Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 4 2012 04 15 1 8 A Kanekar A Bitto 2015 10 03 Background: Ethics is a discipline, which primarily deals with what is moral and immoral behavior. Public Health Ethics is translation of ethical theories and concepts into practice to address complex multidimensional public health problems. The primary purpose of this paper was to conduct a narrative literature review-addressing role of ethics in developing curriculum in programs and schools of public health, ethics-related instruction in schools and programs of public health and the role of ethics in developing a competent public health workforce. Methods: An open search of various health databases including Google scholar and Ebscohost yielded 15 articles related to use of ethics in public health practice or public health training and the salient features were reported.   Results: Results indicated a variable amount of ethics' related training in schools and programs of public health along with public health practitioner training across the nation. Bioethics, medical ethics and public health ethics were found to be subspecialties' needing separate ethical frameworks to guide decision making. Conclusions: Ethics based curricular and non-curricular training for emerging public health professionals from schools and programs of public health in the United States is extremely essential.  In the current age of public health challenges faced in the United States and globally, to have an ethically untrained public health force is arguably, immoral and unethical and jeopardizes population health.  There is an urgent need to develop innovative ethic based curriculums in academia as well as finding effective means to translate these curricular competencies into public health practice. https://ijph.tums.ac.ir/index.php/ijph/article/view/2584 https://ijph.tums.ac.ir/index.php/ijph/article/download/2584/2564

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 4 2012 04 15 9 18 A Bakhtiari Z Yassin P Hanachi A Rahmat Z Ahmad P Sajadi S Shojaei 2015 10 03 Background: To examine the effects of soy [in the form of textured soy protein (TSP) and soy-nut] on body composition in elderly women with metabolic syndrome (MetS). Methods: A 12-week randomized clinical trial was conducted on 75 women between 60-70 years of age with MetS in rural health clinics around Babol, Iran in 2009. The participants were randomly assigned to one of the three groups of soy-nut (35g/d), TSP (35g/d) and control. Body fat, lean mass and anthropometric indicators were measured before and after intervention, too. Results: Participants were classified as overweight and showing android fat distribution. After 12 weeks of intervention, both soy-nut and TSP groups showed an increase of non-significant in lean mass (0.9 and 0.7 kg), hip circumference (0.45 and 0.28 cm), triceps skinfold (TSF) thickness (0.87 and 0.67mm) and reduction in BMI (-0.15 and -0.33), waist circumference (-0.83 and -1.2) and body fat (-1.5% and -1.7%). Significant increase in the mean change of TSF and lean mass was observed in the users of soy-nut compared to the control group (P<0.01, P<0.05).  Conclusion: 12-week intervention of soy had a mild favorable effect on body composition in elderly women with MetS. https://ijph.tums.ac.ir/index.php/ijph/article/view/2585 https://ijph.tums.ac.ir/index.php/ijph/article/download/2585/2565

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 4 2012 04 15 19 25 GS Dauletova LL Karp KS Absattarova 2015 10 03 Background: In Kazakhstan, as in many other countries, a transformation of the traditional stereotypes of reproductive behavior, and change the types of family relationships is occurred. It is caused by social status changes, by the transformation of women's valuable orientations and social-role attitudes. The objective of this study was to identify the indicators of reproductive units and the motives for having children in the family. Methods: Designed questionnaires were used to study the regulation of fertility in young families, and women's views about the ideal, desired, and expected number of children per family. The survey covered 1017 respondents aged less than 39 years. Results: Expected number of children in the family depends on living conditions. The average expected number of children per family increases with improvement of living conditions and with increases in income. Statistically significant differences in the average expected number of children in families with a satisfactory and good income compared to poor income (P <0.001). Revealed the predominance of the expected, desired and ideal number of children among women of Asian ethnic group and on the desired and ideal number of children the differences were statistically significant (P <0.05). By mathematical formula that based on a poll can be calculated probability of birth of each child in the family. Conclusion: Reproductive attitudes of Astana women depend on age, educational level, income, professional employment, marital status, and ethnicity. The findings confirm the hypothesis that family plans are largely exposed to specific conditions of life. https://ijph.tums.ac.ir/index.php/ijph/article/view/2586 https://ijph.tums.ac.ir/index.php/ijph/article/download/2586/2566

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 4 2012 04 15 26 34 H Zhou Zr Guo Xs Hu Lg Yu Bh Xu M Wu Zy Zhou C Yang PMMJS Study Group 2015 10 03 Background: Metabolic syndrome (MS) is the syndrome closely related to cardiovascular disease (CVD) risk factors. Few prospective studies have compared the impact of dynamic changes of MS on the development of cardiovascular diseases (CVD). Methods: Overall, 3461 subjects were recruited from a cohort study on Prevention of Multiple Metabolic disorders and MS in Jiangsu of China (PMMJS) with a follow up of 3.8 years. The associations between the dynamic changes (Difference, the value at first follow-up subtract the value at baseline) of MS, component numbers, components and relative risk (RR) of CVD were analyzed by using Cox regression model. Results: The total incidence standardized rate of CVD was 2.58%,and the incidence standardized rates of CVD in MS-/follow-up MS-,baseline MS-/follow-up MS+, baseline MS+/follow-up MS- and baseline MS+/follow-up groups were 2.05%,5.01%,1.65% and 4.39% separately. After adjustment confounding factors Difference in FPG, BP and TG have significantly effects on the incidence of CVD. Conclusion: Difference of MS component numbers had the prediction ability of CVD, but MS groups based on baseline and first follow-up MS and/or non-MS had not. In Chinese, the dynamic change of MS component numbers was a useful predict factor for CVD. https://ijph.tums.ac.ir/index.php/ijph/article/view/2587 https://ijph.tums.ac.ir/index.php/ijph/article/download/2587/2567

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 4 2012 04 15 35 45 SH Abbaszadeh Ahranjani H Kashani MH Forouzanfar HR Aghaei Meybodi B Larijani M Aalaa MR Mohajeri-Tehrani 2015 10 03 Background: Obesity is an important and life-threatening disease, associated with different chronic conditions such as cardiovascular disease, diabetes, and dyslipidemia. We sought to address the paucity of information on the trends of anthropometric indices such as weight, waist circumference, and body mass index in the adult population of Iran. Methods: We drew upon data from the First Non-communicable Disease Survey in Iran in 2005. In total, 79,611 participants between 20 and 64 years old were selected via the random multistage cluster sampling. The Lambda Median Scale method was applied to construct normal curves for anthropometric indices. Results: The mean of waist circumference in both genders increased with age and in all the age groups except those between 20 and 24 years old was higher in the women. The mean of body mass index was higher in all the age brackets in the women, but the means of weight and height were higher in the men. The association of theses indices with diabetes, hypertension, and dyslipidemia was stronger in men. Conclusion: The ranges of waist circumference and body mass index in Iranian population are different from those of other countries. The higher body mass index and waist circumference in females and the direct association between obesity and chronic diseases, is advisable that the effects of this phenomenon be fully investigated and due heed be paid to the importance of lifestyle modification. https://ijph.tums.ac.ir/index.php/ijph/article/view/2588 https://ijph.tums.ac.ir/index.php/ijph/article/download/2588/2568

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 4 2012 04 15 46 54 AA Noorbala M Agah Heris A Alipour E Mousavi G Farazi 2015 10 03 Background: To compare mental health and well- being in different levels of the perceived discrimination among Iranian people living in Tehran. Method: Using multi- stage sampling, 1255 subjects with the average age of 45 years and 9 months (including 672 women and 583 men) were selected and they completed all items of the general health questionnaire (GHQ), the social well- being inventory (SWI), personal well- being inventory (PWI), and a question to assess the perceived discrimination. Results: Data analysis by Kruskal- Wallis test revealed that there were significant differences between physical symptoms (χ2=5.93, P<0.05) and depression (χ 2=15.70, P<0.05), the subscales of mental health in different levels of the perceived discrimination. Furthermore, comparing personal well- being scores and its subscales in different levels of the perceived discrimination showed significant differences in personal hygiene (χ2=7.20, P<0.05), and security in future (χ2=7.60, P<0.05). Emotional well- being (χ2=12.25, P<0.05), self-rule (χ2=7.45, P<0.05), personal growth (χ2=19.87, P<0.05), and psychological well- being (χ2= 9.09, P<0.05) were significantly different in different levels of the perceived discrimination, too. Moreover, comparing social well- being in different levels of the perceived discrimination indicated significant differences between social acceptance (χ 2=14.91, P<0.05), and social participation (χ 2= 10.91, P<0.05). Conclusion: Therefore, people are more active in society, increases the possibility of encountering with discrimination and consequently the perception of that. https://ijph.tums.ac.ir/index.php/ijph/article/view/2589 https://ijph.tums.ac.ir/index.php/ijph/article/download/2589/2569

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 4 2012 04 15 55 62 Sh Djalalinia F Ramezani Tehrani H Malek Afzali N Peykari M Baradaran Eftekhari 2015 10 03 Background: More than 36 % of the total population of Iran consists of young people aged 15 to 25 yr. Recent studies show that this age group has the highest rate of serious health problems. Youth participatory studies on youth health priority have shown that mental health is one of the most important priorities in youth health. Aim to assessing the mental health needs of youth we conducted a peer group based multidisciplinary study. Methods: To conduct a multi disciplinary approach through involving youth for finding their mental health needs and their suggestion for solving them, we designed a qualitative approach based on grounded theory. To data collection, we used a semi-structured guide questionnaire. Sixteen focus group discussions were conducted by trained peers with youth aged 15-25 years. Result: According to FGDs results, most of youth health needs concern with their interpersonal communica­tions skills particularly with their parents'; they had some problems with their parental expectations meet; life skills; self-expression and problem solving process. They were extremely interested in participatory approach in which they involved in assessment and determination of their health problems also in designing health programs. Conclusion: Success of program shows empowering the community through capacity building and notice to peer group-based interventions to critical enhancing in various aspects of youth health is the most effective method to needs assessment and community mobilization for better health. https://ijph.tums.ac.ir/index.php/ijph/article/view/2590 https://ijph.tums.ac.ir/index.php/ijph/article/download/2590/2570

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 4 2012 04 15 63 68 H Sharifi R Kharaghani S Sigari 2014 06 15 760 8 Ayan Myssayev 1. Surgery and Orthopedic department, Semey State Medical University , Semey, Kazakhstan. Serik Meirmanov 2. Public Health Management, College of Asia Pacific Studies, Ritsumeikan Asia Pacific University , Beppu, Japan. Tolebay Rakhypbekov 3. Semey State Medical University , Semey, Kazakhstan. Tolkyn Bulegenov 4. Department of surgery internship, Semey State Medical University , Semey, Kazakhstan. Yuliya Semenova 5. Pharmacology and evidence-based medicine, Semey State Medical University , Semey, Kazakhstan. 2015 10 15 Kazakhstan, a developing middle-income country, has the highest road traffic collision (RTC) mortality in the European Region. The aims of this study were to determine main characteristics of road traffic fatalities in Semey region, Kazakhstan and to compare findings with National data and middle-income European countries.This descriptive surveillance study assesses RTC mortality rates and epidemiology in the Semey Region of East Kazakhstan Oblast. Data of all 318 road traffic fatalities form the Semey Regional Center for Forensic Medicine were analyzed for the 5-year period of January 1, 2006 through December 31, 2010.Over the study period, the average road traffic mortality in the Semey Region was 12.1 per 100,000 population with downward trend by 35.1% (p=0.002). The victims mean age was 37.1 (SD=17) years. Males predominated at 74.5%. Vehicle fatality was the most common mode of fatality at 61.3%. The majority of collisions, 53.1%, occurred on highways. Most victims, 67.3%, have died at the scene of collision; in 67.3% of fatalities, autopsies identified multiple injuries as cause of death. The high number of fatal collisions took place in "no snow" season (P<0.001), with an overall 5-years downward dynamic.High proportion of males, pedestrians and car occupants among road traffic fatalities; high proportion of death on scene in case of highway collisions are specifics for Semey region, Kazakhstan. These findings can be used to formulate preventive strategies to reduce fatalities and to improve the medical care system for road traffic fatalities. https://ijph.tums.ac.ir/index.php/ijph/article/view/4068 https://ijph.tums.ac.ir/index.php/ijph/article/download/4068/3727

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 6 2014 06 15 769 77 Yudong Miao 1. School of Health Policy and Management, Nanjing Medical University , Nanjing, China. Ting Ye 2. School of Medicine and Health Management of Tongji Medical College of Huazpong University of Science and Technology , Wuhan, China. Dongfu Qian 1. School of Health Policy and Management, Nanjing Medical University , Nanjing, China. Jinlong Li 1. School of Health Policy and Management, Nanjing Medical University , Nanjing, China. Liang Zhang 2. School of Medicine and Health Management of Tongji Medical College of Huazpong University of Science and Technology , Wuhan, China. 2015 10 15 Primary care physicians' visit services for diabetes management are now widely delivered in China's rural public health care. Current studies mainly focus on supply but risk factors from patients' view have not been previously explored. This study aims to present the utilization of rural primary care physicians' visit services for diabetes management in the last 12 months in southwestern China, and to explore risk factors from patients' view.This cross sectional study selected six towns at random and all 385 diabetics managed by primary care physicians were potential participants. Basing on the inclusion and exclusion criteria, 374 diabetics were taken as valid subjects and their survey responses formed the data resource of analyses. Descriptive indicators, χ2 contingency table analyses and Logistic regression were used.54.8% respondents reported the utilization of visit services. According to the multivariate analysis, the positive factors mainly associated with utilization of visit services include disease duration (OR=1.654), use of diabetic drugs (OR=1.869), consulting diabetes care knowledge (OR=1.602), recognition of diabetic complications (OR=1.662), needs of visit services (OR=2.338).The utilization of rural primary care physicians' visit services still remains unsatisfactory. Mass rural health policy awareness, support, and emphasis are in urgent need and possible risk factors including disease duration, use of diabetic drugs, consulting diabetes care knowledge, recognition of diabetic complications and needs of visit services should be taken into account when making rural health policy of visit services for diabetes management in China and many other low- and middle-income countries. https://ijph.tums.ac.ir/index.php/ijph/article/view/4066 https://ijph.tums.ac.ir/index.php/ijph/article/download/4066/3725

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 6 2014 06 15 778 86 Abbas Rahimi Foroushani 1. Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. Fereshteh Farzianpour 2. Dept. of Health Management and Economic, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. Afshin Tavana 2. Dept. of Health Management and Economic, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. Javad Rasouli 1. Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. Shayan Hosseini 3. Dept. of Electrical Power Engineering, Science & Research branch of Islamic Azad University , Tehran, Iran. 2015 10 15 The present study aimed to explore some risk factors affected the mean of the number of tuberculosis (TB) in West Azerbaijan Province, Iran between 2001 and 2010.Our time series study analyzed the data of 2,560 TB patients as registered with TB Patients Care System in West Azerbaijan Province from early 2001 to 2010. A checklist was prepared for collecting the data and they were then analyzed in SPSS V.16 software.The percentage of male and percentage of female were close to each other (52.2% against 47.8%, respectively). A significant increasing trend of TB rate was found over the years of 2001and 2010 with a pick at 2008 (P<0.001). A Poisson log-linear analysis showed that the most important risk factor of the trend of rate was the level of education so that people with primary level or with illiterate level had a statistically significant TB rate of 5.21 (4.66-5.81), adjusted for years. The next risk factor was type of TB and place of residency, i.e., pulmonary TB cases had higher rate than External pulmonary TB cases (RR=1.67; (1.54-1.80). The last factor with the lowest risk was BCG with RR=1.29 (1.20-1.40) for people who received BCG compared to the people who had not received it.Although the co morbidity of AIDS and TB was not a major problem, it is necessary that special attention be paid to the way of implementing the TB control program based on the demographic risk factors of the study population. https://ijph.tums.ac.ir/index.php/ijph/article/view/4064 https://ijph.tums.ac.ir/index.php/ijph/article/download/4064/3723

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 6 2014 06 15 787 92 Ali Akbari Sari 1. Dept. of Health Management& Economics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran ; 2. Knowledge Utilization Research Centre, Tehran University of Medical Sciences , Tehran, Iran. Leila Doshmanghir 3. Health Management and Economics Research Center, Iran University of Medical Sciences , Tehran, Iran ; 4. Dept. of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences , Tehran, Iran. Zahra Neghahban 1. Dept. of Health Management& Economics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. Maryam Ghiasipour 1. Dept. of Health Management& Economics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. Zeinab Beheshtizavareh 1. Dept. of Health Management& Economics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. 2015 10 15 This study aimed to estimate the rate of pressure ulcers in intensive care units (ICUs) and medical and surgical wards of Iranian hospitals and compare the performance of methods of medical record review as well as direct observation for their detection.The research team visited 308 patients in medical and surgical wards of hospitals affiliated with Tehran University of Medical Sciences and a further 90 patients in their ICUs between March 2009 and April 2010. In addition 310 patient records were randomly selected from patients discharged from the ICUs between March 2009 and April 2010. And a further 600 patient records were randomly selected from the patients that were discharged from medical and surgical wards between March 2010 and April 2011. These 910 selected records were retrospectively reviewed to identify pressure ulcers. Data were collected by a structured checklist.In ICUs 24 of 90 patients (26.7%, 95% CI: 17.56 to 35.84) that were directly observed and 59 of 310 patients (19.0%, 95% CI: 14.63 to 23.37) that were studied by retrospective review of medical records had pressure ulcers. In medical and surgical wards, 5 of 308 patients (1.6%, 95% CI: 0.20 to 3.00) that were directly observed had pressure ulcers, but no pressure ulcer was detected by review of 600 medical records.Pressure ulcers are significantly more frequent in ICUs than in medical and surgical wards and a significant proportion of pressure ulcers are not reported. https://ijph.tums.ac.ir/index.php/ijph/article/view/4062 https://ijph.tums.ac.ir/index.php/ijph/article/download/4062/3721

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 6 2014 06 15 793 9 Hamid Shirkhanloo 1. Iranian Petroleum Industry Health Research Institute (IPIHRI), Occupational and Environmental Health Research Center (OEHRC) , Tehran, Iran. Farideh Golbabaei 2. Dept. of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. Hamid Hassani 2. Dept. of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. Farrokh Eftekhar 1. Iranian Petroleum Industry Health Research Institute (IPIHRI), Occupational and Environmental Health Research Center (OEHRC) , Tehran, Iran. Mohammad Javad Kian 1. Iranian Petroleum Industry Health Research Institute (IPIHRI), Occupational and Environmental Health Research Center (OEHRC) , Tehran, Iran. 2015 10 15 Exposure to mercury (Hg) as a heavy metal can cause health effects. The objective of this study was to assess occupational exposure to Hg in a chlor-alkali petrochemical industry in Iran by determining of Hg concentrations in air, blood and urine samples.The study was performed on 50 exposed subjects and 50 unexposed controls. Air samples were collected in the breathing zone of exposed subjects, using hopcalite sorbents. Analysis was performed using a cold vapor atomic absorption spectrophotometer (CV-AAS) according to NIOSH analytical method 6009. For all participants, blood and urine samples were collected and then transferred into sterile glass tubes. After micro-extraction with ionic liquid and back extraction with nitric acid, Hg concentrations in blood and urine samples were determined by CV-AAS.The mean concentration of air Hg was 0.042± 0.003 mg/m(3). The mean concentrations of Hg in blood and urine samples of exposed subjects were significantly higher than unexposed controls (22.41± 12.58 versus 1.19± 0.95 μg/l and 30.61± 10.86 versus 1.99± 1.34 μg/g creatinine, respectively). Correlation of air Hg with blood Hg, urine Hg and blood Hg-urine Hg ratio were significant statistically (P< 0.05).The values of Hg in blood and urine samples of chlor-alkali workers were considerably high. Correlation coefficients showed that blood Hg and blood Hg-urine Hg ratio are better indicators than urine Hg for assessing occupationally exposed workers in terms of current exposure assessment. https://ijph.tums.ac.ir/index.php/ijph/article/view/4060 https://ijph.tums.ac.ir/index.php/ijph/article/download/4060/3719

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 6 2014 06 15 800 8 Ali Zare Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. Mahmood Mahmoodi Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. Kazem Mohammad Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. Hojjat Zeraati Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran.