Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1018 1027 Mohsen VIGEH Maternal, Fetal & Neonatal Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran AND Dept. of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan AND Occupational Epidemiology Research Group, National Institute of Occupational Safety and Health, 6-21-6 Nagao, Tama-ku, Kawasaki, Japan Kazuhito YOKOYAMA Dept. of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan Takehisa MATSUKAWA Dept. of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan Atsuko SHINOHARA Dept. of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan Mamak SHARIAT Maternal, Fetal & Neonatal Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Katsumi OHTANI Occupational Epidemiology Research Group, National Institute of Occupational Safety and Health, 6-21-6 Nagao, Tama-ku, Kawasaki, Japan 2017 07 17 2017 07 17 Background: Although the level of exposure to many toxic metals decreased recently, the adverse effects of these metals on children’s growth and development remain a serious public health issue. Methods: The present study was conducted in three teaching hospitals affiliated with Tehran University of Medical Sciences (Tehran, Iran) from Sep 2012 to Mar 2013. To study the relationship between metals and childhood growth, concentrations of zinc and several potentially toxic metals (lead, cadmium, antimony, cobalt, and molybdenum) were measured in scalp hair for 174 children, aged 20 to 36 months. Results: The hair concentrations of cobalt were significantly (P<0.05) higher in children at the lower percentile of weight than in higher-weight children (0.026 ± 0.04 vs. 0.015 ± 0.01 µg/g, respectively). Hair contents of lead, cobalt, and antimony were significantly higher (P<0.05) in girls than in boys (8.08 ± 8.7 vs. 4.92 ± 5.6 µg/g for lead, 0.026 ± 0.03 vs. 0.16 ± 0.02 µg/g for cobalt, and 0.188 ± 0.29 vs. 0.102 ± 0.12 µg/g for antimony). There were also significant correlations between lead and other metals in the children’s hair. Conclusion: Gender may play a significant role in absorption and/or accumulation of metals. It should be considered when we study metal toxicity in children.     https://ijph.tums.ac.ir/index.php/ijph/article/view/10600 https://ijph.tums.ac.ir/index.php/ijph/article/download/10600/5247

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1007 1017 Parvin MIRMIRAN Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Zeynab AMIRHAMIDI Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hanieh-Sadat EJTAHED Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Zahra BAHADORAN Nutrition 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 2017 07 17 2017 07 17 Background: Diet plays a key role in the development of non-alcoholic fatty liver disease (NAFLD). The aim of this study was to review systematically observational studies available regarding the relationship between food intakes and NAFLD. Methods: We searched Scopus, PubMed, and Cochrane Library databases to identify English observational studies on food groups, dietary patterns, and NAFLD. Cross-sectional, case-control and cohort studies were selected and then duplication, topic, type of study, study population, variables examined and quality of data reporting of the articles were evaluated. Results: We identified 2128 studies in the initial search, of which 33 were reviewed in full text and 7 articles were included in this systematic review. Intakes of red meat, fats, and sweets were high whereas consumption of whole grains, fruits and vegetables were less in NAFLD patients. Moreover, there was a positive association between the Western dietary pattern and the risk of NAFLD, while adherence to the Mediterranean diet was significantly associated with the severity of hepatic steatosis. Conclusion: Generally, different food group intakes and dietary patterns are associated with the progression of NAFLD and its risk factors. Because of the many limitations of available studies reviewed on this topic, more prospective studies are suggested.     https://ijph.tums.ac.ir/index.php/ijph/article/view/10599 https://ijph.tums.ac.ir/index.php/ijph/article/download/10599/5246

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1139 1140 Fen WANG Dept. of Rheumatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China Shujuan LV Dept. of Microbiology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China Jingyu CAI Dept. of Rheumatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China Xianglian ZHOU Dept. of Rheumatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China Qicui ZHU Dept. of Rheumatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China Jianhua XU Dept. of Rheumatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China 2017 07 17 2017 07 17 Please provide alternate text for this image to ensure accessibility for users with text-only browsers or assistive devices. https://ijph.tums.ac.ir/index.php/ijph/article/view/10616 https://ijph.tums.ac.ir/index.php/ijph/article/download/10616/5262

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1028 1037 Yeunhee KWAK Occupational Epidemiology Research Group, National Institute of Occupational Safety and Health, 6-21-6 Nagao, Tama-ku, Kawasaki, Japan Yoonjung KIM Occupational Epidemiology Research Group, National Institute of Occupational Safety and Health, 6-21-6 Nagao, Tama-ku, Kawasaki, Japan 2017 07 17 2017 07 17 Background: This study aimed to identify the association between health-related quality of life and mental health by elderly Koreans’ occupational status. Methods: This descriptive cross-sectional study consisted of a secondary analysis of data from the Korea National Health and Nutrition Examination Survey V-3 (2012). The sample comprised 1431 people aged 65 yr and older. Results: Compared to participants employed, those not showed lower HRQOL. Occupational status significantly affected all of the EuroQoL-5 Dimensions (EQ-5D): mobility, self-care, usual activity, pain/discomfort, and anxiety/depression. Unemployed participants had more suicidal ideation. Among employed elderly persons, significant differences were found between manual and non-manual workers in the EQ-5D index and EQ-5D for mobility and pain/discomfort. Manual workers experienced more depression and suicidal ideation than did non-manual workers. Conclusion: The occupational status of elderly individuals accounts for differences in their quality of life and mental health status. Therefore, additional jobs should be created for the elderly in order to improve their quality of life and mental health.   https://ijph.tums.ac.ir/index.php/ijph/article/view/10601 https://ijph.tums.ac.ir/index.php/ijph/article/download/10601/5248

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1141 1142 Felicia ANDRIONI Dept. of Socio-Human Sciences, Faculty of Sciences, University of Petroșani, Petroșani, Romania Ion PETRICĂ Faculty of Social Sciences, ”Eftimie Murgu” University of Reșita, Reșita, Romania 2017 07 17 2017 07 17 Identify agencies (a person, an organization, or a service) that made contributions to the content or provided funding or support for the work presented in this submission. Separate them with a semi-colon (e.g. John Doe, Metro University; Master University, Department of Computer Science https://ijph.tums.ac.ir/index.php/ijph/article/view/10617 https://ijph.tums.ac.ir/index.php/ijph/article/download/10617/5263

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1038 1045 Qiong YU Dept. of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China Bo PANG Dept. of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China Rui LIU Dept. of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China Wenwang RAO Dept. of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China Shangchao ZHANG Dept. of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China Yaqin YU Dept. of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China 2017 07 17 2017 07 17 Background: The current overweight and obesity guidelines based on the Westerners are not consistent with many studies based on the Asians. The guidelines may be different because of regional diversity. This study aimed to determine the appropriate body mass index (BMI) and waist-hip ratio (WHR) cutoff points in the adults of Northeast China. Methods: Overall, 21206 adults were selected from Jilin Province Adult Chronic Disease and Risk Factor Survey conducted in 2012. A representative sample was collected in the Jilin Province of northeast China by a multistage stratified random cluster sampling design. The age of participants was from 20 to 79 yr old. The test items were clustered by risk factors, and receiver operating characteristic (ROC) curves were computed to analyze. Results: Under different risk factors, BMI cutoff points were affected greatly. Especially for diabetes, the cutoff value was apparently larger than others were. WHR increased with age in both genders. From a general view, male WHR was slightly larger than female. In the male, WHR cutoff point was near 0.88 with a tiny change, as for in the female was near 0.86. Conclusion: The cutoff values of sensitivity and specificity are relatively good and false positives rate is relatively low. BMI cutoffs values of overweight and obesity are 24.5 kg/m2 and 29.0 kg/m2, WHR cutoff values of the male are 0.88, the female is 0.86.     https://ijph.tums.ac.ir/index.php/ijph/article/view/10602 https://ijph.tums.ac.ir/index.php/ijph/article/download/10602/5270

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1143 1144 Martin SAMOHÝL Institute of Hygiene, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic Anna NÁDAŽDYOVÁ Dept. of Stomatology and Maxilofacial Surgery, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic Katarína HIROŠOVÁ Institute of Hygiene, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic Diana VONDROVÁ Institute of Hygiene, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic Daniela KRAJČOVÁ Institute of Hygiene, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic Jana JURKOVIČOVÁ Institute of Hygiene, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic 2017 07 17 2017 07 17 Please provide alternate text for this image to ensure accessibility for users with text-only browsers or assistive devices. https://ijph.tums.ac.ir/index.php/ijph/article/view/10618 https://ijph.tums.ac.ir/index.php/ijph/article/download/10618/5264

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1046 1053 Miguel Ángel GARCIA-GORDILLO Dept. of Economics, Faculty of Economics and Business, University of Extremadura, Badajoz, Spain. AND Dept. of Applied Economics, Faculty of Economics and Business, University of Murcia, Murcia, Spain Daniel COLLADO-MATEO Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain Pedro Rufino OLIVARES Instituto de Actividad Fisica y Salud, Universidad Autonoma de Chile, Talca, Chile AND Higher Institute of Physical Education, University of the Republic, Montevideo, Uruguay José Carmelo ADSUAR Dept. of Applied Economics, Faculty of Economics and Business, University of Murcia, Murcia, Spain AND Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain Eugenio MERELLANO-NAVARRO Instituto de Actividad Fisica y Salud, Universidad Autonoma de Chile, Talca, Chile 2017 07 17 2017 07 17 Background: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality characterized by progressive airflow obstruction and inflammation in the airways, which has an impact on health-related quality of life. The EQ-5D-5L is one of the most used preference-based, health-related quality of life questionnaire. The objective of this study was to provide normative values of EQ-5D-5L for Spanish people suffering from COPD. Methods: Data were extracted from the Spanish National Health Survey (2011/2012). Overall, 1130 people with COPD participated in this survey. The utility index of EQ-5D-5L and the Visual Analog Scale (VAS) score were defined by gender, region, and age. Results: Mean (SD) EQ-5D-5L utility index and VAS score for Spanish people with COPD were 0.742 (0.309) and 60.466 (21.934) respectively. In general, men reported better health status than women. Ceiling effect of the whole sample was 30.35%. Conclusion: The current study provides normative values of EQ-5D-5L for Spanish people affected by COPD. Ceiling effect was high and better results were observed in men compared with women.     https://ijph.tums.ac.ir/index.php/ijph/article/view/10603 https://ijph.tums.ac.ir/index.php/ijph/article/download/10603/5250

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1145 1146 Salman KHAZAEI Dept. of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Somayeh KHAZAEI Dept. of Para-Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Kamyar MANSORI Dept. of Epidemiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran Erfan AYUBI Dept. of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2017 07 17 2017 07 17 Please provide alternate text for this image to ensure accessibility for users with text-only browsers or assistive devices https://ijph.tums.ac.ir/index.php/ijph/article/view/10619 https://ijph.tums.ac.ir/index.php/ijph/article/download/10619/5265

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1054 1061 Yin-Qing HU Dept. of Nursing, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China Yi-Fan WU Dept. of Nursing, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China Li-Li HOU Dept. of Nursing, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China 2017 07 17 2017 07 17   Background: Lung cancer is a serious threat to human health and life worldwide. Anxiety is common amongst palliative care patients with lung cancer and adversely affects quality of life. Acupuncture is an effective and safe treatment method used for the treatment of depressive mood status. We aimed to assess the influence of electrical acupuncture stimulation on self-reported anxiety in palliative care among patients with lung cancer. Methods: This pilot study had an experimental, 3-group, research plan. A total of 188 participants were enrolled from the Shanghai Pulmonary Hospital, Tongji University, Shanghai, China from 2014-2015. This pilot study had an experimental, 3-group, research plan. In TEAS group, participants received standardized palliative care and electrical acupuncture stimulation in Zusanli, Sanyinjiao and Hegu acupoints. Group MS received standardized palliative care and muscle stimulation nearby nonacupoint. Controlled group received standardized palliative care. The patients maintained their assigned acupuncture stimulation for 7 days. Demographic Instrument, Karnofsky Performance Scale Index, SF-16 health questionnaire and Self-Rating Anxiety Scale (SAS) were used. Results: The mean SAS scores in TEAS Group before and after electrical intervention in palliative care intervention were 31.17±7.55,34.58±13.98 and 27.86±6.73, (P=0.00) QoL score showed elevation from 57.13 in 8th day to 60.12 in 28th day, rising further to 5%. Comfort Score showed continuous elevation trend for 28 days. Conclusion: Electric acupuncture stimulation could reduce the anxiety of patients, promote rehabilitation and increase the quality of life among patients with lung cancer in palliative care.     https://ijph.tums.ac.ir/index.php/ijph/article/view/10604 https://ijph.tums.ac.ir/index.php/ijph/article/download/10604/5251

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1147 1148 Peyman REZAEI-HACHESU Dept. of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran AND Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medi-cal Sciences, Tabriz, Iran Reza SAFDARI Dept. of Health Information Technology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran Marjan GHAZISAEEDI Dept. of Health Information Technology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran Taha SAMAD-SOLTANI Dept. of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran AND Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medi-cal Sciences, Tabriz, Iran 2017 07 17 2017 07 17       Please provide alternate text for this image to ensure accessibility for users with text-only browsers or assistive devices https://ijph.tums.ac.ir/index.php/ijph/article/view/10621 https://ijph.tums.ac.ir/index.php/ijph/article/download/10621/5266

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1062 1070 Gaukhar KAYUPOVA Dept. of Healthcare Policy and Management, SD Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan Botagoz TURDALIYEVA Dept. of Healthcare Policy and Management, SD Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan Kazbek TULEBAYEV Dept. of Healthcare Policy and Management, SD Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan Tuyen Van DUONG School of Public Health, Taipei Medical University, Taipei, Taiwan Peter Wushou CHANG School of Public Health, Taipei Medical University, Taipei, Taiwan AND National Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan Diana ZAGULOVA Baltic International Academy, Riga, Latvia 2017 07 17 2017 07 17 Background: This study aimed to evaluate health literacy levels of patients in Almaty City, Kazakhstan and to identify socio-demographics and socio-economic factors related to their health literacy. Methods: An international survey instrument HLS-EU-Q developed by the European Health Literacy Consortium was used in a cross-sectional study with 1000 citizens in the Almaty City at the age of 18 and over who visited the outpatient departments in the polyclinics between Feb and Oct 2014. Results: There were 552 women and 446 men completed the survey, with mean ages as (41.8 ± 13.9) and (44.7 ± 15.2) yr old respectively, and women were significantly younger than men (P<0.001). Their general health literacy was (34.0 ± 8.6) for men and (33.49 ± 9.4) for women, without significant difference. In them, 15.5% or 30.0% were with inadequate or problematic health literacy. Multivariate linear regression analysis showed that higher general health literacy was positively and significantly associated with high self- assessed social status (B=3.86, P<0.001), ability to pay for medications (B=3.42, P<0.001), low frequency of watching health related TV programs (B=2.37, P<0.001), moderate community involvement (B=2.23, P=0.03). Conclusion: Specific demographic and socio-economic determinants related to health literacy were identified the first time in Kazakhstan. This would facilitate programs to improve health outcomes in Kazakhstan.   https://ijph.tums.ac.ir/index.php/ijph/article/view/10605 https://ijph.tums.ac.ir/index.php/ijph/article/download/10605/5252

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1149 1151 Morteza NASIRI School of Paramedicine, Qom University of Medical Sciences, Qom, Iran Azam ARSANJANI SHIRAZI School of Nursing and Midwifery, Dezful Islamic Azad University, Dezful, Iran Omid SADEGHI School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Mahdieh BAGHERI BIDAKHAVIDI School of Health, Kerman University of Medical Sciences, Kerman, Iran 2017 07 17 2017 07 17 dentify agencies (a person, an organization, or a service) that made contributions to the content or provided funding or support for the work presented in this submission. Separate them with a semi-colon (e.g. John Doe, Metro University; Master University, Department of Computer Science) https://ijph.tums.ac.ir/index.php/ijph/article/view/10622 https://ijph.tums.ac.ir/index.php/ijph/article/download/10622/5267

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1071 1078 Manel BEN-HADJ-MOHAMED Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Souhir KHELIL Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Mokhles BEN DBIBIS Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Latifa KHLIFI Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Hend CHAHED Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Salima FERCHICHI Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Elyes BOUAJINA Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia Abdelhédi MILED Biochemistry Laboratory, Farhat Hached Hospital, Sousse, Tunisia 2017 07 17 2017 07 17 Background: Rheumatoid arthritis is an autoimmune inflammatory rheumatic disease that causes chronic synovial inflammation eventually leading to joint destruction and disability. The aim of this study was to determine the variations of hepatic proteins, myeloperoxidase, and iron in rheumatoid arthritis Tunisian patients and their implications in inflammation and in iron metabolism. Methods: Overall, 172 patients from the Rheumatology Department of the University Hospital “Farhat Hached”, Sousse-Tunisia between 2011 and 2012, with rheumatoid arthritis (97.1% women, average age: 48±13 yr) and 147 healthy volunteers (70.1% women, average age: 46± 7 yr) were included in this study. Serum hepatic proteins (high-sensitive C-reactive protein, ceruloplasmin, albumin, transferrin, α-1-acid glycoprotein and haptoglobin) were assessed by immunoturbidimetry (COBAS INTEGRA 400, Roche) and ferritin was measured by a microparticulate immunoenzymatic technic (AxSYM, ABBOTT, Germany), Plasma myeloperoxidase was determined by Enzyme-Linked Immunosorbent Assay. Serum iron was measured according to a colorimetric method at 595 nm (CX9-BECKMANN Coulter-Fuller-Ton, CA). Results: Significantly higher levels of high-sensitive C-reactive protein, α-1-acid glycoprotein, Haptoglobin and myeloperoxidase in patients compared to controls (P<10-3). Albumin and iron rates were significantly decreased in patients compared to healthy group (P=0.026 and P<10-3, respectively). There were no differences between cases and controls for levels of ceruloplasmin, transferrin and ferritin (P=0.782, P=0.808, and P=0.175, respectively). Conclusion: The high-sensitive C-reactive protein, α-1-acid glycoprotein, and haptoglobin increased in acute phase proteins in rheumatoid arthritis disease. The pro-inflammatory cytokines affect iron metabolism leading to the iron deficiency and rheumatoid anemia, which influenced Tf and ferritin levels. https://ijph.tums.ac.ir/index.php/ijph/article/view/10606 https://ijph.tums.ac.ir/index.php/ijph/article/download/10606/5253

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1152 1153 Seyed Ramin RADFAR Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran AND UCLA Integrated Substance Abuse Programs, Los Angeles, USA Pardis NEMATOLLAHI Dept. of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran Ali FARHOUDIAN Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Alireza NOROOZI Dept. of Neuroscience and Addiction, School of Advanced Technologies in Medicine (SATiM), Tehran University of Medical Sciences, Tehran, Iran 2017 07 17 2017 07 17 Please provide alternate text for this image to ensure accessibility for users with text-only browsers or assistive devices. https://ijph.tums.ac.ir/index.php/ijph/article/view/10623 https://ijph.tums.ac.ir/index.php/ijph/article/download/10623/5268

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1079 1085 Xiliang DANG Dept. of Orthopedics, Weinan Central Hospital, Shaanxi Province, Weinan City, Shaanxi Province, China Liping LIAN Dept. of Orthopedics, Weinan Central Hospital, Shaanxi Province, Weinan City, Shaanxi Province, China Dongsheng WU Dept. of Orthopedics, Weinan Central Hospital, Shaanxi Province, Weinan City, Shaanxi Province, China 2017 07 17 2017 07 17 Background: We aimed to explore the prognosis and risk factors influencing tumor recurrence in surgery-treated patients with primary sacral tumors. Methods: Fifty-six patients between February 2011 and December 2016 in Yishui Central Hospital with primary sacral tumors were selected and treated with radical surgeries. The perioperative outcomes and postoperative neurological functions were observed. After postoperative follow-up, the overall survival time (OS), disease-free survival time (DFS), and recurrence were recorded to analyze the potential risk factors influencing tumor recurrence. Results: The average surgical duration and intraoperative hemorrhagic volume were 3.92 ± 1.46 h and 2, 348.21 ± 813.67 ml, respectively. The postoperative short-term complications included three patients with infection from obstructed drainage and two with skin flap necrosis-induced infection, who recovered after anti-infection therapies; nine with incision-edge necrosis; two with calf muscle venous thrombosis; and one with an endorhachis cerebrospinal fluid fistula, who recovered after conventional treatment. Among patients, the 1-, 2- and 3-year survival rates were 91.07% (51/56), 82.14% (46/56), and 75.00% (42/56) while the 1-, 2- and 3-year DFS rates were 89.29% (50/56), 78.57% (44/56) and 71.43% (40/56), respectively. Of the 56 patients, 16 had recurrence after surgery, with recurrence rate of 28.57%. It was predicated that surgical methods and local infiltration were the independent risk factors influencing tumor recurrence (P<0.01). Conclusion: The reservation of bilateral S3 or > unilateral S3 nerves can improve quality of life of patients. Surgical methods and local infiltration are the independent risk factors influencing tumor recurrence, and extensive resection can effectively control the recurrence rate.   https://ijph.tums.ac.ir/index.php/ijph/article/view/10607 https://ijph.tums.ac.ir/index.php/ijph/article/download/10607/5254

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1154 1155 Bang-Sub LEE Sports and Health Care Major, Korea National University of Transportation, Chungju-si, Korea Wi-Young SO Sports and Health Care Major, Korea National University of Transportation, Chungju-si, Korea Wooyoung CHUNG Dept. of College of General Education, Chung-Ang University, Seoul, Korea Eun-Ju CHOI Division of Sport Sciences, Konkuk University, Chungju-si, Korea 2017 07 17 2017 07 17 Please provide alternate text for this image to ensure accessibility for users with text-only browsers or assistive devices. https://ijph.tums.ac.ir/index.php/ijph/article/view/10624 https://ijph.tums.ac.ir/index.php/ijph/article/download/10624/5269

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 46 8 2017 07 17 1086 1094 Morvarid ZARIF-YEGANEH Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Mansoor RASTEGARPANAH Dept. of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Gholamreza GARMAROUDI Dept. of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Molouk HADJIBABAIE Research Center for Rational Use of Drugs and Clinical Pharmacy Dept., Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Hojjat SHEIKH MOTAHAR VAHEDI Emergency Dept., Shariati Hospital, Tehran University of Medical Scienf Health Business Administration, Hung Kuang University, Taichung, Taiwan AND School of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan 2018 06 20 2018 06 20 Background: Physicians and nurses are core staff who are the first points of contact in care provision to patients. We aimed to examine physicians’ and nurses’ perceptions of patient safety in a case hospital by administering the Chinese Safety Attitude Questionnaire (CSAQ), developed from the Taiwan Joint Commission on Hospital Accreditation, in order to provide the patients with a safe environment and excellent medical service. Methods: An intra-organizational online survey was conducted. Confirmatory factor analysis (CFA) was first performed on the assessment of the measures for patient safety culture and seven dimensions with 33 items were identified. Pearson correlation analysis was subsequently used to examine the strength and direction of the relationships between seven dimensions of patient safety culture. Results: A total of 800 questionnaires were issued and 405 valid questionnaires were collected, the effective response rate being 50.6%. The findings highlighted that safety climate (SC) was positively and significantly related to teamwork climate (TC) and perception of management (PM), whereas stress recognition (SR) was negatively related to burnout (BUR). Conclusion: Patient safety culture in healthcare organizations has been considered a critical issue for improving the quality of healthcare. This study further focused on the contribution of a better patient safety culture for healthcare organizations in Taiwan.     https://ijph.tums.ac.ir/index.php/ijph/article/view/13761 https://ijph.tums.ac.ir/index.php/ijph/article/download/13761/6015

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 6 2018 06 20 861 867 Jingfang LIU Dept. of Information Management, School of Management, Shanghai University, Shanghai 200444, China Xiaoyan JIANG Dept. of Information Management, School of Management, Shanghai University, Shanghai 200444, China Qiangyuan CHEN Dept. of Economics, School of Economics, Shanghai University, Shanghai 200444, China Mei SONG Dept. of Software Engineering, School of Smart Education, Jiangsu Normal University, Xuzhou 221116, China Jia LI Dept. of Management Science and Engineering, School of Business, East China University of Science and Technology, Shanghai 200237, China 2018 06 20 2018 06 20   Background: The posts related to Adverse Drug Reaction (ADR) on social websites are believed to be valuable resource for post-marketing drug surveillance. Beyond domain feature, the aim of this study was to find a more effective method to detect ADR related post. Methods: We conducted experiment on posts using sentiment features from March 8 to May 20 in 2016 in Shanghai of China. Firstly, the diabetes posts were collected; the 1814 posts were annotated by hand. Secondly, sentiment features set were generated and the (CHI) statistics were used to select feature. Finally, we evaluated the effectiveness of our method using the different feature sets. Results: By comparing the posts detection performance of different feature sets, using sentiment features by CHI statistics can improve ADR related post detection performance. By comparing the ADR-related group with the non-ADR group, performance of ADR related post detection was better than the performance of non-ADR post detection. We could obtain highest performance owing to introducing sentiment feature and using CHI feature selection technique, and the method was proved to be effective during detecting post related to ADR. Conclusion: By using sentiment feature and CHI feature selection technique, we can get an effective method to detect post related to ADR.   https://ijph.tums.ac.ir/index.php/ijph/article/view/13762 https://ijph.tums.ac.ir/index.php/ijph/article/download/13762/6016

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 6 2018 06 20 868 874 Nahideh MAZHARI Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran Mehdi NATEGHPOUR Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran Peyman HEYDARIAN Dept. of Medical Parasitology and Mycology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran Leila FARIVAR Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Effat SOURI Dept. of Pharmaceutical Chemical, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Afsaneh MOTEVALLI HAGHI Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2018 06 20 2018 06 20 Background: We evaluated the anti-malarial activity of Heracleum persicum individually and in combination with chloroquine. Methods: This study was conducted at the School of Public Health, Tehran University of Medical Sciences, Tehran, Iran in 2015-2016. The Peter̛ s method was used for determining fifty percent effective dose (ED50) of the H. persicum extract and chloroquine individually against chloroquine sensitive P. berghei in small white mice. Six experimental groups for H. persicum and 6 groups for chloroquine and two control group (positive and negative) were considered for determination of ED50. Interaction between H. persicum and chloroquine also was evaluated based on fixed ratios method. Ratios of 0/100, 20/80, 40/60, 60/40, 80/20, 100/0 of ED50 of chloroquine and H. persicum respectively were tested against the parasite. Then inhibitory effects of two drugs were calculated and plotted in the relevant graphs. Results: Overall, 1500 mg/kg, and 1000 mg/kg concentrations of H. persicum against P. berghei resulted in ED50 and ED74 respectively. ED50 of chloroquine against the parasite was obtained as 1.4 mg/kg of mouse body weight. Moreover, combination of H. persicum and chloroquine showed a weak potentiation in ratios of 40/60 (chloroquine +H. persicum) with 64% inhibition, but not in other ratios. Conclusion: Although H. persicum individually showed a reasonable antimalarial efficacy against chloroquine sensitive P. berghei, in combination with chloroquine it showed additive or antagonism result except in ratios of 40%CQ+60%HP.   https://ijph.tums.ac.ir/index.php/ijph/article/view/13763 https://ijph.tums.ac.ir/index.php/ijph/article/download/13763/6017

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 6 2018 06 20 875 883 Mahshad NOROOZI Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Dept. of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Ladannaz ZAHEDI Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Dept. of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Fataneh Sadat BATHAEI Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Dept. of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Pooneh SALARI Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran 2018 06 20 2018 06 20 Background: Respecting patients confidentiality and privacy are considered as the patients’ rights. Confidentiality is the key virtue for trust building in physician-patient relationship. While law considers confidentiality as absolute except for legal situations, despite efforts to maintaining confidentiality, sometimes breaching confidentiality is unavoidable but not necessarily unethical. There is no Iranian unified ethical guideline to define clear approaches to patient confidentiality in clinical setting. To keep all medical data confidential it is necessary to identify the scope of the problem. In this study, we aimed at identifying the scope of the problem. Methods: This study was conducted in three phases including literature review, qualitative study (semi-structured interview) and focus group discussion. The literature review provided a framework for the second phase. Results: The content analysis of the interviews presented 3 main themes indicating problems in maintaining confidentiality in clinical setting including management issues, organizational ethics and physician-patient relationship. Conclusion: Based on the results a draft guideline in confidentiality in clinical setting was prepared and finalized in focus groups discussions.   https://ijph.tums.ac.ir/index.php/ijph/article/view/13764 https://ijph.tums.ac.ir/index.php/ijph/article/download/13764/6018

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 6 2018 06 20 884 892 Ali MOUSELI Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran AND Dept. of Health Management, Policy and Economics, Kerman University of Medical Sciences, Kerman, Iran Mohammadreza AMIRESMAILI Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Mohsen BAROUNI Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Siamak MIRAB SAMIEE Health Reference Laboratory Research Center, Ministry of Health and Medical Education, Tehran, Iran Leila VALI Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran 2018 06 20 2018 06 20 Background: Laboratory services fragmentation creates problems such as non-accountability for costs and quality, not being patient-centered and unsustainability of services in long run. Therefore, health systems consider laboratory services integration an inevitable way. This study aimed to investigate the challenges and barriers to the integration of laboratory services in Iran. Methods: This qualitative case study was conducted in 2016. Using purposive sampling, semi-structured interviews were conducted with 34 informed participants. Each interview lasted between 30 to 60 min. Acceptability, transferability, reliability, and verifiability were used to assess the validity, accuracy and reliability of qualitative data. Framework approach was used to analyze data. Results: Lack of economy of scale, unfair access, lack of grading, low quality, development of national strategies to create an integrated network of laboratories, criteria of the laboratories establishment, creation of necessary infrastructure, empowering the private sector and standardization of indicators were considered the most important problems of laboratory services integration in Iran; they were classified into two main themes. Conclusion: Identified issues are challenges which adversely impact the integration of laboratory services. Therefore, providing infrastructures with increased cooperation between various organizations to increase access to laboratory services in the form of an integrated network is essential.   https://ijph.tums.ac.ir/index.php/ijph/article/view/13765 https://ijph.tums.ac.ir/index.php/ijph/article/download/13765/6019

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 6 2018 06 20 893 900 Jafar Sadegh TABRIZI Tabriz Health Services Management Research Center, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran Leila NIKNIAZ Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Homayoun SADEGHI-BAZARGANI Road and Traffic Injury Research Center, 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 Zeinab NIKNIAZ Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 2018 06 20 2018 06 20 Background: We aimed to evaluate the household food security status and associated factors in East-Azerbaijan, Iran (urban and regional areas). Methods: Data (n=1385) as a part of the major lifestyle promotion project conducted in northwest of Iran were collected in 2015, by short form of the Household Food Security Scale consisting six questions. The Chi-square and Logistic regression were used to for statistical analysis. Results: The prevalence of food insecurity was 58.4%. The rate of food insecurity in the residents of capital city (59.7%) was higher than those of residents of regional cities (57.18%), however, this difference was not statistically significant (P=0.36). The respondents with family size more than 3 (P=0.01), unemployed (0.001) and married (0.01) respondents and the ones with lower education levels (P<0.001) were significantly more food insecure than other respondents. After adjusting for depending factors, the marital status, household size, educational level and the employment status of the head of the family had significant association with food security. Conclusion: Family size, employment status and educational level of the head of the family were significant predictors of food insecurity. Policymakers should focus on increasing minimum education levels and employment situations to decrease food insecurity.   https://ijph.tums.ac.ir/index.php/ijph/article/view/13766 https://ijph.tums.ac.ir/index.php/ijph/article/download/13766/6020

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 6 2018 06 20 901 907 Mahdi YOUSEFI Dept. of Persian Medicine, School of Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Reza AFSHARI Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Masoumeh SADEGHI Dept. of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran Roshanak SALARI Dept. of Pharmaceutical Sciences, School of Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2018 06 20 2018 06 20 Background: Herbal distillates have been used for many centuries as herbal medicines in Traditional Persian medicine. The main purpose of this study was to determine methanol and ethanol contents in commonly-used industrial herbal distillates produced by three famous factories in Khorasan Razavi, Mashhad, Iran (2014-2015). Methods: Ninety herbal waters of ten types of most commonly used herbal distillates including Willow (Salix alba), Ajava seeds (Carum copticum), Fennel (Foeniculum vulgare), Poleigamander (Teucrium polium), Forty plants, Peppermint (Mentha piperita), Camel thorn (Alhagi camelorum), Chicory (Cichorium intybus), Fumitory (Fumaria officinalis) and Rose water (Rosa damascene) of three famous company in Mashhad were randomly bought from market. Methanol and ethanol contents of each sample were measured by Gas chromatography according to the standard method. Collected data were analyzed by SPSS using appropriate descriptive statistical tests. Results: The highest average amount of methanol of all tested distillates is for forty plants (46.06 mg/dl) and M. piperita (46.72 mg/dl) and the lowest for ajava seed (8.46 mg/dl). The maximum and minimum ethanol level was reported for rose water (0.39 mg/dl) and ajava seed (0.15 mg/dl), respectively. Conclusion: High methanol and ethanol concentrations may induce toxicity in people taking these products regularly for a long time. Therefore, considering the harmful effects of methanol and ethanol on human health, further studies are required for determining permitted levels of methanol and ethanol in herbal distillates.   https://ijph.tums.ac.ir/index.php/ijph/article/view/13767 https://ijph.tums.ac.ir/index.php/ijph/article/download/13767/6149

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 47 6 2018 06 20 908 913 Maryam NIYYATI Dept. of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Alireza NAGHAH