Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 10 2012 10 15 1 14 M Balali-Mood K Balali-Mood M Moodi B Balali-Mood 2015 10 03 Organophosphorous (OP) pesticides are used frequently in agriculture, particularly in Asian countries over the past decades. Poisoning by these agents, either as acute or chronic in these nations, is a serious health problem. OP pesticides residue in fruits and vegetables that may not induce early clinical features, could also affect the human health. Therefore, medical and health professionals should be aware and learn more on the toxicology, prevention and proper management of OP poisoning. The well-known mechanism of OP toxicity is the inhibition of acetyl cholinesterase, resulting in an accumulation of acetylcholine and continued stimulation of acetylcholine receptors. Therefore, they are also called anticholinesterase agents. Determination of blood acetyl cholinesterase and butyryl cholinesterase activities remains a mainstay for the rapid initial screening of OP pesticides. Quantitative analysis of OP and their degradation products in plasma and urine by mass spectrometric methods is a more specific method, but is expensive and limited to specialized laboratories. Therefore, history of OP pesticides exposure and clinical manifestations of a cholinergic syndrome is sufficient for management of the exposed patients. However, electrophysiological tests may be required for the diagnosis of delayed neuropathy of OP poisoning. The standard management of OP poisoning includes decontamination, atropine sulphate with an oxime. Recent advances focus on blood alkalinisation and magnesium sulphate as promising adjunctive therapies. Preventive measures in OP exposure are of great importance in human health in developing countries. Therefore, regulations and controls on safe use of OP particularly in Asian countries are recommended. https://ijph.tums.ac.ir/index.php/ijph/article/view/2495 https://ijph.tums.ac.ir/index.php/ijph/article/download/2495/2475

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 10 2012 10 15 15 23 V Radović L Ćurčić 2015 10 03 Background: The aim of the study was a recommendation and establishment the concept of the appropriate communication between public health, other competent services and population in emergency as the corner stone which guarantee that all goals which are important for community life will be achieved. Methods: We used methodology appropriate for social science: analyses of documents, historical approach and comparative analysis. Results:  The finding shows the urgent need for accepting of crises and emergency risk communication principles, or some similar concepts, in Serbia, and implementing effective two way communication especially in multiethnic region. The pragmatic value of the paper lays in information about the recent improvement of health workforce and emergency services in emergencies using new concept of communication and as source of numerous useful documents published in USA and few recent Serbian examples. Conclusion: Health workforce has significant role in the process of protection of population in emergencies. Policy makers should work on finding a way to improve their coordination and communication, creating new academic programs, providing of  adequate training, and financial means in order to give them different role in society and provide visibility. From other side health workforce should build back to the citizen trust in what they are doing for society welfare using all their skills and abilities.  https://ijph.tums.ac.ir/index.php/ijph/article/view/2496 https://ijph.tums.ac.ir/index.php/ijph/article/download/2496/2476

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 10 2012 10 15 24 28 Asmaee Majid S Seghatoleslam T Homan HA Akhvast A Habil H 2015 10 03 Background: The aim of this study was to evaluate whether an eight-week group mindfulness-based stress reduction program would be an acceptable and effective treatment for patients suffering from GAD. Methods: Eligible subjects with generalized anxiety disorder were recruited to Parsa Hospital and Shahid Rajaee Counseling and Social Work Center from June 2009 to October 2011. An experienced psychiatrist diagnosed these patients with a structured clinical interview for axis I disorders and a clinical psychologist conducted a clinical interview for in order to confirm the diagnosis. Subjects were randomized to an eight week course of group mindfulness based stress reduction program (16 subjects) or a control group (15 subjects). Subjects completed measures of anxiety, depressive symptoms and worry at baseline and end of treatment. To investigate the relationship between anxiety, depression and worry symptoms and mindfulness based stress reduction as well as controlling pretest effect, data were analyzed with analysis of covariance. Results: There were significant reductions in anxiety (P<0/001), depressive (P<0/001) and worry symptoms (P<0/001) from baseline to end of treatment. Conclusion: Mindfulness- based stress reduction may be an acceptable intervention in the improvement of generalized anxiety disorder symptoms. Future trials include development of randomized clinical trials of MBSR for GAD. https://ijph.tums.ac.ir/index.php/ijph/article/view/2497 https://ijph.tums.ac.ir/index.php/ijph/article/download/2497/2477

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 10 2012 10 15 29 35 V Lokaj-Berisha N Berisha B Lumezi L Ahmetaj G Bejtullahu N Karahoda H Pupovci 2015 10 03 Background: The aim of this study was to identify the most common aeroallergens in patients with asthma and rhinitis. Methods: The study enrolled 102 participants including 64 patients with respiratory allergies (among them 15 were clinically diagnosed as asthma patients, 41 with rhinitis, 8 were both) and 38 healthy controls. All of participants were subject of skin prick tests (SPT) with series of common allergenic extracts. Sera from all participants were tested for total IgE and eosinophil count. To measure airflow limitation and reversibility in asthma patients the pulmonary function testing were carried out. Results: M/F ratio was 1:1.6 in patients  and 1:0.7 in control group with mean age 28.88 year (SD 13.16; range 6 - 55 year) and 20.47 respectively (SD 1.16; range 19-23 year). The most common risk factors in these patients were total IgE more than 100 IU/ml, eosinophils above 4% and positive family history of atopy. Skin prick testing results showed prevalence rates for allergen groups in this manner: house dust mites 81.3 %, pollens 57.8 %, animal dandruff 12.5% and moulds 4.9%. Polysensitization was common in 51.6% of all sensitized patients being positive to more than one group of allergens.      Conclusion: House dust mites are the main sensitizing allergens among our allergic patients as well as healthy controls. Next in importance, in all participants, are grasses. This pattern of prevalence was expected based on herbal geography, climate and specially lifestyle. It was also compatible with the results from studies carried out in places with the same habitat. https://ijph.tums.ac.ir/index.php/ijph/article/view/2498 https://ijph.tums.ac.ir/index.php/ijph/article/download/2498/2478

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 10 2012 10 15 36 42 Yi-Soo Shin Wi-Young So 2015 10 03 Background: The purpose of this study was to investigate the association between physical inactivity and academic record in Korean adolescents. Methods: Adolescent students from the first grade of middle school to the third grade of high school (n=75,066) participated in the 5th Korea Youth Risk Behavior Web-based Survey project in 2009. The association between physical inactivity and academic record was assessed using multivariate logistic regression analysis after adjusting for gender, age, body mass index, family's socioeconomic status, parents' education level, and frequency of vigorous or moderate physical activity (PA) as well as muscular strength exercises. Results: During weekdays, the odds ratios (ORs) (95% confidence interval [CI]) for reporting a higher than average academic record, as compared with <1 hour of physical inactivity per day, was 0.796 (0.761-0.832, for ≥1 to <2 hours, 0.632 (0.603-0.663, for ≥2 to <3 hours, 0.567 (0.535-0.601, for ≥3 to <4 hours, and 0.494 (0.468-0.522, P < 0.001 for all cases) for ≥4 hours of physical inactivity per day. During the weekends, the ORs (95% CI) for reporting a higher than average academic record, as compared with <1 hour of physical inactivity per day, were 0.901 (0.848-0.957, P = 0.001) for ≥3 to <4 hours and 0.785 (0.743-0.830, P < 0.001) for ≥4 hours of physical inactivity per day. Conclusion: Korean adolescents who spend more time engaged in physical inactivity are predisposed to a below-average academic record. https://ijph.tums.ac.ir/index.php/ijph/article/view/2499 https://ijph.tums.ac.ir/index.php/ijph/article/download/2499/2479

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 10 2012 10 15 43 51 M Rezai-Rad R Vaezi F Nattagh 2015 10 03 Background: Concept of e-readiness is used in many areas such as e-business, e-commerce, e-government, and e-banking. In terms of healthcare, e-readiness is a rather new concept, and is propounded under the title of E-healthcare. E-health readiness refers to the readiness of communities and healthcare institutions for the expected changes brought by programs related to Information and Communications Technology (lCT). The present research is conducted aiming at designing E-health Readiness Assessment Framework (EHRAF) in Iran. Methods: The e-health readiness assessment framework was designed based on reviewing literature on e-readiness assessment models and opinions of ICT and health experts. In the next step, Delphi method was used to develop and test the designed framework. Three questionnaires developed to test and modify the model while determining weights of the indices; afterward they were either sent to experts through email or delivered to them in face. Results: The designed framework approved with 4 dimensions, 11 constituents and 58 indices. Technical readiness had the highest importance coefficient (0.256099), and the other dimensions were of the next levels of coefficient importance: core readiness (0.25520), social communication readiness (0.244658), and engagement readiness (0.244039). Conclusion: The framework presents the movement route and investment priorities in e-health in Iran. The proposed framework is a good instrument for measuring the e-readiness in health centers in Iran, and for identifying strengths and weaknesses of these centers to access ICT and its implementation for more effectiveness and for analyzing digital divide between them, as well. https://ijph.tums.ac.ir/index.php/ijph/article/view/2500 https://ijph.tums.ac.ir/index.php/ijph/article/download/2500/2480

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 10 2012 10 15 52 59 A Keramat B Larigani H Adibi 2015 10 03 Background: We aimed to define and compare the risk factors of spinal and femoral osteoporosis in postmenopausal Iranian women. Method: It was a multicentre based study carried out in two stages during 2002 to 2005 among post menopausal women in Tehran. In first stage case group included 140 women with diagnosed spinal osteoporosis using DEXA method as definition of WHO and Controls were 167 women with normal spinal BMD. In second stage, among the same study population case groups were 72 women with total femoral neck osteoporosis. The controls included 191 women with normal femoral BMD.` Odds Ratio was used for estimation the association of risk factors with spinal and femoral osteoporosis. Results: Plus common well known osteoporosis risk factors, significant risk factors for each region with their odds ratios included: Steroid use (2.4) and low activity (3.6) for femoral osteoporosis and parity>3 (2) and lactation duration > 2 yr (1.9) for spinal osteoporosis. Conclusions: There are some common and different protective and risk factors for spinal and femoral osteoporosis in this population. https://ijph.tums.ac.ir/index.php/ijph/article/view/2501 https://ijph.tums.ac.ir/index.php/ijph/article/download/2501/2481

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 10 2012 10 15 60 64 A Akbari Sari S Babashahy A Olyaeimanesh A Rashidian 2015 10 03 Background: The aim of this study was to estimate the frequency and rate of the first 50 common types of invasive procedures in Iran. Methods: Data about the number of all invasive procedures and each type of procedure that were conducted in Iran in 2010 were collected using the main insurance organizations database. These numbers were sorted in an excel database, and the first 50 invasive procedures with the most common frequency were selected. Then according to the population covered by the given insurance organizations, and based on the total population of Iran in 2011, we estimated the number and rate of each invasive procedure for the selective procedures. Results: It was estimated that a total of 769,500 (1,026 per 100,000 population) natural vaginal delivery (NVD) was performed in Iran in 2011, followed by 416,790 cataract operation (556 per 100,000 population), 401,436 cesarean delivery (535 per 100,000 population), 260,514 coronary angiography disease (347 per 100,000 population), 181,836 varicocele (242 per 100,000 population), 144,918 appendectomy (193 per 100,000 population), 134,766 rhinoplasty (180 per 100,000 population) and 105,912 pilonidal cyst (141 per 100,000 population). Conclusion: The result could be used to identify and select the most frequent invasive procedures in Iran, to calculate the average cost of each procedure and to use these costs to estimate hospital budget and improve policy-making. https://ijph.tums.ac.ir/index.php/ijon recipients 316 22 Moghaddameh Mirzaee 1. Dept. of Epidemiology and Biostatistics, Tehran University of Medical Sciences , Tehran, Iran. Kazem Mohammad 1. Dept. of Epidemiology and Biostatistics, Tehran University of Medical Sciences , Tehran, Iran. Mahmood Mahmoodi 1. Dept. of Epidemiology and Biostatistics, Tehran University of Medical Sciences , Tehran, Iran. Hojjat Zeraati 1. Dept. of Epidemiology and Biostatistics, Tehran University of Medical Sciences , Tehran, Iran. Mohammad-Reza Ebadzadeh 2. Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences , Kerman, Iran. Abbas Etminan 2. Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences , Kerman, Iran. Faramarz Fazeli 3. Dept. of Urology, Zahedan University of Medical Sciences , Zahedan, Iran. Mohammad Hasan Dehghani Firouzabadi 2. Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences , Kerman, Iran. Hossein Sattary 2. Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences , Kerman, Iran. Mahdiyeh Haghparast 2. Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences , Kerman, Iran. Abbas Rahimi Foroushani 1. Dept. of Epidemiology and Biostatistics, Tehran University of Medical Sciences , Tehran, Iran. 2015 10 15 Renal transplantation is a therapy for end-stage renal disease. During the study of recipients' survival after renal transplantation, there are some events as intermediate events that not only affect the recipients' survival but also events which are affected by various factors. The aim of this study was to handle these intermediate events in order to identify factors that affect recipients' survival by using multi-state models.This retrospective cohort study included 405 renal transplant patients from Afzalipour Hospital, Kerman, Iran, from 2004 to 2010. The survival time of these recipients was determined after transplantation and the effect of various factors on the death hazard with and without renal allograft failure and hazard of renal allograft failure was studied by using multi-state models.During 4.06 years (median) of follow-up; 28 (6.9%) recipients died and allograft failure occurred in 51 (12.6%) recipients. Based on the results of multi-state model, receiving a living kidney transplantation decreased the hazard of renal allograft failure (HR=0.38; 95% CI: 0.17- 0.87), pre-transplant hypertension (HR=2.94; 95% CI: 1.54- 5.63) and serum creatinine levels >1.6 upon discharge from the hospital (HR=7.38; 95% CI: 3.87- 7.08) increased the hazard of renal allograft failure. Receiving living kidney transplantation decreased the hazard of death directly (HR=0.18; 95% CI: 0.04- 0.93).It was concluded that the effect of donor type, pre-transplant hypertension and having serum creatinine >1.6 upon discharge from the hospital was significant on hazard of renal allograft failure. The only variable that had a direct significant effect on hazard of death was donor type. https://ijph.tums.ac.ir/index.php/ijph/article/view/4190 https://ijph.tums.ac.ir/index.php/ijph/article/download/4190/3847

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 3 2014 03 15 323 30 Kourosh Holakouie Naieni 1. Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences; Iranian Epidemiological Association , Tehran, Iran. Alireza Ahmadvand 1. Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences; Iranian Epidemiological Association , Tehran, Iran. Elham Ahmadnezhad 1. Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences; Iranian Epidemiological Association , Tehran, Iran. Ali Alami 1. Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences; Iranian Epidemiological Association , Tehran, Iran. 2015 10 15 Community assessment is one of the core competencies for public health professionals; mainly because it gives them a better understanding of the strengths and drawbacks of their jurisdictions. We planned to recognize an appropriate model that provides a conceptual framework for the Iranian community.This study was conducted in Tehran, during 2009-2010 and consisted of two parts: a review of the literature and qualitative interview with selected experts as well as focus group discussion with health field staff. These steps were done to develop a conceptual framework: planning for a steering committee, forming a working committee, re-viewing community assessment models and projects, preparing the proposed model draft, in-depth interview and focused group discussions with national experts, finalizing the draft, and preparing the final model.Three different models published and applied routinely in different contexts. The 2008 North Carolina Community Assessment model was used as a reference. Ten national and 18 international projects were compared to the reference and one and six projects were completely compatible with this model, respectively.Our final proposed model takes communities through eight steps to complete a collaborative community assessment: form a community assessment team, solicit community participation and gain inter-sectoral collaboration, establish a working committee, empower the community, collect and analyze community's primary and secondary statistics, solicit community input to select health priorities, evaluate the community assessment and develop the community assessment document, an develop the community action plans. https://ijph.tums.ac.ir/index.php/ijph/article/view/4188 https://ijph.tums.ac.ir/index.php/ijph/article/download/4188/3845

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 3 2014 03 15 331 41 Mahdi Sharif-Alhoseini 1. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences , Tehran, Iran. Vafa Rahimi-Movaghar 1. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences , Tehran, Iran. 2015 10 15 The goal of this study was to describe the hospital-based incidence of traumatic spinal cord injury in Tehran, Iran.We retrospectively reviewed the hospital records of traumatic spinal cord injury patients, admitted between March 2010 and July 2011 in 61/68 hospitals of Tehran.Overall, 138 cases of traumatic spinal cord injury were identified. The majority of patients were male (84.8%). The mean age was 33.2 ± 14.3 years. 54.3% patients were residing in Tehran and the others were referred from other cities. The mean annual incidence of hospitalized traumatic spinal cord injury patients of Tehran was 10.5/1,000,000/year (95% confidence interval: 9-12). Fall was the leading cause of injury (45.7%), followed by road traffic crash (40.6%). The most common cause of tetraplegia (cervical traumatic spinal cord injury) was road traffic crash. The duration of hospital stay for tetraplegia and paraplegia (thoracic and lumbar traumatic spinal cord injury) was 22.7±23.7 and 12.5±7.5, respectively (P<0.001). Early surgery (surgical decompression within 24 h) was done for 19% of the patients. The median day of hospitalization for early and late surgery was 7.5 and 12, respectively (P=0.044).Preventing traumatic spinal cord injury should focus on males, age group of 21-30 years, falls and road traffic crash. More studies are suggested to evaluate the incidence of non-hospitalized traumatic spinal cord injury patients. https://ijph.tums.ac.ir/index.php/ijph/article/view/4186 https://ijph.tums.ac.ir/index.php/ijph/article/download/4186/3843

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 3 2014 03 15 342 8 Arash Mirabzadeh 1. Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran. Ameneh Setareh Forouzan 1. Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran. Farahnaz Mohammadi 1. Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran. Masoumeh Dejman 1. Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran. Monir Baradaran Eftekhari 1. Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran ; 2. Undersecretary for Research & Technology, Ministry of Health and Medical Education , Tehran, Iran. 2015 10 15 In Iran, more than 25% of women suffer from mental disorders. Mental disorders and subclinical problems are associated with socioeconomic problem. At the community level, mental health promotion can reduce social damage. The aim of this study as a part of community based mental health promotion intervention was to explore how mental health in Iranian women is viewed.According to a qualitative method in 2012, participants were selected by purposeful sampling from married women 18 to 65 years who are residents in Tehran. Fifteen in depth individual interviews were conducted with regard to the concept of mental health, causal pathway and help-seeking behavior according to explanatory model.Mental health was perceived as the same of emotional well-being. It conceptualized not only lack of mental disorder but also sense of satisfaction and healthy functioning. According to participant's view, the causal pathway of mental health problems were classified to individual, familial and social factors. Physical and behavioral problems were related to individual factor, Lack of marital adjustment was one of the most important issues in familial item and in social factor, cultural context and socio-economic problems were extracted. In help seeking process, all of the participants believed that the religion has important effect in mental health.Marital adjustment is an important stage in process of mental health in women. https://ijph.tums.ac.ir/index.php/ijph/article/view/4184 https://ijph.tums.ac.ir/index.php/ijph/article/download/4184/3841

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 3 2014 03 15 349 54 Ali Ardame 1. Dept. of Clinical Psychology, Shahid Chamran University , Ahvaz, Iran. Soodabe Bassaknejad 1. Dept. of Clinical Psychology, Shahid Chamran University , Ahvaz, Iran. Yadollah