Health Center Research Articles

Assessing Tobacco Treatment Engagement in Assertive Community Treatment Programs.

Despite high tobacco use prevalence among those with serious mental illnesses, few Assertive Community Treatment (ACT) programs provide tobacco treatment. Understanding the factors associated with the intentions to engage in tobacco treatment from both provider and consumer perspectives is important. The purpose was to examine ACT providers' intention to provide and consumer intention to engage in tobacco treatment. A cross-sectional survey of ACT program providers (N = 51) and consumers (N = 43) from four community mental health centers. Multiple linear regression analyses were used to examine factors associated with the intentions to provide or engage in tobacco treatment from among attitudinal, subjective norms, and perceived behavioral control variables. Providers reported positive attitudes, high degree of perceived behavior control, and high intentions for delivering tobacco treatment, but poor perceptions of subjective norms. These results were like consumers' intentions to engage in tobacco treatment. In regression analysis, only subjective norms and perceived behavior control were significant predictors for providers' intentions to provide tobacco treatment, but there were no significant predictors of consumers' intentions to engage in tobacco treatment. Both providers and consumers endorsed poor implementation of evidence-based tobacco treatment. Poor engagement in tobacco treatment within ACT programs indicates the need for policymakers to support tobacco treatment within the services. This finding calls for training of mental and behavioral health providers while supporting tobacco-free initiatives in ACT treatment service settings.

Federally Qualified Health Centers' Screening for social risk factors and Health Outcomes.

Federally Qualified Health Centers (FQHCs) are ideally positioned to identify and address health-related social needs, but little is understood about the relationship between social risk factor (SRF) screening and health outcomes. We studied 1352 FQHCs from the 2019 Uniform Data System. Ordinary least squares regression was used to estimate the relationship between SRF screening and the percentage of patients with adequately controlled diabetes and hypertension. Results show 71% of the FQHCs in the sample collected SRFs. FQHCs' screened for SRFs had higher percentages of patients with adequately controlled diabetes (69.5% vs 67.0%, P <.001) and hypertension (63.8% vs 59.4%, P <.001) relative to FQHCs not collecting SRFs.

The Impact of Telehealth on Obstetrical Outcomes during the COVID-19 Pandemic.

Nationwide, obstetric clinics modified prenatal care to include telehealth visits in response to the COVID-19 pandemic, enabling the opportunity to investigate its impact on patient outcomes. We hypothesized that use of prenatal telehealth visits would increase the number of prenatal visits, decrease the frequency of urgent triage/emergency department (ED) visits, and improve perinatal outcomes. To determine the impact of telehealth on number of obstetric prenatal visits and urgent triage/ED visits amidst the COVID-19 pandemic. This is a retrospective cohort of patients from a federally qualified health center (FQHC) in central Texas. Patients with a singleton gestation who delivered after 32 weeks were included. Comparison groups were made between those patients who delivered between May 2020 to December 2020 (presumed modified prenatal visit schedule with in-person and telehealth) and those patients delivering between June 2019 to February 2020 (the traditional care model with in-person visits only). Multivariable linear and logistic regression models were used to estimate differences in the number of prenatal visits and unscheduled triage/ED visits. A total of 1654 patients were identified with 801 (48.4%) patients undergoing modified prenatal care and 853 (51.6%) patients receiving traditional care during the study period. No significant differences were seen in overall prenatal attendance or triage/ED presentations. However, when stratified by parity, multiparous patients undergoing modified prenatal care were less likely to experience an urgent triage/ED presentation (8.7% vs. 12.7%; odds ratio, 1.69; 95% confidence interval, 1.10-2.61). When compared to a traditional prenatal visitation cohort pre-pandemic, patients who received modified telehealth prenatal care during the COVID-19 pandemic had similar prenatal attendance and unscheduled emergency presentations. However, multiparous patients experienced a decreased rate of unscheduled emergency presentations. Supplementing prenatal care with telehealth may provide overall comparable prenatal care delivery.

Trauma exposure correlates among patients receiving care in federally qualified health centers.

Over 80% of adults in the general population experience trauma. Rates of patients with posttraumatic stress disorder (PTSD) are high in primary care settings and are likely to be even higher in federally qualified health centers (FQHCs). Trauma exposure has been linked to psychiatric symptoms and physical health comorbidities, though little research has focused on FQHC patients. This study addresses this by examining clinical and sociodemographic correlates of specific trauma types among FQHC patients. We analyzed secondary data from patients who screened positive for PTSD and were receiving health care in FQHCs in a clinical trial (N = 978). Individuals who did versus did not experience a specific trauma type were compared using between-group tests. In the sample, 91.3% of participants were exposed to a DSM-5 Criterion A traumatic event, with 79.6% experiencing two or more trauma types. Witnessing a life-threatening event (57.3%) and physical assault (55.7%) were the most common traumatic experiences. Physical health comorbidities and worse physical health functioning were associated with a higher likelihood of exposure to all trauma types, with effect sizes larger than PTSD, ds = 0.78-1.35. Depressive and anxiety symptoms were also associated with a higher likelihood of experiencing nearly all trauma types to a lesser magnitude. People of color, OR = 2.45, and individuals experiencing financial inequities, OR = 1.73, had higher odds of experiencing serious accidents as well as other trauma types. The findings highlight the need for trauma-informed care, including routine trauma and PTSD screening, for FQHC patients.

Omission errors in medical prescriptions dispensed in a Public Health Center of Iztapalapa in Mexico City in 2021

Omission errors in medical prescriptions dispensed in a Public Health Center of Iztapalapa in Mexico City in 2021

Health systems challenges, mitigation strategies and adaptations to maintain essential health services during the COVID-19 pandemic: learnings from the six geopolitical regions in Nigeria

BackgroundThe COVID-19 pandemic control strategies disrupted the smooth delivery of essential health services (EHS) globally. Limited evidence exists on the health systems lens approach to analyzing the challenges encountered in maintaining EHS during the COVID-19 pandemic. This study aimed to identify the health system challenges encountered and document the mitigation strategies and adaptations made across geopolitical zones (GPZs) in Nigeria.MethodsThe national qualitative survey of key actors across the six GPZs in Nigeria involved ten states and the Federal Capital Territory (FCT) which were selected based on resilience, COVID-19 burden and security considerations. A pre-tested key informant guide was used to collect data on service utilization, changes in service utilization, reasons for changes in primary health centres’ (PHCs) service volumes, challenges experienced by health facilities in maintaining EHS, mitigation strategies implemented and adaptations to service delivery. Emerging sub-themes were categorized under the appropriate pillars of the health system.ResultsA total of 22 respondents were interviewed. The challenges experienced in maintaining EHS cut across the pillars of the health systems including: Human resources shortage, shortages in the supply of personal protective equipments, fear of contracting COVID-19 among health workers misconception, ignorance, socio-cultural issues, lockdown/transportation and lack of equipment/waiting area (. The mitigation strategies included improved political will to fund health service projects, leading to improved accessibility, affordability, and supply of consumables. The health workforce was motivated by employing, redeploying, training, and incentivizing. Service delivery was reorganized by rescheduling appointments and prioritizing some EHS such as maternal and childcare. Sustainable systems adaptations included IPC and telehealth infrastructure, training and capacity building, virtual meetings and community groups set up for sensitization and engagement.ConclusionThe mitigation strategies and adaptations implemented were important contributors to EHS recovery especially in the high resilience LGAs and have implications for future epidemic preparedness plans.

Malaria Prevalence and Risk Factors in Outpatients at Teda Health Center, Northwest Ethiopia: A Cross-Sectional Study

Malaria Prevalence and Risk Factors in Outpatients at Teda Health Center, Northwest Ethiopia: A Cross-Sectional Study

Low-dose naltrexone for post-COVID fatigue syndrome: a study protocol for a double-blind, randomised trial in British Columbia

IntroductionA significant proportion of individuals suffering from post COVID-19 condition (PCC, also known as long COVID) can present with persistent, disabling fatigue similar to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and...

Correlates of COVID-19 vaccine uptake among the forcibly displaced: evidence from Libya

BackgroundVaccine hesitancy and refusal can hinder the control of infectious diseases such as coronavirus disease 2019 (COVID-19). Although forcibly displaced individuals are at high risk of contracting COVID-19, evidence shows that they are less likely to accept the COVID-19 vaccine. Given their predicament, the factors influencing vaccine uptake in the general population might differ vastly from those in displaced populations. Given the limited evidence on vaccine uptake from humanitarian settings, the current study examined the determinants of COVID-19 vaccine uptake among the forcibly displaced in Libya.MethodsData were extracted from the World Bank/United Nations High Commissioner for Refugees (UNHCR) microdata repository. Data were collected between April and July 2021 after the rollout of the first dose of the COVID-19 vaccine in Libya. Percentages, means, and standard deviations were used to quantify the distribution of the sample population. Logistic regression models were employed to identify factors influencing COVID-19 vaccine uptake.ResultsOdds ratios (ORs) with p values are used to present the regression analysis results. The study revealed that people unaffected by COVID-19 were less likely (OR = .71, 95%CI = 0.67–0.89) to accept the vaccine. Similarly, individuals with access to free COVID-19 vaccines were more likely to be vaccinated than those without free vaccines (OR = 38, 95%CI = 0.19–0.28). Finally, the results indicated that individuals were six times more likely to be vaccinated at mass vaccination sites ((OR = 6.31, 95%CI = 5.46- 7.94) and 1.92 times more likely to be vaccinated at local health centers (OR = 1.92, 95%CI = 0.1.72–3.11) than they were at hospitals and distant health facilities.ConclusionImplementing comprehensive mass vaccination venues, public education initiatives, and awareness campaigns regarding the importance of vaccination can decrease vaccine hesitancy among the forcibly displaced.

Risk factors for the development of severe or very severe respiratory syncytial virus-related lower respiratory tract infection in Indian infants: A cohort study in Melghat, India.

Respiratory syncytial virus (RSV) is undoubtedly the single most important cause of severe lower respiratory tract infection (LRTI) globally. While new prevention measures in young infants have become available, their use in developing countries is likely many years away. While risk factors for severe or very severe RSV LRTI in impoverished rural areas likely differ to urban areas, there are very few studies, especially those conducted in India, the major country contributing to the global burden of disease. Active surveillance for acute LRTI in enrolled infants and children <2 years of age, was conducted through weekly home visits in 93 villages of Melghat, India, from August 2016 to December 2020. Local hospitals and primary health centres were surveyed for admissions of enrolled subjects. Nasopharyngeal swabs were collected from children with severe, or very severe LRTIs and all who died, with RSV testing using nucleic acid tests at ICMR, National Institute of Virology Pune. Risk factors for both RSV associated and non-RSV associated, severe and very severe LRTI were identified through univariate and multivariate logistic regression. There were 483 severe or very severe RSV LRTI cases and 2807 non-RSV severe or very severe LRTI infections in a cohort of 13,318 children. Weight for age z-score ≤-2, the use of kerosene or wood for cooking, obtaining drinking water from a public tap and low gestational age significantly increased the risk of RSV LRTI. A higher wealth score index and water purification were protective. Comparison with non-RSV LRTI showed male sex as an additional risk factor. The analysis highlighted the risk of kerosene use [OR = 17.8 (3.0-104.4) (p ≤ 0.001)] and [OR = 3.4 (0.8-14.4) (p ≤ 0.05)] for RSV and non-RSV LRTIs, respectively. Nutritional status and environmental air quality are predisposing factors for developing an RSV LRI in young children, factors which are amenable to environmental and behavioural interventions.

Training on Determining Beyond Use Date (BUD) on Pharmacy Practice at Surabaya Health Vocational School

All drugs must be injected immediately after being prepared because the life of the drug can be shorter and it no longer refers to the Expiration Date (ED). If the medicine is not injected immediately, then to maintain the quality of the medicine before the BUD limit is to give the medicine vial a mark of the date and time the medicine was prepared and it must be stored according to storage requirements. The method used theoretical presentation, question/answer, discussion and practice offline in one of Surabaya Health Vocational School classrooms. The results are the community service activities through training on determining the Beyond Use Date (BUD) in Pharmacy practice at the Surabaya Health Vocational School received a positive response and the participants were very enthusiastic. It is hoped that there will be special standards established by the Surabaya Health Vocational School to help provide understanding regarding determining the Beyond Use Date (BUD) in the pharmaceutical practice and further collaboration with the Health Service, Community Health Center or Hospital on an ongoing basis.

The practice and determinants of ambulance service utilization in pre-hospital settings, Jimma City, Ethiopia

BackgroundIn pre-hospital setting, ambulance provides emergency care and means of transport to arrive at appropriate health centers are as vital as in-hospital care, especially, in developing countries. Accordingly, Ethiopia has made several efforts to improve accessibility of ambulances services in prehospital care system that improves the quality of basic emergency care. Yet, being a recent phenomenon in Ethiopia, empirical studies are inadequate with regard to the practice and determinants of ambulance service utilization in pre-hospital settings. Hence, this study aimed to assess the ambulance service utilization and its determinants among patients admitted to the Emergency Departments (EDs) within the context of pre-hospital care system in public hospitals of Jimma City.MethodA cross-sectional study design was used to capture quantitative data in the study area from June to July 2022. A systematic sampling technique was used to select 451 participants. Interviewer-administered questionnaire was used to collect data. Data analysis was done using SPSS version 26.0; descriptive and logistic regressions were done, where statistical significance was determined at p < 0.05.ResultsAmbulance service was rendered to bring about 39.5% (of total sample, 451) patients to hospitals. The distribution of service by severity of illnesses was 48.7% among high, and 39.4% among moderately acute cases. The major determinants of ambulance service utilization were: service time (with AOR, 0.35, 95%CI, 0.2-0.6 for those admitted to ED in the morning, and AOR, 2.36, 95%CI, 1.3-4.4 for those at night); referral source (with AOR, 0.2, 95%CI, 0.1-0.4 among the self-referrals); mental status (with AOR, 1.9, 95%CI, 1-3.5 where change in the level of consciousness is observed); first responder (AOR, 6.3 95%CI, 1.5-26 where first responders were the police, and AOR, 3.4, 95%C1, 1.7-6.6 in case of bystanders); distance to hospital (with AOR,0.37, 95%CI, 0.2-0.7 among the patients within ≤15km radius); and prior experience in ambulance use (with AOR, 4.1,95%CI, 2.4-7).ConclusionAlthough the utilization of ambulance in pre-hospital settings was, generally, good in Jimma City; lower levels of service use among patients in more acute health conditions is problematic. Community-based emergency care should be enhanced to improve the knowledge and use of ambulance services.

Psychometric properties of the experiences of maternity care scale among Iranian women

BackgroundAssessing women’s perceptions of the care they receive is crucial for evaluating the quality of maternity care. Women’s perceptions are influenced by the care received during pregnancy, labour and birth, and the postpartum period, each of which with unique conditions, expectations, and requirements. In England, three Experience of Maternity Care (EMC) scales – Pregnancy, Labour and Birth, and Postnatal – have been developed to assess women’s experiences from pregnancy through the postpartum period. This study aimed to validate these scales within the Iranian context.MethodsA methodological cross-sectional study was conducted from December 2022 to August 2023 at selected health centers in Tabriz, Iran. A panel of 16 experts assessed the qualitative and quantitative content validity of the scales and 10 women assessed the face validity. A total of 540 eligible women, 1–6 months postpartum, participated in the study, with data from 216 women being used for exploratory factor analysis (EFA) and 324 women for confirmatory factor analysis (CFA) and other analyses. The Childbirth Experience Questionnaire-2 was employed to assess the convergent validity of the Labour and Birth Scale, whereas women’s age was used to assess the divergent validity of the scales. Test-retest reliability and internal consistency were also examined.ResultsAll items obtained an impact score above 1.5, with Content Validity Ratio and Content Validity Index exceeding 0.8. EFA demonstrated an excellent fit with the data (all Kaiser-Meyer-Olkin measures > 0.80, and all Bartlett’s p < 0.001). The Pregnancy Scale exhibited a five-factor structure, the Labour and Birth Scale a two-factor structure, and the Postnatal Scale a three-factor structure, explaining 66%, 57%, and 62% of the cumulative variance, respectively, for each scale. CFA indicated an acceptable fit with RMSEA ≤ 0.08, CFI ≥ 0.92, and NNFI ≥ 0.90. A significant correlation was observed between the Labour and Birth scale and the Childbirth Experience Questionnaire-2 (r = 0.82, P < 0.001). No significant correlation was found between the scales and women’s age. All three scales demonstrated good internal consistency (all Cronbach’s alpha values > 0.9) and test-retest reliability (all interclass correlation coefficient values > 0.8).ConclusionsThe Persian versions of all three EMC scales exhibit robust psychometric properties for evaluating maternity care experiences among urban Iranian women. These scales can be utilized to assess the quality of current care, investigate the impact of different care models in various studies, and contribute to maternal health promotion programs and policies.

The role of perceived quality of care on outpatient visits to health centers in two rural districts of northeast Ethiopia: a community-based, cross-sectional study

BackgroundPatients who have had a negative experience with the health care delivery bypass primary healthcare facilities and instead seek care in hospitals. There is a dearth of evidence on the role of users’ perceptions of the quality of care on outpatient visits to primary care facilities. This study aimed to examine the relationship between perceived quality of care and the number of outpatient visits to nearby health centers.MethodsA community-based cross-sectional study was conducted in two rural districts of northeast Ethiopia among 1081 randomly selected rural households that had visited the outpatient units of a nearby health center at least once in the previous 12 months. Data were collected using an interviewer-administered questionnaire via an electronic data collection platform. A multivariable analysis was performed using zero-truncated negative binomial regression model to determine the association between variables. The degree of association was assessed using the incidence rate ratio, and statistical significance was determined at a 95% confidence interval.ResultsA typical household makes roughly four outpatient visits to a nearby health center, with an annual per capita visit of 0.99. The mean perceived quality of care was 6.28 on a scale of 0–10 (SD = 1.05). The multivariable analysis revealed that perceived quality of care is strongly associated with the number of outpatient visits (IRR = 1.257; 95% CI: 1.094 to 1.374). In particular, a significant association was found for the dimensions of provider communication (IRR = 1.052; 95% CI: 1.012, 1.095), information provision (IRR = 1.088; 95% CI: 1.058, 1.120), and access to care (IRR = 1.058, 95% CI: 1.026, 1.091).ConclusionsService users’ perceptions of the quality of care promote outpatient visits to primary healthcare facilities. Effective provider communication, information provision, and access to care quality dimensions are especially important in this regard. Concerted efforts are required to improve the quality of care that relies on service users’ perceptions, with a special emphasis on improving health care providers’ communication skills and removing facility-level access barriers.

The economic impact of two-stage knee arthroplasty revisions: a projection for a specialized health center in Türkiye

Objectives: The increase in the number of arthroplasty surgeries worldwide also leads to an increase in revision surgeries. This study examines the costs of primary and revision arthroplasty treatments in a tertiary university hospital's orthopedics and traumatology clinic. It also explores the impact of revision surgeries on the healthcare system. Methods: Seventy-six patients who had total knee arthroplasty at a university hospital between 01.01.2017 and 30.09.2022 were included in the study. The patients were divided into three groups: primary (n=25), aseptic reasons one-stage revision (n=27), and septic reasons two-stage revisions (n=24). For each patient included in the study, detailed documents regarding medical supplies, anesthesia, operating room, intensive care, consultation, medicine/serum, medical treatment, laboratory, blood and blood products, microbiology, radiology, food, bed, and attendant fees were provided separately by the hospital purchasing and statistics departments. Results: When comparing the costs of primary, one-stage revision, and two-stage revision surgeries, the average costs were 5689 Turkish Lira (₺), 8294.97 ₺, and 40919.67 ₺, respectively. In patients with septic reasons, the group that underwent two-stage revisions had significantly higher costs than the aseptic group in terms of surgery time, hospital stay duration, medication, treatment, surgery, anesthesia, intensive care, laboratory tests, imaging, blood center services, consultations, visits, meal expenses, and invoiced amount (P&amp;lt;0.001). Conclusion: Preventing and treating periprosthetic infections is costly and challenging. We need more research to develop effective protocols and reduce costs. As the number of patients undergoing knee arthroplasty is expected to rise, healthcare systems must ensure the sustainability of public financial resources, especially in public university hospitals.

Ayurveda is on the Way to Open the Golden Door of Indian Tourism through Panchakarma - A Review

ABSTRACT Over the years, Ayurveda, the science of healing and regeneration, has become increasingly popular throughout the world. Numerous Ayurvedic centres are expanding nowadays, as they are one of the primary tourist attractions in the southern region. India is becoming a popular destination for medical tourism due to a number of draw factors, including easy accessibility, affordable and high-quality medical care, beautiful vacation spots, etc. The best place is in South India, which is also the nation's centre of health. The boundaries and opportunities of Ayurvedic tourism have undoubtedly expanded with the recognition of Ayurvedic healing on a national and worldwide level. With any fortunate, India will be the world's top choice for high-quality medical facilities within the next several years. Ayurveda was supposedly bestowed upon humanity by the gods to enable us to live long, healthy lives free from illness. Nearly every tribe in India swiftly embraced ayurveda, and it soon started to spread to nations like Afghanistan, China, and Iran. Panchakarma can provide a long-lasting or permanent treatment for multi-system disruptions. Panchakarma is becoming a vital component of medical travel. Therefore, the government ought to actively support the growth of Panchakarma travel. This review discusses the many facets of ayurvedic travel to India, including Panchakarma, its development, and current trends. Keywords-Ayurveda, Tourism, Panchakarma, health .

Child life specialist services, practice, and utilization across health care: a scoping review.

The objective of this review was to map the available evidence regarding the scope of child life specialist services, practice, and utilization. Child life specialists are members of multidisciplinary health care system teams who prioritize the developmental needs of pediatric patients to support and improve patient and family health care experiences. Evidence of the effectiveness of child life specialist services and the utilization of those services is often incorporated in multidisciplinary research reports and thus overlooked. All quantitative, qualitative, and mixed methods research study reports and systematic reviews investigating child life specialist services, practice, and utilization in health care systems were included. This review was guided by the JBI methodology for scoping reviews and a published a priori protocol. CINAHL (EBSCOhost), MEDLINE (PubMed), Scopus, and PsycINFO (APA) were searched for evidence published from January 1980 to August 2022. Research publications about child life specialist services, practice, and utilization have increased dramatically over the past decade with more than 50% of studies published in the last 5 years. Although the first authors of the majority of the research publications were physicians, these multidisciplinary author teams depicted child life specialist services in a variety of roles, including co-investigators, interventionists, and research subjects. The 105 full-text publications reviewed were from 10 countries and occurred across a wide scope of health care settings and medical subspecialties, but primarily in hospitals and health centers, and to a lesser extent, in ambulatory clinics and communities. A wide variety of child life specialist services were described across these settings. The concept of child life services began in 1922 and emerged as the child life specialist services specialty in the United States in the 1970s and 1980s. Mapping the research can help delineate the barriers and facilitators to these services in health care systems. This scoping review provides evidence of the global diffusion of child life specialist services across health care system settings with recent increases in research publications involving child life specialist services.

Deep learning-based detection of irreversible pulpitis in primary molars.

Changes in healthy and inflamed pulp on periapical radiographs are traditionally so subtle that they may be imperceptible to human experts, limiting its potential use as an adjunct clinical diagnostic feature. This study aimed to investigate the feasibility of an image-analysis technique based on the convolutional neural network (CNN) to detect irreversible pulpitis in primary molars on periapical radiographs (PRs). This retrospective study was performed in two health centres. Patients who received indirect pulp therapy at Peking University Hospital for Stomatology were retrospectively identified and randomly divided into training and validation sets (8:2). Using PRs as input to an EfficientNet CNN, the model was trained to categorise cases into either the success or failure group and externally tested on patients who presented to our affiliate institution. Model performance was evaluated using sensitivity, specificity, accuracy and F1 score. A total of 348 PRs with deep caries were enrolled from the two centres. The deep learning model achieved the highest accuracy of 0.90 (95% confidence interval: 0.79-0.96) in the internal validation set, with an overall accuracy of 0.85 in the external test set. The mean greyscale value was higher in the failure group than in the success group (p = .013). The deep learning-based model could detect irreversible pulpitis in primary molars with deep caries on PRs. Moreover, this study provides a convenient and complementary method for assessing pulp status.

Identify mental health needs of adolescent pregnant women: a qualitative study.

The purpose of this study is to explore adolescent pregnant women related to their pregnancy experience about mental health needs during pregnancy for the prevention of depression during pregnancy. This research is a qualitative study design with a phenomenological approach. Data collection using interviews (in-depth interviews). This study involved 18 participants consisting of 12 pregnant women aged 15-19 years and 6 midwives who work at the health center. The criteria for informants of pregnant women are pregnant with Trimester I to III, age 15-19 years and not experiencing complications of pregnancy. Based on interviews conducted with informants, five themes were obtained about the experiences and needs of pregnant women in adolescence. These themes are (1). Risk of depression, (2). Social and family support needs, (3). Needs of mental health services, (4). Obstacles for midwives in providing mental health services, and (5). needs of mental health information media. Five needs of teenage pregnant women are factors that can support mental health to prevent depression during pregnancy.

Plant protein substitution for animal protein and its association with cardiovascular risk factors and inflammatory biomarkers in elderly men: A substitution analysis

BACKGROUND: Substituting different types of protein intake may be associated with cardiovascular risk factors and inflammatory biomarkers. However, there are few studies conducted on elders and the findings are contradictory. OBJECTIVE: We decided to examine the association of substituting plant protein for animal protein with cardiovascular risk factors and inflammatory biomarkers among elderly men. METHOD: The current cross-sectional study included 357 elderly men chosen from health centres in southern Tehran, Iran. They provide written consent to be included in the study. We used a validated and reliable food frequency questionnaire (FFQ) to assess dietary intake. All biochemical factors like lipid profile, fasting blood sugar (FBS), high sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL6), tumor necrosis factor-α (TNF-α) were measured. Waist circumference (WC) and blood pressure (BP) were also assessed. The substitution analysis by STATA was used to examine the aforementioned association. RESULTS: Substituting animal protein with plant protein had significant beneficial association with WC (OR: –4.28; 95% CI: –8.51, –0.62; Ptrend = 0.047) and LDL/HDL (OR: –0.26; 95% CI: –0.48, –0.05; Ptrend = 0.018). CONCLUSION: In elderly men, substituting animal protein with plant protein had favorable association with some of cardiovascular risk factors including WC and LDL/HDL but there was no significant association for inflammatory biomarkers.