Application of “Human Factor Analysis and Classification System” (HFACS) Model to the Prevention of Medical Errors and Adverse Events: A Systematic Review

International Journal of Preventive Medicine (Int J Prev Med)2008-7802141120231218Application of “Human Factor Analysis and Classification System” (HFACS) Model to the Prevention of Medical Errors and Adverse Events: A Systematic Review111ENDepartment of Occupational Health Engineering, School of Public Health, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Occupational Health Engineering, School of Public Health, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Occupational Health Engineering, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran1- School of Occupational and Public Health, Ryerson University, Toronto, Canada20231218Hospitals, as one of most important subsectors in human societies, are responsible for providing safe and effective medical services to clients. But sometimes these hospitals are the source of injury and death in patients by creating medical errors. In this systematic review study, the application of human factor analysis and classification system (HFACS) method in the classification of medical errors was investigated. Major electronic databases including Scopus, Web of Science, and MEDLINE were searched. All studies that investigated the application of HFACS method for coding, causation, and classification of medical errors and adverse events conducted from 2001 until February 2021 were included. A total of 108 articles were found. Due to duplication, 18 studies were removed from the review list. After reading the titles and abstracts, 50 of these publications were excluded because they had objectives different from this review. The remaining 40 publications were retrieved for further assessment. Of these, 28 publications were excluded because it did not meet the inclusion criteria. Finally, 12 articles remained for the final systematic review. We found that in 65% of the selected studies, preconditions for unsafe acts have been the major causal level of medical errors and adverse events. In the majority of the studies, communication and coordination, adverse mental states, physical environment, crew resource management, and technological environment have also been recognized as the most important causal categories in this study. As a result, to prevent medical errors and adverse events, the main focus should be on controlling the preconditions for unsafe acts including personnel factors, operator conditions, and environmental factors.<span class="ej-journal-name" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">International Journal of Preventive Medicine <span id="ej-journal-date-volume-issue-pg" style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><a style="box-sizing: border-box; color: #005b92; text-decoration: none; background-color: transparent; cursor: pointer; outline: 0px;" href="https://journals.lww.com/ijom/pages/currenttoc.aspx">14():127, November 2023.</a><span style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> | <span class="ej-journal-doi" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">DOI: <span style="color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">10.4103/ijpvm.ijpvm_123_22 Corresponding Author: Dr. Habibollah DehghanE‑mail: ha_dehghan@hlth.mui.ac.irYou can also search for this author in: <a title="PubMed" href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28Habibollah+Dehghan%5BAuthor%5D%29+AND+%28Isfahan+University+of+Medical+Sciences%5BAffiliation%5D%29%29">PubMed</a> <a title="Google Scholar" href="https://scholar.google.com/citations?user=h2HUwLAAAAAJ&hl=en&oi=ao">Google Scholar</a>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2883http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2883/717718724

International Journal of Preventive Medicine (Int J Prev Med)2008-7802141120231218Seroprevalence of VZV and HSV‑2 Antibodies among Women of Childbearing Age Referring to Health Centres of Mashhad, Iran: The Need for Consideration of VZV Vaccination Program1216EN1. Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMedical Student, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDepartment of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran20231218Background: Infections with herpes simplex virus type 2 (HSV‑2) and varicella‑zoster virus (VZV) are associated with serious maternal and neonatal health consequences. The literature review reveals a research gap regarding the seroprevalence of HSV‑2 and VZV among women of reproductive age in Mashhad, Northeast of Iran. The present study aims to evaluate the seroprevalence of these viruses among a group of women in Mashhad, Iran. Methods: Sera were collected by health center personnel using a cluster sampling method from healthy women with specific age characteristics residing in three distinct socioeconomic regions of the city. The participants, aged 20–35, were divided into three groups (20–25, 26–30, and 31–35 years). The levels of VZV and HSV‑2 IgG antibodies were evaluated using commercial ELISA kits. Subsequently, the results were analyzed using SPSS software. Results: A total of 93 women were included in the study. Anti‑HSV‑2 IgG antibody was detected in 3 out of 93 participants (7.5%), while anti‑VZV IgG antibody was found positive in 80 out of 93 individuals (83.3%). The HSV‑2 positive cases were concurrently positive for the VZV antibody. There was no significant difference in the positivity of anti‑HSV‑2 and anti‑VZV antibody positivity within age groups or socioeconomic status (P > 0.05). Conclusions: The high seroprevalence of VZV among nonvaccinated participants indicates a widespread presence of the virus and underscores its potentially serious impact on community health. Therefore, it is recommended that a VZV vaccination program be considered by the health system. Furthermore, the reactivation of latent HSV‑2, whether symptomatic or asymptomatic, during pregnancy should not be disregarded as a life‑threatening threat.<span class="ej-journal-name" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">International Journal of Preventive Medicine <span id="ej-journal-date-volume-issue-pg" style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><a style="box-sizing: border-box; color: #005b92; text-decoration: none; background-color: transparent; cursor: pointer; outline: 0px;" href="https://journals.lww.com/ijom/pages/currenttoc.aspx">14():123, November 2023.</a><span style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> | <span class="ej-journal-doi" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">DOI: <span style="color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">10.4103/ijpvm.ijpvm_239_22 Corresponding Author: Dr. Majid Khadem‑RezaiyanE‑mail: Khademrm@mums.ac.irYou can also search for this author in: <a title="PubMed" href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28Majid+Khadem%E2%80%91Rezaiyan%5BAuthor%5D%29+AND+%28Mashhad+University+of+Medical+Sciences%5BAffiliation%5D%29%29">PubMed</a> <a title="Google Scholar" href="https://scholar.google.com/citations?user=WjZ3PqYAAAAJ&hl=en&oi=ao">Google Scholar</a>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2879http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2879/717718720

International Journal of Preventive Medicine (Int J Prev Med)2008-7802141120231218Evaluation of Synbiotics in the Prevention of Ventilator‑Associated Pneumonia: A Randomized, Triple‑Blind, Placebo‑Controlled Clinical Trial1721EN1- Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran2- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran, 3- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran4- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran2- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran5- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran1- Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 6- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran20231218Background: Ventilator‑associated pneumonia (VAP) is one of the most common nosocomial infections. The role of probiotics in preventing VAP is still questionable. This study aimed at evaluating the effect of synbiotic FamiLact 2plus on the prevention of VAP in patients admitted to the intensive care unit (ICU). Methods: A total of 80 mechanically ventilated patients were included and divided into two groups of 40. Group 1 received FamiLact 2plus, and group 2 received placebo. The outcome variables were compared, including the incidence of VAP, the time interval between the onset of ventilation and VAP, the duration of mechanical ventilation, and the length of stay in the ICU. Results: VAP is documented in four patients (10%) in group 1 and 11 patients (27.5%) in group 2 (P = 0.045). The length of stay in the ICU in group 1 was significantly shorter than in group 2, and the time interval between the start of intubation and the onset of VAP in group 1 was longer than in the placebo group. During the intervention, 15 patients in group 1 (37.5%) and 26 patients in group 2 (65%) developed diarrhea, which was a significant difference (P = 0.02). Conclusions: Synbiotic is associated with a reduction in the incidence of VAP as well as a reduction in ICU stay and delayed VAP.<span class="ej-journal-name" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">International Journal of Preventive Medicine <span id="ej-journal-date-volume-issue-pg" style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><a style="box-sizing: border-box; color: #005b92; text-decoration: none; background-color: transparent; cursor: pointer; outline: 0px;" href="https://journals.lww.com/ijom/pages/currenttoc.aspx">14():124, November 2023.</a><span style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> | <span class="ej-journal-doi" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">DOI: <span style="color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">10.4103/ijpvm.ijpvm_329_22 Corresponding Author: Dr. Atousa HakamifardE‑mail: atousahakamifard@sbmu.ac.irYou can also search for this author in: <a title="PubMed" href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28Atousa+Hakamifard%5BAuthor%5D%29+AND+%28Isfahan+University+of+Medical+Sciences%5BAffiliation%5D%29%29">PubMed</a> <a title="Google Scholar" href="https://scholar.google.com/citations?user=_U016y4AAAAJ&hl=en&oi=ao">Google Scholar</a>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2880http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2880/717718721

International Journal of Preventive Medicine (Int J Prev Med)2008-7802141120231218The Influence of Noise Exposure at Different Loudness Levels on EEG Index and Types of Attention2230ENDepartment of Occupational Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran1- Department of Occupational Health and Safety Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran2- Department of Occupational Health Engineering, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran3- Department of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran4- Department of Biomedical Engineering, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran6- Department of Occupational Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran20231218Bachground: Noise is one of the most important harmful factors in the environment. There are limited studies on the effect of noise loudness on brain signals and attention. The main objective of this study was to investigate the relationship between exposure to different loudness levels with brain index, types of attention, and subjective evaluation. Methods: Four noises with different loudness levels were generated. Sixty‑four male students participated in this study. Each subject performed the integrated visual and auditory continuous performance test (IVA-2) test before and during exposure to noise loudness signals while their electroencephalography was recorded. Finally, the alpha‑to‑gamma ratio (AGR), five types of attention, and the subjective evaluation results were examined. Results: During exposure to loudness levels, the AGR and types of attention decreased while the NASA‑Tax Load Index (NASA‑TLX) scores increased. The noise exposure at lower loudness levels (65 and 75 phon) leads to greater attention dysfunction than at higher loudness. The AGR was significantly changed during exposure to 65 and 75 phon and audio stimuli. This significant change was observed in exposure at all loudness levels except 85 phon and visual stimuli. The divided and sustained attention changed significantly during exposure to all loudness levels and visual stimuli. The AGR had a significant inverse correlation with the total score of NASA‑TLX during noise exposure. Conclusions: These results can lead to the design of methods to control the psychological effects of noise at specific frequencies (250 and 4000 Hz) and can prevent non‑auditory damage to human cognitive performance in industrial and urban environments.<span class="ej-journal-name" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">International Journal of Preventive Medicine <span id="ej-journal-date-volume-issue-pg" style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><a style="box-sizing: border-box; color: #005b92; text-decoration: none; background-color: transparent; cursor: pointer; outline: 0px;" href="https://journals.lww.com/ijom/pages/currenttoc.aspx">14():125, November 2023.</a><span style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> | <span class="ej-journal-doi" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">DOI: <span style="color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">10.4103/ijpvm.ijpvm_395_22 Corresponding Author: Dr. Mohammad Javad Jafari,E‑mail: mj.jafari1952@gmail. comYou can also search for this author in: <a title="PubMed" href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28Mohammad+Javad+Jafari%5BAuthor%5D%29+AND+%28Shahid+Beheshti+University+of+Medical+Sciences%5BAffiliation%5D%29%29">PubMed</a> <a title="Google Scholar" href="https://scholar.google.com/citations?user=K5q-l48AAAAJ&hl=en&oi=ao">Google Scholar</a>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2881http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2881/717718722

International Journal of Preventive Medicine (Int J Prev Med)2008-7802141120231218Content Analysis of Entrepreneurship and Employment Development Policies in Iran’s Health Sector: Is It a Health Wealth Promoter?3137EN1- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran2- Professors of Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran2- Professors of Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran3- Head of Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran20231218Context: Growing needs mandates economic growth. Entrepreneurship policies play a significant role in achieving productive employment and sustainable development for the health and wealth of society. Aims: This study is conducted to find the accordance of this document with the basic theory of the global alphabet model of entrepreneurship on the one hand and a comparison to the real entrepreneurial and economic achievements as social determinants of health (SDOH) on the other hand. Methods and Material: This research is a quantitative and qualitative content analysis of entrepreneurship documents in the health sector of Iran, using the basic theory of the global alphabet model as our target. We reviewed the Work Bank and Global Entrepreneurship Monitor (GEM) reports as world indicators to compare whether our entrepreneurship policies have been successful. Statistical Analysis: MAXQDA is a software program designed for computer-assisted qualitative and mixed methods data, text and multimedia analysis in academic, scientific, and business institutions. Results: The findings showed that the retelling of the word employment is more dominant than entrepreneurship. Imbalanced attention is paid to the components of the standard global alphabet model, and a downhill regression is seen in almost all aspects of entrepreneurial results. Conclusions: The written health policies have not been effective in promoting the development of health by wealth.<span class="ej-journal-name" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">International Journal of Preventive Medicine <span id="ej-journal-date-volume-issue-pg" style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><a style="box-sizing: border-box; color: #005b92; text-decoration: none; background-color: transparent; cursor: pointer; outline: 0px;" href="https://journals.lww.com/ijom/pages/currenttoc.aspx">14():126, November 2023.</a><span style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> | <span class="ej-journal-doi" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">DOI: <span style="color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">10.4103/ijpvm.ijpvm_43_23 Corresponding Author: Dr. Soudabeh Vatankhah,E‑mail: Vatankhah_s@yahoo.comYou can also search for this author in: <a title="PubMed" href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28Soudabeh+Vatankhah%5BAuthor%5D%29+AND+%28Iran+University+of+Medical+Sciences%5BAffiliation%5D%29%29">PubMed</a> <a title="Google Scholar" href="https://scholar.google.com/citations?user=CWgyMUwAAAAJ&hl=en&oi=ao">Google Scholar</a> http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2882http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2882/717718723

International Journal of Preventive Medicine (Int J Prev Med)2008-7802141120231218Association between Brachial Flow‑Mediated Dilation and Calcium Score in Patients with Symptomatic CAD3842ENCardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, IsfahanCardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, IsfahanCardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan1- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran20231218Background: Endothelial function plays an important role in the protection of vessels from atherosclerosis. Detection of endothelial dysfunction by non‑invasive methods (flow‑mediated dilation) and its association with other imaging modalities (calcium score in coronary computed tomography [CT] angiography) is still controversial. In this study, we aim to investigate the association between endothelial function evaluated by flow‑mediated dilation (FMD) and calcium score evaluated by coronary CT. Methods: In this cross‑sectional study, 124 patients with known coronary artery disease (CAD, positive calcium score) were enrolled. FMD as an indicator of endothelial function was evaluated in these participants. FMD less than 7.1%was considered abnormal. Correlation between calcium score and severity of calcification(calcium score above 100 considered as the cutoff point of the high score) and glow‑mediated dilation was obtained using the linear regression model. Results: The association between calcium score and FMD was strongly significant (P < 0.001). Among individuals with low calcium scores, only 15 (18.1%) had abnormal FMD findings, but the majority of individuals with high calcium scores (95.1%) had abnormal FMD findings. Conclusions: Our findings provide strong evidence of association between FMD, a marker of vascular endothelial dysfunction, and intensity of coronary atherosclerosis, as assessed by the calcium score on the CCTA.<span class="ej-journal-name" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">International Journal of Preventive Medicine <span id="ej-journal-date-volume-issue-pg" style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><a style="box-sizing: border-box; color: #005b92; text-decoration: none; background-color: transparent; cursor: pointer; outline: 0px;" href="https://journals.lww.com/ijom/pages/currenttoc.aspx">14():128, November 2023.</a><span style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> | <span class="ej-journal-doi" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">DOI: <span style="color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">10.4103/ijpvm.ijpvm_143_22 Corresponding Author: Dr. Amirreza Sajjadieh KhajoueiE‑mail: Amirrezasajjadiehkhajouei@gmail.comYou can also search for this author in: <a title="PubMed" href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28Amirreza+Sajjadieh+Khajouei%5BAuthor%5D%29+AND+%28Isfahan+University+of+Medical+Sciences%5BAffiliation%5D%29%29">PubMed</a> <a title="Google Scholar" href="https://scholar.google.com/citations?user=f5o3tRMAAAAJ&hl=en&oi=ao">Google Scholar</a>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2884http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2884/717718725

International Journal of Preventive Medicine (Int J Prev Med)2008-7802141120231218What are the Criteria and Conditions for Performing the Micronucleus Assay in Oral Exfoliated Cells from Waterpipe and Cigarette Smokers?4344ENDepartment of Biosciences, Federal University of Sao Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos ‑ 11050‑020, São Paulo20231218I read the published paper titled “Comparison of Repair Index in Cigarette and Waterpipe Smokers: A Bio‑Monitoring Assessment Using Human Exfoliated Buccal Mucosa Cells” by Jalili et al. [1] in the International Journal of Preventive Medicine. The authors demonstrated that oral micronucleated cells were increased in waterpipe smokers when compared to control and cigarette smokers. The same picture was observed in broken eggs and karyorrhexis. Karyolysis increased in the groups of waterpipe and cigarette smokers as well.<span class="ej-journal-name" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">International Journal of Preventive Medicine <span id="ej-journal-date-volume-issue-pg" style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><a style="box-sizing: border-box; color: #005b92; text-decoration: none; background-color: transparent; cursor: pointer; outline: 0px;" href="https://journals.lww.com/ijom/pages/currenttoc.aspx">14():122, November 2023.</a><span style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> | <span class="ej-journal-doi" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">DOI: <span style="color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">10.4103/ijpvm.ijpvm_120_22 Corresponding Author: Prof. Daniel A. RibeiroE‑mail: daribeiro@unifesp.brYou can also search for this author in: <a title="PubMed" href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28Daniel+A.+Ribeiro%5BAuthor%5D%29+AND+%28Department+of+Biosciences%5BAffiliation%5D%29%29">PubMed</a> <a title="Google Scholar" href="https://scholar.google.com/citations?user=v64xvPcAAAAJ&hl=en&oi=ao">Google Scholar</a>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2878http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2878/717718719