Maziar Moradi-Lakeh, Salime Goharinezhad, Ali Amirkafi, Seyed Mohsen Zahraei, Arash Tehrani-Banihashemi and Abdolreza Esteghamati
Despite significant progress in Iran's immunization programs, vaccine policymaking in the country still faces various challenges and shortcomings. To address these issues and…
Abstract
Purpose
Despite significant progress in Iran's immunization programs, vaccine policymaking in the country still faces various challenges and shortcomings. To address these issues and ensure sustained progress toward achieving comprehensive vaccination policies, it is essential to identify the critical factors influencing vaccine policies in Iran. Our study aims to provide evidence-based insights that can inform the development of effective and equitable vaccine strategies, leading to a more sustainable and efficient approach to vaccination in the country.
Design/methodology/approach
This mixed-method study aimed to analyze the factors influencing the future of human vaccine policy using Cross Impact Analysis. Firstly, a scoping review was conducted to identify the factors affecting the future of human vaccine development. Secondly, a semi-structured interview was conducted with experts in this field to add more factors and confirm the identified factors within the Iranian context. Finally, a Cross-Impact Analysis (CIA) approach was applied to comprehend the complex relationships between the identified factors. Thematic analysis was used for the qualitative data, and MICMAC analysis was applied to characterize the relationships between the factors.
Findings
Seventeen key driving force factors were identified through comprehensive review and interviews. These factors were assigned weighted values ranging from zero to three and subsequently analyzed using MICMAC software. Employing the Cross-Impact Analysis (CIA) technique, the study characterized the impact of each factor on vaccine policy and elucidated the intricate interactions between them. The findings underscored that robust leadership and governance, an innovative ecosystem, and well-established immunization information systems emerged as pivotal driving forces shaping vaccine policy in Iran.
Research limitations/implications
While this study contributes valuable insights into the driving factors influencing vaccine policy in Iran, it is important to acknowledge several limitations. The results rely on the subjective perceptions of a diverse group of specialists, and future research could delve into additional factors in other countries to identify common themes and differences.
Practical implications
This study provides evidence to assist policymakers in making informed decisions regarding vaccines in Iran. The findings suggest that enhancing access to vaccines, fostering trust in the healthcare system, and prioritizing equity in distribution can contribute to increased vaccination rates and a reduction in vaccine-preventable diseases.
Originality/value
This study provides a unique contribution to the field of vaccine policy by utilizing the cross-impact analysis to examine the complex interactions among various factors. The results of this analysis demonstrate that these interactions can significantly impact the overall system, highlighting the need for policymakers to consider multiple factors when formulating effective strategies. By revealing the significance of these interactions, this research offers valuable insights into the development of successful policies that can shape a desirable future for vaccine policy in Iran. Future studies could ratify the findings from this research by applying other methodological approaches.
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Zamzam Paknahad, Leila Yazdanpanah, Mohammad Reza Maracy, Amir Reza Moravejolahkami, Seyed Ali Javad-Mousavi and Abbas Nemati
Patients with chronic obstructive pulmonary disease (COPD) suffer from many health problems including poor sleep. This paper aims to evaluate the relationship between diet quality…
Abstract
Purpose
Patients with chronic obstructive pulmonary disease (COPD) suffer from many health problems including poor sleep. This paper aims to evaluate the relationship between diet quality indices (DQIs) and sleep quality in COPD.
Design/methodology/approach
The current cross-sectional study was carried on 121 COPD patients. Subjective quality of sleep was determined by Pittsburgh Sleep Quality Index (PSQI) and categorized into “poor” and “good” sleep quality. Dietary history was assessed by the DQIs. Disease status was categorized according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines.
Findings
In total, 103 men and 18 women with a mean age of 66.1 ±10.9 were studied. The subjects were categorized into four groups based on GOLD; 3.3% of subjects were at Stage 1, 38% in Stage 2, 38% in Stage 3 and 20.7% in Stage 4. In total, 38% of subjects were good, and 62% were bad sleepers according to PSQI score. There was no significant relationship between the severity of COPD and PSQI score. We observed a significant inverse relation between PSQI total score and Mediterranean diet (MED) scale, Healthy Eating Index (HEI)-2010 and HEI-2005 (p = 0.024, 0.037 and 0.024, respectively) in males.
Originality/value
This study showed a high prevalence of poor quality of sleep and sleep disturbances among COPD patients. There was an inverse association between PSQI and sleep disorders and DQIs scores in COPD patients. Regardless of the severity of airflow obstruction, poor diet quality may constitute a risk factor for sleep quality.
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Zahra Mirzaei-Azandaryani, Yousef Javadzadeh, Elnaz Shaseb and Mojgan Mirghafourvand
Because of the importance of having enough sleep in life and health, this study aims to determine the effect of vitamin D supplementation on sleep quality and pregnancy symptoms…
Abstract
Purpose
Because of the importance of having enough sleep in life and health, this study aims to determine the effect of vitamin D supplementation on sleep quality and pregnancy symptoms (primary outcomes) and side effects (secondary outcome).
Design/methodology/approach
In this triple-blind randomized controlled clinical trial, 88 pregnant women with gestational age of 8–10 weeks and serum vitamin D concentration less than 30 ng/ml were allocated into vitamin D (n = 44) and control (n = 44) groups by blocked randomization method. The vitamin D group received a 4,000 IU vitamin D pill, and the control group received a placebo pill daily for 18 weeks. Independent t-, Mann–Whitney U and ANCOVA tests were used to analyze the data.
Findings
The post-intervention mean (SD: standard deviation) of total sleep quality score in the vitamin D and placebo group were 1.94 (2.1) and 4.62 (1.71), respectively. According to the Mann–Whitney U test, this difference between the two groups was statistically significant (p < 0.001). The mean (SD) of pregnancy symptoms in the vitamin D and placebo groups was 23.95 (16.07) and 26.62 (13.84), respectively, and there was no significant difference between the two groups based on ANCOVA test (p = 0.56). Considerable side effects were not observed in any groups.
Originality/value
This study was conducted due to the contradictory results of the effect of vitamin D on sleep quality and the high prevalence of sleep disorders and pregnancy symptoms.