Iranian Medical Sciences Research Articles

Mortality Rate and Years of Life Lost Due to Premature Death From Respiratory Diseases: A Five-year Trend (2014-2018)

Background: Chronic respiratory diseases impose a significant socioeconomic burden on individuals and communities and are severely overlooked compared to other non-communicable diseases, such as cardiovascular disease, cancer, and diabetes. This study aimed to investigate the mortality rate and years of life lost due to respiratory diseases in northern Iran. Methods: The documentary research method was used and data were collected using the census. The population included all deaths registered in the Department of Health, Golestan University of Medical Sciences in Iran during 2014-2018. Results: Between 2014 and 2018, 2462 deaths due to respiratory diseases were recorded in Golestan Province, of which 1416 people (57.5%) were men and 1046 people (42.5%) were women. The Mean±SD age of death was 62.28±26.29 years, with an Mean±SD of 62.56±25.32 years for men and 61.90±27.56 years for women. The highest number of deaths due to respiratory diseases in all the studied years was in men and women aged 80 years and above (28.7% and 31.1%, respectively). Approximately, 6864 years of life were lost due to premature death during this period, with men (3511 years, 7.2 per 1,000) contributing more than women (3353 years, 7.2 per 1,000). Conclusion: Given the rapid increase in population and given that the crucial risk factors for respiratory diseases are smoking, exposure to pollutants, and allergens, more comprehensive research seems necessary throughout Iran. In addition, this study was designed before the onset of the COVID-19 pandemic, and due to changes that this pandemic has caused in the mortality rate, therefore, it is recommended to investigate the trend of mortality by respiratory diseases during this pandemic.

Recurrence of medical errors despite years of preventive measures: A grounded theory study.

Despite great efforts to improve patient safety, serious preventable medical errors continue to occur. Accurate rooting causes of error recurrence are essential for reviewing methods to prevent them. This study aimed to identify the main causes of the recurrence of medical errors despite their previous occurrence. This qualitative study was performed using the grounded theory method, with theoretical sampling from April to July 2021, through semi-structured interviews with 25 experts and treatment staff of hospitals under the auspices of four universities of medical sciences in Iran. Four main parts were identified: 1) primary and secondary factors leading to the occurrence of errors, 2) error prevention policies, 3) causes of error repetition, and 4) contextual factors. The attention, seriousness, and commitment of health system managers, from top to bottom, to patient safety are essential for preventing error recurrence. The institutionalization of patient safety education from universities and attention to individual, social, and cultural factors should also be given serious attention.

The Impact of Coronavirus-2019 On General Health Anxiety Among Students of Iranian Medical Sciences

Background: During the Coronavirus 2019 (COVID-19) outbreak, Iranian medical sciences students were at higher risk of contracting this virus because they were in infected environments. So, they are predisposed to high levels of anxiety that could worsen their lives. The determent of factors and levels of anxiety could be helpful to reduce anxiety and control its worse effects. Hence, this study aimed to measure the anxiety index and its factors among medical sciences students during the COVID-19 pandemic in Iran. Materials and Methods: In this cross-sectional study, an online survey was sent to students from 27 medical sciences universities in Iran from 20th December 2020 to 10th March 2021. The online survey consists of the Health Anxiety Inventory (HAI) for measured general health anxiety as well as the baseline characteristics of students. Results: 723 students responded, including 483 (66.8%) females and mean HAI score was 16.76 ± 8.35. Based on our findings, gender, past medical, and drug history were significantly related to the high level of anxiety. However, there was no coloration between HAI scores with age, the field of study, study duration, university location, and attendance in the hospital and/or COVID-19 ward (P˃0.05). Conclusions: Students with notable past medical history and/or drug history and female students more than others were predisposed to anxiety in a pandemic such as COVID-19. Hence, in a pandemic situation, psychological care should concern them.

Ethics Education in Medical Sciences; A National Descriptive Survey.

Background: Historically, teaching medical ethics was always an important educational objective; however, the educational strategies to fulfill this goal varied in different times and areas. In the past two decades, teaching ethics has become an important part of the core curriculum of medical sciences in IRAN; however, ethics is relatively a newcomer to the undergraduate curriculum of medical sciences. This study aimed to evaluate the current status of teaching ethics in medical sciences in Iran. Methods: This descriptive survey was quantitatively conducted in two phases; evaluation of the curricula and syllabus of all undergraduate programs and surveying medical ethics teaching in all medical universities and/or schools using a questionnaire. The course title, content, hours (units), the recommended references, the teaching and students' assessment methods, and the information of ethics teachers were reviewed and analyzed. Results: The study showed some features about the current status of ethics teaching in medical sciences, including 1) no incorporation of ethics in 10 BS and MSc curricula; 2) different course titles, course contents and course units in similar programs; 3) non-adherence to the curriculum in terms of the core content, the references, and teaching and assessment methods; 4) non-adherence to the ethics core content especially in medical, dentistry, and pharmacy schools; 5) lack of qualified ethics teachers; and 6) no horizontal or vertical integration in ethics teaching. Conclusion: Taken together, to overcome shortcomings in teaching ethics, the authors suggest a four-phase approach for strengthening and reforming ethics education in medical sciences including determining the core content for ethics teaching by experts consensus, revising curricula in all undergraduate programs of medical sciences, training ethics teachers, and amending infrastructures for teaching ethics.

Designing a development physical training model for students of Iranian medical sciences universities

Background and aims: The importance of developing physical training and the need to expand it among students increases when the social harms and anomalies observed in this space are carefully analyzed. Knowing the pattern and model governing this matter helps prevent social anomalies. Since no study was done to discover this model, the present research was conducted to investigate the design of the development model of physical training for students of Iranian medical sciences universities. Methods: This study was conducted with an exploratory-fundamental nature, a qualitative approach, and the foundation’s data strategy in 2021-2022. The data collection method was a semi-structured interview with 19 specialists and experts using purposeful sampling. The method of coding and forming concepts from the interviews was used to analyze the data. MAXQDATA2020 software was used to analyze the data. Then, the codes were categorized, and a conceptual model was presented. Results: The codes extracted from the interviews included 191 codes in 6 categories of causal conditions, central phenomenon, contextual conditions, intervening conditions, strategic conditions, and consequential conditions, as well as 38 components. Causal conditions include seven components and 27 codes; central phenomenon includes three components and 11 codes; contextual conditions include seven components and 36 codes; intervening conditions include eight components and 41 codes; strategic conditions include eight components and 43 codes and conditions a result includes five components and 24 codes. Conclusion: The developments of physical education and sports for students of medical sciences in Iran, taking into account its causes, axes, contexts, obstacles, and consequences, can inform the managers and planners of sports students of the Ministry of Health about its development process and trend. Students go to physical activity to prevent the wastage of available resources, including financial, human and physical, with careful planning and organization.

Designing A Quality Assessment Model for Nursing Services Management in Selected Medical Universities of Iran

Background: Advancing a culture of care greatness, at distinctive levels of management and care such as nursing management, has created way better desires and inspiration. Objectives: To design a suitable model for measuring the quality of nursing services management in selected universities of medical sciences in Iran. Methods: This was exploratory mixed research. In the qualitative stage, the data collection tool was interview. Semi-structured interviews with 12 experts and university professors were used. Qualitative data is first collected, then, based on the findings of qualitative data, research tools are taken, and quantitative data are collected. Categories are extracted after implementing the discussions on paper, open coding (reading the data line by line, extracting the main concepts and sentences, forming the first categories and classes) and axial coding (data classification, subcategory specification, final class formation). In the next step, there is optional coding. The statistical population in this study is all nurses in Tehran, Kermanshah and Guilan, totally 255 people. A researcher-made questionnaire was used to collect data in a quantitative phase. 152 completed questionnaires were collected from the samples. After collecting the questionnaires, it was statistically analyzed. Confirmatory factor analysis was used to evaluate the validity of the questionnaire, and structural equation modeling (SEM) with the help of SmartPLS 3 software was used to evaluate the research questions. Results: Factors affecting the quality of nursing services management in Tehran, Kermanshah and Guilan Universities of Medical Sciences are: Individual factors, educational factors, motivational factors, international factors, social factors, environmental factors, intra-organizational factors and technological factors. Conclusions: The Proposed model has a strong fit. Suggestions based on the research results are: Evaluation of training courses, repetition of skills in the program by the trainee should be predicted so that the skill in the person becomes a behavioral habit and, in fact, behavioral consolidation, repetition of skills in the program by the trainee should be so in order for a skill to become a behavioral habit in the individual and in fact to be behaviorally established, the difference between individuals must be identified.

Impact of operational planning implementation on performance of Iranian medical sciences universities

ABSTRACT Objectives In 2015, the Iranian Ministry of Health and Medical Education (MoHME) developed and introduced an operational plan (OP) mandatory for implementation for all medical sciences universities. Through this program, a set of indicators were defined for the annual assessment of the universities’ performance. This study examined the effect of OP implementation on universities’ performance and the healthcare system. Methods We compared seven key performance indicators before and after OP implementation related to public health, education, research, nursing, treatment, food and drug and student affairs. Descriptive statistics, paired t-tests and Wilcoxon tests were used for data analyses using SPSS 26. Results Of 32 studied indicators, ten indicators were not affected by the OP. Of 22 indicators, including public health (7 indicators), education (2 indicators), research (2 indicators), nursing (5 indicators), treatment (1 indicator), food and drugs (4 indicators), and student (1 indicator) that changed, 17 have improved. Conclusion OP implementation reached some of its intended goals. The existing OP program process should be replaced with evidence-informed health policies and programs to achieve significant changes in health system functioning and overall public health.

Fundamental Factors Effective in Developing a Local Model for Virtual University of Medical Sciences: A Qualitative Study

Background: Many studies have defined the term ‘virtual university’ as a learner-centered university. Over the past 20 years, the number of virtual universities, especially in medical sciences, has grown rapidly, and the number of online curricula is constantly increasing. On the other hand, regarding the challenges of higher education in the third millennium and considering the 20-Year National Vision of the Islamic Republic of Iran and the potential of information and communication technology, the need to move towards virtual academic education is felt more than ever. Objectives: Accordingly, attempts were made to discover the main and necessary factors affecting the development of a model for virtual university of medical sciences regarding Iran's cultural and social dimensions. Moreover, considering inadequate qualitative research, it was decided to conduct a qualitative study by examining the subjective phenomena and informants’ experiences in the field of virtual university of medical sciences in Iran to reveal their understanding of the main factors affecting the development of the local model for virtual universities of medical sciences. Methods: This qualitative study adopted a thematic content analysis approach. Seven participants were selected using the maximum-intensity sampling method. The data were collected using semi-structured interviews and analyzed according to Braun and Clarke's six-step comparative thematic analysis method. To observe data rigor, Guba and Lincoln's four criteria were used. Results: Out of the seven participants, three cases were male, and four persons were female. The analysis of the data resulted in 520 primary codes, 38 subcategories, and 13 categories. According to the participants' experiences, the four main themes extracted in this study were educational manifestation, technological appearance, Iranian context, and institutional virtual medical education. Conclusions: The data analysis revealed that the virtual university model could be developed by considering curriculum design based on learners’ cognitive needs as well as the effects of technologies on the formation of virtual education culture. Moreover, theories underpinning the traditional education system are no longer responding to the new changes in virtual education, and there is an urgent need for scientific theories tailored to virtual education to manage technology.

Neoadjuvant VS adjuvant chemotherapy in patients with locally advanced breast cancer; a retrospective cohort study.

Breast cancer is one of the most common challenges for women's health. Until now, neoadjuvant chemotherapy is a standard approach in locally advanced breast cancer (LABC), as it increases the probability of breast-conserving surgery (BCS). This study aimed to compare the survival rate in neoadjuvant and adjuvant groups to suggest a better treatment strategy for locally advanced breast cancer. The study was conducted between 2009 and 2019 on 845 LABC patients at the Cancer Research Center of Shahid Beheshti University of Medical Sciences in Iran. All patients with LABC at stages 3A, 3B, and two were evaluated for treatment with adjuvants (n=520 female patients) and neoadjuvant (n=320 female patients) treatment strategies. Patients were followed up for at least 120 months. The Kaplan-Meier method calculated the survival rate using SPSS version 23 software. The 5 and 10 years survival rates of neoadjuvant and adjuvant groups were 87±0.04, 80±0.07% and 87±0.02, 83±0.03%, respectively. Statistical analysis results with the mentioned treatment strategies did not show any significant difference in overall survival. The result of this study on LABC patients demonstrated that compared to surgery first following adjuvant chemotherapy, the neoadjuvant chemotherapy has several benefits, including downstaging and more BCS, with no statistically significant difference in the overall survival rate of the patients.

Reflection on near-peer shadowing program: impact on operating room student’s perception of their future profession

BackgroundReflection is a key element in learning from observation and experience of future profession’s roles and responsibilities in clinical encounters. Moreover, reflection helps students cope with the challenges, complexities, and uncertainties of professional development. Students’ written reflections on clinical exposure offer valuable information, and their analysis provides instructors with invaluable insight into students' experiences. This study evaluated Operating Room students’ written reflections on their first clinical exposure experiences towards their future profession through the shadowing program.MethodsThis study was a qualitative analysis on Operating Room freshmen’s reflections in the undergraduate program of Zahedan and Zabol University of Medical Sciences in Iran. After the shadowing program, all participants were asked to write an unstructured written reflection, and these fifty written reflections were de-identified and independently analyzed‏ using the thematic analysis approach.ResultsQualitative analysis extracted 10 subthemes and four main themes including (i) Moving towards the guiding realities of future profession, (ii) Discovering milestones of realizing professional identity, (iii) Managing the emotions affecting the perception of future profession’s desirability, and (iv) Excellence in professional growth and development.ConclusionReflecting on the experience of the shadowing program, the participants described being in the OR environment as a stimulating and valuable learning opportunity. Moreover, this experience helped improve their perception of future profession’s realities, as well as initiate realization of professional identity and planning for professional developments.

Acute Coronary Syndrome in Mashhad, Northeastern of Iran: Report of a Decade

Background: Acute coronary syndrome (ACS) is a major cause of morbidity and mortality all over the world. Despite substantial efforts that have been made over the last decades, ACS management still remains challenging in most of the regions. Objectives: This study describes the characteristics and trends of outcomes for ACS patients in a decade in north-east of Iran. Methods: In this cross-sectional study, two tertiary academic hospitals of Mashhad University of Medical Sciences in Iran were investigated during a 10-year period starting from January 1, 2007. Patients were identified according to their final diagnosis at discharge using the international classification of diseases 10th revision (ICD-10). The ten-year trend of prevalence of ACS was plotted. The outcomes (alive, death) were compared between the two types of myocardial infarction (MI) (ST-elevation myocardial infarction (STEMI), and non-ST elevation myocardial infarction (NSTEMI)/unspecific). Results: During the study period, there were a total of 9068 admissions for acute MI or unstable angina. The mean age of admitted patients was 61.6 ± 13.7 years and the majority (67.8%) was male. The in-hospital mortality rate was 12.3% (927), which was significantly higher in NSTEMI/unspecific AMI compared to STEMI patients (15.3% vs. 9.8%, P < 0.001). Females were significantly older than males (65.7 ± 12.5 vs. 59.6 ± 13.8, P < 0.001) and have higher mortality rates compared to males (16.7 vs. 10.1, P < 0.001). The prevalence rate of all MI categories had an increasing secular trend, though the mortality rate was decreased. Conclusions: Although the prevalence rate of AMI has slightly increased, the mortality rate has decreased. Close cooperation between general practitioners, health providers and cardiologists are of great importance in this field.

Epidemiological Study of Cutaneous Leishmaniasis in the Population Covered by Shahid Beheshti University of Medical Sciences in Iran from 2011 to 2021

Background: The World Health Organization has identified leishmaniosis as one of the eight major tropical parasitic diseases in the world. Every year, from 0.7 million to 1.3 million new cases of cutaneous leishmaniasis (CL) are registered in the world. Cutaneous leishmaniasis is still a great health problem in Iran. Of the total annual cases of leishmaniasis in Iran, about 80% are related to rural cutaneous leishmaniasis, 5% to visceral leishmaniasis and the rest are related to urban cutaneous leishmaniasis. this study aimed to investigate the epidemiological factors in patients with cutaneous leishmaniasis. Methods: A total of 2119 patients afflicted with cutaneous leishmaniosis due to skin lesions were examined. The data were analyzed after entering the data into SPSS software, vol 26. Tables and graphs were used for displaying the qualitative variables; central indicators and dispersion were used for indicating quantitative variables, and chi-square test was used for analyzing the data. The level of P ≤ 0.05 was considered as the level of significance. Results: The mean age of 2119 patients was 28.32 ± 20.38 years. Furthermore, 65.2% of male patients and 34.8% of female ones were infected with the disease. As for the nationality of the patients, 81.8% of them were Iranians and 18.1% of them were Afghans, and 88.9% of them had a history of traveling to other areas. More than 51% of the cases occurred in the young age group, the age group of 21 to 30 years had the highest incidence (18.4%), and the incidence trend of the disease did not decrease. There was a statistically significant relationship between patients’ nationality and travel history, gender, and occupation (P = 0.0001). There was no statistically significant relationship between the incidence season and travel history (P = 0.221). Conclusions: Due to the patients’ travel to endemic areas, providing them with training on effective methods for preventing mosquito bites may have had a great impact on reducing the incidences of cutaneous leishmaniosis in travelers.

Mental Health of Nursing Students and Associated Factors during the COVID-19 Pandemic: A Cross-sectional Web-based Study

Background: Specific conditions arising from the COVID-19 pandemic may affect the mental health of nursing students. Objectives: This study aimed to investigate the mental health of nursing students and associated factors during the COVID-19 pandemic at Ahvaz and Kermanshah Universities of Medical Sciences in Iran. Methods: This cross-sectional study was conducted on 384 nursing students at Ahvaz and Kermanshah Universities of Medical Sciences in Iran from May 10, 2021, to June 26, 2021. The required data were collected using a web-based questionnaire via social networks, such as WhatsApp and Telegram. Symptom Checklist-25 (SCL-25) was used to measure mental health. Descriptive statistics and stepwise linear regression were used to analyze the data. Results: The mean total mental health score was 47.48±16.03, and 235 (61.0%) students had good mental health, 124 (32.2%) cases had suspected mental disorders, and 26 (6.8%) respondents had severe mental disorders. Using the stepwise regression method, four variables, including gender, history of mental illness, history of coronavirus infection or being suspected of having coronavirus, and level of trust in statistics about the incidence and mortality rate of COVID-19 had the greatest impact on mental health modeling. Conclusion: In general, the COVID-19 pandemic may have a negative impact on the mental health of nursing students. Therefore, it is very important to identify and consider the factors that can reduce their mental distress.

The blacksmith approach: a strategy for teaching and learning in the medical anatomy course (a qualitative study)

Background:Anatomy is a symbolic, essential core topic and one of the fundamental pillars of medical and paramedical knowledge. Nevertheless, few exploratory data analyses have focused on how students approach learning anatomy. This study examined how students perceive their learning experience during anatomy lessons and how to make a model which promotes their meaningful learning and professional identity.Methods:Using purposive sampling with maximum variation, we conducted a qualitative content analysis at the Shiraz University of Medical Sciences in Iran (2020 to 2021). Twenty-four medical students and twelve faculty members of Iran’s medical science universities were enrolled in the study. The data were collected through semi-structured interviews and analyzed according to the theme.Results:A conceptual model emerged from the data analysis with the main theme called the blacksmith approach, which included Three sub-themes: (1) making a new forge (adequate preparation and mindful beginning), (2) heating the students’ hearts (considering supporting systems that learners need) and (3) using Sledgehammer’s approach (teaching anatomy by using more active methods and engaging all neuroanatomical regions) and (Using fun for enjoyable learning). All the concepts were related to each other.Conclusion:Medical students experience a challenging fundamental evolution into professional doctors. Educational systems focus primarily on teaching and learning, while students’ transition can be facilitated by a three-step model called the Blacksmith Approach. It best serves as an educational framework for any pivotal, preclinical course capable of helping students acquire new roles and tackle challenges. Further research should be conducted to confirm how hard work leads to satisfying results with the opportunity to create enjoyable learning.

Investigating the link between organisational justice, positive organisational behaviour and productivity in emergency nurses.

Human resource management and employees' performance are fundamental to the success of healthcare organisations. Therefore, it is important to consider the factors that may affect employees' performance. To determine the relationship between perceived organisational justice, positive organisational behaviour (POB) and the productivity of emergency nurses. This was a descriptive-analytical study that involved distributing questionnaires to emergency nurses working in hospitals affiliated with Mazandaran University of Medical Sciences in Iran. The researchers used proportionate stratified sampling to calculate the sample size. Three questionnaires were used to collect data on organisational justice, POB and productivity. The data were analysed using the Pearson correlation coefficient and multiple regression tests. The questionnaires were distributed to 284 emergency nurses and completed by 234 of them. The results demonstrated a significant relationship between the productivity of the emergency nurses and the variables of perceived organisational justice and POB. Higher levels of perceived organisational justice and POB in the ED setting are likely to lead to increased productivity among emergency nurses, and as a result the quality of patient care is likely to improve. Therefore, healthcare organisations should pay particular attention to the application of organisational justice, with the aim of promoting POB among nurses and increasing their productivity.

Domains of competence in midwifery students: a basis for developing a competence assessment tool for iranian undergraduate midwifery students

BackgroundCurrent study was conducted with the aim of explaining domains of clinical competence in undergraduate midwifery students so that it addresses the challenges in midwifery curriculum and improving clinical assessment methods in Iranian undergraduate midwifery students.MethodsQualitative approach and conventional content analysis were used in the design of the present study. The research setting included midwifery and nursing schools and hospitals and health centers affiliated to Tehran and Guilan universities of medical sciences in Iran. The target population consisted of undergraduate midwifery students in the fourth to eighth semesters of school, midwives working in hospitals and health centers, midwifery faculty members, and obstetricians. The participants were selected through purposive maximum variation sampling, which continued until data saturation. After in-depth semi-structured interviews, the content of the interviews was analyzed according to the steps proposed by Zhang & Wildemuth.ResultsTwenty-four people participated in this study, including seven midwifery students, seven midwives, nine midwifery and reproductive and sexual health faculty members, and one obstetrician. The participants were aged 20–56 years and their mean age was 39.75 years. Their level of education varied from midwifery student to PhD. The mean work experience of the participants was 13.62 years and the mean duration of the interviews was 48 min. The analysis of the data obtained from the experiences of the participants led to the formation of the four categories of ethical and professional function in midwifery, holistic midwifery care, effective interaction, and personal and professional development, along with ten subcategories.ConclusionThe findings of the present study showed that clinical competence in midwifery students involves different domains that correspond well overall to the general definitions of clinical competence in different sources. These findings can be used as a basis for the design and psychometric assessment of a clinical competence assessment tool for undergraduate midwifery students.

Outstanding qualities of a successful role model in medical education: Students and professors' points of view.

IntroductionRole models play a crucial role in determining the professional development of medical trainees. The purpose of this study was to gain in-depth understanding of the outstanding qualities of successful role models.Material and methodsIn this qualitative-descriptive study, data were collected through conducting interviews, and the inductive content analysis was performed. The study was done at the school of medicine of Tehran University of Medical Sciences in Iran. Twenty-five medical students, medical graduates, and faculty members participated in 25 interviews from April to December 2019. The participants were recruited via purposive sampling.Resultsfive categories and 13 subcategories were extracted from the data. The results of this study illustrated five crucial qualities of a good clinical role model including an excellent character, effective coach and mentor, inspiring medical leader, expert clinical teacher, and a professional physician. Our results also highlighted the lasting effects of positive role modeling of clinical teachers on medical trainees' professional careers. Another category in the present study was connected to future consequences of being a role model in a clinical setting.ConclusionThe result of this study illustrated crucial qualities of a good medical role model. This result can assist the leaders to engage with medical educators to better understand the process of role modeling and design the best plan for development of role modeling in medical education.

Explanation of Evolving Health Technical and Vocational Education and Training System: A National Experience

: Around the world, the changing needs of the labor market are met under the umbrella of technical and vocational education and training (TVET). The Iran Technical and Vocational Training Organization (ITVTO) plays this role. However, a significant issue in Iran's TVET system is that the targeting of vocational training has been oriented towards industrial professions while society also needs general and specialized training in health sciences. IN response to needs, the National Center for Technical and Vocational Education and Training of Medical Sciences was established by the Ministry of Health, Treatment, and Medical Education (MoHME) in Iran. This article intends to introduce the TVET system and the National Center for Technical and Vocational Education and Training of Medical Sciences in Iran and discuss its future horizon. Although the beginning of this path is very commendable, the path of evolution for this center will be more difficult because there is a vast world of concepts, phenomena, and problems against the TVET in Iran's medical sciences. However, what can be deduced from the study results is that with a bit of courage, we can say something new and take firm steps to transform.

The association between body image, emotional health, relationships, and unhealthy dietary behaviors among medical sciences students: A structural equation modeling analysis.

Although it showed that poor body image may drive an individual to unhealthy dietary behaviors, but less is known about the role of emotional health and interpersonal relationships in this regard in different age group of population. This study aimed to investigate the association between body image, emotional health, relationships, and unhealthy dietary behaviors among medical sciences students. In this cross-sectional study, using a three-stage stratified sampling method, 248 Iranian medical sciences students were recruited. The participants completed self-administered questionnaires, including Youth Risk Behavior Survey Questionnaire, Adolescent Health Concerns Inventory, and Body Image Concern Inventory. The data were analyzed using SPSS-20 and structural equation modeling in the Amos software version 24. The results indicate the acceptability of the goodness of fit model index. Direct association of body image with emotional health (β= 0.91, p= 0.005) and relationships (β= 0.88, p= 0.009) was significant, but any direct and indirect association between body and unhealthy dietary behaviors was not found. This study underlines the importance of being aware of the association between body image, emotional health, and relationships Further studies are recommended to explore the relationship between these factors and unhealthy dietary behaviors in medical sciences students.

An Alarming Shift of HIV Infection from Injection Drug to Sexual Transmission in Mashhad, Iran, 1989-2014

Introduction: Iran is facing to a rapid change in the epidemiological pattern of HIV. The trend of annual number of new HIV infections and factors associated with the development of HIV over the last two decades in Iran, were examined.
 Methods: The data were retrospectively collected from patients who attended the Behavior Diseases Consultation Center of Mashhad University of Medical Sciences in Iran. Individuals were contributed if they were HIV-positive. Baseline factors including demographic, behavioral and clinical characteristics for all participants were examined. Changes in population characteristics were assessed using chi-square test or the Fisher’s exact test.
 Results: From 1989 to 2014, 584 individuals were eligible for present analysis according to the inclusion criteria. Most patients were men (87%) with most being 36–52 years old, unemployed (58%), married (39.3%), less educated (47.7%) and had a history of imprisonment (83%). The most common modes of HIV transmission were injection drug use (IDU) (51.4%) and IDU along with the sexual relationship (26.5%). These transmission modes varied significantly according to gender (p-value<0.001). Similarly, IDU and sexual relationship were most important transmission modes in males and females, respectively. The number of new HIV infections through sexual-related modes has risen sharply in recent years.
 Conclusion: In Iran, the pattern of HIV transmission is shifting from unsafe injection drug to unsafe sexual contact for forthcoming years. Also, increasing trend of HIV incidence in women is remarkable. Accordingly, HIV-prevention strategies need to be changed.