Humanistic Studies and Social Researches

Abstract Introduction: The global healthcare workforce shortage is a critical issue impacting patient care, economic stability, and healthcare access, particularly in specialties like orthopedics, anesthesiology, and nursing. In Iran, this crisis is worsened by economic sanctions, limited training opportunities, and unequal distribution of healthcare workers. This review examines the causes, impacts, and potential solutions to workforce shortages, with a focus on Iran.

Methods: A narrative review was conducted to analyze existing literature on workforce shortages in orthopedics, anesthesiology, and nursing. Sources included peer-reviewed articles, WHO reports, and national surveys. Data were synthesized to identify trends, impacts on patient care, and strategies for addressing these gaps.

Results: The shortage of orthopedic surgeons and anesthesiologists has led to delays in surgeries and worse patient outcomes, especially in underserved regions. Nursing shortages are driven by low wages, poor working conditions, and gender disparities. In Iran, sanctions restrict access to medical equipment, worsening the crisis. Additionally, healthcare workers are concentrated in urban areas, deepening the gap in rural settings. These shortages contribute to higher mortality rates, reduced care quality, and escalating healthcare costs.

Conclusion: The healthcare workforce shortage, particularly in orthopedics, anesthesiology, and nursing, presents a significant global challenge. Solutions include expanding training programs, improving working conditions, providing incentives for rural placements, and fostering international collaboration. These efforts are especially vital in countries like Iran, where external economic pressures exacerbate the issue.

Abstract Background: Parkinson's disease (PD) is a neurodegenerative disorder that affects both motor and non-motor functions, with communication impairments playing a significant role in patients' quality of life and mental health. While motor symptoms are widely addressed, difficulties in speech, language comprehension, and cognitive processing are also critical challenges. This review explores the communication difficulties faced by PD patients, the impact on daily life, and strategies to improve communication, with a particular focus on how medical treatments, including anesthesiology, influence these outcomes.
Methods: A narrative review of studies published through October 2024 was conducted using digital repositories such as PubMed, Scopus, and Web of Science. The focus was on research related to speech, language, cognitive functions, and social support for PD patients.
Results: PD patients frequently experience challenges in speech production, language comprehension, and cognitive processing, leading to diminished social interactions, isolation, and psychological distress. Medical treatments such as deep brain stimulation (DBS) and anesthesia during surgeries can further impact cognitive function and postoperative communication, necessitating careful anesthetic management. Effective strategies like augmentative and alternative communication (AAC) devices, patient-centered care, and information communication technologies (ICTs) have shown potential in improving communication. Strong social support systems and improved health literacy are also essential for enhancing well-being and treatment adherence.
Conclusion: A holistic, multidisciplinary approach that integrates personalized communication strategies, robust social support, and specialized anesthetic management can significantly improve communication abilities and the overall quality of life for individuals with Parkinson’s disease.

Abstract Introduction: Thyroid surgery has evolved significantly, with ongoing debates surrounding indications, techniques, and postoperative outcomes. Historically, total thyroidectomy was the standard approach for both benign and malignant thyroid diseases. However, more conservative methods, like thyroid lobectomy, have gained traction, especially for well-differentiated thyroid cancer (WDTC). Additionally, minimally invasive and transoral techniques are emerging as potential alternatives to improve patient outcomes and reduce scarring. This review explores these developments and examines the challenges associated with thyroid surgery, particularly postoperative complications.
Methods: This narrative review synthesizes recent literature on thyroid surgery, focusing on total thyroidectomy, thyroid lobectomy, and hemi-thyroidectomy for benign and malignant thyroid conditions. It also evaluates the impact of minimally invasive and transoral approaches, along with common postoperative complications such as recurrent nerve palsy, hypocalcemia, and hematoma, and their management strategies.
Results: Thyroid lobectomy has shown to be a safe and effective alternative to total thyroidectomy for low-risk WDTC, offering similar outcomes. Minimally invasive and transoral techniques have improved cosmetic results and reduced recovery times, though they require specialized skills. Postoperative complications, including recurrent nerve injury and hypocalcemia, remain significant but manageable with proper monitoring and early intervention.
Conclusion: Thyroid surgery has shifted toward more conservative approaches, such as thyroid lobectomy, and newer minimally invasive techniques. While these advancements offer improved patient outcomes, the management of complications remains crucial. Continued research and collaboration are key to refining surgical practices and enhancing patient care.

Abstract Background: The social determinants of health (SDOH) significantly shape the prevalence, incidence, and management of diabetes. This review examines the complex relationship between SDOH and diabetes, focusing on economic factors, education, insurance coverage, community context, physical environment, healthcare access, lifestyle factors, and key considerations in orthopedic and anesthesiology care.
Methods: A review of peer-reviewed articles and studies published over the past decade was conducted to explore how SDOH impact diabetes outcomes. The review also addresses orthopedic and anesthesiology concerns, especially related to musculoskeletal complications and anesthesia management for diabetic patients.
Results: Lower economic status, limited education, and insufficient insurance coverage are strongly linked to worse diabetes outcomes. Social and community support, including mental health resources and community programs, is crucial for diabetes self-management. The physical environment—such as access to nutritious food and safe spaces for physical activity—also influences diabetes risk. Additionally, orthopedic issues, such as diabetic neuropathy and musculoskeletal complications, and anesthesiology challenges, such as blood glucose control and cardiovascular concerns during surgery, are vital factors in the care of diabetic individuals.
Conclusion: Addressing diabetes requires a holistic, multidisciplinary approach that incorporates economic, educational, and healthcare factors, along with specialized care for orthopedic and anesthesiology needs. Policy interventions, community-based programs, and healthcare reforms are essential to improving outcomes and reducing disparities. Future research should focus on integrated strategies that incorporate SDOH into diabetes care, particularly for underserved populations.

Abstract Academic procrastination is a prevalent issue among university students, particularly those in high-stress programs like medical studies. This behavior is often associated with negative consequences such as lower academic performance, heightened stress, and a decline in psychological well-being. One promising solution to this problem involves teaching self-regulated learning (SRL) strategies, with a focus on metacognition, which encourages students to monitor, evaluate, and adjust their learning processes. This review synthesizes the body of research on the effectiveness of SRL and metacognitive strategies in reducing academic procrastination and enhancing key outcomes, including psychological well-being, academic self-efficacy, and overall academic satisfaction, particularly among medical students. The review finds that SRL and metacognitive interventions significantly improve both academic performance and mental health by helping students better manage their time, reduce procrastination, and increase motivation. By promoting greater awareness and control over their learning habits, students can overcome procrastination tendencies, leading to improved academic outcomes and greater satisfaction in their studies. The findings of this review suggest that SRL and metacognitive approaches are valuable tools in addressing procrastination and fostering more successful, well-rounded students, particularly in demanding academic environments such as medical education.

Abstract Chronic low back pain and sciatica caused by intervertebral disc herniation are among the leading causes of disability and healthcare utilization worldwide. Effective management of lumbar disc herniation is crucial, encompassing medical therapy, physiotherapy, and interventional procedures. Nucleotomy, the gold standard for decades, directly removes herniated disc material but carries risks such as infection and adjacent segment disease. Recently, percutaneous laser disc decompression (PLDD), a minimally invasive technique, has gained prominence due to its favorable safety profile, reduced recovery times, and efficacy in selected cases. PLDD employs laser energy to vaporize the nucleus pulposus, reducing intradiscal pressure and alleviating nerve compression. This review critically compares nucleotomy and PLDD, focusing on their techniques, indications, outcomes, and complications. While nucleotomy is preferred for complex herniations, PLDD is effective for smaller, contained cases, with success heavily reliant on patient selection. The integration of nutraceuticals with PLDD represents a promising innovation, enhancing neuroprotection and pain management. With a growing emphasis on minimally invasive solutions, PLDD offers a cost-effective alternative for patients seeking less invasive options. This discussion aims to guide clinicians and patients in selecting the most appropriate treatment while exploring advancements shaping the future of spinal care.

Abstract aim: This review explores the effectiveness of anxiety prevention education for adolescent service recipients in healthcare centers.

Methods: A comprehensive literature review was conducted, synthesizing evidence from systematic reviews, meta-analyses, and randomized controlled trials (RCTs) focusing on anxiety prevention education. Studies were retrieved from databases such as PubMed, PsycINFO, Scopus, and Google Scholar using relevant keywords. Selected studies assessed the effectiveness of psychoeducational interventions, cognitive-behavioral techniques (CBT), and stress management strategies in reducing adolescent anxiety.

Results: Evidence indicates that structured anxiety prevention programs, particularly those integrating psychoeducation and CBT, effectively reduce anxiety symptoms and enhance coping skills among adolescents. School-based interventions have shown significant short-term benefits, with some effects persisting for up to a year. However, research on healthcare-based interventions remains limited. Primary healthcare centers, as accessible and community-trusted institutions, have the potential to provide a structured and sustainable approach to anxiety prevention. Challenges such as mental health stigma, resource constraints, and limited training of healthcare professionals must be addressed to optimize program implementation.

Conclusion: Integrating anxiety prevention education into healthcare centers in Sari County presents a promising strategy for reducing adolescent anxiety and promoting mental well-being. By leveraging existing healthcare infrastructure and adopting evidence-based interventions, these programs can offer scalable and cost-effective solutions. Policy support, professional training, and community engagement are essential for ensuring the long-term success of such initiatives. Future research should focus on assessing the sustained impact of healthcare-based interventions and developing culturally adapted models tailored to the needs of Iranian adolescents.