Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 8 2014 08 15 1022 32 Sepideh Nabipour 1. Dept. of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia. Mas Ayu Said 1. Dept. of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia. Mohd Hussain Habil 2. Dept. of Psychological Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia. 2015 10 15 Addiction to the illicit and prescribed use of opiate is an alarming public health issue. Studies on addictive disorders have demonstrated severe nutritional deficiencies in opiate abusers with behavioral, physiological and cognitive symptoms. Opiate addiction is also link with a significant number of diseases including Human Immunodeficiency Virus (HIV), Hepatitis C Virus (HCV) and other blood borne diseases generally stem from the use of needles to inject heroin. The use of medication assisted treatment for opioid addicts in combination with behavioural therapies has been considered as a highly effective treatment. Methadone is a long-lasting μ-opioid agonist and a pharmacological tool which attenuates withdrawal symptoms effectively replacement therapies. This review article aims to explain opiate addiction mechanisms, epidemiology and disease burden with emphasis on dietary and nutritional status of opiate dependent patients in methadone maintenance therapy. https://ijph.tums.ac.ir/index.php/ijph/article/view/3951 https://ijph.tums.ac.ir/index.php/ijph/article/download/3951/3610

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 8 2014 08 15 1033 44 Elżbieta Biernat 1. Collegium of World Economy, Warsaw School of Economics , Poland. Monika Piątkowska 2. Dept. of Organization and History of Physical Culture, Josef Pilsudski University of Physical Education in Warsaw , Poland. 2015 10 15 The aim of the current investigation was to evaluate the sedentary lifestyle of the Polish population and its link with prolonged sitting in light of individual and environmental factors.The sample consisted of 1505 Polish people between 18 and 64 years old. The Computer-Assisted Telephone Interview (CATI) survey was conducted with the Polish version of International Physical Activity Questionnaire (IPAQ-LF) and the survey of the determinants of a sport activity among the Polish population. The relationships between the time spent sitting and the individual and environmental factors among Polish citizens were investigated through log-linear analysis.The total time Polish people spent sitting was 2812.4±1593.9 min/week. During the weekend, men (Chi(2)=45.0; P=0.04) spent significantly more time sitting than women (251.1±170.1min/week, 230.9±155.0 min/week, respectively). Despite the relatively high proportion of people declaring participation in the Sport for All initiative (67.8%), only 9.6% of Polish people undertake a physical activity on a daily basis. The odds ratios above the median (>2545 min/week) are higher (OR=1.33; 95% CI=1.03-1.72) for those who are not physically active (54.5% vs. 45.5%). There was no relationship between prolonged sitting time and the environmental factors.It is necessary to increase consistent efforts to create an environment that would successfully promote anactive lifestyle among Polish citizens in their place of residence and prevent sedentary behaviours within this population. The recommendations for physical activity should include the guidelines intervening in the time people spend sitting. https://ijph.tums.ac.ir/index.php/ijph/article/view/3947 https://ijph.tums.ac.ir/index.php/ijph/article/download/3947/3608

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 8 2014 08 15 1045 59 Azian Hariri 1. Faculty of Mechanical and Manufacturing Engineering, Universiti Tun Hussein Onn Malaysia , Johor, Malaysia. Nuur Azreen Paiman 1. Faculty of Mechanical and Manufacturing Engineering, Universiti Tun Hussein Onn Malaysia , Johor, Malaysia. Abdul Mutalib Leman 2. Faculty of Engineering Technology, Universiti Tun Hussein Onn Malaysia , Johor, Malaysia. Mohammad Zainal Md Yusof 1. Faculty of Mechanical and Manufacturing Engineering, Universiti Tun Hussein Onn Malaysia , Johor, Malaysia. 2015 10 15 This study aimed to develop an index that can rank welding workplace that associate well with possible health risk of welders.Welding Fumes Health Index (WFHI) were developed based on data from case studies conducted in Plant 1 and Plant 2. Personal sampling of welding fumes to assess the concentration of metal constituents along with series of lung function tests was conducted. Fifteen metal constituents were investigated in each case study. Index values were derived from aggregation analysis of metal constituent concentration while significant lung functions were recognized through statistical analysis in each plant.The results showed none of the metal constituent concentration was exceeding the permissible exposure limit (PEL) for all plants. However, statistical analysis showed significant mean differences of lung functions between welders and non-welders. The index was then applied to one of the welding industry (Plant 3) for verification purpose. The developed index showed its promising ability to rank welding workplace, according to the multiple constituent concentrations of welding fumes that associates well with lung functions of the investigated welders.There was possibility that some of the metal constituents were below the detection limit leading to '0' value of sub index, thus the multiplicative form of aggregation model was not suitable for analysis. On the other hand, maximum or minimum operator forms suffer from compensation issues and were not considered in this study. https://ijph.tums.ac.ir/index.php/ijph/article/view/3945 https://ijph.tums.ac.ir/index.php/ijph/article/download/3945/3606

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 8 2014 08 15 1060 9 Yuan Zhao 1. Imaging Center, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054 , Xinjiang, China. Wenya Liu 1. Imaging Center, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054 , Xinjiang, China. Ma Hua 1. Imaging Center, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054 , Xinjiang, China. Raoni Shi 2. Urumqui Center for Disease Control and Prevention, Urumqi 830011 , Xinjiang, China. Haitao Wang 1. Imaging Center, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054 , Xinjiang, China. Wen Yang 1. Imaging Center, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054 , Xinjiang, China. 2015 10 15 Peak bone mineral density (PBMD) is influenced by both genetic and environmental factors, genes explains most of variation. As the novel candidate genes CATSPERB and NR5A2 may have been associated with spinal PBMD in adult. This study was to investigate the relationship among these two genes^ PBMD and the life style factors in young female.The rs1298989 single nucleotide polymorphism (SNP) of the CATSPERB gene and the rs3762397 SNP of the NR5A2 gene were genotyped using SNaPshot® in 359 students from Xinjiang. The prospective study included 203 Han and 156 Uyghur subjects. PBMD was measured using quantitative computed tomography (QCT). Calcium, phosphate and alkaline phosphatase were measured by ELISA method. Physical activity, dietary calcium and life styles were assessed by questionnaire.Both SNPs showed differences in genotype and allele frequencies (P < 0.05) between the Han and Uyghur subjects. Total calcium intake, energy intake, tea and milk intake were also significantly different between two groups (P < 0.05). Multiple regression analysis showed an association between PBMD and vitamin D intake (P = 0.000), milk (P = 0.000), exercise (P = 0.029), rs1298989 (P = 0.028), energy intake (P = 0.043).This study demonstrated the polymorphisms of the rs1298989 and rs3762397 are associated with PBMD both in Han and Uyghur subjects. PBMD, in Xinjiang, appears to be associated with several known factors that are well described in the literature. While the genotypes of rs1298989 and rs3762397 do not appear have a strong effect on the PBMD. https://ijph.tums.ac.ir/index.php/ijph/article/view/3943 https://ijph.tums.ac.ir/index.php/ijph/article/download/3943/3604

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 8 2014 08 15 1070 8 Petra Duchečková 1. Dept. of Preventive Medicine, Faculty of Medicine, Masaryk University , Brno, Czech Republic ; 2. Dept. of Anthropology, Faculty of Science, Masaryk University , Brno, Czech Republic. Martin Forejt 1. Dept. of Preventive Medicine, Faculty of Medicine, Masaryk University , Brno, Czech Republic. 2015 10 15 The purpose of this study was to examine the relation between daily steps and aerobic steps, and anthropometric variables, using the waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR).The participants in this cross-sectional study were taken the measurements of by a trained anthropologist and then instructed to wear an Omron pedometer for seven consecutive days. A series of statistical tests (Mann-Whitney U test, Kruskal-Wallis ANOVA, multiple comparisons of z' values and contingency tables) was performed in order to assess the relation between daily steps and aerobic steps, and anthropometric variables.A total of 507 individuals (380 females and 127 males) participated in the study. The average daily number of steps and aerobic steps was significantly lower in the individuals with risky WHR and WHtR as compared to the individuals with normal WHR (P=0.005) and WHtR (P=0.000). A comparison of age and anthropometric variables across aerobic steps activity categories was statistically significant for all the studied parameters. According to the contingency tables for normal steps, there is a 5.75x higher risk in the low-activity category of having WHtR>0.50 as compared to the high-activity category.Both normal and aerobic steps are significantly associated with central obesity and other body composition variables. This result is important for older people, who are more likely to perform low-intensity activities rather than moderate- or high-intensity activities. Our results also indicate that risk of having WHtR>0.50 can be reduced by almost 6x by increasing daily steps over 8985 steps per day. https://ijph.tums.ac.ir/index.php/ijph/article/view/3941 https://ijph.tums.ac.ir/index.php/ijph/article/download/3941/3602

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 8 2014 08 15 1079 90 Mohsen Shati 1. Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. AliAkbar Haghdoost 2. Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences , Kerman, Iran. Reza Majdzadeh 1. Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. Kazem Mohammad 1. Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. SeyedeSalehe Mortazavi 3. Dept. of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran. 2015 10 15 Network scale-up is an indirect method for estimating the size of hidden, hard-to-count or high risk populations. Social network size estimation is the first step in this method. The present study was conducted with the purpose of estimating the social network size of the Tehran Province residents and its determinants.Maximum Likelihood Estimation was applied to estimate people's network sizes by using populations of known sizes and the scale-up method. Respondents were selected from Tehran province through convenience sampling in 2012. Out of thirteen selected subpopulations with known size, ten had minimum accuracy which used in our analysis.Of the 1029 respondents in this study, 46.7% were male. The social network size of Tehran Province residents was estimated to be 259.1 (CI95%: 242.2, 276) based on the ten known populations remained in this study. This size was 291.8 in men and 230.4 in women. Younger people (18-25 years old) had larger network sizes compared to the other age groups (P<0.001).Our estimation for social network size of Tehran inhabitants was smaller than that previously estimated size for the whole country (c=380). In addition, we found that the social network of subpopulations was different. This difference means that we need local estimations for sub-populations to improve the accuracy of population size estimation using network scale up method. https://ijph.tums.ac.ir/index.php/ijph/article/view/3939 https://ijph.tums.ac.ir/index.php/ijph/article/download/3939/3600

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 8 2014 08 15 1091 8 Maryam Farhadian 1. Dept. of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences , Hamadan. Iran . Hossein Mahjub 2. Research Center for Health Sciences and Dept. of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences , Hamadan, Iran. Abbas Moghimbeigi 3. Modeling of Noncommunicable Diseases Research Center and Dept. of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences , Hamadan, Iran. Jalal Poorolajal 3. Modeling of Noncommunicable Diseases Research Center and Dept. of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences , Hamadan, Iran. Muharram Mansoorizadeh 4. Dept. of Computer Engineering, Faculty of Engineering, Bu-Ali Sina University , Hamadan, Iran. 2015 10 15 An important aspect of microarray studies includes the prediction of patient survival based on their gene expression profile. To deal with the high dimensionality of this data, use of a dimension reduction procedure along with the survival prediction model is necessary. This study aimed to present a new method based on wavelet transform for survival relevant gene selection.The data included 2042 gene expression measurements from 40 patients with Diffuse Large B-Cell Lymphomas (DLBCL). The pre-processing gene expression data is decomposed using third level of the 1D discrete wavelet transform. The detail coefficients at levels 1 and 2 are filtered out and expression data reconstructed using the approximation and detailed coefficients at the third level. All the genes are then scored based on the t score. Then genes with the highest scores are selected. By using forward selection method in Cox regression model, significant genes were identified.The results showed wavelet-based gene selection method presents acceptable survival prediction. Using this method, six significant genes were selected. It was indicated the expression of GENE3359X and GENE3968X decreased the survival time, whereas the expression of GENE967X, GENE3980X, GENE3405X and GENE1813X increased the survival time.Wavelet-based gene selection method is a potentially useful tool for the gene selection from microarray data in the context of survival analysis. https://ijph.tums.ac.ir/index.php/ijph/article/view/14911 https://ijph.tums.ac.ir/index.php/ijph/article/download/14911/6157

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 10 2018 10 06 1504 1510 Hülya KÖK EREN Dept. of Psychiatric Nursing, Faculty of Health Sciences, Eskişehir Osmangazi University, Eskişehir, Turkey Özlem ÖRSAL Dept. of Public Health Nursing, Faculty of Health Sciences, Eskişehir Osmangazi University, Eskişehir, Turkey 2018 10 06 Background: We aimed to determine the level of computer game addiction and loneliness among 9-10-yr-old children. Methods: The study was conducted with 4th-grade students at a primary school, located at the city center, during 2017-2018 academic years. There was no sampling in the research, all 4th-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. Results: 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; P<0.000). Conclusion: 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.   https://ijph.tums.ac.ir/index.php/ijph/article/view/14912 https://ijph.tums.ac.ir/index.php/ijph/article/download/14912/6158

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 10 2018 10 06 1511 1519 Wenxiang LI Dept. of Gynecology, Women & Children’s Health Care Hospital of Linyi, Linyi, China 2018 10 06 Background: We aimed to investigate the influence of nursing intervention on recurrent vulvovaginal candidiasis (RVVC) patients treated with adenosine triphosphate (ATP)-infrared bio-effect technique. Methods: Sixty eight RVVC patients of Women & 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. Results: After the total course of treatment, there was significant difference in the cure rate between the two groups of patients (P<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 (P=0.029; P=0.049; P=0.042; P=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 (P<0.01). Conclusion: 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.        https://ijph.tums.ac.ir/index.php/ijph/article/view/14913 https://ijph.tums.ac.ir/index.php/ijph/article/download/14913/6159

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 10 2018 10 06 1520 1528 Selen YILMAZ IŞIKHAN Vocational School of Social Sciences, Hacettepe University, Ankara, Turkey AND Dept. of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey Dilek GÜLEÇ Polatlı Vocational School of Health Services, Hacettepe University, Ankara, Turkey 2018 10 06 Background: 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. Methods: 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. Results: 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 (P<0.001). Conclusion: 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.   https://ijph.tums.ac.ir/index.php/ijph/article/view/14914 https://ijph.tums.ac.ir/index.php/ijph/article/download/14914/6160

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 10 2018 10 06 1529 1536 Jing WANG Clinical Laboratory, Weihaiwei People’s Hospital, Weihai 264200, China Xiaofeng LIU Clinical Laboratory, Pingdu People’s Hospital, Pingdu 266700, China 2018 10 06 Background: We aimed to investigate the correlation between Helicobacter pylori infection and the development and prognosis of gastric cancer. Methods: 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 H. pylori infection in gastric cancer tissues and paracancerous tissues. The relationship between clinicopathological parameters and H. pylori relative infection was analyzed. Kaplan-Meier was used for survival analysis. Results: The relative amount of H. pylori infection in gastric cancer tissues was significantly higher than that in paracancerous normal tissues (P<0.001). The relative H. pylori infection was related to tumor size, lymph node metastasis, clinical stage, and depth of invasion (P<0.05). The 1-, 3-, and 5-year survival rates of gastric cancer patients were negatively correlated with the relative H. pylori infection. The relative H. pylori 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. Conclusion: The relative H. pylori infection and clinical stage of patients could increase the risk of death in gastric cancer patients. H. pylori 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.   https://ijph.tums.ac.ir/index.php/ijph/article/view/14915 https://ijph.tums.ac.ir/index.php/ijph/article/download/14915/6161

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 10 2018 10 06 1537 1545 Nazish IMRAN Dept. of Child & Family Psychiatry, King Edward Medical University/Mayo Hospital, Lahore, Pakistan Atif RAHMAN Institute of Psychology, Health & Society, University of Liverpool, Liverpool, United Kingdom Nakhshab CHAUDHRY Dept. of Basic Sciences, King Edward Medical University, Lahore, Pakistan Aftab ASIF Dept. of Psychiatry & Behavioral Sciences, King Edward Medical University/Mayo Hospital, Lahore, Pakistan 2018 10 06 Background: 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. Methods: 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. Results: Teachers identified learning problems, inattention, disobedience, aggression, lying & 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. Conclusion: 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.     https://ijph.tums.ac.ir/index.php/ijph/article/view/14916 https://ijph.tums.ac.ir/index.php/ijph/article/download/14916/6162

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 10 2018 10 06 1546 1551 Yao CHEN Dept. of Obstetrics, The Fifth Affiliated Hospital Sun Yat-Sen University, Zhuhai, China Zhihuai MO Dept. of Obstetrics, The Fifth Affiliated Hospital Sun Yat-Sen University, Zhuhai, China Jianyong CAO Dept. of Obstetrics, The Fifth Affiliated Hospital Sun Yat-Sen University, Zhuhai, China Zhaojuan SU Dept. of Obstetrics, The Fifth Affiliated Hospital Sun Yat-Sen University, Zhuhai, China Yuexia ZHANG Dept. of Obstetrics, The Fifth Affiliated Hospital Sun Yat-Sen University, Zhuhai, China Fang CHEN Dept. of Obstetrics, The Fifth Affiliated Hospital Sun Yat-Sen University, Zhuhai, China Jianying WANG Dept. of Neurology, The Fifth Affiliated Hospital Sun Yat-Sen University, Zhuhai, China 2018 10 06 Background: To investigate the effect of applying doctor-nurse-patient integration management mode to patients with endometriosis (EMT). Methods: 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. Results: 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 (t=-11.44, -9.42, P<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, P<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, P< 0.01). Conclusion: 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.   https://ijph.tums.ac.ir/index.php/ijph/article/view/14917 https://ijph.tums.ac.ir/index.php/ijph/article/download/14917/6163

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 10 2018 10 06 1552 1557 Masoud BEHZADIFAR Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran Tina BEYRANVAND Dept. of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Mehdi JAFARI Dept. of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Meysam BEHZADIFAR Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran Masood TAHERI MIRGHAED Dept. of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Mariano MARTINI Dept. of Health Sciences (DISSAL), Section of History of Medicine and Ethics, University of Genoa, Genoa, Italy Nicola Luigi BRAGAZZI Dept. of Health Sciences (DISSAL), School of Public Health, University of Genoa, Genoa, Italy 2018 10 06 Background: 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. Methods: 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. Results: 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) Conclusion: 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.   https://ijph.tums.ac.ir/index.php/ijph/article/view/14919 https://ijph.tums.ac.ir/index.php/ijph/article/download/14919/6164

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 10 2018 10 06 1558 1566 Mohammad Hosein KALANTAR MOTAMEDI Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran Abolfazl ABOUIE Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran Nima HAFEZI-NEJAD Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran Soheil SAADAT Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran Afarin RAHIMI-MOVAGHAR Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran Abbas MOTEVALIAN Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran Masoumeh AMIN-ESMAEILI Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran Vandad SHARIFI Dept. of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Ahmad HAJEBI Research Center for Addiction & Risky Behavior (ReCARB), Iran University of Medical Sciences, Tehran, Iran AND Dept. of Psychiatric, Iran University of Medical Sciences, Tehran, Iran Ali EBRAHIMI Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran Vafa RAHIMI-MOVAGHAR Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran 2018 10 06 Background: This study was aimed to determine the prevalence, predictors and cost of CAM practitioner use among traumatic patients in Iran. Methods: 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. Results: 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. Conclusion: 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.     https://ijph.tums.ac.ir/index.php/ijph/article/view/14920 https://ijph.tums.ac.ir/index.php/ijph/article/download/14920/6165

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 10 2018 10 07 1567 1574 Davood YARI Cellular and Molecular Research Center, Zahedan University of Medical Sciences, Zahedan, Iran AND Dept. of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran Ramin SARAVANI Cellular and Molecular Research Center, Zahedan University of Medical Sciences, Zahedan, Iran AND Dept. of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran Samira SARAVANI Dept. of Biology, School of Fundamental Science, University of Zabol, Zabol, Iran Kamran EBRAHIMIAN Dept. of Molecular Biotechnology, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain Hamid Reza GALAVI Dept. of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran 2018 10 07 Background: Keratoconus (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. Methods: 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. Results: CAT rs7943316 A/T, AA genotype and A allele have a protective role against disease (OR =0.28, 95% CI =0.13-0.61, P=0.001 and OR = 0.50, 95% CI =0.35-0.72, P=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, P=0.03). Conclusion: 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.     https://ijph.tums.ac.ir/index.php/ijph/article/view/14927 https://ijph.tums.ac.ir/index.php/ijph/article/download/14927/6166

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 10 2018 10 07 1575 1582 Mehdi MOHAMMADZADEH Dept. of Pharmacoeconomy and Administrative Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Pharmacoeconomy & Medical-Pharma Management Research Center, Tehran, Iran Hamid DERAFSHI Dept. of Ophthalmology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran AND Dept. of Ophthalmology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Tayebeh GHARI Pharmacoeconomy & Medical-Pharma Management Research Center, Tehran, Iran AND Dept. of Pharmaceutics, School of Pharmacy, Alborz University of Medical Sciences, Karaj, Iran 2018 10 07 Background: 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. Methods: 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. Results: Economic burden of HCV infection was obtained 26242.8 purchasing power parity (PPP$). Intangible costs of HCV was calculated 207421.6 PPP$. Conclusion: 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.   https://ijph.tums.ac.ir/index.php/ijph/article/view/14928 https://ijph.tums.ac.ir/index.php/ijph/article/download/14928/6167

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 10 2018 10 07 1583 1592 Jafar Sadegh TABRIZI Tabriz Health Services Management Research Center, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran Homayoun SADEGHI-BAZARGANI Dept. of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran Mostafa FARAHBAKHSH Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran Leila NIKNIAZ Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Zeinab NIKNIAZ Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 2018 10 07 Background: This population-based study aimed at investigating the prevalence and associated factors of overweight /obesity and abdominal obesity in Iran. Methods: 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. Results: 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 (P< 0.001). In men and women, nonsmokers (P<0.01) and subjects having more than two kids (P< 0.001) were also more expected to be overweight or obese and abdominally obese respectively. Conclusion: More actions mostly focusing on education and physical activity levels, and changing eating habits are required.   https://ijph.tums.ac.ir/index.php/ijph/article/view/14929 https://ijph.tums.ac.ir/index.php/ijph/article/download/14929/6168

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 10 2018 10 07 1593 1598 Reza AZIMI Health Care Management, Sari Branch, Islamic Azad University, Sari, Iran Ghahraman MAHMOUDI Hospital Administration Research Center, Sari Branch, Islami