Iranian Journal of Public Health http://ijph.tums.ac.ir/index.php/ijph en-US ijph@tums.ac.ir (Prof. Dariush D.Farhud) journals@tums.ac.ir (TUMS Technical Support) Sun, 07 Oct 2018 11:05:44 +0330 OJS 3.1.1.1 http://blogs.law.harvard.edu/tech/rss 60 Effects of Rock Climbing Exercise on Physical Fitness among College Students: A Review Article and Meta-analysis http://ijph.tums.ac.ir/index.php/ijph/article/view/14904 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> The aim of this study was to systematically determine the effects of rock climbing on College Students’ physical fitness by means of Meta-analysis.</p> <p><strong>Methods:</strong> Studies investigated the possible fitness benefits of rock climbing were identified through a computerized search of six electronic databases: China National Knowledge Infrastructure, China Science Periodical Database, PubMed, Web of Science, SPORTDiscus and PsycINFO. Effects of rock climbing exercise intervention trials <u>&gt;</u>4 wk, published in English and Chinese between Jan 1996 and May 2016, including between subject and within subject designs, were reviewed. Nine studies were included in this meta-analysis. Ten selected variables in this meta-analysis were: Body fat percentage, VO<sub>2</sub>max, Heart rate, Handgrip strength, Lower limb pedaling power, Vertical Jump, Push-Ups, Pull-Ups, Sit-Ups, and Sit-and-reach. The effect sizes of these ten variables were calculated (<em>P</em>&lt;0.05) and forest plots along with effective sizes were presented.</p> <p><strong>Results:</strong> Rock climbing can significantly improve Handgrip strength, Lower limb pedaling power, Vertical Jump, Push-Ups, Pull-Ups, Sit-Ups and Sit-and-reach (<em>P</em>&lt;0.01), and significantly increase VO<sub>2</sub>max (<em>P</em>&lt;0.05), however, rock climbing did not show significant improvement on Heart rate and Body fat percentage.</p> <p><strong>Conclusion:</strong> As a newly popular physical exercise, rock climbing has a significantly positive impact on the physical fitness among college students. Rock climbing may be more effective if the college students engage in it for a longer term.</p> <p>&nbsp;</p> Lun LI, An RU, Ting LIAO, Shisi ZOU, Xiao Hong NIU, Yong Tai WANG ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14904 Sat, 06 Oct 2018 00:00:00 +0330 Next Generation Sequencing in Clinical Oncology: Applications, Challenges and Promises: A Review Article http://ijph.tums.ac.ir/index.php/ijph/article/view/14905 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> The aim of this mini-review is to highlight the potential applications of next-generation sequencing technology to the field of clinical oncology with respect to genetic diagnosis, cancer classification, predictive biomarkers and personalized medicine.</p> <p><strong>Methods:</strong> Scientific databases were searched to collect relative data.</p> <p><strong>Results:</strong> Effective systematic analysis of whole-genome sequence and whole-exome sequence of tumors, targeted genome profiling, transcriptome sequencing and tumor- normal comparisons can be performed using NGS in order to diagnosis of several types of cancer.</p> <p><strong>Conclusion:</strong> NGS technology can be powerful enough to discover new and infrequent gene alterations, identify hereditary cancer mutation carriers and provide a reliable molecular portrait of wide range of cancers in a quick and cost-effective manner.</p> <p>&nbsp;</p> Faezeh SHABANI AZIM, Hamidreza HOURI, Zohreh GHALAVAND, Bahram NIKMANESH ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14905 Sat, 06 Oct 2018 00:00:00 +0330 The History of Trachoma and Current Prevalence (Spotlight on Iran): A Review Article http://ijph.tums.ac.ir/index.php/ijph/article/view/14907 <p>&nbsp;<strong>Background:</strong> Trachoma as a common cause of infectious blindness is caused by <em>Chlamydia trachomatis</em>. This study aimed to review the available data from variety of sources and provide an overview of the epidemiological situation of Trachoma in Iran focused on the past seventy five years.</p> <p><strong>Methods:</strong> A literature search of English and Farsi articles regarding trachoma in Iran from the electronic databases and paper documents was performed. Original articles, case reports and letters were included.</p> <p><strong>Results:</strong> By the early and mid-20<sup>th</sup> century, trachoma was widely endemic with the prevalence rate of more than 60% in Iran. Currently, trachoma prevalence is significantly lower than in the past and the elimination of trachoma is achievable in the near future. The decline in active disease is mainly attributed to improvement of socio-economic situation and personal and environmental hygiene rather than targeted interventions for epidemic control.</p> <p><strong>Conclusion:</strong> Elimination of trachoma in Iran is achievable. However, trachoma prevalence estimation is required to be interpreted with some caution. Uncertainty around these estimates is partly because of the mismatch between the presence of infection and clinical findings.</p> <p><strong>&nbsp;</strong></p> <p>&nbsp;</p> Gholamhossein YAGHOOBI, Gholamreza ANANI SARAB ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14907 Sat, 06 Oct 2018 00:00:00 +0330 Oral Health Impact Profile and Associated Variables in Southern Brazilian Drug Users http://ijph.tums.ac.ir/index.php/ijph/article/view/14908 <p><strong>Background:</strong> This study investigated the association between sociodemographic, behavioral, oral health, variables of drug consumption, and the short version of the Oral Health Impact Profile (OHIP-14), in Southern Brazilian drug users.</p> <p><strong>Methods:</strong> In this cross-sectional study, 202 drug users aged 18 or over admitted for treatment at the Institute for Research and Treatment of Alcoholism (<em>Instituto de Pesquisa e Tratamento do Alcoolismo </em>-IPTA) from the municipality of Campo Largo, PR, Brazil, from 2012 to 2014, were involved. They answered a questionnaire and were examined by a calibrated researcher. Data were collected and bivariate (Chi-square test) and multivariate (logistic regression and Wald’s test) analyses were performed.</p> <p><strong>Results:</strong> There was statistical difference (<em>P</em>&lt;0.05) in bivariate analysis and the worst impacts were reported by non-whites, those who reported feeling metallic taste in mouth and tooth mobility, which use cigarettes for over 15 yr and consume more than 3 g of crack/day, with DMFT &gt;10, and number of teeth in mouth ≤27. In the multivariate analysis, statistical difference remained, except for ethnicity (<em>P</em>=0.207).</p> <p><strong>Conclusion:</strong> Self-perception of oral health was associated with the variables explored, which suggests the need for strategies focused on this population.</p> <p><strong>&nbsp;</strong></p> <p>&nbsp;</p> Susan Jaccoud Ribeiro DE SOUZA, Andrea de Castro DOS SANTOS, Milena Binhame ALBINI, Marilisa Carneiro Leão GABARDO, Antonio Adilson Soares DE LIMA, Maria Ângela Naval MACHADO ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14908 Sat, 06 Oct 2018 00:00:00 +0330 Exploring the Association between Parental Factors and Age of Onset of Alcohol and Tobacco’s Using http://ijph.tums.ac.ir/index.php/ijph/article/view/14909 <p><strong>Background:</strong> There are few reports about relationship between parents’ age of onset of substance use and their children’s age of onset. The aim of this study was to explore the association between parents’ age of onset of substance use and that of their children, the influence of parents’ factor on their children’s age of onset of substance use.</p> <p><strong>Methods:</strong> Overall, 2036 Chinese college students from ten universities in five cities were assessed for their alcohol and tobacco’s use, and they reported on their parents’ alcohol and tobacco’s use, their parents’ attitudes towards their substance use and their parental education level. Among current substance users, multiple regression analyses were used to test whether their parents’ age of onset of substance use and their parents’ attitudes towards their substance use predict their age of onset of substance use.</p> <p><strong>Results:</strong> Parents of children who used substances earlier showed significantly more tolerance towards their children’s substance use than parents of children with a later onset of substance use. Among current substance users, their parents’ age of onset of substance significantly predicted children’s age of onset. The parents’ attitudes had a significant impact on their children’s age of onset of substance use.</p> <p><strong>Conclusion:</strong> Parental factors (attitudes towards their children’s substance use and parents’ age of onset of substance use) are related to age of onset and substance use in children. Prevention program for parents is necessary, especially for those parents who have a tolerant attitude towards their children’s substance use.</p> <p>&nbsp;</p> Zhuo Li TAO, Yi LIU ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14909 Sat, 06 Oct 2018 00:00:00 +0330 The Prevalence of Lymphatic Filariasis in Elementary School Children Living in Endemic Areas: A Baseline Survey Prior to Mass Drug Administration in Pekalongan District-Indonesia http://ijph.tums.ac.ir/index.php/ijph/article/view/14910 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> WHO initiated lymphatic filariasis (LF) elimination globally. Pekalongan District, as LF endemic area, started a program of mass drug administration (MDA) to combat LF in 2015. This study aimed to determine prevalence of <em>Wuchereria bancrofti</em> infection prior to the MDA.</p> <p><strong>Methods:</strong> LF infection was detected by the existence of circulating filarial antigen (CFA) <em>W. bancrofti </em>using immunochromatographic card test (ICT). The study population consisted of 1404 elementary school (ES) students living in Pekalongan District. Overall, 1033 were selected as study subjects. Prevalence survey was also conducted on 436 general population in areas where infected students were found.</p> <p><strong>Results:</strong> The subjects ranged from 7-17 yr old (mean 9.85±1.296) and equally distributed between both sexes. Prevalence of <em>W. bancrofti </em>infection was 1.98% in children. Infection was mostly found in older students (12 yr old), male, in 6th grade, but did not differ significantly (<em>P</em>=0.129, 0.376, and 0.212 respectively). On the other hand, distribution of infection was significantly different by school (<em>P</em>=0.009) and sub-district (<em>P</em>=0000). Most of children with LF infection were found in Tirto Sub District. In general population, the prevalence of <em>W. bancrofti </em>infection in Tirto was 4.4%. Proportion of infection in males (12.2%) was greater than females (3.8%), with 78.9% of positive cases were in adult over 20 yr old.</p> <p><strong>Conclusion:</strong> Cases of <em>W. bancrofti </em>infection exist in Pekalongan District, both in children and adults. Implementation of MDA must be carefully monitored in order to achieve elimination target.</p> <p>&nbsp;</p> Praba GINANDJAR, Lintang Dian SARASWATI, Dedy SUPARYANTO, Mateus SAKUNDARNO, Taniawati SUPALI ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14910 Sat, 06 Oct 2018 00:00:00 +0330 Analysis of the Factors Influencing Enterprise and Government Participation in the Medicines Patent Pool Based on System Dynamics Model http://ijph.tums.ac.ir/index.php/ijph/article/view/14911 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> The participation of enterprises and governments in the Medicines Patent Pool (MPP) improves the disease management levels by enhancing the accessibility of medical resources. Non-participation of the stakeholders restricts the development of the MPP. Hence, systematic analysis of the key factors influencing MPP participation is necessary.</p> <p><strong>Methods:</strong> A system dynamics model of the market before and after enterprises and governments join the MPP was constructed by considering the economic benefits of both stakeholders. The effects of generic drug prices, royalty rates, pooling subsidies, and enterprise scale on the relevant benefit difference were analyzed. Data from the China Medical and Economic Network for the period 2003-2016, as well as the 2017 annual report of Celgene Corporation, were used as test data.</p> <p><strong>Results:</strong> The proper pooling subsidy coefficient ranges between 0.05 and 0.08 when the generic drug price ratio and royalty rate are lower than 36% and 34%, respectively. These factors could enhance the willingness of both stakeholders to join the MPP. Initial R&amp;D investments and the relative drug patent intensity of enterprises respectively exert positive and negative impacts on their willingness to join the MPP.</p> <p><strong>Conclusion:</strong> To encourage stakeholders to join the MPP, generic drug prices should be lowered, license fees and subsidies should be adjusted appropriately, and the R&amp;D scale and strength of original drug enterprises should be taken into account. The research results provide a reference for formulating the rules of MPP and other policies aiming to facilitate the sharing and innovation of medical resources.</p> <p>&nbsp;</p> <p>&nbsp;</p> Jinjing ZENG, Wende ZHANG, Qingming TANG ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14911 Sat, 06 Oct 2018 00:00:00 +0330 Computer Game Addiction and Loneliness in Children http://ijph.tums.ac.ir/index.php/ijph/article/view/14912 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> We aimed to determine the level of computer game addiction and loneliness among 9-10-yr-old children.</p> <p><strong>Methods:</strong> The study was conducted with 4<sup>th</sup>-grade students at a primary school, located at the city center, during 2017-2018 academic years. There was no sampling in the research, all 4<sup>th</sup>-grade students of the school were reached. “Personal Information Form”, “Computer Game Addiction Scale” and “UCLA Loneliness Scale” were used for collecting data. Mann Whitney U test, Kruskal Wallis test, and Correlation Analysis were used to evaluate the data of the research.</p> <p><strong>Results:</strong> 50.7% (n=104) of the students were female, most frequent number of sister/brother was one 39.0% (n=80), both their mother 31.7% (n=65) and their father 34.1% (n=69) were mostly high school graduated. The average scores that students got from the scales were; 48.66±.27.02 (min.: 21.00, max.: 105) for “Computer Game Addiction Scale” and 40.55±8.50 (min: 22.00, max.: 64) for “UCLA Loneliness Scale”. A weak, positive and significant relationship was found between students’ loneliness scale scores and computer game addiction scale scores (r=0.357; <em>P</em>&lt;0.000).</p> <p><strong>Conclusion:</strong> A significant relationship was found between students’ computer game addiction and loneliness. It is suggested to perform children’s loneliness and computer game addiction assessments, evaluate effectiveness and establish a rehabilitating treatment system among school-hospital-family for abnormal cases.</p> <p>&nbsp;</p> Hülya KÖK EREN, Özlem ÖRSAL ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14912 Sat, 06 Oct 2018 00:00:00 +0330 Influence of Nursing Intervention on Recurrent Vulvovaginal Can-didiasis Patients Treated with ATP-infrared Bio-effect Technique http://ijph.tums.ac.ir/index.php/ijph/article/view/14913 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> We aimed to investigate the influence of nursing intervention on recurrent vulvovaginal candidiasis (RVVC) patients treated with adenosine triphosphate (ATP)-infrared bio-effect technique.</p> <p><strong>Methods:</strong> Sixty eight RVVC patients of Women &amp; Children’s Health Care Hospital of Linyi were randomly divided into intervention group (n=34) and control group (n=34) from to June, 2016 to June 2017. Patients in intervention group received the one-to-one intervention based on ATP-infrared bio-effect technique; the individualized nursing intervention program was developed. Patients in control group were treated with routine nursing for vaginitis and follow-up. The intervention effect was evaluated via clinical efficacy and MOS 36-item short-form health survey (SF-36) scale.</p> <p><strong>Results:</strong> After the total course of treatment, there was significant difference in the cure rate between the two groups of patients (<em>P</em>&lt;0.05). 1 month after all courses of treatment, the scores of physical functioning (PF), mental health (MH), vitality (V) and bodily pain (BP) in intervention group were higher than those in control group, displaying statistically significant differences (<em>P</em>=0.029; <em>P</em>=0.049; <em>P</em>=0.042; <em>P</em>=0.039, respectively). 6 months after the total course of treatment, the score of each dimension in intervention group was higher than that in control group during the same period (<em>P</em>&lt;0.01).</p> <p><strong>Conclusion:</strong> Nursing intervention can increase the cure rate, change the adverse cognition and improve the quality of life of RVVC patients treated with ATP-infrared bio-effect technique.</p> <p><strong>&nbsp;&nbsp; </strong></p> <p><strong>&nbsp; Keywords:</strong> Nursing intervention, ATP-infrared bio-effect technique, Recurrent vulvovaginal candidiasis, Quality of life</p> <p>&nbsp;</p> Wenxiang * LI ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14913 Sat, 06 Oct 2018 00:00:00 +0330 The Clustering of World Countries Regarding Causes of Death and Health Risk Factors http://ijph.tums.ac.ir/index.php/ijph/article/view/14914 <p><strong>Background:</strong> We aimed to determine how many clusters, WHO member countries would be grouped based on the causal rates of disease-specific deaths and preventable risk factors, and evaluated the cluster memberships using some sociodemographic and socioeconomic factors.</p> <p><strong>Methods:</strong> We constructed a dataset relating to 146 WHO countries using reports and some official websites. An explanatory factor analysis was implemented to reveal the underlying patterns of the dataset. The Ward Hierarchical clustering method and gap statistical analyses were used to group countries that have similar causes of death. Clusters were then compared using subgroup analysis based on some socioeconomic and sociodemographic indicators.</p> <p><strong>Results:</strong> We divided 146 countries into six meaningful clusters. In a comparative analysis, the differences between clusters were found to be statistically significant according to disease-specific causes of death, risk factors, socioeconomic, and sociodemographic indicators (<em>P</em>&lt;0.001).</p> <p><strong>Conclusion:</strong> Income levels, expenditure rates on health, educational levels, and causes of death in a country are directly proportional to one another. Furthermore, it was surprising that the country clusters regarding causes of death and health risk factors showed regional distributions.</p> <p>&nbsp;</p> Selen YILMAZ IŞIKHAN, Dilek GÜLEÇ ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14914 Sat, 06 Oct 2018 00:00:00 +0330 Correlation Analysis between Helicobacter pylori Infection Sta-tus and Tumor Clinical Pathology as Well as Prognosis of Gas-tric Cancer Patients http://ijph.tums.ac.ir/index.php/ijph/article/view/14915 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> We aimed to investigate the correlation between <em>Helicobacter pylori</em> infection and the development and prognosis of gastric cancer.</p> <p><strong>Methods:</strong> Retrospective analysis was used to collect 120 paraffin-embedded specimens and 42 paracancerous specimens of gastric cancer patients archived in Department of Pathology, Weihaiwei People’s Hospital from 2010-2012. All patients with gastric cancer were followed for 5 years. Real-time fluorescent quantitative PCR was used to detect the relative <em>H. pylori</em> infection in gastric cancer tissues and paracancerous tissues. The relationship between clinicopathological parameters and <em>H. pylori</em> relative infection was analyzed. Kaplan-Meier was used for survival analysis.</p> <p><strong>Results:</strong> The relative amount of <em>H. pylori</em> infection in gastric cancer tissues was significantly higher than that in paracancerous normal tissues (<em>P</em>&lt;0.001). The relative <em>H. pylori</em> infection was related to tumor size, lymph node metastasis, clinical stage, and depth of invasion (<em>P</em>&lt;0.05). The 1-, 3-, and 5-year survival rates of gastric cancer patients were negatively correlated with the relative <em>H. pylori</em> infection. The relative <em>H. pylori</em> infection, age, tumor size, lymph node metastasis, distant metastasis, clinical stage and depth of invasion were positively correlated with the prognosis of patients with gastric cancer.</p> <p><strong>Conclusion:</strong> The relative <em>H. pylori</em> infection and clinical stage of patients could increase the risk of death in gastric cancer patients. <em>H. pylori</em> is one of the independent risk factors for the progression and prognosis of gastric cancer. It is also an index to evaluate the development process and prognosis of gastric cancer.</p> <p>&nbsp;</p> Jing WANG, Xiaofeng LIU ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14915 Sat, 06 Oct 2018 00:00:00 +0330 On the Frontline: Exploring the Perceptions of Lahore’s Inner-city School Teachers Regarding Children Problems http://ijph.tums.ac.ir/index.php/ijph/article/view/14916 <p><strong>Background:</strong> We aimed to explore inner city school teachers’ perceptions of problems faced in schools, it causes and role of schools and teachers in promoting child social and emotional well-being, using qualitative approach.</p> <p><strong>Methods:</strong> Following ethical approval and informed consent, In-depth interviews were conducted in 2017 with twenty teachers belonging to four private schools in inner city area of Provincial capital, Lahore, Pakistan. Inclusion criteria were at least 12 years of formal education and minimum of 5 years’ experience in teaching profession. Framework Analysis was used to analyze data.</p> <p><strong>Results:</strong> Teachers identified learning problems, inattention, disobedience, aggression, lying &amp; disrespect as the most commonly encountered problems of children, with very few teachers mentioning emotional difficulties. Teachers view the family, parenting practices and home environment alongside media (in particular social media) as being the main causes of child behavioral problems. With prompts, however, they did identify various school and teacher-related factors having negative impact on children. Fair conceptualization of good school and good teacher was observed. Need for teacher awareness and training for strategies promoting child emotional and social wellbeing was highlighted.</p> <p><strong>Conclusion:</strong> As perceived by teachers, children studying in inner city schools have several behaviour problems. Study results and the gaps identified will help in ensuring that teachers receive training targeted towards their needs. Findings of the study also substantiate the need for targeting whole school-wide preventive approach as efforts begin to implement school mental health initiative in Pakistan.</p> <p><strong>&nbsp;</strong></p> <p>&nbsp;</p> Nazish IMRAN, Atif RAHMAN, Nakhshab CHAUDHRY, Aftab ASIF ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14916 Sat, 06 Oct 2018 00:00:00 +0330 Application of Doctor-Nurse-Patient Integration Management Mode in Patients with Endometriosis http://ijph.tums.ac.ir/index.php/ijph/article/view/14917 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> To investigate the effect of applying doctor-nurse-patient integration management mode to patients with endometriosis (EMT).</p> <p><strong>Methods:</strong> A total of 160 patients with EMT from the Department of Neurology of The Fifth Affiliated Hospital Sun Yat-Sen University from January 2017 to October 2017 were selected. They were divided into control group and experimental group according to the time sequence of hospitalization, with 80 patients in each group. The traditional nursing management mode was implemented in the control group, and doctor-nurse-patient integration mode was implemented in the experimental group. The psychological status, quality of life, and satisfaction of the 2 groups of patients were compared one year after surgery.</p> <p><strong>Results:</strong> The anxiety and depression scores in the observation group were (41.89±7.50) and (42.40±7.40) points, respectively, and those in the control group were (57.55±9.68) and (55.00±9.35) points, respectively. The differences between the two groups were statistically significant (<em>t</em>=-11.44, -9.42, <em>P</em>&lt;0.05). The improvement rate of quality of life (sleep, work and sexual life) in the observation group was 87.5%, which was higher than that in the control group (63.8%). The difference between the 2 groups was statistically significant (U=583, <em>P</em>&lt;0.01). The satisfaction rate in the observation group was 90.00%, which was higher than that in the control group (78.75%) (U=592.00, <em>P</em>&lt; 0.01).</p> <p><strong>Conclusion:</strong> The doctor-nurse-patient integration management mode can effectively improve the negative psychological status and quality of life of patients with EMT and improve patient satisfaction, which is worth popularizing.</p> <p>&nbsp;</p> Yao CHEN, Zhihuai MO, Jianyong CAO, Zhaojuan SU, Yuexia ZHANG, Fang CHEN, Jianying WANG ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14917 Sat, 06 Oct 2018 00:00:00 +0330 A Description of the Temporal Pattern of Out-of-Pocket Expenditure Related to Iranian Healthcare Services during 1995-2014 http://ijph.tums.ac.ir/index.php/ijph/article/view/14919 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> Out-of-pocket (OOP) expenditure directly impacts on poverty and household welfare, especially when there is a decline in healthcare financing. This study was aimed to describe the temporal pattern of OOP expenditures related to Iranian healthcare services during 1995-2014.</p> <p><strong>Methods:</strong> For describing the trend of OOP spending in Iran, the database of the World Bank was mined for the period under study. Further, the trend analysis has been complemented by an exhaustive and comprehensive review of the extant literature.</p> <p><strong>Results:</strong> From 1995 to 2014, out-of-pocket decreased from 53.59% to 47.8% of the total health expenditure, probably because of the different health reforms implemented throughout the years. However, out-of-pocket expenditure in Iran remains higher than the world average (roughly 3 times higher)</p> <p><strong>Conclusion:</strong> It is an onus of the Iranian government to make serious attempts in order to reduce out-of-pocket expenditure, as well as to protect particularly poor and vulnerable subjects against catastrophic health expenditure. In order to ensure an equitable and affordable access to the healthcare system, decision- and policy-makers in Iran should implement a review of health care costs, insurance tariffs, and healthcare services packages covered by insurance organizations as well as introduce a progressive tax-based financing scheme as soon as possible.</p> <p><strong>&nbsp; </strong></p> Masoud BEHZADIFAR, Tina BEYRANVAND, Mehdi JAFARI, Meysam BEHZADIFAR, Masood TAHERI MIRGHAED, Mariano MARTINI, Nicola Luigi BRAGAZZI ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14919 Sat, 06 Oct 2018 00:00:00 +0330 Prevalence and Costs of Complementary/Alternative Medicine among Traumatic Patients in Iran: A Nationwide Population-based Study http://ijph.tums.ac.ir/index.php/ijph/article/view/14920 <p><strong>&nbsp;Abstract</strong></p> <p><strong>Background:</strong> This study was aimed to determine the prevalence, predictors and cost of CAM practitioner use among traumatic patients in Iran.</p> <p><strong>Methods:</strong> This cross-sectional household survey of a nationally representative sample of Iranians 15 to 64 yr old was conducted in 2011, using a three-stage cluster sampling. Short Form Injury Questionnaire 7 (SFIQ7) was utilized through face-to-face interviews and data on demographics, history of injuries, mechanism, site and type of injury, type and place of the treatment were attained. Via telephone calls, service use and costs of treatment were also collected.</p> <p><strong>Results:</strong> The prevalence of CAM practitioner use in injured people and victims seeking medical care was 0.7% and 4.1%, respectively in 3-month interval in 2011. There were no significant sociodemographic differences between victims who seek unconventional settings and those who seek conventional treatment. The most common injury description treated by CAM providers was as follows: fracture (type of injury), upper limb (site of injury), fall (mechanism of injury) and cast, splint, and physiotherapy (type of treatment). The average medical cost of CAM practitioner was US$14.7 while this amount in the conventional setting was US$195.5.</p> <p><strong>Conclusion:</strong> Use of CAM is not very common among injured people in Iran. However, due to lack of formal training, CAM usage has possible side effects.</p> <p>&nbsp;</p> <p>&nbsp;</p> Mohammad Hosein KALANTAR MOTAMEDI, Abolfazl ABOUIE, Nima HAFEZI-NEJAD, Soheil SAADAT, Afarin RAHIMI-MOVAGHAR, Abbas MOTEVALIAN, Masoumeh AMIN-ESMAEILI, Vandad SHARIFI, Ahmad HAJEBI, Ali EBRAHIMI, Vafa RAHIMI-MOVAGHAR ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14920 Sat, 06 Oct 2018 00:00:00 +0330 Genetic Polymorphisms of Catalase and Glutathione Peroxidase-1 in Keratoconus http://ijph.tums.ac.ir/index.php/ijph/article/view/14927 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> Keratoconus&nbsp;(KC) is a degenerative eye disease which results from thinning of the cornea and causes vision distortion. Oxidative stress damage to KC corneas may be because of the failure of corneas to process reactive oxygen species which leads to corneal thinning and loss of vision. Genetic variants in antioxidant defense genes such as catalase (CAT) and glutathione peroxidase (GPX) can decrease antioxidant capacity or increase oxidative stress and alter the risk of KC in patients. We investigated and evaluated the effects of single nucleotide polymorphisms in CAT, GPX-1 on the risk of KC in an Iranian population sample.</p> <p><strong>Methods:</strong> This case-control study was performed on 140 patients with KC and 150 healthy control subjects in a sample of Iranian population from Zahedan, southern Iran in 2015. Genotyping of CAT rs7943316 and GPX-1 rs1050450 polymorphisms was done using polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) method.</p> <p><strong>Results:</strong> CAT rs7943316 A/T, AA genotype and A allele have a protective role against disease (OR =0.28, 95% CI =0.13-0.61, <em>P</em>=0.001 and OR = 0.50, 95% CI =0.35-0.72, <em>P</em>=0.0001, respectively) and decreased the risk of KC. Moreover, GPX-1 rs1050450 T allele increased the risk of KC in comparison with C allele (OR = 1.42, 95% CI = 1.01-2.03, <em>P</em>=0.03).</p> <p><strong>Conclusion:</strong> CAT rs7943316 A/T, AA genotype, and A allele decreased the risk of KC. Moreover, in GPX-1 rs1050450 C/T polymorphism, T allele was associated with an increased risk of KC in our population.</p> <p><strong>&nbsp;</strong></p> <p>&nbsp;</p> Davood YARI, Ramin SARAVANI, Samira SARAVANI, Kamran EBRAHIMIAN, Hamid Reza GALAVI ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14927 Sun, 07 Oct 2018 00:00:00 +0330 The Estimation of Economic Burden of Hepatitis C Virus Infection in Iran http://ijph.tums.ac.ir/index.php/ijph/article/view/14928 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> One of the major causes of liver-related mortality and morbidity is Hepatitis C Virus (HCV) infection. It is also one of the reasons behinds of chronic liver disease and related complications such as cirrhosis and hepatocellular carcinoma. This autoimmune liver disease imposes a high economic burden on individuals and the society. This study aimed to estimate burden of HCV in Iran.</p> <p><strong>Methods:</strong> Overall, 200 patients with HCV infection, referred to hospitals in three cities of Tehran, Karaj and Tabriz, Iran during year 2015, were randomly enrolled. To estimate the total burden of hepatitis, direct and indirect costs, costs of DALYs and social welfare were calculated.</p> <p><strong>Results:</strong> Economic burden of HCV infection was obtained 26242.8 purchasing power parity (PPP$). Intangible costs of HCV was calculated 207421.6 PPP$.</p> <p><strong>Conclusion:</strong> Total direct costs of HCV for each patient are more than household consumption expenditure. Therefore, it is a reasonable policy to control and increase insurance coverage of HCV patients in order to decrease their costs.</p> <p>&nbsp;</p> Mehdi MOHAMMADZADEH, Hamid DERAFSHI, Tayebeh GHARI ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14928 Sun, 07 Oct 2018 00:00:00 +0330 Prevalence and Associated Factors of Overweight or Obesity and Abdominal Obesity in Iranian Population: A Population-based Study of Northwestern Iran http://ijph.tums.ac.ir/index.php/ijph/article/view/14929 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> This population-based study aimed at investigating the prevalence and associated factors of overweight /obesity and abdominal obesity in Iran.</p> <p><strong>Methods:</strong> The study population consists of 2818 inhabitant of the urban and regional area of East-Azerbaijan, Iran in 2015. The weight, height and waist circumferences were measured and the body mass index (BMI) and conicity index were calculated. The ANCOVA and logistic regression were used for statistical analysis.</p> <p><strong>Results:</strong> Prevalence of overweight, obesity and abdominal obesity was 39.6%, 24%, and 76.4% respectively. Women showed the higher prevalence of obesity (32.2%) and abdominal obesity (81.4) than men (obesity: 15.1%; abdominal obesity: 68.6%). Age, marriage and family history of obesity were independent predictors of obesity in the population (<em>P</em>&lt; 0.001). In men and women, nonsmokers (<em>P</em>&lt;0.01) and subjects having more than two kids (<em>P</em>&lt; 0.001) were also more expected to be overweight or obese and abdominally obese respectively.</p> <p><strong>Conclusion:</strong> More actions mostly focusing on education and physical activity levels, and changing eating habits are required.</p> <p>&nbsp;</p> Jafar Sadegh TABRIZI, Homayoun SADEGHI-BAZARGANI, Mostafa FARAHBAKHSH, Leila NIKNIAZ, Zeinab NIKNIAZ ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14929 Sun, 07 Oct 2018 00:00:00 +0330 Ranking Factors Affecting the Attraction of Foreign Medical Tourists in Hospitals Affiliated to Mashhad University of Medical Sciences Based on Marketing Mix Model http://ijph.tums.ac.ir/index.php/ijph/article/view/14930 <p><strong>Abstract</strong></p> <p><strong>Background:</strong> This study was designed to rank factors affecting attraction of foreign medical tourists based on marketing mix model.</p> <p><strong>Methods:</strong> In this descriptive study, data were collected through a questionnaire. Foreign patients, hospitalized from Jan 2015 to Sep 2016 in all hospitals of Mashhad were chosen as the study population (13 hospitals). Data analysis was conducted using Friedman test and Wilcoxon test in SPSS 21 at a significance level of 0. 05.</p> <p><strong>Results:</strong> Factors of staff, service and process gained the highest score from the perspective of patients; while price, facilities and promotion scored the lowest among parameters affecting the attraction of medical tourists to hospitals of Mashhad. In this context, factors of staff (96%) and price (66%) had the highest and lowest effect on absorption of tourists, respectively.</p> <p><strong>Conclusion:</strong> To promote medical tourism, important factors such as staff, service, and process should be further stressed and variables of price, facilities and promotion demand for a revision by the authorities in this industry.</p> <p>&nbsp;</p> Reza AZIMI, Ghahraman MAHMOUDI, Habib-Allah ESMAEILI ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14930 Sun, 07 Oct 2018 00:00:00 +0330 Effect of Temporomandibular Disorders on Quality of Life in Elderly Individuals http://ijph.tums.ac.ir/index.php/ijph/article/view/14931 <p>No Abstract</p> Thomás SANTANA SÓRIA, Giordano S ANTANA SÓRIA, Raul ANTÔNIO CRUZ, Myrian CAMARA BREW, Eduardo GROSSMANN, Caren SERRA BAVARESCO ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14931 Sun, 07 Oct 2018 00:00:00 +0330 Kinetic Analysis of Korean Traditional Dance Movements by Using Ground Reaction Force http://ijph.tums.ac.ir/index.php/ijph/article/view/14932 <p>No Abstract</p> Kyeong-Won JUNG, Dai-Hyuk CHOI, Wi-Young SO ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14932 Sun, 07 Oct 2018 00:00:00 +0330 Construing Interpersonal Meaning through Doctors’ Choice of In-terrogatives: An Investigation of Doctor-patient Conversations in China http://ijph.tums.ac.ir/index.php/ijph/article/view/14933 <p>No Abstract</p> Xi LUO, Zhengzhi FENG, Bingjun YANG ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14933 Sun, 07 Oct 2018 00:00:00 +0330 Influences of Nursing Work Environment and Patient Safety Environment on Nurse Outcomes http://ijph.tums.ac.ir/index.php/ijph/article/view/14934 <p>No abstract</p> Sujin PARK, Youngji KIM ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14934 Sun, 07 Oct 2018 00:00:00 +0330 Two New Therapies in the Cocaine-dependents: Comparison of Topiramate and Contingency Management http://ijph.tums.ac.ir/index.php/ijph/article/view/14935 <p>No Abstract</p> Bijan PIRNIA, Ali Akbar SOLEIMANI, Abbas TAVALLAII, Rasool ROSHAN, Kambiz PIRNIA ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14935 Sun, 07 Oct 2018 00:00:00 +0330 The Role of INSR & Diabetes in Polycystic Ovarian Syndrome http://ijph.tums.ac.ir/index.php/ijph/article/view/14936 <p>No Abstract</p> Afrouz KHAZAMIPOUR, Azim NEJATIZADEH, Eghbal EFTEKHAARI TASNIM ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14936 Sun, 07 Oct 2018 00:00:00 +0330 Management of Computerized Cognitive Training Programs in Children with ADHD: The Effective Role of Decision Support Systems http://ijph.tums.ac.ir/index.php/ijph/article/view/14937 <p>No Abstract</p> Marjan GHAZISAEEDI, Leila SHAHMORADI, Sharareh R. NIAKAN KALHORI, Azadeh BASHIRI ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14937 Sun, 07 Oct 2018 00:00:00 +0330 Standardization of Health Terminology Systems and the Role of Responsible Organizations http://ijph.tums.ac.ir/index.php/ijph/article/view/14938 <p>No Abstract</p> Farid KHORRAMI, Maryam AHMADI, Abbas SHEIKHTAHERI ##submission.copyrightStatement## http://ijph.tums.ac.ir/index.php/ijph/article/view/14938 Sun, 07 Oct 2018 00:00:00 +0330