Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 3 2012 03 15 1 8 R Prakash Upadhyay 2015 10 03 Non-communicable disease continues to be an important public health problem in India, being responsible for a major proportion of mortality and morbidity. Demographic changes, changes in the lifestyle along with increased rates of urbanization are the major reasons responsible for the tilt towards the non-communicable diseases. In India, there is no regular system for collecting data on non-communicable diseases (NCDs) which can be said to be of adequate coverage or quality. Lack of trained health care workers, primary care providers armed with inadequate knowledge and skills along with ill-defined roles of various health sectors i.e. public, private, and voluntary sectors in providing care have played key hurdles in combating the growing burden of non-communicable diseases. Empowerment of the community through effective health education, use of trained public health personnel along with provision of free health care and social insurance would prove beneficial in effectively controlling the growing prevalence of NCDs. https://ijph.tums.ac.ir/index.php/ijph/article/view/2598 https://ijph.tums.ac.ir/index.php/ijph/article/download/2598/2578

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 3 2012 03 15 9 19 A Sathiya Susuman 2015 10 03 Ethiopia's childhood mortality has continued to decline although at a swift pace. The drop in urban childhood mortality decline, duration of breastfeeding is the principle reason for the overall decline in mortality trends in Ethiopia.  Data from the Ethiopian Demographic and Health Surveys 2000 and 2005 were used. Indirect estimation of Brass and Trussell's methods were adopted. Selected demographic and socio-economic variables were included in the analysis with statistically significant effects. Findings clearly show neonatal and post neonatal mortality decline gradually.  Even though, Ethiopia's childhood mortality rates are still high. The result shows less than 2 years birth interval have higher infant mortality rates than higher birth interval (113 deaths per 1000). The proper spacing of births allows more time for childcare to make more maternal resources available for the care of the child and mother. Therefore, further research is urgent for regional level and national level investigation. https://ijph.tums.ac.ir/index.php/ijph/article/view/2599 https://ijph.tums.ac.ir/index.php/ijph/article/download/2599/2579

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 3 2012 03 15 20 25 Lh Tu H Li Hp Zhang Xd Li Jj Lin Cl Xiong 2015 10 03 Background: To determine the prevalence and characteristics of birth defects in perinatal infants in Hubei Province during 200l-2008. Methods: The prevalence of birth defects in perinatal infants delivered after 28 weeks or more was analyzed in Hubei surveillance hospitals during 200l-2008. Results: The incidence of birth defects in perinatal infants from 200l to 2008 was 120.0 per 10,000 births, and was increased by about 41% from 81. 1 in 2001 to 138.5 per 10,000 births in 2008. The incidence in the first 4 years (2005-2008) was much higher than the latter four (2001-2004) (χ2=77.64 , P <0.05). The difference in prevalence between urban and rural was of no significance in 2008 (χ2=0.03，P >0.05), but that between male and female was significant (χ2=5.24 , P <0.05), as the former prevalence was much higher. The prevalence of birth defects was slightly higher among mothers over 35 years old than those under 35 years old, but with no significance (χ2=1.98, P >0.05). The two leading birth defects were cleft lip and/or palate and polydactyly, followed by congenital heart disease, hydrocephaly, external ear malformation and neural tube defects. The prevalence of congenital heart disease was rising. Conclusions: Eight years' birth defects data indicate that the birth defect rate was on the rise and the birth defects prevalence in Hubei province should be valued. https://ijph.tums.ac.ir/index.php/ijph/article/view/2600 https://ijph.tums.ac.ir/index.php/ijph/article/download/2600/2580

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 3 2012 03 15 26 35 Q Cheng W Wang H Wang W ang Z Zhao 2015 10 03 Background: Heavy metal pollution in the sediment of the Yellow River draws wide attention in the recent years. The Yellow River Wetland Nature Reserve of Zhengzhou is one of the major wetlands of the river and located at the beginning of the lower reach. In this article, we aimed to investigate the degree and the sources of the metal pollution in the reserve. Methods: Metals as Cu, Pb, Cr, Cd and Mn in the sediment were monitored using flame atomic absorption spectrometry. The index of geo-accumulation (Igeo) and the modified degree of contamination (mCd) were developed to evaluate individual metal pollution and overall enrichment impact of the elements. Results: Compared with sediment quality guidelines, the effect of Cr and Pb are more serious than others. Igeo values show Pb pollution are moderate at the Xinzhai, Langchenggang and Nansutan sites, and mCd analysis indicate the whole contamination at the Wantan, Langchenggang and Nansutan sites was low. Principal component analysis indicated that the first factor was Cu, Mn and Cd, mainly from soil erosion and the irrational use of phosphate fertilizers; the second Pb from fossil fuel burning; and the third Cr from weathering process. Conclusion: We conclude that Pb contamination is serious in the reserve, and the main sources of the metal are crude oil consumption and coal combustion of the brick kilns around. We also draw a conclusion that it is vital to evaluate contamination degree with both individual elements and overall average. https://ijph.tums.ac.ir/index.php/ijph/article/view/2601 https://ijph.tums.ac.ir/index.php/ijph/article/download/2601/2581

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 3 2012 03 15 36 47 SH Abbasi A Ponce De Leon SE Kassaian AA Karimi Ö Sundin J Soares G Macassa 2015 10 03 Background: Given gender differences in the risk of coronary artery disease (CAD), the present study sought to investigate these dissimilarities amongst patients who underwent angiography at a major, tertiary heart hospital in Iran. Methods: Between 2005 and 2010, 44,820 patients who underwent coronary angiography were enrolled in a registry. Pre-procedural data such as demographics, CAD risk factors, presenting symptoms, and laboratory tests, as well as post-procedural data were collected. The data were, subsequently, compared between the men and women. Results: Out of the 44,820 patients (16,378 women), who underwent coronary angiography, 37,358 patients (11,995 women) had CAD. Amongst the CAD patients, the females were not only significantly older, less educated, and more overweight than were the males but also had higher levels of triglyceride, cholesterol, low-density lipoprotein, high-density lipoprotein, and fasting blood sugar (P< 0.001). Of all the risk factors, hypertension and diabetes mellitus showed the strongest association in our female CAD patients (OR=3.45, 95%CI: 3.28-3.61 and OR=2.37, 95%CI: 2.26-2.48, respectively). Acute coronary syndrome was more prevalent in the men (76.1% vs. 68.6%, P< 0.001), and chronic stable angina was more frequent in the females (31.4% vs. 23.9%, P< 0.001). With respect to post-procedural recommendations, the frequency of recommendations for non-invasive modalities was higher in the females (20.1% vs. 18.6%, P< 0.001).  Conclusion: Hypertension and diabetes mellitus had the strongest association with CAD in our female patients. In the extensive CAD patients, medical treatment was recommended to the women more often. https://ijph.tums.ac.ir/index.php/ijph/article/view/2602 https://ijph.tums.ac.ir/index.php/ijph/article/download/2602/2582

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 3 2012 03 15 48 64 S Nur Sulku D Minbay Bernard 2015 10 03 In this study, we examine whether and to what extent the health insurance system in Turkey provided adequate protection against high out of pocket expenditures in the period prior to "The Health Transformation Programme". Furthermore, we examine the distribution of out of pocket expenditures by demographic characteristics, poverty status, health service type, access to health care and self-reported health status. We employ the 2002/03 National Household Health Expenditure Survey data to analyze financial burden of health care expenditure. Following the literature, we define high burdens as expenses above 10 and 20% of income. We find that 19%  of the nonelderly population were living in families spending more than 10% of family income and that 14% of the nonelderly population were living in families spending more than 20% of family income on health care. Furthermore, the poor and those living in economically less developed regions had the greatest risk of high out of pocket burdens. The risk of high financial burdens varied by the type of insurance among the insured due to differences in benefits among the five separate public schemes that provided health insurance in the pre-reform period. Our results are robust to three alternative specifications of the burden measure and including elderly adults in the sample population. We see that prior to the reforms there were not adequate protection against high health expenditures. Our study provides a baseline against which policymakers can measure the success of the health care reform in terms of providing financial protection. https://ijph.tums.ac.ir/index.php/ijph/article/view/2603 https://ijph.tums.ac.ir/index.php/ijph/article/download/2603/2583

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 3 2012 03 15 65 70 R Bakhtiari MM Soltan Dallal JF Mehrabadi S Heidarzadeh MR Pourmand 2015 10 03 Background: Group  B  streptococcus  (GBS)  is  one  of  the  most  important  cause  of  morbidity  and  mortality  among  newborns  especially  in  developing  countries.  It  has  been  shown  that  the  screening  approach  rather  than  the  identification  of  maternal  clinical  risk  factors  for  early-onset  neonatal  GBS  disease  is  more  effective  in  preventing  early-onset  GBS  neonatal  disease.  The  objective  of  this  study  was  to  detect  GBS  among  clinical  samples  of  women  using  PCR  and  standard  microbiological  culture. Methods: Samples  were  taken  from  375  women  at  28-38  weeks  of  gestation  during  six month  from  January  15  till  June  15,  2011  from  a  hospital  in  Tehran,  Iran.  Samples  were  tested  by  standard  culture  using  Todd-Hewitt  broth,  blood  agar  and  by  PCR  targeting  the  cfb  gene. Results: Among  the  375  women,  35  (9.3%)  were  identified  as  carriers  of  group  B  streptococci  on  the  basis  of  the  results  of  the  cultures  of  specimens,  compared  to  42  (11.2 %)  on  the  basis  of  PCR  assay. Conclusion: We  found  that  GBS  can  be  detected  rapidly  and  reliably  by  a  PCR  assay  in  vaginal  secretions  from  women  at  the  time  of  delivery.  This  study  also  showed  that  the  rate  of  incidence  of  GBS  is  high  in  Iranian  women. https://ijph.tums.ac.ir/index.php/ijph/article/view/2604 https://ijph.tums.ac.ir/index.php/ijph/article/download/2604/2584

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 41 3 2012 03 15 71 81 J Poorolajal R Zamani RS Mir-Moeini B Amiri MM Majzoobi H Erfani SJ Bathaei 2015 10 03 Background: Now the increasing growth of chronic diseases is the major health challenge worldwide. This survey was conducted to assess noncommunicable diseases related risk factors. Methods: A population-based cross sectional study was conducted in 2005 and repeated annually by 2009 in Hamadan province, the west of Iran using two-stage cluster sampling method. A total sample of 6500 subjects 15 to 64 years old were enrolled. Results: The total prevalence of cigarette smoking was 18% [95% CI 17% to 19%], 35.1% in men versus 1.1% in women. The smokers consumed on average 15 cigarettes per day. Almost 26.3% [95% CI 24.8% to 27.7%] of the target population eat five or more servings of fruits and vegetables per day; 52.8% [95% CI 51.2% to 54.3%] had work related physical activity; 28.1% [95% CI 26.7% to 29.4%] had physical activity during leisure time; 80.3% [95% CI 79.0% to 81.5%] had transportation related physical activity; 47.2% [95% CI 46.0% to 48.4%] were either overweight or obese; 8.1% [95% CI 7.1% to 9.2%] had impaired fasting blood sugar or were confirmed diabetes; 33.7% [95%e. Besides, the haplotype GCG of TLR-4 was significantly associated with A. baumanii infection (P = 0.027). Conclusion:  TLR-4 and TLR-9 may be related to the susceptibility to A. baumanii infection in a Chinese population.     https://ijph.tums.ac.ir/index.php/ijph/article/view/5840 https://ijph.tums.ac.ir/index.php/ijph/article/download/5840/5274

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 1 2016 02 13 107 108 Hua ZHANG Dept. of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China Jianqian CHAO Dept. of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China Shiyuan WANG Dept. of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China Pei LIU Dept. of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China 2016 01 27 2016 01 27 No Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/5854 https://ijph.tums.ac.ir/index.php/ijph/article/download/5854/5288

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 1 2016 02 13 27 33 Omid HAMIDI Dept. of Science, Hamadan University of Technology, Hamadan, Iran Jalal POOROLAJAL Modeling of Noncommunicable Diseases Research Center, Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Maryam FARHADIAN Modeling of Noncommunicable Diseases Research Center, Dept. of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Leili TAPAK Dept. of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran 2016 01 27 2016 01 27 Background: Kidney transplantation is the best alternative treatment for end-stage renal disease. Several studies have been devoted to investigate predisposing factors of graft rejection. However, there is inconsistency between the results. The objective of the present study was to utilize an intuitive and robust approach for variable selection, random survival forests (RSF), and to identify important risk factors in kidney transplantation patients. Methods: The data set included 378 patients with kidney transplantation obtained through a historical cohort study in Hamadan, western Iran, from 1994 to 2011. The event of interest was chronic nonreversible graft rejection and the duration between kidney transplantation and rejection was considered as the survival time. RSF method was used to identify important risk factors for survival of the patients among the potential predictors of graft rejection. Results: The mean survival time was 7.35±4.62 yr. Thirty-seven episodes of rejection were occurred. The most important predictors of survival were cold ischemic time, recipient's age, creatinine level at discharge, donors’ age and duration of hospitalization. RSF method predicted survival better than the conventional Cox-proportional hazards model (out-of-bag C-index of 0.965 for RSF vs. 0.766 for Cox model and integrated Brier score of 0.081 for RSF vs. 0.088 for Cox model). Conclusion: A RSF model in the kidney transplantation patients outperformed traditional Cox-proportional hazard model. RSF is a promising method that may serve as a more intuitive approach to identify important risk factors for graft rejection.   https://ijph.tums.ac.ir/index.php/ijph/article/view/5841 https://ijph.tums.ac.ir/index.php/ijph/article/download/5841/5275

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 1 2016 02 13 109 111 Seyed Ramin RADFAR Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran AND UCLA Integrated Substance Abuse Program, Los Angeles, USA Pardis NEMATOLLAHI Dept. of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mahfar ARASTEH Delasa Heart Center, Sina Heart Hospital, Isfahan, Iran 2016 01 27 2016 01 27 No Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/5855 https://ijph.tums.ac.ir/index.php/ijph/article/download/5855/5289

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 1 2016 02 13 34 40 Jie SHEN Dept. of Nursing, Xuzhou First People's Hospital，Xuzhou, China AND Xuzhou Eye Disease Prevention and Research Institute, Xuzhou, China Su-Yan LI Xuzhou Eye Disease Prevention and Research Institute, Xuzhou, China AND Dept. of Ophthalmology, Xuzhou First People's Hospital, Xuzhou, China Jian-Yu WANG Dept. of Nursing, Xuzhou First People's Hospital，Xuzhou, China AND Xuzhou Eye Disease Prevention and Research Institute, Xuzhou, China Jing CHEN Xuzhou Eye Disease Prevention and Research Institute, Xuzhou, China AND Ward of Ophthalmology Department, Xuzhou First People's Hospital, Xuzhou, China Wen WANG Xuzhou Eye Disease Prevention and Research Institute, Xuzhou, China AND Operating Room of Ophthalmology Department, Xuzhou First People's Hospital，Xuzhou, China 2016 01 27 2016 01 27 Background: We observed the clinical effects of comprehensive nursing intervention pattern in 23G minimally invasive vitreous surgery according to the comprehensive nursing intervention table developed by our hospital, which would supply a basis for its clinical application. Methods: In this prospective study, we followed 120 patients undergoing 23G minimally invasive vitreous surgery from Xuzhou First People's Hospital from February 2013 to February 2015 and divided them into control and observation groups by a random number table (60 patients in each group). A regular nursing pattern was adopted for the control group, and a comprehensive nursing intervention pattern was adopted for the observation group. After that, a comparative analysis was made to identify the differences between the clinical effects of the two groups. Results: Scores of cognition ratio, patient compliance and comfort level of patients in the observation group were higher than those of the control group were, and there was significant difference between the groups (P＜0.05). Complication incidence of the observation group is significantly lower than that of the control group (P＜0.05). Conclusion: The comprehensive nursing intervention pattern developed by our hospital can improve clinical effects notably, which is of application value .We recommend it to be applied in eye diseases.     https://ijph.tums.ac.ir/index.php/ijph/article/view/5842 https://ijph.tums.ac.ir/index.php/ijph/article/download/5842/5276

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 1 2016 02 13 112 113 Morteza BONYADI Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Iran AND Liver & Gastrointestinal Disease Research Center, University of Medical Sciences Tabriz, Iran Gholamreza NIAEI Dept. of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran Reza ABDOLMOHAMMADI Liver & Gastrointestinal Disease Research Center, University of Medical Sciences Tabriz, Iran 2016 01 27 2016 01 27 No Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/5856 https://ijph.tums.ac.ir/index.php/ijph/article/download/5856/5290

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 1 2016 02 13 41 47 Marjan AFGHAN Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Asghar GHASEMI Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Fereidoun AZIZI Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2016 01 27 2016 01 27 Background: Considering the lack of data available on changes of physical activity over time in Iran, this study was designed to evaluate changes in physical activity levels among Iranian adults over a median 6.5 yr period. Methods: In this population-based cohort study, 3515 participants, aged ≥ 20 yr (2100 females and 1415 males) were followed from phase II (2002-2005) to phase IV (2008-2011) of the Tehran Lipid and Glucose Study. Information on physical activity, both leisure time (LTPA) and occupational (OCPA), was collected using the Modifiable Activity Questionnaire. Scores ≤600 METs-min/wk were considered as having low physical activity. Wilcoxon test was performed for comparing MET values between the two phases. McNemar test was used to evaluate differences between paired qualitative data. Results: In both phases, 59.8% of adults were women, with mean±SD age 44.3±14.6 and 50.9±14.6 yr, in phases II and IV respectively. The prevalence of low physical activity decreased significantly in the follow up period (from 45.9% in phase II to 42.6% in phase IV, P=0.004). In both genders, a non-significant decrease in OCPA was observed, However, there was a significant decrease in LTPA among women (P=0.031), but not in men. Conclusion: Despite the high levels of physical activity in Tehranian adults, a decreasing trend was observed. Significant decrease in LTPA among women indicates the urgent need to target women for prevention and implementation of public educational programs to promote physical activity levels and LTPA in particular, to compensate the reduction in OCPA.     https://ijph.tums.ac.ir/index.php/ijph/article/view/5843 https://ijph.tums.ac.ir/index.php/ijph/article/download/5843/5277

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 1 2016 02 13 114 115 Salman KHAZAEI Dept. of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Hamid SALEHINIYA Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran Shahin SOLTANI Dept. of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Abdollah MOHAM­MADIAN-HAFSHEJANI Dept. of Epidemiology & Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran 2016 01 27 2016 01 27 No Abstract.  https://ijph.tums.ac.ir/index.php/ijph/article/view/5857 https://ijph.tums.ac.ir/index.php/ijph/article/download/5857/5291

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 1 2016 02 13 48 53 Xueqin LI Dept. of Hyperbaric Oxygen, Laiwu People's Hospital, Laiwu, China Yan ZHANG Dept. of Hemodialysis, Laiwu People's Hospital, Laiwu, China Hang GAO Dept. of Cardiovascular，Laiwu People's Hospital, Laiwu, China Xiujuan SUN Dept. of Urology Surgery，Laiwu People's Hospital, Laiwu, China Weifeng LV Dept. of Urology Surgery，Laiwu People's Hospital, Laiwu, China Guangyu XU Dept. of Urology Surgery，Laiwu People's Hospital, Laiwu, China 2016 01 27 2016 01 27 Background: In this study, specific measures of extended nursing services and its values on patients with bladder cancer after endoscopic bladder electrosection were examined. Methods:  Sixty-six patients diagnosed with bladder cancer in Laiwu People's Hospital(NO. 001, Xueyehu Street, Changshao Road, Laiwu, Shandong, China) between February 2012 and February 2014, and underwent endoscopic bladder electrosection were enrolled in the study. Patients were randomly allocated into the control group (n=30 cases) or the observation group (n=36 cases) according to the order of hospitalization. Conventional nursing measures were given to the control group while extended nursing service measures were given to the observation group, and the differences of nursing effect were compared.  Results: The occurrence rate of postoperative complications within the hospital for the observation group was significantly lower than that of the control group, as was the length of hospital stay. The nursing service satisfaction was also significantly improved within the observation group. These differences were statistically significance (P<0.05). The anxiety and depression scores for the observation group were significantly lower than that of control group and these differences were also of statistical significance (P<0.05). The follow-up compliance after hospitalization for the observation group was significantly enhanced, quality of life scores were signifD Dept. of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Payam TABARSI Mycobacteriology Research Center, National Research Institute for Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of