Overview of oral health status and associated risk factors in maritime settings: An updated systematic review

OBJECTIVES

The aim of this study is to provide an updated overview of the oral health status and associated risk factors in maritime settings.

METHODS

We systematically searched PubMed, Ovid Embase, Web of Science, CINAHL and SCOPUS from January 2010 to April 2023. Two independent reviewers extracted the data. The quality of included studies was assessed using relevant assessment tools.

RESULTS

A total of 260 records were found in the initial search; 24 articles met the inclusion criteria. Most studies had descriptive design, and only two randomized controlled trials were found. The main oral health issues noted are oral cancer, dental caries, periodontal diseases, oral mucosal lesions, and dental emergency. Male seafarers have higher risk of oral cancers in the tongue, lips, and oral cavity while oral mucosal lesions are more prevalent among fishermen.

CONCLUSIONS

Dental caries and periodontal diseases are prevalent in both seafarers and fishermen. The consumption of tobacco, alcohol, fermentable carbohydrate, and poor oral hygiene are risk factors that affect the oral health status at sea. The occurrence of oral diseases in maritime setting requires more attention of researchers and authorities to develop strategies to tackle these issues.

TRIAL REGISTRATION

Systematic review registration number in PROSPERO: CRD42020168692.

Economic Sanctions Affecting Household Food and Nutrition Security and Policies to Cope With Them: A Systematic Review

BACKGROUND

This review was conducted to identify the impact of economic sanctions on household food and nutrition security and policies to cope with them in countries exposed to sanctions.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines 2020 were used to identify, select, appraise, and synthesize studies. Electronic databases in addition to Persian ones have been systematically searched for all related documents published until March 2022. Exclusion criteria were: lack of data related to food insecurity in countries subject to sanction and very low quality of the article. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal checklists. The results were presented as qualitative and quantitative syntheses.

RESULTS

Of 1428 identified studies, 36 publications remained in the review, which belong to Iran (n=8), Cuba (n=8), Russia (n=7), Iraq (n=7), and Haiti (n=6), respectively. Declining gross domestic product (GDP), devaluation of the national currency, and the quality of food, increase in inflation, unemployment, and consumer prices, infant and under 5 years mortality, energy, and protein deficiency, and the poverty rate were reported as sanction consequences. The most important strategies to improve food security were the humanitarian assistance provided by the international community (Haiti), equity and priority for vulnerable groups mainly by expanding the healthcare system (Cuba), adopting a food ration system in the oil-for-food program, and fixing the price of food baskets (Iraq), import substitution and self-sufficiency (Russia), support domestic production, direct and indirect support and compensation packages for vulnerable households (the approach of resistance economy in Iran).

CONCLUSION

Due to the heterogeneity of studies, meta-analysis was not possible. Since inadequate physical and economic food access caused by sanctions affects especially disadvantaged and vulnerable groups, planning to improve food security and providing support packages for these groups seems necessary.

A qualitative study of Covid-19 effects on nutrition associated problems in recovered patients

BACKGROUND

World is currently challenging with Covid-19 pandemic. Nutritional status is a determinant factor in the treatment process and recovery for patients with Covid-19. Although a limited data is available about the effects of nutrition on this disease. Therefore, the aim of this study was to identify nutritional problems in patients recovering from Covid-19 before, during and after the disease.

METHODS

This qualitative descriptive study was carried out based on the specified inclusion criteria through targeted sampling of 45 patients recovered from Covid-19, 2021-2022. In-depth semi-structured individual interviews were used to collect data. Interviews were recorded, transcribed and analyzed using qualitative content analysis method and MAXQDA Software.

RESULTS

Based on the participants' description of this stage, it can be reported that most of the individuals who were infected had no specific symptoms. Nutrition-linked problems in the main stage of the disease included troubles in tolerating foods and nutrition (e.g., fatty and solid foods), highly consumed foods in the main stage of the disease (e.g., beverages), individuals' approaches to improve nutritional challenges (e.g., consumption of herbal teas and soft texture foods) and using supplements. The patients stated fewer nutritional problems after recovering from the disease. The most significant change included their desire to eat solid foods such as rice, bread, pasta and fast foods.

CONCLUSION

appropriate nutrition with medication can help accelerate the recovery process of the patients, especially hospitalized patients with further severe degrees of the illness.

The effects of subsidies on foods in Iran: A narrative review

Background

Subsidy payments are used to support low-income groups and may improve income distribution and increase social welfare. The food subsidy programs and their long-term effects have been considered as major developmental issues in many developing countries. This review study aimed to examine the effects of subsidies on the food and nutritional status of Iranian people.

Methods

English and Persian language databases were searched using related keywords to discover studies on the effects of subsidies on food and nutritional status in Iran. A manual search was also conducted encompassing national and local research projects in Iran. In total, 12 articles were finally included out of an initial total of 70 studies.

Results

Subsidy payment affects many socio-economic variables. In Iran, subsidies are often paid for the basic goods and commodities that are a main part of the consumption patterns of most Iranian people. So, if the basic needs of the people are not well-understood, changes in economic structures may lead to a change in consumption patterns. In addition, physical payments for food may lead to an increase in the consumption of different groups, but cash payments do not necessarily lead to an increase in food intake.

Conclusion

The method of payment should be chosen correctly to improve the protection of vulnerable populations. The distribution of targeted subsidies for food security is inevitable due to limited resources available to support vulnerable populations.

Why has the taxing policy on sugar sweetened beverages not reduced their purchase in Iranian households?

Objective

This study aimed at analyzing the effectiveness of the policy of taxing Sugar-Sweetened Beverages (SSBs) on their purchases during the last decade in Iranian households.

Methods

The present mixed method study was done in 2017 in four phases: (1) A meta-review of the fiscal policies during the last decade, (2) Collecting existing data on soft drinks' production, price, and household expenditure during the last decade, (3) Conducting 19 semi-structured interviews with key informants, and (4) Facilitating a national meeting to achieve a consensus on the recommendations and future implications.

Results

Document reviews showed that based on the Permanent Provisions of National Development Plans of Iran, the Ministry of Health and Medical Education (MOHME) should announce the list of health threatening products to increase taxation for them. The government is allowed to impose taxes on domestically produced and imported SSBs. The average household expenditure on SSBs increased in the rural and urban households of Iran during 2006-2016 in spite of taxation. In the different key informants' opinion, only value-added tax (VAT) was implemented among different fiscal policies, and the other parts, including tax and tolls were debated.

Conclusion

The present research findings further proposed some suggestions for increasing the effectiveness of financial policies in reducing the prevalence of NCDs in Iran.

The Viewpoints of Hospitalized Patients with Cancer Regarding Their Nutritional Challenges in Hospital: A Phenomenological Study

Background: Complications of anti-cancer therapies can lead to inadequate nutrient intake, indigestion and deficiency of nutrients. The present study aims to better understand the nutritional challenges of hospitalized patients with cancer. Methods: The participants were patients referred to the oncology ward of the hospital who were selected by the maximum diversity sampling of patients with various cancers. Semi-structured interviews were conducted to collect data and continued until data saturation with 20 participants. Inductive content analysis was applied to interpret data using MAXQDA 2018 software. Results: The views of hospitalized patients with cancer regarding the nutritional complications were explored in four main themes, including "Inefficiency in patient food management”, “The need for care and support of the treatment team”, “Problems due to the consequences of the disease”, “Patients' strategies in conditions of dissatisfaction with the hospital food environment”. The sub-themes included "Dissatisfaction with the hospital food environment”, “Neglect of patients' specific conditions”, “Problem with the characteristics of hospital food”, “Uncertainty of the responsible person/people”, “Lack of continuous communication between the treatment team and patients”, “Patients’ need to consult with the treatment team”, “Patients’ concerns”, “Disease side-effects”, “Chemotherapy side effect”, and “Dissatisfaction of food and environment". Conclusion: It is necessary to obtain a comprehensive understanding of patients' needs by a treatment team, including physicians, nurses, and nutritionists by establishing appropriate communication with the patients and nutrition education from the time of diagnosis and treatment.

Role of Traffic Light Labeling on Point of Purchase Behaviors: A Systematic Review

Background: Traffic Light Labeling (TLL) system is a simple tool to communicate information regarding the nutrients content of food products and has been widely applied to promote public health. However, evidence on the effectiveness of the TLL system on consumers’ choices is conflicting. The present study aims to systematically summarize the effects of TLL on consumers’ point of purchase behaviors. Methods: Five electronic databases, including PubMed/Medline, Scopus, Web of knowledge, the Cochrane library, and Science direct were searched from 2000/01/01 to 2021/11/01. Randomized-controlled trials, in English or Farsi languages, investigating the effects of TLL on choosing healthier foodstuffs or beverages were examined for eligibility and included in the review. Of 6408 potentially relevant publications (including 1255 duplicates), five clinical trials were finally included in the study. Results: The duration of the interventions ranged from 4 to 12 weeks and all studies except one had high methodological quality. Out of 5, three clinical trials did not show positive effects of TLL on customers' choices to purchase healthier food products. Conclusions: The present review showed that TLL without other public health-promoting interventions may have no substantial effects on consumer’s food choice.