, ulcers brought on by Helicobacter pylori have been a significant public health concern. This study looked at how specific risk factors affected the prevalence of Helicobacter pylori infection among peptic ulcer patients visiting medical institutions in Lafia, Nigeria. Methods: The blood and stool samples of 180 individuals (71 men and 109 women) were collected randomly, checked for H. pylori using test strips for H. pylori antibodies and antigens (Azure Biotech Inc.), and the feces also were grown on Columbia blood agar base (TITAN Biotech Ltd). Using a standardized questionnaire, some participant risk data was also gathered.Results: A positive culture method (CM) test result was obtained from 14/71 (19.72%) of the 71 male patients and 37/109 (33.94%) of the 109 female subjects out of a total of 210 subjects. For CM alone, it was discovered that female participants had a considerably greater incidence of Helicobacter pylori infection than their male counterparts (p=0.038). Nevertheless, all analytical techniques discovered no evidence of a significant difference between age groups (p>0.05). Only the blood antibody (BAB) approach showed a substantially greater prevalence (p=0.021) in married patients, with 79/116 (68.10%) reactive instances. The presence of drinking water source (p < 0.001, 0.001, 0.002 using CM, BAB, and SAG, respectively) and number of occupants per room (p < 0.001, 0.001, 0.002 using CM, BAB, and SAG, respectively) as potential risk factors for H. pylori infection was also demonstrated.Conclusion: The majority of risk factors that were taken into consideration for this study demonstrated a strong correlation with Helicobacter pylori infection in Lafia, Nigeria.
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2022.253909

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Background: Longitudinal data on SARS-CoV-2 re-infection are scarce. Objectives: 1) Characterize COVID-19 reinfection cases clinically and epidemiologically; 2) Determine whether the risk of SARS-CoV-2 reinfection has altered over time in the context of the development of beta, delta, and omicron variants.Methods: From March 1, 2020 to July 1, 2022, an observational, longitudinal, and prospective investigation of Covid-19 re-infections was done in a general medical practice in Toledo, Spain.Results: There were 43 cases in total, including 45 reinfections (2 cases presented 2 reinfections). The average period between first infection and reinfection was 346 days (range: 95-813 days). The average age was 41 years (range: 17-70 years). 5% were over the age of 65. 56% were female. 14% belonged to an ethnic minority. 82% of reinfections occurred among individuals who had been vaccinated (19%, 28%, and 35% in those who had received one dose, two doses, and a booster, respectively). They were symptomatic in 96% of the cases. All cases of reinfection were minor, with nonspecific symptoms (discomfort, asthenia, myalgia, fever, arthralgia) predominating (39%). Chronic illnesses were present in 60% of reinfection cases, with the Genitourinary (19%), Endocrine (17%), and Respiratory (16%) systems predominately. Reinfections have been steadily growing since 2020, with 67% occurring in 2022.Conclusion: We discovered evidence of a continual increase in the incidence of reinfections in Toledo, Spain, primarily beginning in January 2022, which is temporally congruent with the introduction of the omicron variety, indicating its improved ability to infect previously infected persons.
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2022.253343

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Background: During the ongoing COVID-19 pandemic, the importance of epidemiologists and epidemiology as a science is becoming clear. An epidemiologist leads the team that deals with health emergencies and pandemics. Whatever type of epidemiologist they are, they must have specific competencies, skills, functions, and ethics.Methods: PubMed and Google were searched for full texts of studies published in English using the key words "epidemiologist" in conjunction with definition, competencies, skills, functions, roles, types, and ethics. This narrative review included all of the literature that was retrieved. We only included the most recent and pertinent articles. Standard epidemiology textbooks were also screened for the relevant review heading.Results: We summarized the contributions of key epidemiologists from Hippocrates to Austin Bradford Hill, as well as their competencies or skills, functions, and 16 types of epidemiologists. Finally, epidemiologists' ethics were discussed.Conclusion: For early detection and prevention of epidemics and health disasters, effective liaison between epidemiologists, clinicians of various specialties, and policymakers is required. This is especially important in developing and developed countries where the number of epidemiologists is low and the majority work in teaching institutions where their contributions are undervalued.
, Sonymol K
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2022.252524

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Background: The Coronavirus Disease-2019 manifested as a serious infectious disease that affected people of all ages and genders, particularly older patients with comorbidities. Patients who have recovered from COVID have serious restrictions. Aims: The purpose of this study was to determine the prevalence of post-COVID-19 functional status (PCFS) in patients and the relationship between post-COVID-19 functional status and selected demographic characteristics.Methods: This study employed a descriptive survey research design and a quantitative, non-experimental research approach. Data were obtained from 190 COVID-19 recovered patients admitted to an Indian quaternary hospital who met the inclusion criteria utilizing an online survey approach and a mobile app. Prior to the study, the institutional scientific and ethical committees approved it. The study's findings were analyzed using descriptive statistics and chi-square.Results: The percentage of demographic data is identified, and the post COVID functional limitation of samples shows that 58 percent have negligible functional limitation, 24 percent have no functional limitation, 16 percent have slight functional limitation, 1 percent have moderate functional limitation, and 1 percent have severe functional limitation. There was an association between PCFS and age, as well as PCFS and the COVID-19 group.Conclusion: Some COVID-19 survivors suffered functional difficulties after infection. The severity of the disease and its duration are important risk factors for the development of post-COVID-19 functional impairments. The study's findings assist healthcare professionals in improving their understanding of post-COPID functional status and providing appropriate care to post-COPID recovered patients.
Habibollah Hosseini, Parvaneh Khorasani, Zahra Noori
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2022.253067

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Introduction: The purpose of this study was to assess the status of diabetes management among elderly people living in Isfahan nursing homes using the Donabedian framework in three parts: structure, process, and outcome.Methods: In 2018, the current descriptive-cross-sectional approach was used in 13 nursing homes in Isfahan. Data was collected using a dependable and valid research-created checklist that evaluated diabetes management through three components: organizational structure (8 dimensions and 33 items), processes (3 dimensions and 23 items), and outcomes (2 dimensions and 7 items). Data was collected by observing the equipment and human resources, interviewing key informants and nurses, reviewing documents, and collecting blood and urine samples under standard conditions.Results: Structure, process, and outcome mean scores were 34.5±2.6, 38.5±5.9, and 65.6±13.9, respectively. The highest and lowest structure scores were associated with "referral system" and "trained personnel," respectively; process scores were associated with "counseling and risk factor reduction" and "immunization," and outcome scores with "physical examination and history taking" and "documentation of laboratory results." The mean score of structure was found to have a direct relationship with process and outcome (p < 0.05). There was also a direct relationship (p <0.05) between the mean process and outcome scores. Linear regression analysis revealed that structure was a significant predictor of outcome (p = 0.01).Conclusions: The findings revealed some issues with the structure, process, and outcome of providing appropriate diabetes management care in nursing homes. To achieve positive results in this area, it is necessary to focus on the human resources, facilities, and equipment required to manage diabetes in nursing homes.
Oyepata S Joseph
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.6.2022.251435

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Background and Objective: COVID-19 has had a worldwide impact in a variety of ways since its discovery in China. As a result, it's critical to maintain a constant eye on the virus's impact around the world. The goal of this research is to compile a global assessment of COVID-19 demographics and distribution, as well as a COVID-19 update report till February 17th, 2022.Methods: Data was provided by the United Nations Geochem database from 151 nations and areas throughout the world. The results were compiled and compared to the figures obtained for the United States.Result: When compared to the United States, the American continent has a lower incidence but the same fatality rate. When compared to the United States, most European and Asian countries have the same cumulative incidence and mortality rates as the United States, except for a few countries such as the United Kingdom and the Netherlands. When compared to the United States, the African continent has an extremely low incidence and fatality rate.Conclusion: The development of the Omicron variety seems to make COVID-19's approach and comprehension more complicated. As a result, the virus has had a long-term impact all over the world. Africa, on the other hand, is not particularly afflicted by all the virus's strains. As a result, the rest of the world must research the cause of this "African exception" and maybe comprehend its ramifications in terms of potential immunity.
, Bahareh Yousefi, Omid Taherkhani, Ali Mahmoudi
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.5.2022.251433

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Introduction: It is vital to identify psychological disorders and their effective elements among nurses working in acute wards. As a result, the current study was carried out with the goal of determining the link between COVID-19-related anxiety and nurse resilience.Methods: At 2021, 249 nurses working in Qazvin teaching hospitals participated in this descriptive cross-sectional survey. A three-part tool was used to gather information: a demographics questionnaire, the Corona Disease Anxiety Scale, and the Connor-Davidson Resilience Scale.Results: The mean resilience and COVID-19-related anxiety scores were 66.28 ± 14.12 and 9.81 ± 9.74 (p0.001), respectively. Resilience, job tenure in corona wards, work experience in corona wards, and workplace are the most effective and significant factors on nurses' COVID-19-related anxiety, while marital status and workplace are the most effective and significant factors on nurses' resilience, according to the results of univariate regression analysis.Conclusions: COVID-19-related anxiety was reduced in the wards by nurses with higher resilience levels. This discovery can be used in management planning to help nurses feel less anxious.
, Seyyed Mohammad Tabatabaei
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.5.2022.251434

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A "prevention paradox," according to Thompson, is a type of prevention that has many benefits for the entire population but may not be as beneficial to each individual as it is to the entire community. COVID-19 is one of the most mysterious developing viruses in history, capable of being transmitted from one person to another mostly through breathing. If we do not follow specific advice, such as wearing a face mask, we will all become infected very rapidly. To save the lives of a small percentage of the population, millions of people should wear face masks.
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.4.2022.249490

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Background: It's unclear whether vaccination individuals against SARS-CoV-2 protects family members in the same way. Objective: The assessment of risk factors for SARS-CoV-2 transmission from index cases with COVID-19 breakthrough infection in completely vaccinated patients to fully vaccinated family members. Methods: From February 1 to November 30, 2021, an observational, longitudinal, and prospective research of families with one primary case of COVID-19 breakthrough infection was done in a general medicine practice in Toledo, Spain.Results: Thirteen primary cases of COVID-19 breakthrough infection in 13 families with at least one other family member were included, of which 9 were positive secondary cases (sick) and 8 were negative partners (healthy) properly vaccinated. Being a woman, being over 45 years old, being a social-health professional, being an ethnic minority, and having chronic conditions all increased the likelihood of developing COVID-19 in fully vaccinated contacts and main cases. Although vaccination 2ChAdOx1 nCoV-19 had a higher effectiveness than BNT162b2 mRNA, none of these risk or protective factors were statistically significant.Conclusion: Young women, social health workers, ethnic minority groups, and people with chronic diseases are the completely vaccinated contacts with the highest risk of having COVID-19, after primary cases also vaccinated in the family, in Toledo (Spain), when the delta variant became dominant but before the rise of omicron.
Sarah Cuschieri, Tamara Attard Mallia, Elaine Piscopo, Anneka Pace, Daniela Chatlani, Karl Mifsud, Nicole Mifsud, Jake Vella, Andrea Cuschieri
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.4.2022.250821

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Background: COVID-19 has impacted the European microstates of Andorra, Liechtenstein, Malta, Monaco, the Republic of San Marino, and Vatican City. Even though they have similar population sizes, they are rarely studied. The goal was to summarize the COVID-19 situation (January 2020–July 2021) for these microstates, as well as the outcome and immunization roll-out throughout the first 18 months. While researching COVID-19 incidence and mortality trends among microstates and their land bordering nations,Methods: Epidemiological data was gathered from the database "Our World in Data," whereas COVID-19-related tactics were based on Ministry of Health webpages and local newspapers. Using COVID-19 data (where applicable), the six microstates and their adjacent nations were compared.Results: From the start of COVID-19 until August 1, 2021, the microstates reported a total of 60,174 positive cases and 730 deaths. Andorra had the greatest rates of COVID-19 infection (190 per 1,000) and mortality (1.66 per 1,000). The microstates had similar COVID-19 results, but their bordering nations shared the most striking similarities. COVID-19 cases, fatality rates, and vaccine doses all have a bidirectional link.Conclusion: Whether land borders exist, timely mitigation measures and vaccination rollouts appear to be the keys to pandemic containment. The greatest pandemic impact on a country, however, appears to be dependent on cross-border transmission rates.
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.3.2022.249170

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Background: A mathematical investigation of the reasons for the fifth wave's quick expansion and reduction in Tokyo, Japan, is required to avoid the spread of subsequent COVID-19 infections. Methods: Using the simple IR theory underlying the susceptible-infectious-removed (SIR) hypothesis of infectious disease epidemics, infected persons (I), infection rate, and testing/isolation rate are determined from accessible data of daily positive cases (R) and testing numbers. Results: The rapid spread of illness from late July to mid-August was owing to a drop in the number of people tested to half that of weekdays during the Olympic Games' four and three-day vacations. The maximum number of daily positives would have been lowered to two-fifths of the actual positives in early August if the number of weekday tests had been maintained during these holidays and would have fallen monotonically thereafter. The infection rates mean value fell steadily from 0.65 in late August to around 0.25 by the end of September. The significant increase in vaccination rates is mostly to blame for the fall in infection rates. In Tokyo, the impact of mRNA-based vaccines on infection prevention and increased vaccination rates could reduce the infection rate to 1/2 on September 10 and 1/3 by the end of October. Conclusion: According to the findings, a new infection like the delta variant can be suppressed to less than the fifth wave by increasing vaccination rates, eliminating three consecutive holidays, and implementing a precautionary testing system that maintains the same number of tests on weekends as on weekdays in the event of a rapid spread of infection in an emergency.
Paulraj Manickavelu, Babu S, Anand Babu Kaliyaperumal
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.3.2022.249173

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Background: Allied and Healthcare Education (AHE), which prepares students to work as physical therapists, occupational therapists, nutritionists, dietitians, medical laboratory technicians, and other health and allied professionals. AHE students' healthy lifestyles may aid in the formation of a healthy community, which is more likely to provide effective patient care. Several studies have been carried out to investigate the global prevalence of physical activity (PA) and Sedentary Behavior in the general population. The present study aims to assess the level of diurnal physical mobility and sedentary behavior among AHE students in Pondicherry.Methods: The prevalence study included 158 AHE undergraduate students, with data collected using the International Physical Activity Questionnaire (IPAQ) and reported in metabolic equivalents (MET).Results: Among 158 study populations, it was found that 86 (54.4%) university students practiced low level of physical mobility with a mean MET of 318.5, and 44 (27.8%) students practiced moderate physical mobility with a mean MET value of 1260.9, and only 28 (17.7%) students performed high levels of physical mobility with a mean MET value of 5250.5.Conclusion: The study concluded that the majority of AHE students have altered their physical mobility behavior. The study also found that a higher percentage of students were physically inactive and that this puts them at risk of developing early illness.
, Fatih Kara, Bekir Keskinkilic, Murat Turkyilmaz, Fahriye Unlu, Selin Dundar, Erkin Aribal, Serap Gultekin
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2.2022.248388

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Introduction: In Turkey, a population-based breast cancer screening program for women aged 40 to 69 years old was recently introduced. The goal of this study was to document early outcomes and assess the program's success.Method: This study looked at the 348,638 women who were screened in 2016. For end results, all data was gathered from the national centralized reporting system and the Cancer Registry database. For benign discoveries, Breast Imaging-Reporting and Data System (BI-RADS) 1-2 were applied, and for recalls, BI-RADS 0, 4, or 5 were utilized, depending on the level of suspicion. The study looked at the age distribution, recall rate, cancer detection, and interval cancer rates. The stages of identified malignancies were examined and compared to those of the nonscreened group throughout the same time frame.Results: In the screening population, 43.2 percent of women were between the ages of 40 and 49, and 56.8% were between the ages of 50 and 69. The age range of 50–69 was responsible for 70% of screen-detected malignancies. The total recall rate (n = 19,607) was 5.6 percent. The malignancy rate for BI-RADS 5 recalls was 70.2 percent, 19.2 percent for BI-RADS 4, and 1.7 percent for BI-RADS 0 recalls. Screen-discovered malignancies were detected at a rate of 3.2 per 1000 screening exams (n = 1,120). When compared to the Non screened group, the screened group had a larger percentage of early-stage illness (54.3%). (46.7 percent). Interval cancers were discovered in 231 women (0.66 per 1000 screened women).Conclusion: Turkey's recently launched population-based breast cancer screening program appears to be viable and successful, according to preliminary results. According to this study, the breast cancer screening program should be sustained, with coverage of the target group rising.
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.2.2022.248387

Abstract:
Vaccination has offered the hope of restoring life to pre-COVID-19 normalcy. However, new COVID-19 cases have continued to emerge and have increased in certain regions even with increasing vaccination coverage. This study aims to explore the correlations between daily COVID-19 case fatality rates, vaccination coverage as well as daily new cases and deaths of COVID-19 in Malaysia. It aims to compare the pre- and post-vaccination COVID-19 case fatality rates and examine if any difference between the rates is statistically significant. It also aims to identify the main predictors of COVID-19 case fatality rates. This study obtained the data of daily new cases and deaths of COVID-19, as well as the daily vaccination coverage in Malaysia from official platforms and government offices for non-parametric statistical analysis. It explored the Spearman’s correlations between daily COVID-19 case fatality rates, daily new COVID-19 cases and deaths as well as the vaccination coverage in Malaysia. It examined the difference in the pre- and post-vaccination daily COVID-19 case fatality rates with Mann-Whitney U Test. It constructed a multiple regression model to identify the significant predictors of the daily case fatality rates. This study shows that daily COVID-19 case fatality rates are positively correlated with daily new COVID-19 cases and deaths, and vaccination coverage. It reveals that post-vaccination case fatality rates are lower than pre-vaccination and the difference is statistically significant. People fully vaccinated per 100 population is a significant predictor of the decline of daily case fatality rates.
, Nimetcan Mehmet
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.1.2022.247746

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Background: In Africa, HIV is one of the most serious public health issues. The purpose of this study was to look into the prevalence and incidence rates of HIV/AIDS in West Africa across all age ranges and population groups.Methods: This is a comprehensive study of published and unpublished studies on HIV/AIDS prevalence and incidence in West Africa. All publications published between 2010 and 2020 that were retrieved from databases, as well as other records containing information on the topic under consideration, were examined.Results: The comprehensive assessment of the literature generated 13 papers with data on the prevalence and incidence of HIV after applying the inclusion, exclusion, and quality criteria. These items came from nine different countries in West Africa. The prevalence rate of HIV in a specific group ranged from 1.4 percent to 54.9 percent in this article review.Conclusions: The review found that HIV prevalence in important demographics in West African nations was high. It also revealed that women are the ones who are most affected. HIV prevalence and incidence differ from country to country. In comparison to other nations, HIV prevalence in important populations was greater in Nigeria and lower in Benin.
Soheila Masoudi, Hooman Angoorani, Molood Jafari Fesharaki, Bita Zoghalchi, Paniz Jahani, Marzieh Urumieh
International Journal of Epidemiology and Health Sciences, Volume 3; https://doi.org/10.51757/ijehs.3.1.2022.247403

Abstract:
Background: Following the resumption of football training and competitions during the coronavirus disease 2019 (COVID-19) pandemic, it was necessary to tighten up the hygiene protocol and impose restrictions such as prohibiting spectators from entering stadiums and the detection of positive disease cases, particularly among sub clinically infected players. The purpose of our study was to find out how common COVID-19 is among professional football players and to see if regular PCR testing and symptom recording are adequate screening methods in football.Study design: A cross-sectional retrospective study was used as the study design.Method: Periodic polymerase chain reaction (PCR) testing are used to evaluate athletes and other involved people for breaks in the transmission chain and to preserve their health. From March to November 2020, 784 players from Iran's prime and second division leagues participated in this study. The symptoms of the participants, as well as the results of the PCR testing, were recorded.Results: The results showed that 107 cases (13.6%) had positive PCR tests, with 52 Premier League players (10.4%) and 55 second-tier League players among them (19.3 percent). 41.1 percent of individuals who had positive PCR testing were symptom-free, while 17.5 percent of those who tested negative experienced at least one symptom. Myalgia was the most commonly reported symptom among symptomatic participants (7%).Conclusion: Due to the large number of asymptomatic patients, we advocate combining a periodic PCR test with serologic tests for the diagnosis of COVID-19 in football players to improve diagnostic accuracy.
, Akinola Ayoola Fatiregun, Ekun Opeyemi, David Adeleke, Tsemaye Jacdonmi, Stephen Fagbemi, Famokun Gboyega, Abiona Samuel, Adefesoye Victor Akinpelumi, Rosemary Onyibe Ifeoma
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.12.2021.246984

Abstract:
Background: The last case of the indigenous Wild Polio Virus in Ondo state was in 2008, and the last Polio compatible infection was in 2010. Poliovirus transmission was stopped thanks to the World Health Organization's (WHO) standards, which included acute flaccid paralysis (AFP) surveillance. We wanted to describe the state's polio surveillance performance during the last five years, from 2016 to 2020, using WHO-recommended measures and find areas where it could improve.Methods: Between January 2016 and December 2020, AFP case-based surveillance data was used to undertake a retrospective examination of records. Microsoft Excel was used for data processing, and Quantum Geographic Information System was used for mapping (GIS).Results: From 2016 to 2020, a total of 1,096 AFP instances were recorded, none of which were confirmed as Poliomyelitis. The bulk of the cases (77.2 percent) were found in children under the age of five. Males made up more than half of the cases (53.4%). More than 89 percent of reported cases received three or more OPV doses. Between 2016 and 2020, there was a 79 percent decline in reported incidents. Between 2016 and 2020, the average Non-Polio AFP rate was 11.2 per 100,000, with a stool adequacy of 98.4%.Conclusion: AFP surveillance in Ondo state met the minimum WHO targets during the study period, according to the findings. However, because of the possibility of poliovirus being imported from endemic countries, which might threaten Nigeria's polio-free status, all surveillance actors' sensitization and active case search should be strengthened, particularly in underperforming local government areas (LGAs).
, Maedeh Mortezanasab, Farahnaz Mohammadi-Shahboulaghi, Mostafa Shokati Ahmad Abad, Mahdi Noroozi
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.11.2021.245812

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Background: Medical students must have sufficient expertise to provide health services to the old as the global population of the elderly grows. Few research, however, have looked into this issue among medical, health, and nursing students. As a result, the purpose of this study was to look into the knowledge of medical, health, and nursing students on aging and related variables.Methods: In the year 2020, a cross-sectional study was done in Yazd, Iran. The research community was founded by Yazd University of Medical Sciences students. A total of 105 students from medical, health, and nursing were needed for the study. Two tools were used to collect data. a) A list of demographic characteristics Age, gender, level of education, and b) The Facts on Aging Quiz are among the items on this checklist (FAQI). FAQI is made up of 25 things in four dimensions, each of which can be answered with one of three options: "correct," "don't know," or "false." A higher score suggests a better position and a greater understanding of aging facts.Results: Students were 29 years old on average. Women made up almost 75% of those who took part. Only over a quarter of the attendees went to conferences and seminars on senior health. The majority of students in all three areas (medicine, health, and nursing) had never volunteered with the elderly before. Medical, nursing, and health students scored 11.093.4, 8.83.1, and 11.82.8 out of a possible 25 points on their understanding of aging facts, respectively. Only the area of study was statistically associated to the mean score of facts of aging among the demographic variables, indicating that the knowledge score of medicine and nursing students was lower than that of health students.Conclusion: The students that took part in this study lacked appropriate awareness of the facts of aging. Students' understanding in this area must be increased through the implementation of relevant educational programs.
, Safei F., Derris F., Salehitali S.
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.10.2021.245581

Abstract:
Introduction: Patients with chronic renal disease are at risk for dyspnea, which can have a negative impact on their quality of life. The current study aims to investigate the influence of breathing exercise on respiratory parameters in hemodialysis patients due to a lack of agreement on the efficacy of breathing exercise in the respiratory status of hemodialysis patients.Method: Participants were randomly assigned to one of two groups in this single-blind clinical investigation (intervention and control). Under the supervision of a nurse, the intervention group practiced breathing interventions (deep and slow breathing) for eight sessions over the course of a month. Data was collected using two questionnaires (demographic and respiratory parameter checklist).Results: There was a significant change (P=0.000) between the pre- and post-scores of the respiratory score in the intervention and control groups.Conclusion: Because breathing intervention is beneficial in lowering dyspnea and improving respiratory parameters, nurses should consider using it as an appropriate therapy for these patients due to its simplicity and low cost.
Fatemeh Ghapanvari, , Undefined Undefined
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.9.2021.245203

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Background: Recent studies on hemodialysis patients have focused more on the suffering caused by physical and psychological problems in them, and they have paid less attention to their caregivers. Since the caregivers of these patients are intensively affected by the physical and psychological problems caused by this method of treatment, it is necessary to pay more attention to the challenges as well as the problems that exist among them. This study aimed to describe the lived experiences of caregivers in caring for hemodialysis patients. Methods: The present study is a qualitative study with a phenomenological design. Sampling was first done through a purposive sampling method, and the snowball sampling method was then applied in order to select 21 caregivers for the hemodialysis patients from three hemodialysis centers in Qazvin, Iran. An audio recorder were used to collect the data of in-depth face-to-face semi-structured interviews. The interviews were analyzed using Colaizzi's approach. The criteria of Lincoln and Guba was followed for trustworthiness. Results: Analysis of the interviews in response to the main question revealed 108 initial codes, 18 subcategories, and 3 main themes, including 1. Care: Growth experience, 2. Care: Living in solitary confinement, and 3. In silence: Seeking help. Conclusion: In situations where the caregivers of hemodialysis patients felt they did not have sufficient material and spiritual support from those around them, they reported two different and conflicted experiences. Some people experienced progress and excellence, while others felt stuck and had to make ideal sacrifices. More in-depth research is required to discover the factors that influence such diverse insights.
M. A. Bashir, A. I. Yahaya, Mukhtar Muhammad,
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.9.2021.245213

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Prehypertension is a borderline blood pressure status associated with both higher incidence of cardiovascular disease as well as higher risk of progression to hypertension. The rising burden of hypertension and prehyperension globally is a serious concern to all and sundry. This study aims to estimate the burden of prehypertension in Nigeria. Online searches of Google Scholar, PubMed and African Index Medicus were conducted and studies selected based on predefined criteria. 21 studies consisting of 25839 individuals conducted between 2011 and 2021 were included in the meta-analysis. The pooled prevalence of prehypertension in Nigeria was found to be 34%(95% CI: 30%-40%) translating to 41.4 million adult Nigerians. Males have higher prehypertension prevalence of 39.1% (95% CI: 30.9%-47.6%) than females with prevalence of 28.5% (95% CI: 21.2%-36.4%). Differences between sexes are not statistically significant. The region with the lowest prehypertension prevalence is North-East at 18%. The region with the highest prevalence of prehypertension is North-West at 43%. Differences between the regions are statistically significant. The pooled prevalence in rural settlements is 32% whereas the pooled prevalence for urban settlements is 37%. Differences rural and urban settlements were not statistically significant. In conclusion, the burden of prehypertension in Nigeria is high and represents a future burden of hypertension and other cardiovascular diseases
Razieh Akbari, , Nasrollah Alimohammadi
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.8.2021.244538

Abstract:
Background: Most survivors of traumatic head injury, due to functional disorders, are dependent on their family members. In fact, these families are at the forefront of many challenges and stresses. The aim of the present study was to investigate the effectiveness of a family-centered empowerment program on the care needs of the families of patients with traumatic head injuries discharged from Al-Zahra Hospital in Isfahan in 2019.Methods: The present study was a clinical trial conducted among 56 family members of patients with traumatic head injury. The samples were randomly allocated to two groups: experiment and control. The experimental group received an empowerment program based on the "family-centered empowerment model" through 3-5 sessions of 45-60 minutes, while the control group received routine education during discharge. Data was collected using a checklist for demographic information as well as the standardized Family Need Questionnaire (FNQ).Results: Based on the findings of the present study, the level that the care needs have been met regarding health information, emotional support, instrumental support, and professional support was statistically significant higher in the experimental group compared to the control group (p < 0.001). The average care needs related to health information, emotional care, and instrumental support were statistically significant lower in the experimental group compared to the control group (p < 0.05). While considering community support network, the average care needs were statistically significant lower in the control group compared to the experimental group (p < 0.05); however, about involvement in care, no statistically significant difference was found between the two groups of experiment and control (p > 0.05).Conclusion: To meet the care needs of the families of patients with traumatic head injuries discharged from medical centers, implementation of the family-centered empowerment program is effective, and it results in improvement and continuous providing of services at home and meeting families’ care needs. Therefore, the application of such programs is recommended for healthcare planners.
Hossein Tavangar, Farzan Madadizadeh, Zohre Kalani, Razie Beygi Rizi, Zakieh Tavakoli, Mostafa Shokati Ahmad Abad
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.8.2021.244539

Abstract:
Background: The presence of pain and anxiety in a patient affects the results and, therefore, the process of healing, as well as the postoperative complications. Therefore, this study was performed to gauge the effect of individual education-supported needs assessment on anxiety among elderly patients who were candidates for open-heart surgery.Method: This quasi-experimental study was carried out in Iran in 2019. Sixty-one patients, who were candidates for open-heart surgery and aged 60 years or older, were divided into two groups: experiment and control. The patients within the control group received routine care, and therefore, the patients with the intervention received education-supported needs assessment in addition to routine care. The State-Trait Anxiety Inventory was used to assess the patients’ anxiety levels. All analysis was performed in SPSS v19 with a significance level of 0.05.Results: The demographic variables were similar in both groups (p <0.05). The mean scores of both the state and the trait anxiety among the patients in the intervention group decreased significantly after the intervention (p 0.05).Conclusion: Individual education based on needs assessment among elderly patients is an effective strategy for reducing their anxiety before open-heart surgery.
, Yolanda V. Bayugo, Ukam Ebe Oyene, Jonathan Abrahams, Nina Gobat, Suvagee Good, Mary Manandhar, Samar Elfecky, Ana Gerlin Hernandez Bonilla, Nicole Valentine, et al.
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.7.2021.244835

Abstract:
Community Engagement (CE) plays a crucial role in successful public health actions, achieving universal health coverage, and the realization of the United Nations Sustainable Development Goals. It has emerged as an effective strategy across different settings through prevention, preparedness, readiness and response, and recovery towards attaining community resilience, Primary Health Care (PHC) strengthening and universal health coverage (UHC), health security, and sustainable development. We reviewed the existing literature and various data sources and found that several CE training packages are available from international partners, focusing on the principles, theories, general questions, and CE techniques. However, there are still challenges because they are often fragmented, with little or no systematic procedures to guide the CE processes in different settings.In this light, WHO initiated a discourse on the CE Package (CEP) development in consultation with some selected international partners. The CEP Project will focus on developing a database, learning, and workshop packages based on curation of CE experiences in different settings using defined criteria. The CEP would harmonize CE processes and facilitate the reinforcement of the CE integration into public health. Further, the CEP Project serves as a collection of selected best practices for pre-service and in-service training packages for health professionals. Also, there is an anticipated inclusion into curricula of health training institutions and WHO staff capacity development. Finally, the database for compiling best practices is designed such that it can be periodically updated and becomes a compendium of CE for learning, research, and informing practice.
, Poorva Bhalerao
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.7.2021.244388

Abstract:
Background: The COVID-19 pandemic was expected to affect India severely; cases rose exponentially from May-June 2020, but around mid-September reached their peak and started declining. It showed a sign of the wave’s completion by the end of January 2021. This decline was not predicted by any models and the authors have not come across any explanation. Winter seasonality of influenza and similar viruses is well known and observed fact and that it has a direct correlation to the colder temperatures as well as lower humidity. Similarly, in low humidity, viruses are most viable, and they become ineffective as the humidity increases and reaches its maximum extent. This article hypothesizes and tries to explain the cause behind the first major decline and shows the subsequent rise of the second wave, and one short low humidity period followed by a high humidity period between the first and second waves. Methods: The humidity cycles in India were studied to find high and low relative humidity periods, which then corresponded to the daily cases in the country (macro-level), region (mid-level), and smaller regions (micro-level). Results: A definite correlation was observed between Monsoon-induced humidity and the incidence rate decline. This happens in 8 to 10 weeks. Incidence rates start declining about 4 weeks after the peak humidity is reached in a particular region. A decrease in humidity below 65% or 55% or lower causes an increase in the case increase/uptrend in about 3-4 weeks. Conclusion: COVID-19 has a seasonal peak in India, peaking in the middle of the monsoon season around mid-September and reaching its lowest levels in January-February. As humidity drops from February to June/July, a trend reversal and sharp rise are expected. The subsequent wave/case peak would be expected to be seen around mid-September 2021.
, Akinola Ayoola Fatiregun, Stephen Fagbemi, Famokun Gboyega, Rosemary Onyibe
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.7.2021.244239

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Background: Acute gastroenteritis, a very common disease in humans affecting both children and adults, remains a major public health concern worldwide. Several groups of viruses have been reported as the causative agents of acute gastroenteritis. An outbreak of acute gastroenteritis with a high fatality rate was reported in Ondo State, Southwest, Nigeria, in September 2020. Methods: To provide a descriptive epidemiology of the outbreak, a field investigation was carried out in affected communities in September 2020. Results: Four Local Government Areas (LGA) were affected, with Odigbo LGA having the highest attack rate of 14.9 per 100,000 population. The epidemic curve was propagated in nature. 50 cases were reported with 21 deaths (42%). The outbreak primarily affected 15-year-olds (94%, n=47) and more males (58%, n=29). Conclusion: Poor sanitation, food, and water hygiene conditions in communities of the LGA visited were observed. The spread of the outbreak was probably facilitated by water sellers.
Samira Zouhri, Mohcine El Baroudi
Published: 1 June 2021
by 10.51757
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.6..2021.244138

The publisher has not yet granted permission to display this abstract.
, Mohcine El Baroudi
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.6.2021.244138

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A woman in her sixties with a normal medical history was admitted to a general medical floor with Neuropathic pain symptoms such as a burning sensation throughout her body (head, back, spine, throat, and tongue with dry mouth, chest, abdomen, kidneys, thighs, toes), inability to eat, urinary incontinence, difficulty wearing clothing, and difficulty leaning on the back. There was a difficulty and delay in diagnosing the patient's condition, which was confirmed to have severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with no respiratory symptoms. The patient's pain did not respond to the covid-19's first-line medications, but it did respond to neuropathic medication with Pregabalin and Alprazolam. Our study shows that Pregabalin could be helpful in relieving the patient’s pain and very effective for treating neuropathic pain with a safe profile, unlike Alprazolam, which interferes with the same stages of sleep, which made her sleep condition worse.
, Berry Ting Wei Qi, Betty Tang Zhi Xin, Chang Kai Xin, Chee Fei San, Chen Kar Mey
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.6.2021.244125

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Background. The worldwide economic impact of the COVID-19 pandemic is comparable with the largest disastrous events of modern human history, such as the first and second world wars. This study investigated the nationwide impact of the pandemic on the local Malaysian firms.Methods. A cross-sectional, online survey was carried out in East and West Malaysia by inviting the Malaysian firms’ executives to fill in a questionnaire that was adopted from previous similar studies in other countries. The final questionnaire included 16 questions distributed in three categories. The executives of firms were contacted through email and social media. SSPS was used to analyse the collected data.Results. A total of 379 responses were received. Nearly 42% of firms reported a small impact with some difficulties in business operations but overall stability. Approximately 32% of businesses were severely impacted, and operations were barely maintained. Six percent of the firms had no significant difficulties and 5.3% reported that the pandemic provided new opportunities for development.Conclusion. Almost one-third of the Malaysian firms are affected significantly by the COVID-19 pandemic. The business operation of half of the Malaysian firms is also affected to some extent. Supportive policies are needed to reduce the companies’ manufacturing costs and assist them in surviving and eventually returning to normal business operations.
Kourosh Zali
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.6.2021.243816

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The presence of a placebo arm is certainly a substantial element in randomized control trials (RCTs) because the effectiveness or efficacy of a new therapy can be evaluated through a direct comparison between the test treatment and the placebo arm. Conducting a placebo-controlled RCT is often very difficult or even impossible. To solve this problem, the availability of standard treatments and ethical concerns have led scientists to consider an active or positive control treatment as a comparator to assess the treatment effect without a placebo arm. Such an assessment is often made under a so-called “non-inferiority trial” (NIT) design. Non-inferiority margin (NIM) is the most important part of an NIT. Because there is no well-established method to determine the NIM, it is very important that this margin be pre-specified and the criteria for how it was established well defined prior to conducting the study. All methods of determination of NIM rely upon subjective judgment with unverifiable assumptions. This article demonstrates six simple methods to calculate NIM.
Shima Heidary, , Roya Choopani
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.5.2021.242846

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Introduction: Mothers of preterm infants, as the primary caregiver, need to learn more about their infants and the complex environment of neonatal intensive care. This study aimed to develop and evaluate the educational module for the mothers of premature infants admitted to the neonatal intensive care unit (NICU) in Iran.Method: The online databases (SID, Magiran, Google Scholar, ScienceDirect, PubMed, Elsevier, and Scopus) were accessed from 2009 to 2019, using the keywords ‘mother’, ‘neonatal intensive care’, ‘program’, ‘intervention education,’ and ‘empowerment’. In general, 275 articles were retrieved and a total of 12 studies was retained for appraisal, after screening the titles, abstracts, and full-text reviews. Finally, the qualitative module validity and face validity were determined, using the opinions of 11 experts and 10 mothers of premature infants, respectively.Results: Eight themes were identified based on thematic analysis, including orientation with the NICU, characteristics of premature infants, premature infants’ problems, needs of premature infants, preparation of premature infant’s environment, behavioral symptoms of premature infants, the positioning of premature infants, and preparation for discharge and measures were developed after the discharge of the premature infant. Considering all acquired interventions for all items, a content validity ratio of 0.59 and content validity index of 0.79 based on the opinions of experts at two levels of specialists and mothers.Conclusion: Due to the lack of enough nursing staff and a high workload in the NICU, this review offers nurses to spend less time educating mothers and focusing more on premature infants. Moreover, supporting mothers can help to provide better care. The educational module can help nurses and mothers have more effective care for premature infants.
Mojtaba Senmar, Ali Razaghpoor, Faezeh Safarali, Faeze Ramezani, Neda Fallah, Saeidehi Hosseini,
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.4.2021.239706

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Background: While evidence-based practice (EBP) should be considered by all of midwifery and nursing groups, it is more important to midwives and nurses working with neonates and infants. Due to the limited number of available studies in this area, the objective of this study was to examine the knowledge, attitude, and intention of midwives and nurses of pediatrics and neonatal units regarding EBP.Methods: This study was taking place in 2019 in Iran. A descriptive analytical study was carried out with 125 midwives and nurses working in pediatrics and neonatal units. The knowledge, attitude, and intention were assessed through a 34-item Rubin and Parrish questionnaire. Of these 34 items, 10, 14, and 10 items could assess the knowledge, attitude, and intention of the participants, respectively.Results: The total average knowledge score was 36.7 with a standard deviation of 5.6. The overall average of attitude score was 45.4 with a standard deviation of 4.7. The overall average of intention score was 38.1 with a standard deviation of 5.4. Two factors of “participating in EBP workshops” and “participating in research projects and having published articles” were the two factors that resulted in an increase in the level of knowledge, positive attitude, and a rise in the level of intention regarding EBP (p <0.05). Moreover, higher education has significantly increased the intention to use EBP (p <0.05).Conclusion: Participants in this study had a moderate level of knowledge, moderate intention, and a relatively positive attitude toward EBP. It is recommended that this situation be improved by providing training courses and workshops on EBP and involving clinical nurses and midwives in research projects.
Farshad Kakian, Mohammad Ghasemi Palangi,
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.3.2021.47993

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Background: Urinary stones are one of the major health problems worldwide and a significant part of referrals to physicians. Also, growing antibiotics resistance is an important concern. The purpose of this study was to evaluate the prevalence of urinary stones and bacterial strains with antibiotic resistance in women admitted to shiraz, southwest of Iran, from 2014 to 2019. Methods: In this period, all women admitted to the Zeinabieh Hospital were evaluated. The frequency of urinary stones and bacterial strains and antibiogram patterns of bacterial isolates were investigated from 2014 to 2019.Antibacterial susceptibility testing was done by disk diffusion method, fulfilling the standard criteria of “Clinical and Laboratory Standards Institute (CLSI) Performance Standards for Antimicrobial Susceptibility”. Results: Out of 101 isolates, the identified gram-negative bacteria were E. coli (68.3%), Klebsiella (6.9%), Enterobacter (6.9%), Pseudomonas (5%), Proteus (1%), and Acinetobacter (1%). Of gram-positive strains, Coagulase-positive Staphylococci (5.9%), coagulase-negative Staphylococcus (CONS) (3%) and Non-Hemolytic Streptococci (2%) were identified. Also, the frequency of urinary tract stones was about 5%. Four cases of kidney stones were associated with E. coli and one case with Klebsiella. All isolates had the highest resistance to co-trimoxazole (62.5%), Ampicillin and Nalidixic acid.Conclusion: In this study, no association was found between the type of bacteria and urinary stone. From the variable bacteria isolated, the highest rate of E. coli (as an important pathogen) was confirmed. Also, most of the bacterial isolates were resistant to multiple antibiotics, although Amikacin and nitrofurantoin (as the empirical therapy in our hospital) were dominated.
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.2.2021.241686

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BackgroundMost people with COVID-19 receive care at home, increasing the likelihood of exposure for household members.ObjectiveTo study the prevalence and characteristics of secondary cases in families after the appearance of a primary caseMethodologyAn observational and retrospective study of families with at least one polymerase chain reaction (PCR) confirmed COVID-19 primary case was conducted from March 15 to December 25, 2020, in a general medicine office in Toledo, Spain. Socio-demographic and clinical variables were compared between primary and secondary cases in the families. The outcome of interest was secondary attack rate of SARS-CoV-2 within the family.Results39 families with a primary case (average size 3.4 members) with a total of 132 cohabitants were included. There were 22 cohabitants with negative PCR (22/92 = 24%), 70 secondary cases with positive PCR (Secondary attack rate 76%), of which 25 were asymptomatic (25/70 = 36%), and a cohabiting new-born. A high frequency of people from ethnic minorities, low household income and complex families was found, both in primary and secondary cases. The secondary cases with respect to the primary ones were more women, younger, students and with a lower socio-occupational level, with more asymptomatic cases, and milder symptomatic cases.ConclusionsIn this context, the prevalence of secondary domestic contacts is very high, and it occur in young women, being asymptomatic or mild. The high secondary attack rate suggests the importance of the pre-symptomatic or early symptomatic period of COVID-19, as well as the possible failure to comply with isolation measures.
Amanuel Godana Arero, Godana Arero, Shimels Hussien Mohammed, Sahar Eftekhari
International Journal of Epidemiology and Health Sciences, Volume 2; https://doi.org/10.51757/ijehs.2.1.2021.47841

Abstract:
Background and objective: Low back pain (LBP), as a musculoskeletal disorder, remains a common health problem and is one of the most prevalent occupational injuries affecting adults living in both developed and developing countries. To increase the power and improve the prevalence estimates of LBP among the working Ethiopian population, a comprehensive meta-analysis was carried out. Methods: A comprehensive systematic literature search was conducted through multiple international electronic bibliographic databases such as Web of Science, Pub Med, EMBASE, Scopus, and Google Scholar. Population-based studies with the prevalence of LBP among the working population living in Ethiopia were included. Meta-analyses, meta-regression, and sensitivity analysis was conducted. Funnel plot symmetry visualization followed by Begg’s rank correlation, and Egger’s regression asymmetry test methods were performed to detect the existence of publication bias. Heterogeneity between studies was assessed by using the Cochrane Q and I2 statistics. Results: Overall, 719 articles were identified and 13 articles with 6513 participants met the inclusion criteria for meta-analyses. The pooled point and twelve-month prevalence of LBP among the working Ethiopian population was 49% (95% CI: 40-58) and 56% (95% CI: 49-62), respectively. Conclusion: The results showed a high prevalence of LBP among the working Ethiopian population, especially among teachers. We believe that prevention strategies addressing the early onset of LBP among the working population would most likely be the answer to the burden of LBP on future economies in Ethiopia.
Mojtaba Senmar, Mohammad Reza Mostafaei, Ali Razaghipour, Fateme Yousefi, Razie Alipour,
International Journal of Epidemiology and Health Sciences, Volume 1; https://doi.org/10.51757/ijehs.1.5.2020.46958

Abstract:
Background: Euthanasia and its related factors are addressed as an important ethical issue in end-of-life care nursing. It's an illegal issue in Iran. This study aimed to examine the attitude towards euthanasia in nursing students, and its relationship with their personal beliefs’ level.Methods: The current cross-sectional study was conducted in Qazvin during the education year of 2017-2018. The samples of this study consisted of 121 nursing students who were studying at the Qazvin University of Medical Sciences for more than two semesters. The Euthanasia Attitude Scale and Palutzian and Ellison Spiritual Wellbeing Scale were used for the data collection.Results: The response rate was 73.3% (121 of 165 nursing students). All of nursing students in the present study were Muslim. The mean overall scores of attitudes towards euthanasia and spiritual wellbeing were 60.24±9.82 and 75.73±7.48, respectively. No significant relationship was found between attitude towards euthanasia and personal beliefs among them (p=0.204).Conclusion: Iranian nursing students reported a relatively neutral attitude towards euthanasia which is mainly related to its legal issue in Iran. Also, no significant relationship was observed between attitude towards euthanasia and personal beliefs among the participants. Further studies are needed in this regard.
Kourosh Zali
International Journal of Epidemiology and Health Sciences, Volume 1; https://doi.org/10.51757/ijehs.1.4.2020.46956

Abstract:
The randomized controlled trial (RCT) is considered the best interventional design to assess issues related to treatment and prevention. The RCTs can have different designs including superiority, equivalence, or non-inferiority design. A superiority trial aims to detect the potential superiority of new therapy compared to an active comparator or a placebo, an equivalence trial tends to demonstrate that a new therapy is an equivalent (within margins) to its active comparator, and a non-inferiority trial (NIT) is going to show that the new therapy is not worse than the comparator, as a typical active drug. Increasingly, major trials are conducted to see if the efficacy of a new treatment is as good as a standard treatment. The new treatment usually has some other advantages (e.g., fewer side effects, ease of administration, lower cost), making it worthwhile to demonstrate non-inferiority in respect to efficacy. Thus, NIT is going to determine whether a new treatment is not worse than a reference treatment by more than an acceptable amount. Among the challenges of NITs compared with superiority, trials are the choices of the non-inferiority margin (NIM), the primary population for analysis, and the comparator treatment considering several choices for the comparator arm in an NIT. This article is going to review the current knowledge about NIM.
Parisa Fathizadeh, Haydeh Heidari, Reza Masoudi, Morteza Sedehi, Feridoun Khajeali
International Journal of Epidemiology and Health Sciences, Volume 1; https://doi.org/10.51757/ijehs.1.3.2020.46189

Abstract:
Introduction: Tele-nursing is a modern way of promoting quality of nursing care, treatment outcome, reducing medical costs and the need for visits, patient and family involvement in decision making, and careful patient monitoring by using all kinds of technologies. The aim of this article was to determine the most popular methods and related reasons for their common use in Iran.Methods: In this narrative literature review, PubMed, Science Direct, Google Scholar, SID, and Nindex were searched for full texts of Iranian studies published in English or Persian by using the descriptors of Tele-nursing, MHealth, nursing care, Telecare, and follow-up with phone calls between 2010 and 2020. The search found 472 articles and after considering the eligibility of articles, 56 articles were included.Results: The review found that 74% of papers reported the telephone as the first common method for tele-nursing. The second popular method was short message service (SMS) followed by internet and smartphone software.Conclusion: Tele-nursing includes many methods that nurses can use for distance nursing care which is not limited to telephone or SMS. In Iran, about 68 million people have a smartphone and have access to the internet. Nurses can use this potential capacity to improve nursing care.
Farshad Kakian, Mohammad Hoseein Rezaei, Masoud Amiri, Saeid Janabadi, , Abolfazle Gholipour, Kourosh Naderi
International Journal of Epidemiology and Health Sciences, Volume 1; https://doi.org/10.51757/ijehs.1.2.2020.44700

Abstract:
Background and aim: Klebsiella is an opportunistic organism that is the cause of many nosocomial infections. The present study was designed to investigate the molecular epidemiology of Verona integron-encoded metallo-β-lactamase (VIM) and Imipenemase (IMP)-producing Klebsiella isolates in patients with urinary tract infection (UTI) in an educational hospitalin Shahrekord, in the center of Iran. Methods: In a cross-sectional study, from 234 urine samples, 80 isolates of Klebsiella were identified with biochemical tests. In order to determine the production of Metallo-β-lactamases (MBLs), Modified Hodge Test (MHT), EDTA Disc Synergy (EDS) test and AmpC disc test were performed. The frequency of VIM and IMP genes was determined after DNA-amplification with PCR by electrophoresis technique. Thereby, 16SrRNA was considered as an internal control in PCR.Results: Phenotypic tests showed that out of the 80 isolates, 18 (22. 5%), 18 (22. 5%) and 10­ (12.5%) isolates were positive for MHT, EDS and AmpC disc test, respectively. Following DNA amplification by PCR, the genes of interest were analyzed by electrophoresis technique. The findings were as follows: 22­ isolates (27.­5%) carried the VIM gene, but the IMP gene was not found in any of the isolates. Conclusions: Expansion of Klebsiella strains that produce MBLs is a severe threat to health centers and public health. The findings of this study showed that Klebsiella may produce MBLs. These enzymes can in turn degrade carbapenem antibiotics, which are considered as a last resort in the treatment of multidrug-resistant (MDR) infections.
International Journal of Epidemiology and Health Sciences, Volume 1; https://doi.org/10.51757/ijehs.1.1.2020.39686

Abstract:
The occurrence of pressure ulcers can be problematic for patients and health care systems. A medical device-related pressure ulcer (MDRPU) is considered as one of the important indicators of patient safety assessment as well as the quality of care provided to the patient. This case report concerns a 54-year-old male patient, who was admitted to the cardiac unit of a hospital. The patient developed stage II pressure ulcers due to the connection of a nonstandard probe of the electrocardiogram to its chest. Nurses had not taken any action to treat the patient’s ulcers. To improve this matter, necessary measures such as training courses should be considered by the officials and healthcare planners. Apart from this, to prevent the development of MDRPUs in the future, it is of great importance to pay special attention to the probes that are being used for the recording of an ECG.
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