Journal of Preventive Medicine and Hygiene (JPMH)
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Assessment of Knowledge and Practices Related to Children\u27s Physical Fitness and Health Among French PE Teachers.: PE Teachers\u27 Knowledge on Children\u27s Fitness
No full textObjectives: To assess PE teachers\u27 knowledge of physical fitness and its link to children\u27s health and identify barriers and facilitators for its management in schools.
Methods: A total of 2,378 PE teachers (56% men) completed an online questionnaire on their knowledge, perceived barriers, and facilitators regarding physical fitness.
Results: Most of teachers reported being aware of the associations between cardiorespiratory fitness (CRF) (96%) and muscular strength (MS) (88%) with current health in youth. A smaller proportion of teachers acknowledged knowing the potential associations of these fitness components with future health in adulthood, specifically 40% for CRF and 22% for MS. The majority of teachers (80%) reported being sufficiently trained during their training courses to assess and develop the CRF. Only 50% of teachers reported feeling sufficiently trained to assess MS, while 58% reported being adequately trained to develop this component. Among the teachers, 82% reported that insufficient practice time, large class sizes, and high heterogeneity are key obstacles. Less than 50% identified other prioritized objectives as barriers, while 30% reported a lack of material resources as a significant limitation. Then, 84% of teachers reported being interested in participating in continued professional development focused on the promotion of physical fitness in youth through PE.
Conclusions: Barriers such as limited training, structural constraints, and low awareness of MS recommendations hinder effective fitness management. Addressing these through improved curricula, teacher training, and resources is crucial to enhancing youth fitness and health in France
Investigating the Theoretical Possibility of Dengue Fever in Ancient Egypt
Full text linkDengue fever, a mosquito-borne viral disease transmitted primarily by the mosquito species Aedes aegypti, has become a significant global health concern, with cases surging in recent years. While no explicit records of dengue exist from ancient Egypt, this study explores the theoretical possibility of its presence during that era. By integrating contemporary epidemiological data, historical medical texts, entomological studies, and palaeoclimatic analyses, the problem of whether ancient Egyptians could have encountered a disease resembling dengue is assessed
Performance-based payment systems for general practitioners and specialists in selected countries: a comparative study
Full text linkContext: due to the growing increase in the needs of health systems in the field of financial and human resources management, as well as the challenges related to enhancing the quality of health care, performance-based payment has been the subject of attention by health and welfare policymakers. This study aimed to compare the components of performance-based payment in selected countries.
Methods: This comparative study was conducted in 2021. The search was performed in two search engines (Google Scholar and Google), three databases (Medline, Scopus, and Web of Science), and the websites of WHO and the Ministry of Health and Welfare of the selected countries. The selection of countries was based on three measures: the type of health insurance system, the development of the performance-based payment system, and the state of economic development of the countries. Finally, England, Taiwan, United States of America, Canada, Germany, Turkey, France, and Iran were included in this study. The findings were organized using comparative analysis tables. The general framework of performance-based payment systems, including goals, activities and actions, people involved in the program, and the way of encouraging and punishing, was used for analysis.
Results: The findings of the study showed that in most of the programs, aspect of clinical quality has the highest weight. Other dimensions include patient experience and satisfaction, physician financial performance, and patients’ access to services. In most programs, various risk adjustment methods such as exception reporting, combined payments, payment according to demographic characteristics, were used to reduce provider risk, and clinical service providers were actively involved in the program design. In several programs incentive payments were made at the group level. The method of payment in several programs was also staggered and progressive.
Conclusion: In general, developed countries have formal performance-based payment systems with different mechanisms. On the other hand, in most developing countries, scattered measures have been taken in this field. Despite the widespread use of performance-based payment programs in most countries, these programs face limitations and shortcomings. By linking incentives to individual, team, and organizational performance, a performance-based payment program can increase clinicians’ morale capacity, improve teamwork, and create integrated health care
Epidemiological Analysis of Cases of Animal Bite Injuries at Rabies Prevention Centers Affiliated with Iranshahr University of Medical Sciences
Full text linkObjective: Among the oldest common viral diseases between humans and animals, Rabies is still one of the greatest threats to public health in the 21st century, particularly in developing countries, where it is an increasing problem. This study was conducted to determine the epidemiological patterns of animal bites in Iranshahr, southeast of Iran during the years of 2019 to 2021.
Methods: In this descriptive study we were conducted to analyze the epidemiological characteristics of 6085 animal bites reported to the rabies prevention centers of Iranshahr University of Medical Sciences between April 2019 and March 2021. A demographic profile (age, gender, occupation, and nationality), the type of the attacking animal (a dog, a cat, or another type of animal), the year and month of the bite, as well as the state of the injury and treatment, were collected. Data analysis using SPSS version 19 at a significant level (P-value ≤ 0.05), ArcGIS version 10.8.2, and Excel 2019 were used to generate frequency distributions, descriptive statistics, and the distribution map of animal bites.
Results: The mean age of the injured was 25.22±20.1 years. Out of 6085 animal bite cases, 4071 cases (66.9%) were males and the rest were women. Regarding the residential area, 4083 (67.1%) related to rural areas and 38% of the victims were under 19 years old. Dogs made up the majority of animal biting cases (89.8%), followed by cats (5.2%). Also, the spring season was reported with the highest share of bites (30.8 percent). The cumulative incidence of animal bites during the time period was 151/100,000 population, which was the lowest during the first year of the COVID-19 pandemic (131/100,000), and the highest during the three years in Rask City (253/100,000). A total of 14 cases of suspected animals were sampled, of which 8 cases were confirmed as animal rabies-positive by the Pasteur Institute of Iran.
Conclusions: School-aged children and adolescents were most likely to be bitten by dogs, suggesting educational programs should target these age groups. Furthermore, confirmed cases of rabies in animals are also alarming for other organizations involved in the rabies program, which require control programs that include relocating stray dogs and vaccinating owners\u27 dogs
Psychometric Evaluation of Iranian Version of Beliefs about Third-Hand Smoke Scale (BATHS-T) in Pregnant Women
Full text linkIntroduction: Exposure to third-hand smoke (THS) is hazardous for human health, especially for pregnant women. This study aimed at psychometric evaluation of the Iranian version of “Beliefs about Third-Hand Smoke Scale”(BATHS-T) in pregnant women.
Aims & Methods: The data collected from 364 pregnant women referring to Yazd health centers. The BATHS scale was translated into Persian, and the stages of adaptation of the BATHS scale in Persian were evaluated with CVR=0.87 and CVI=0.88. Confirmatory factor analysis (CFA) was performed to analyze the construct validity of the scale. Besides, the correlation test was used to evaluate the correlation of categories and subcategories of the scale.
Results: The BATHS structural equation model showed a favorable fit as RMSEA value was less than 0.05 and X2/df varied between 2 to 5. Moreover, other indices such as CFI and NFI were more than 90%, indicating the optimal fit of the present model. The correlation between the overall scale of BATHS and its two subcategories was 0.843 (P<0.001) and the correlation between health and stability subcategories was 0.886 (P<0.001). Since there was a positive and highly significant correlation, the fitted BATHS scale was considered to be structurally consistent with its subcategories. The reliability of the whole scale was 0.86 using Cronbach\u27s α coefficient.
Conclusion: The Iranian version of the BATHS scale is reliable and valid. This scale provides the required prerequisites for further research and education on third hand smoke exposure. It can also be possibly used in similar studies
Health-care associated infections in the two university hospitals of southern Tunisia: a point prevalence survey : Health-care associated infections in Southern Tunisia
No full textIntroduction
Despite advances in the prevention of healthcare-associated infections (HAI) in recent decades, this once-almost-usual adverse event remains relatively common and still has a definite impact on patients and public health. In light of this, this study aimed to determine the HAI prevalence, to describe their main specificities and to identify their associated factors, in Southern Tunisia.
Methods
We conducted a cross sectional study to assess HAI point prevalence in a two university hospitals in southern Tunisia. The study was started in February 20th to March 13th 2023.
Results
There were 1028 patients included in the survey and (47.3%) of them were women (n=486). The median age was 48 years (Interquartile Range (IQR)= [30-65]) years. We noted 86 HAI in the two establishments visited, with a global HAI prevalence of 8.4%. Multivariate analyses showed that independent factors of HAI were immune suppression (AOR=2.5; p=0.004), hospital stay duration≥6 (AOR=4.5; p<0.001), surgery 30 days prior to the study date (AOR=1.9; p=0.021), having central vascular catheter (AOR=2.44; p=0.032) and having intubation or endotracheal tube (AOR=3.5; p=0.002).
Conclusions
This study highlighted a relatively high prevalence of HAI in southern Tunisia. Therefore, urgent and ongoing corrective measures should be done, maintained and re-evaluated continuously in order to control HAI and promote care safety
Designing a performance-based payment model for physicians at outpatient clinics contracted with Iran health insurance: a case study from Iran
Full text linkSummary
Context: One of the essential conditions for providing quality healthcare services is the presence of capable physicians with high performance levels. To improve physicians\u27 performance, an effective performance-based payment system can achieve three goals: productivity, high-quality clinical services, and patient satisfaction. The aim of this study is to design a performance-based payment model for physicians in outpatient clinics contracted with the Iran Health Insurance Organization, tailored to the context and structure of this organization.
Methodology: This study is a mixed-methods study in which data were collected and analyzed using both quantitative and qualitative methods. In this study, through literature review and interviews with experts, the determining indicators for performance-based payments to general and specialized physicians in the outpatient sector who have direct contracts with the Health Insurance Organization were identified, along with the criteria for selecting these indicators. The extracted indicators were reviewed in several expert panels, and the indicators were entered into a prioritization matrix according to the structures of health insurance. In this phase, 49 questionnaires were completed, ultimately leading to the formulation of the operational framework for the indicators.
Results: From the aggregation of findings from the systematic review of literature and interviews, 47 determining indicators for performance-based payments to physicians and 18 criteria for the final selection of these indicators were extracted. Ultimately, with the entry of 24 selected indicators from the expert panel into the prioritization matrix, 9 indicators for general physicians and 13 indicators for specialized physicians were chosen. These indicators were categorized into three statuses: current, transitional, and desired, in accordance with the infrastructures of the Health Insurance Organization and its partner organizations. Selected indicators included the average number of prescribed medications, registered and sent electronic prescriptions, per capita number of prescribed diagnostic procedures, timely presence of physicians, complaints against physicians, physicians\u27 work history, adherence to guidelines in physicians\u27 decision-making, completion of electronic patient records, patient satisfaction, participation in training courses, and the average number of tests prescribed by physicians. The indicator profile contained the indicator title, indicator formula, indicator standard, method of data collection, and data source.
Conclusion: Policymakers can direct physicians\u27 performance towards the goals of the insurance organization, such as reducing costs, accelerating processes, and increasing patient satisfaction, by utilizing the selected indicators in the pay-for-performance (P4P) system. The identified indicators assess various aspects of physicians\u27 performance and will provide a basis for improving their performance by clarifying the organization\u27s objectives for them
Network Analysis of the HLS 19-Q12 Health Literacy Questionnaire: Insights from an Italian Pilot Study: A Network Analysis of the Italian HLS19-Q12 Questionnaire
No full textBackground:The widespread use of the internet and social media has transformed how people access health information impacting health literacy. Health literacy, the ability to access, understand, and use health information, is crucial to promote and maintain good health. This study is the first exploring with network analysis the correlation and distribution of the items of the Health Literacy Survey Questionnaire (HLS-Q) 12 short form to verify their correspondence to the principal domains of the health literacy conceptual model proposed by Sorensen et al. in 2013.
Materials and Methods:A digital version of the Italian HLS19-Q12 questionnaire was distributed online through social media and informal channels in May 2024. The sample consisted of 352 participants from the metropolitan area of Cagliari, Italy. Network analysis was employed to examine the clustering and relationships between the questionnaire items, via JASP using the Ising Fit method.
Results: Key findings include significant difficulties in accessing professional help and understanding medical emergencies. Network centrality measures highlighted the prominence of items related to understanding medical emergencies and making health decisions. Three clusters corresponding to healthcare, disease prevention, and health promotion, were visually identified with the last two closely interconnected. The item "making decisions to improve health" is crucial, acting as a bridge between clusters. Some items traditionally belonging to one domain shifted to another.
Conclusions:The network analysis provided a clear depiction of health literacy as complex system, emphasizing interactions. Health literacy involves accessing, evaluating, and applying information, with empowerment playing a key role according to our findings. By addressing identified needs and focusing on prominent items, healthcare professionals and policymakers can enhance health literacy and improve health outcomes for individuals and communities. This pilot study\u27s findings could benefit future research and interventions to improve health literacy
Effectiveness of Theory Based Educational Intervention on Health Literacy, Medication Adherence and Self-Management Behaviors of Patients with Type 2 Diabetes: Applying Extended Theory of Planned Behavior: Effectiveness of Diabetes Education on Medication Adherence and Self-Management
No full textIntroduction: Theory-based educational interventions can play an important role in improving health literacy and promoting self-care behaviors and preventing diabetes complications. This study was conducted with the aim of investigating the effectiveness of the educational intervention based on the extended theory of planned behavior on health literacy, medication adherence, self-care behaviors and metabolic indicators in T2D patients.
Methods: The present research was a Quasi-experimental study with a control group and measuring outcome variables at baseline and 3 months after the theory based intervention. With multi-stage sampling, 112 patients with T2D referred to health care centers of Qazvin city were equally assigned to experimental and control groups. The intervention included 6 online group education along with educational video, pamphlets and 60 SMS reminders using strategies as role-playing, lecture, and scenario presentation. The data collection tools were: Demographic items, summary of diabetes self-care activities scale, short test of functional health literacy in adults, The Morisky 8-item medication adherence scale, Sub-Scales of extended TPB (36 items). Paired & independent t-test, chi-square, ANOVA and ANCOVA were used to data analysis.
Results: The mean of attitude, subjective norms, perceived behavioral control, action planning, coping planning, trust and the intention associated with health literacy and medication adherence increased significantly in the experimental group in the post-test by controlling the effect of the pre-test variable (P<0.001). In addition, the results of ANCOVA showed the improvement in the total mean score of self-care and its dimension along with the mean of FBS and HbA1c in the experimental group in the post-test (P<0.001).
Conclusion: The focus of nurses and other medical staffs on improving health literacy, action & coping planning and psychological variables in the design of cognitive behavioral interventions can lead to improving self-care and medication adherence in T2D patients