Background:Asphyxia is considered an important cause of morbidity and mortality in neonates. This condition can affect many vital organs including the central nervous system and may eventually lead to death or developmental disorders.Objectives:Considering the high prevalence of asphyxia and its adverse consequences, the present study was conducted to evaluate the risk factors for birth asphyxia and assess their correlation with prognosis in asphyxiated infants.Patients and Methods:This two-year follow-up cohort study was conducted on 260 infants (110 asphyxiated infants and 150 healthy neonates) at Mashhad Ghaem Hospital during 2007 - 2014. Data collection tools consisted of a researcher-designed questionnaire including maternal and neonatal information and clinical/laboratory test results. The subjects were followed-up, using Denver II test for 6, 12, 18, and 24 months (after discharge). For data analysis, t-test was performed, using SPSS version 16.5. P value ≤ 0.05 was considered statistically significant.Results:Of 260 neonates, 199 (76.5%) and 61 (23.5%) cases presented with normal neonatal outcomes and with abnormal neonatal outcomes (developmental delay), respectively. Variables such as the severity of asphyxia (P = 0.000), five-minute Apgar score (P = 0.015), need for ventilation (P = 0.000), and severity of acidosis at birth (P = 0.001) were the major prognostic factors in infants with asphyxia. Additionally, prognosis was significantly poorer in boys and infants with dystocia history (P = 0.000).Conclusions:Prevalence of risk factors for developmental delay including the severity of asphyxia need for mechanical ventilation, and severity of acidosis at birth, dystocia, and Apgar score were lower in surviving infants; therefore, controlling these risk factors may reduce asphyxia-associated complications.

There are increasing calls for public health policies to realize the visions of a health literate society and health literacy on a global scale. However, there are still more gaps in what researchers recognize and what steps they should take to improve health literacy (HL) skills. This review aimed to measure the HL status of the Iranian population and the effect size of the underlying association between HL and other health outcomes, and to examine the effectiveness of HL interventions on improving the functional dimension of HL, self-efficacy, and health-promoting behaviors. All full text published articles written in English and Persian language were included from inception until January 2019, but the type of study is not limited. A total of 52 potentially relevant articles with data on 36,523 participants were included in this review. In the population with health conditions, the average HL score was 62.51 (95% CI: 59.95–65.08), while in the patient population, the HL score was 64.04 (95% CI: 60.64–67.45). Health literacy was positively and significantly correlated with self-care behaviors 0.42 (95% CI; 0.35–0.49), self-efficacy 0.35 (95% CI; 0.26–0.43), knowledge 0.50 (95% CI; 0.44–0.55), communication skills 0.33 (95% CI; 0.25–0.41), and health promotion behaviors 0.39 (95% CI; 0.35–0.44). The meta-analyses showed that overall, HL interventions significantly improved HL status, self-efficacy, and health promotion behaviors. Results indicate that HL status was in the range of marginal HL level in the Iranian population. Our finding highlights the beneficial impact of HL intervention on health-promoting behaviors and self-efficacy, particularly in low literacy/socioeconomic status people.

The term organizational health literacy (OHL) is a new concept that emerged to address the challenge of predominantly in patients with limited health literacy (HL). There is no consensus on how OHL can improve HL activities and health outcomes in healthcare organizations. In this study, a systematic review of the literature was conducted to understand the evidence for the effectiveness of OHL and its health outcome, and the facilitators and barriers that influence the implementation of OHL. A literature search was done using six databases, the gray literature method and reference hand searches. Thirteen potentially articles with data on 1254 health organizations were included. Eight self-assessment tools and ten OHL attributes have been identified. Eleven quality-improvement characteristics and 15 key barriers were reviewed. Evidence on the effectiveness of HL tools provides best practices and recommendations to enhance OHL capacities. Results indicated that shifting to a comprehensive OHL would likely be a complex process because HL is not usually integrated into the healthcare organization’s vision and strategic planning. Further development of OHL requires radical, simultaneous, and multiple changes. Thus, there is a need for the healthcare system to consider HL as an organizational priority, that is, be responsive.

Serum high‐sensitivity C‐reactive protein (hs‐CRP) is predictive of coronary artery disease (CAD). The aim of this study was to examine the possible association of hs‐CRP with presence and severity of CAD and traditional CAD risk factors. This case‐control study was carried out on 2,346 individuals from September 2011 to May 2013. Of these 1,187 had evidence of coronary disease, and were subject to coronary angiography, and the remainder were healthy controls (n = 1,159). Characteristics were determined using standard laboratory techniques and serum Hs‐CRP levels were estimated using enzyme‐linked immunosorbent assay (ELISA) kits, and severity of CAD was assessed according to the score of obstruction in coronary artery. Serum hs‐CRP levels were higher in those with severe coronary disease, who had stenosis ≥ 50% stenosis of at least one coronary artery (all p < 0.001 vs. individuals in healthy control), and correlated significantly with the score for coronary artery disease (all p < 0.01). After adjustment for conventional risk factors, regression analysis revealed that smoking habits, fasting blood glucose, total cholesterol, high‐density lipoprotein, hs‐CRP, blood pressure, anxiety, dietary intake of vitamin E, and cholesterol remained as independent determinants for angiographic severity of CAD. The area under the receiving operating characteristic (ROC) curve for serum hs‐CRP was 0.869 (CI 95% 0.721–0.872, p < 0.001). The optimal values for the cut‐off point was a serum hs‐CRP of 2.78 mg/l (sensitivity 80.20%, specificity 85%) to predict severity of CAD. Increased serum hs‐CRP levels are significantly associated with angiographic severity of CAD, suggesting its value as a biomarkers for predicting CAD.