Editorial.
Authors: Abstract Many regions of the world continue to bear witness to the controversial and culturally sensitive subject of gender violence, whether the practice of female genital mutilation (FGM) or domestic aggression, and this issue of the Eastern Mediterranean Health Journal examines research on this topic in Sudan and India. Changing attitudes through education is the underlying theme in the Article "Opinions of university students about female genital mutilation", whereby current gender-based attitudes to the practice of FGM are examined in order to assess how Sudan's professional community of to...
Source: Eastern Mediterranean Health Journal - June 19, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Opinions of university students about female genital mutilation in Sudan.
Conclusions: This study shows that even educated individuals demand FGM/C in spite of knowing the harm. It is therefore suggested continuing educational studies on this subject. PMID: 31210342 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - June 19, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Compliance with school nutrition policy in Saudi Arabia: a quantitative study.
Conclusions: While the Saudi policy is clear on what should not be served in school cafeterias, it fails to provide guidance on what must be served to improve the nutritional value of meals provided. PMID: 31210343 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - June 19, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Comparison of time-restricted feeding and Islamic fasting: a scoping review.
Conclusion: Time-restricted feeding and Islamic fasting have many similar characteristics and reported positive health effects. PMID: 31210344 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - June 19, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Screening for infectious diseases in newly arrived asymptomatic immigrants in southern Italy.
Conclusions: Asymptomatic immigrants are at increased risk for some infections, mainly HBV and tuberculosis. PMID: 31210345 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - June 19, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Effects of the Health Transformation Plan on caesarean section rate in the Islamic Republic of Iran: an interrupted time series.
This study aimed to assess the effects of the Health Transformation Plan (HTP) on the C-section rate in the Islamic Republic of Iran. Methods: This study was an interrupted time series analysis that used segmented regression analysis to assess the immediate and long-term effects of the HTP on C-section rate in two groups of hospitals affiliated and not affiliated to the Ministry of Health and Medical Education (MoHME) in Kurdistan province. Study samples were selected using the data on monthly C-section rate collected over a period of four years. Results: We observed significant decreases in C-section rate immediat...
Source: Eastern Mediterranean Health Journal - June 19, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Gender-based violence in New Delhi, India: forecast based on secondary data analysis.
Conclusion: Within limitations, it is concluded that the safety of women will continue to be a concern in the near future. PMID: 31210347 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - June 19, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Communicable diseases management in disasters: an analysis of improvement measures since 2005, Islamic Republic of Iran.
Conclusions: The findings highlighted improvements in communicable diseases management in disasters, including interorganizational collaboration, information flow and use of new technologies such as web-based or mobile phone-based systems. PMID: 31210348 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - June 19, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Fasting and post-prandial plasma glucose screening for gestational diabetes mellitus.
Conclusions: Fasting and postprandial plasma glucose screening can replace gestational diabetes mellitus screening in women who refuse to have the glucose load test. PMID: 31210349 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - June 19, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Methodological issue on population and mortality profile in the Islamic Republic of Iran.
Authors: Naderi M, Ataey A, Jafarvand E PMID: 31210350 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - June 19, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Rheumatic heart disease in the Eastern Mediterranean Region.
Authors: PMID: 31210351 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - June 19, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Editorial.
Authors: Abstract The Eastern Mediterranean Health Journal examines a diverse number of topics in this issue that underpin public health-related activities in the Eastern Mediterranean Region (EMR), including research methods, communicable disease prevention, drug administration, and palliative care. In fact, the EMR continues to have some of the most pressing public health challenges brought about by social conflict and health systems degradation, exacerbated by natural disasters, including desertification, floods, earthquakes, and soil erosion. The issue of non-adherence to medication schedules by patients i...
Source: Eastern Mediterranean Health Journal - May 8, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Adherence to levothyroxine among patients with hypothyroidism in Lebanon.
Conclusion: Educational programmes should be implemented, doctor-patient and pharmacist-patient relationship could be improved and new treatment regimens be considered in order to enhance patient adherence. PMID: 31054225 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - May 8, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Agenda setting analysis for maternal mortality reduction: exploring influential factors using Kingdon's Stream Model.
Conclusions: The three streams: problem, policy and politics are not separate from each other. Political stability and commitment, having a national plan and benefiting from technical or financial support of international entities was a common feature among almost all the studied countries. The key actions leading to the opening of the window of opportunity were those actions that led to highlighting the problem. PMID: 31054226 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - May 8, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Practice implications of an antimicrobial stewardship intervention in a tertiary care teaching hospital, Qatar.
Conclusions: Effective communication, continuous documentation in records, and repetitive education promote rational antibiotic prescribing and enhance ASPs. PMID: 31054227 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - May 8, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

The translation and cultural adaptation validity of the Actual Scope of Practice Questionnaire.
Conclusion: Subject to psychometric analysis, the A-ASCOP is suitable for use in Lebanon and countries of the Middle Eastern region. PMID: 31054228 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - May 8, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Human development index, maternal mortality rate and under 5 years mortality rate in West and South Asian countries, 1980-2010: an ecological study.
Authors: Alimohamadi Y, Khodamoradi F, Khoramdad M, Shahbaz M, Esmaeilzadeh F Abstract Background: Human Development Index (HDI), maternal mortality rate (MMR) and children aged under 5 years mortality rate (U5MR) are fundamental issues, especially in low- and middle-income countries. Aims: The aim of this study was to evaluate the changes in HDI, MMR and U5MR from 1980 to 2010 in certain West Asian countries as well as the relationship between these indexes. Methods: In this ecological study, HDI, MMR and U5MR information from studied countries during 1980 to 2010 was extracted from the gap minder site and...
Source: Eastern Mediterranean Health Journal - May 8, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Serum 25-hydroxyvitamin D status and wheezing in pre-school children, Kuwait.
Conclusions: Vitamin D deficiency increases the risk of wheezing among preschoolers in Kuwait. A possible link between low serum 25(OH)D and MTW could highlight a specific role for vitamin D in relation to atopy. Prevention and prompt management of vitamin D deficiency should be considered among infants and children with wheezing. PMID: 31054230 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - May 8, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Pain characteristics of older residents in Iranian nursing homes.
Authors: Foroughan M, Shahboulaghi FM, Jafari Z, Rashedi V, Biglarian A Abstract Background: Pain is a common complaint among the aging population, particularly among the older residents of nursing homes. Aims: The main aim of the study was to examine the pain characteristics among older residents of nursing homes in Tehran, Islamic Republic of Iran. Methods: This was a cross-sectional study. The sample consisted of 394 older adults admitted to Tehran nursing homes. To gather the required data, Brief Pain Inventory and Abbreviated Mental Test score were used. Results: 51% of the female and 26% of the ma...
Source: Eastern Mediterranean Health Journal - May 8, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Field lessons in surveying healthcare waste management activities in Pakistan.
Conclusions: Apart from technical improvement, behavioural changes are vital for a positive change regarding HWM. Overall, this study led to an increased awareness of public health issues related to HWM that had hitherto gone unnoticed by hospital staff as well as relevant public authorities in the city. PMID: 31054232 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - May 8, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Methodological note on spatial classification.
Authors: Radmanesh A, Pourhoseingholi MA, Olfatifar M PMID: 31054233 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - May 8, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Consultation on establishing robust integrated national reporting systems for viral hepatitis.
Authors: PMID: 31054234 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - May 8, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Mental health services for youth in the Eastern Mediterranean Region: challenges and opportunities (Editorial).
Authors: Rahman A, Hamoda HM, Rahimi-Movaghar A, Khan M, Saeed K Abstract The Global Burden of Disease study shows that the burden from mental and substance use disorders, measured in Disability Adjusted Life Years (DALYs), has steadily risen in the Eastern Mediterranean Region (EMR) over the last three decades and is higher than the global average for almost all EMR countries). Even more alarming is the finding that depression, self-harm, anxiety and conduct disorders constitute four of the top 10 causes of DALYs among girls and boys aged 15-19 years and suicide is a leading cause of adolescent mortality. More...
Source: Eastern Mediterranean Health Journal - April 5, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Knowledge, practices and attitudes of physicians towards evidencebased medicine in Egypt.
Conclusions: Most participants in this study have a positive attitude towards EBM, have a fair knowledge of it, but poor practices. EBM should be integrated in the curriculum of both undergraduate and postgraduate studies, and EBM training courses provided to residents to ensure correct application of EBM in daily practice. PMID: 30942471 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - April 5, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Assessment of device-associated infection rates in teaching hospitals in Islamic Republic of Iran.
Conclusions: This study showed high incidence rates of DAIs and resistant organisms, and appropriate interventions are necessary to reduce these rates. PMID: 30942472 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - April 5, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Antenatal care among Palestine refugees in Jordan: factors associated with UNRWA attendance.
Authors: Tittle V, Bennett DL, Hajat S, Shishtawi A, Zeidan W, Abuzabaida F, Ballout G, Abu-Zayed I, Hababeh M, Khader A, Seita A Abstract Background: Maternal and neonatal mortality is a global issue acknowledged by the Sustainable Development Goals (SDGs). Adequate ante-natal care (ANC) is pivotal to reducing these mortality rates, while understanding why women don't attend ANC is crucial to addressing the SDGs. Aims: Using routine primary health care data to determine the factors associated with inadequate attendance by Palestine refugees (PR) to ANC seeking facilities provided by the United Nations Relief a...
Source: Eastern Mediterranean Health Journal - April 5, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

A country-wide comparison of cost recovery and financing systems of blood and blood products.
Conclusions: In countries with low and lower-middle income economies, total or partial costs of blood and blood products are recovered directly from the patients. While countries in which blood and blood products are 'free of charge' for patients are mostly categorized in upper-middle- or high-income economies with well-developed healthcare and insurance systems. There is no clear relation between blood usage and the type of cost recovery system. However, having an efficient cost recovery system will help blood establishments to sustain their service delivery. PMID: 30942474 [PubMed - in process] (Source: Eastern Medit...
Source: Eastern Mediterranean Health Journal - April 5, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Tobacco and waterpipe use among university students in Saudi Arabia: impact of tobacco sales ban.
Conclusions: Waterpipe and cigarette smoking, despite the ban on tobacco sales, is still common among Taibah University students in Medina, Saudi Arabia. PMID: 30942475 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - April 5, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Inequalities in access to hospitals: a case study in the Islamic Republic of Iran 1997-2012.
Conclusions: Over the total period under study, the results revealed that hospitals were concentrated in the central and southern areas of Kermanshah. PMID: 30942476 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - April 5, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

A review of family planning policies and services in WHO Eastern Mediterranean Region Member States.
Conclusions: The findings of the survey indicate that national policies and programmes endorse FP to achieve national targets. Despite progress in many areas in FP services, many countries still struggle with weak implementation of FP programmes. There are also policy gaps for key vulnerable groups including the poor, the disabled and adolescents. This review highlighted policy and programmatic gaps required to strengthen those FP services that can help improve maternal and infant health outcomes. Special programmes for adolescents, refugees and persons with disabilities need to be streamlined and strengthened. PMID: 3...
Source: Eastern Mediterranean Health Journal - April 5, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Ultrapure water in haemodialysis: a step towards better quality in Lebanon.
This article reports on the problems previously encountered regarding water quality in Lebanon. It exposes the recent changes in standards as recommended by the government, especially the mandatory three sessions per week and ultrapure water. In addition, it analyses the cost-effectiveness of ultrapure water implementation in a low/middle-income country and demonstrates that the cost is lower than in high-income countries. Finally, this article summarizes the obstacles met and suggests a practical approach to maintain this high level of water treatment quality. PMID: 30942478 [PubMed - in process] (Source: Eastern Medi...
Source: Eastern Mediterranean Health Journal - April 5, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Tackling obesity in the Eastern Mediterranean Region.
Authors: PMID: 30942479 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - April 5, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Editorial.
Authors: Abstract This issue of the Eastern Mediterranean Health Journal covers a spectrum of public health research throughout the Region, much of which has direct relevance with the work of the World Health Organization. From industrial environmental health to vector control disease surveillance, the public health issues that currently afflict the Region are not necessarily unique, but certainly highlight areas of research that can have a particular urgency when considering the specific challenges faced by populations throughout the Middle East and North Africa. Chemical accidents have the potential for imme...
Source: Eastern Mediterranean Health Journal - March 30, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Industrial chemical accidents: a growing health hazard in the Islamic Republic of Iran.
Conclusions: Action is needed to improve the areas of weakness so as to achieve the necessary capacities for chemical safety, and preparedness and response to chemical incidents in line with the IHR. PMID: 30919919 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - March 30, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

National quality assessment questionnaire for physiotherapy centres: a pilot study in Lebanon.
Conclusions: Further studies are needed to validate the quality assessment in physiotherapy centres questionnaire, and to implement it as a primary tool for assessing quality standards and for accreditation of physiotherapy centres. PMID: 30919920 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - March 30, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Nutritional risk screening of hospitalized children aged < 3 years.
Nutritional risk screening of hospitalized children aged
Source: Eastern Mediterranean Health Journal - March 30, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Determinant factors in applying electronic medical records in healthcare.
Conclusions: The study findings suggest that the proposed conceptual integrated model of TOE-TAM is a favourable model for identifying the relevant factors of EMR adoption. The present study clearly recognized nine significant determinants that affect end-users' intention when comprehensive implementation of ERMs is considered. PMID: 30919922 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - March 30, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Effect of fasting during Ramadan on thermal stress parameters.
Conclusions: Robust workplace measures are needed for industries with high process temperatures, located in the Gulf Region, in order to minimize the enhanced risk of heat stress and illness during Ramadan. PMID: 30919923 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - March 30, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Knowledge, attitude and practice of travel medicine among primary care physicians in Oman: the need for intervention.
Conclusions: This study showed that travel health is in an early stage of development in Oman and supports the need for the establishment of travel medicine services. PMID: 30919924 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - March 30, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Global prevalence of chronic obstructive pulmonary disease: systematic review and meta-analysis.
Conclusions: Global prevalence of COPD among men is about 5% higher than among women. The most prevalent stage of COPD is stage 1. PMID: 30919925 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - March 30, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Enhancing surveillance for early detection of Zika virus infection: strategies for the countries of Eastern Mediterranean Region.
Conclusions: Enhancing surveillance for ZIKAV would require no shift in the existing system. A number of considerations would be required to integrate this syndromic and event-based surveillance approaches within the existing system. PMID: 30919926 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - March 30, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Leishmaniasis among neighbouring endemic countries in the Eastern Mediterranean, African and European regions.
Authors: PMID: 30919927 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - March 30, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Eastern Mediterranean Health Journal reviewers' panel, 2018.
Authors: PMID: 30919928 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - March 30, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Developing the Eastern Mediterranean Health Journal to support public health research in the Region (Editorial).
Authors: Dingwall P, Mandil A, Rashidian A Abstract Since 1995, the Eastern Mediterranean Health Journal (EMHJ) has sought to publish public health research, regionally and globally, in accordance with the mandate and goals of the World Health Organization (WHO). As part of a family of WHO journals, the EMHJ is an open access public health journal and makes no charge for review or publication of accepted papers, allowing research manuscripts as well as policy-related works from institutions with different financial status an opportunity to be published and remain freely accessible to all. Supporting countries that ...
Source: Eastern Mediterranean Health Journal - February 27, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Assessment of undernutrition using Composite Index of Anthropometric Failure among children aged < 5 years in rural Yemen.
Assessment of undernutrition using Composite Index of Anthropometric Failure among children aged
Source: Eastern Mediterranean Health Journal - February 27, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Successful implementation of general health policies in the Islamic Republic of Iran: barriers and mechanisms.
Conclusions: A thorough understanding of barriers and mechanisms for implementation of general health policies can provide the necessary background to ensure successful health promotion in the country. PMID: 30799552 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - February 27, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Knowledge by physicians concerning cervical cancer and testing: Benimellal province, Morocco.
Conclusions: The knowledge of general practitioners was deficient and therefore initial and continuing training on cervical cancer is required. PMID: 30799553 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - February 27, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Northern Iranian growth charts for children aged 7-11 years: comparison with international reference curves.
Conclusions: BMI centiles for 7-11 years schoolchildren in Babol differed significantly from the international growth reference curves. Therefore, local and population-specific BMI curves should be developed to assess physical growth of children. PMID: 30799554 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - February 27, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Prevalence and workplace correlates of tobacco smoking among male expatriate workers in Riyadh, Saudi Arabia.
Conclusions: Concerted efforts at the national (health policies)and employers' levels are required to reduce smoking prevalence among male expatriate workers, including provision of comprehensive health insurance with tobacco cessation therapy as benefits, enforcement of workplace smoking ban, anti-tobacco heal th programmes and web/telephone smoking cessation counselling. PMID: 30799555 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - February 27, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research

Perceptions of Iranian women regarding breast cancer screening behaviour.
Conclusions: Interventions should focus on diminishing barriers and increasing women's' self-efficacy and interpersonal communication about breast cancer screening. PMID: 30799556 [PubMed - in process] (Source: Eastern Mediterranean Health Journal)
Source: Eastern Mediterranean Health Journal - February 27, 2019 Category: Middle East Health Tags: East Mediterr Health J Source Type: research