The result of this study shows that there are many barriers to the implementation and use of EBM. Identifying barriers is just the first step to removing barriers to the use of EBM. Extra resources will be needed if these barriers are to be tackled.

BackgroundThis population-based study aimed at investigating the prevalence and associated factors of prehypertension/hypertension in Iran.Methods and FindingsThe data (n = 2818) for this study were collected in 2015 as a part of the major Lifestyle Promotion Project (LPP) conducted in East Azerbaijan (urban and regional parts). The data for socio-demographic status, dietary information, and physical activity and anxiety levels were collected through validated questionnaires. Then, physical examination including systolic and diastolic blood pressure (SBP, DBP), body mass index (BMI) and conicity index was performed. First-morning spot urine (SU) sample was collected to assume salt intake. The One-way ANOVA, logistic regression, chi-square test and independent t-test were used for statistical analysis. The prevalence of prehypertension, stage I and stage II hypertension, and overall hypertension was 47.3%, 13.6%, 5.45% and 22.6% respectively. The mean systolic (p = 0.004) and diastolic (p<0.001) blood pressure in men were significantly higher than women. Results of logistic regression analysis showed that in both sexes, family history of hypertension, obesity, abdominal obesity, anxiety and having high levels of sodium intake were associated with high blood pressure (p< 0.05). Additionally, 45.8% of the hypertensive patients were aware of their disease, 10.0% of the aware patients, and 44.5% of everyone with high blood pressure were receiving antihypertensive medication.ConclusionsOur data showed that prehypertension/hypertension is a major health problem in Iran. Focusing on identifying risk factors to hypertension, regular drug intake, good nutrition, physical activity, and changing lifestyles of patients with hypertension are essential.

These results do not provide evidence that any of the occupational factors examined are risk factors for either prostate cancer or BPH.

Purpose The purpose of this paper is to describe reliability and relative validity of the short-food frequency questionnaire (SH-FFQ) used for assessing food groups and nutrient intakes of Iranian adults. Design/methodology/approach The food list used in the SH-FFQ was elaborated based on a dietary survey of a sample of 60 individuals aged between 15 and 65 years. A total of 180 subjects (93 males and 87 females) were included in the study. All participants completed two SH-FFQs with one month interval, a single 24 hours recall (24hR) and two food records for three non-consecutive days. Findings No significant differences were observed in the mean daily intakes of energy, food groups and most of the nutrients between the reference tools and the two semi-quantitative SH-FFQs (p>0.05). The mean energy-adjusted reliability coefficients for all variables were 0.54 and 0.55 in men and women. The mean energy-adjusted and deattenuated correlation coefficients for all items between the SH-FFQ and reference tools were 0.54. Also, the mean percent misclassified into opposite quartiles for all food groups and nutrients was 12.6 percent. Originality/value The designed SH-FFQ developed for the Life style Promotion Project has reasonable reliability and relative validity for food groups and nutrient in Iranian adults.

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BackgroundIranian traditional primary health care (PHC) system, although proven to be successful in some areas in rural populations, suffers major pitfalls in providing PHC services in urban areas especially the slum urban areas. The new government of Iran announced a health reform movement including the health reform in PHC system of Iran. The Health Complex Model (HCM) was chosen as the preferred health reform model for this purpose.MethodsThis paper aims to report a detailed research protocol for the assessment of the effectiveness of the HCM in Iran. An adaptive controlled design is being used in this research. The study is planned to measure multiple endpoints at the baseline and 2 years after the intervention. The assessments will be done both in a population covered by the HCM, as intervention area, and in control populations covered by the traditional health care system as the control area.DiscussionAssessing the effectiveness of the HCM, as the Iranian PHC reform initiative, could help health system policy makers for future decisions on its continuation or modification.

Purpose Accreditation is an essential component in primary healthcare (PHC) systems. The purpose of this paper is to investigate the most suitable PHC accreditation models and standards, worldwide, and to prepare a comprehensive and unbiased summary from research on these models. Design/methodology/approach A systematic search was undertaken using Web of Science, Scopus, Science Direct, Springer, PubMed and ProQuest databases in August 2016 and updated in January 2018. English language studies addressing PHC accreditation standards and models, published between 1995 and January 2018, were included, resulting in 9051 citations. After excluding duplicates and irrelevant studies, 19 were included in the final review. Two independent reviewers critically appraised the studies. Consequently, accreditation standards in the models were extracted and compared. Findings Results indicate that USA, Australia, Canada, UK and New Zealand (non-eastern Mediterranean regions (EMR)) and Jordan, Saudi Arabia, Lebanon and Egypt (EMR) had well-developed and high-quality PHC accreditation models. The Jordanian, Egyptian and Saudi models had the highest diversity in their PHC standards domains. Community-oriented care, safe care, high-quality care, care continuity and human resource management had the highest priority among PHC accreditation programs. Originality/value The authors provide PHC accreditation benchmarks and determine high priority practical domains in accreditation standards. The findings should help health system managers and policymakers design new PHC accreditation programs and promote PHC service quality.

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