Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1439 1444 Caren Serra BAVARESCO Discipline of Dentistry and Society, Graduate Program in Dentistry, School of Dentistry, Lutheran University of Brazil, Canoas, RS, Brazil Silvana BRAGANÇA Discipline of Pediatric Dentistry, Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil Francine de Paula FRIES School of Dentistry, Lutheran University of Brazil, Canoas, RS, Brazil Giordano Santana SÓRIA Graduate Program in Dentistry, School of Dentistry, Lutheran University of Brazil, Canoas, RS, Brazil Flávio Renato Reis DE MOURA Discipline of Dentistry and Society, Graduate Program in Dentistry, School of Dentistry, Lutheran University of Brazil, Canoas, RS, Brazil Elken Gomes RIVALDO Graduate Program in Dentistry, School of Dentistry, Lutheran University of Brazil, Canoas, RS, Brazil Otávio Pereira D´ÁVILA Discipline of Epidemiology, Department of Collective Health, School of Dentistry, Federal University of Pelotas, Canoas, RS, Brazil Roberto Nunes UMPIERRE Discipline of Family and Community Medicine, Department of Family and Community Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil Erno HARZHEIM Municipal Health Department, Porto Alegre, RS, Brazil Jonas Almeida RODRIGUES Discipline of Pediatric Dentistry, Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil 2019 07 18 Background: The aim of the present study was to assess the level of satisfaction of dentists working in primary healthcare (PHC) with a Distance learning (DL) course in pediatric dentistry offered by the TeleHealthRS center, and to the investigate possible associations between the variables indicative of their satisfaction and their performance on the questionnaires applied before and after the course. Methods: The course was offered in 2015 by the Federal University of Rio Grande do Sul (UFRGS) together with the TeleHealthRS center in Brazil. Data were collected on the participants’ personal and professional profile, their pre- and post-course knowledge about pediatric dentistry, and their satisfaction with the course. Student's t-test and the ANOVA test were used to assess the possible associations between the variables indicative of their satisfaction and their performance on the questionnaires applied before and after the course. Results: Overall, the participants were satisfied with the course, however, no statistically significant association was found between the variables indicative of their satisfaction and the grades they earned on the pre- and post-course questionnaires. Conclusion: The available pediatric dentistry course received positive evaluations from the participants, constituting a possible strategy for the qualification of primary care dentists. Future studies are warranted to further investigate the expectations of DL course participants, aiming to enhance the quality of future editions of this learning modality for pediatric dentistry contents.   https://ijph.tums.ac.ir/index.php/ijph/article/view/17814 https://ijph.tums.ac.ir/index.php/ijph/article/download/17814/6469

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1395 1404 Hun-Young PARK Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea Won-Sang JUNG Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea Jisu KIM Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea Hyejung HWANG Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea Kiwon LIM Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea AND Department of Physical Education, Konkuk University, Seoul, Republic of Korea 2019 07 18 Background: Obesity is recognized as an important global health problem that increases the risk of all-cause death. It is a major risk factor for various cardiovascular and metabolic diseases. Methods: We conducted this review through searching the related literature plus internet links.  Results: Recently, many researchers have been applying various efficient alternative exercise paradigms for treating obesity, such as high-intensity interval training, whole-body vibration training, and hypoxic therapy. Compared with moderate-intensity continuous training, high-intensity interval training involves a shorter exercise time but higher energy expenditure and excess post-exercise oxygen consumption via a higher exercise intensity and is effective for treating obesity. Whole-body vibration training effectively reduces the rate of fat production and accumulation through passive vibration of the whole body and improving the body composition, muscle function, and cardiovascular function of the obese population. Hypoxic therapy has been reported to improve obesity and obesity-related diseases through appetite loss, reduced dietary intake, increased energy consumption, improved glycogen storage and fatty acid oxidation, angiogenesis and left ventricle remodeling, decreased mechanical load, and reduced sarcopenia progression due to aging. Conclusion: The new therapeutic exercise modalities, namely, high-intensity interval training, whole-body vibration training, and hypoxic therapy, are practical, useful, and effective for improving obesity and various metabolic and cardiovascular diseases induced by obesity.   https://ijph.tums.ac.ir/index.php/ijph/article/view/17809 https://ijph.tums.ac.ir/index.php/ijph/article/download/17809/6464

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1523 1527 Rui ZHAO Faculty of Geosciences and Environmental Engineering, Southwest Jiaotong University, Chengdu 611756, China AND Sichuan Province Cyclic Economy Research Center, Southwest University of Science and Technology, Mianyang 621010, China Yibo ZHANG Faculty of Geosciences and Environmental Engineering, Southwest Jiaotong University, Chengdu 611756, China Sidai GUO Sichuan Province Cyclic Economy Research Centre, Southwest University of Science and Technology, Mianyang 621010, China 2019 07 18 We report a case to provide an improved air quality index (AQI) based upon association between individual health risk and Particulate matter (PM2.5) exposure. A Poisson sampling distribution model was used to quantify the health risk, in which the coefficient of exposure-response was derived from a simple Meta-analysis. The result shows that the old people are the most vulnerable population while exposing to PM2.5, for which they are advised to reduce intensity of their physical activities. It is expected that this study is insightful to create a nexus between air quality information and public communication, which help publics take appropriate actions on health protection.      https://ijph.tums.ac.ir/index.php/ijph/article/view/17827 https://ijph.tums.ac.ir/index.php/ijph/article/download/17827/6481

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1532 1534 Sung Man YOON Department of Business Administration, Seoul National University of Science and Technology, Seoul, South Korea Byung Wook JUN Graduate School of Science in Taxation, University of Seoul, Seoul, South Korea 2019 07 18 No Abstract#### https://ijph.tums.ac.ir/index.php/ijph/article/view/17829 https://ijph.tums.ac.ir/index.php/ijph/article/download/17829/6483

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1512 1517 Yousef VEISANI Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran Ali DELPISHEH Department of Clinical Epidemiology, School of Public Health, Ilam University of Medical Sciences, Ilam, Iran Reza VALIZADEH Department of Psychology, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran Sattar KIKHAVANI Department of Psychology, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran 2019 07 18 Background: Research in source of inequality and enhance of knowledge can be reducing the inequalities in the coming decades. Therefore, we aimed to ascertain effects of income inequality measured by Gini-coefficient to death from suicide in Iran. Methods: This is an ecological study on the relation of Gini-coefficient and suicide death in Iran. Data were obtained from Iranian Urban and Rural Household Income for Gini-coefficient and Expenditure Survey and Iranian Forensic Medicine Organization for suicide. Concentration Index was used to determine of inequality by Gini-coefficient in suicide death and prediction model was applied by Stata software. Significant level considered less than 5%. Results: A Gini-coefficient between 0.2523 and 0.3755 (mean, 0.3092) was observed. The overall concentration index CI was -0.10 (95% CI= -0.19 to -0.01), therefore our results confirmed a positive inequality in incidence suicide rate result from income inequality in Iran. Conclusion: Our results showed a positive inequality due to Gini-coefficients in suicide death. This study could be a start for investigation of inequality source in geographical units and at the individual level in all provinces.       https://ijph.tums.ac.ir/index.php/ijph/article/view/17823 https://ijph.tums.ac.ir/index.php/ijph/article/download/17823/6478

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1445 1451 Liming CAO Department of Respiration, Xiangya Hospital, Central South University, Changsha 410008, P.R. China Long LONG Department of Cardio-Thoracic Surgery, Xiangya Hospital, Central South University, Changsha 410008, P.R. China Chengping HU Department of Respiration, Xiangya Hospital, Central South University, Changsha 410008, P.R. China 2019 07 18 Background: We aimed to investigate the efficacy of paclitaxel combined with kanglaite injection in the treatment of bone metastases of lung cancer in mice. Methods: Human lung cancer cell line A549 was inoculated into 100 C57BL/6 mice to establish bone metastasis model of lung cancer. Eighty successful modeling mice were randomly divided into four groups: Kanglaite (group A), Paclitaxel (group B), Paclitaxel combined with kanglaite (group C) and 0.9% sodium chloride solution (control group), 20 in each group. The mice started taking drugs on the 5th day after inoculation. The treatment lasted for 21 days, and the changes of body weight were observed. Evaluation of the efficacy of drug therapy was performed by comparing the pain behavior of the treated mice with that of the control mice. Results: The physical improvement rates in group A and group B were lower than that in group C (P<0.05). The bone metastasis area and tumor weight in group A, group B and group C were significantly lower than those in control group after 21 days of treatment (P<0.05). The tumor area and tumor weight in group C were significantly lower than those in group A and group B (P<0.05). Conclusion: Paclitaxel combined with kanglaite is more effective than paclitaxel or kanglaite alone in improving bone metastasis of lung cancer and has an important significance in clinical treatment of bone metastasis of lung cancer.     https://ijph.tums.ac.ir/index.php/ijph/article/view/17815 https://ijph.tums.ac.ir/index.php/ijph/article/download/17815/6470

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1405 1417 Gaoming YANG Department of Neurology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China AND Department of Neurology, Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu, 610000, China Dengfeng HAN Department of Neurology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China Jianhua MA Department of Neurology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China Xiaoning ZHANG Department of Neurology, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi, 830054, China 2019 07 18 Background: The monotherapies of statin and ezetimibe had not successfully achieved their objectives in the management of lipid levels of dyslipidemia patients. We aimed to compare the effects of combined low-dose simvastatin and ezetimibe versus high-dose statin on the lipid-lowering treatment of dyslipidemia patients. Methods: We searched five databases published before May 2018, namely PubMed, Embase, Cochrane, Web of Science, and Clinicaltrials.gov. Completely published randomized controlled trials (RCTs) comparing the effect of high-dose statin (S) with ezetimibe/simvastatin (10/10 mg; E/S) on the management of dyslipidemia patients were included. Results: A total of ten RCTs met the inclusion criteria, including 1,624 patients (E/S:691, S:933). Six outcomes underwent pooled analysis, including weighted mean difference (WMD) from baseline in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), high sensitivity C-reactive protein (hs-CRP), triglyceride (TG), and non-high-density lipoprotein cholesterol (non-HDL-C). No significant gap was found between high-dose statin and ezetimibe/simvastatin (10/10 mg) in LDL-C (-1.55; 95% confidence interval [CI]:-4.42~1.31, P=0 .29), HDL-C (1.05; 95%CI:-0.21~2.3, P=0 .1), TG (4.03; 95%CI:-4.53~12.58, P=0 .36), and hs-CRP (0.14; 95%CI:-0.50~0.78, P=0.67). However, there was significant difference found between the two lipid-lowering treatments in TC (-0.45; 95%CI:-9.07~ -0.83, P=0.02) and non-HDL-C (-4.97; 95%CI -8.46~-1.49, P=0 .005). Conclusions: Ezetimibe co-administered with simvastatin (10 mg) and high-dose statin monotherapy may show similar effects in reducing LDL-C, TG, and hs-CRP levels and in increasing HDL-C levels. However, the results suggest that there was greater TC and non-HDL-C lowering through high-dose statin monotherapy as compared with ezetimibe/simvastatin co-administration.     https://ijph.tums.ac.ir/index.php/ijph/article/view/17810 https://ijph.tums.ac.ir/index.php/ijph/article/download/17810/6465

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1528 1531 Meysam SHARIFDINI Department of Medical Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Elham HAJIALILO Department of Parasitology and Mycology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran AND Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran Laleh GHANBARZADEH Department of Parasitology and Mycology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran AND Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran Mehrzad SARAEI Department of Parasitology and Mycology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran AND Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran 2019 07 18 We report a human case of Hymenolepis diminuta infection in Guilan Province, northern part of Iran in 2017. The patient was a 15-month-old boy with gastrointestinal symptoms. In stool examination, eggs of H. diminuta was found based on morphological characteristic. The infant was successfully treated with a single oral dose of praziquantel, and then completely recovered. For the first time, we report human infection with this species in north of Iran.     https://ijph.tums.ac.ir/index.php/ijph/article/view/17828 https://ijph.tums.ac.ir/index.php/ijph/article/download/17828/6482

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1535 1536 Aria GUSTI Department of Environmental Health, Faculty of Public Health, Andalas University, Padang, Indonesia 25121 Resi Arifa YURNAL Department of Environmental Health, Faculty of Public Health, Andalas University, Padang, Indonesia 25121 2019 07 18 No Abstract#### https://ijph.tums.ac.ir/index.php/ijph/article/view/17830 https://ijph.tums.ac.ir/index.php/ijph/article/download/17830/6484

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1518 1522 Mojtaba NOWROZI Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Gholam Reza MOWLAVI Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Mostafa ALISHAVANDI Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Gholamreza HATAM Basic Sciences in Infectious Diseases Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran 2019 07 18 Background: Parasitoses are among the most important problems of most countries especially developing countries. We aimed to detect the situation of intestinal parasitic infections in the Farashband district in Fars Province South of Iran and identify influential factors in the escalation of parasitic diseases and to reduce them. Methods: Overall, 1009 participants from the age of 6 months to 90 years were selected from 3 cities and 15 villages of Farashband district, Fars Province South of Iran from 2015 to 2016. Parasitological methods such as the direct assay method, formalin-ether concentration method, and zinc sulfate flotation were used for diagnosis of worm eggs, cysts, and protozoa trophozoite. Susceptible and protozoan positive samples were stained using the Trichrome staining method. The modified acid-fast staining procedure was conducted for diarrheal samples and the results were used for diagnosis of coccidia. Results: Overall, 313 subjects were infected with at least one intestinal parasite (pathogenic and nonpathogenic). Helminthes infection and protozoan infection were observed in 9 (0.9%) and 304 (30.13%) participants, respectively. Fecal samples of 34 patients with diarrheal feces were used to prepare smears for further examinations using the Ziehl-Neelsen staining method. Examinations showed no infection with coccidia. Conclusion: Helminthes infection has decreased drastically but protozoan infection is still considered a health issue in this region. It is possible to reduce parasitic infections through proper measures such as increasing public awareness and education the public, especially children on health problems with education courses.   https://ijph.tums.ac.ir/index.php/ijph/article/view/17824 https://ijph.tums.ac.ir/index.php/ijph/article/download/17824/6479

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1452 1460 Chai YANG School of Management, Hefei University of Technology, Hefei 230009, PR China And TheFirst Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230031, PR China Wei GU The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China Hefei, 230031, PR China Tongzhu LIU The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China Hefei, 230031, PR China 2019 07 18 Background: Supply, processing, and distribution (SPD) model is sparingly used in hospitals in China. We evaluated its effects on the management efficiency, quality control, and operating costs of medical consumables (MCs) in the clinical nursing surroundings in a single Chinese hospital-Anhui Provincial Hospital from 2014 to 2015. Methods: Amount-based packages (ABP) and procedure-based packages (PBP) models were created. They were introduced the use of quick response (QR) code scanning for using in clinical nursing departments (CNDs). Questionnaires were prepared by referring to previous literature and using Delphi method repeatedly, further discussed and formalized. Partial results of the formal questionnaire were analyzed using SPSS. Results: Frequency of MCs claims reduced without any requirements of MCs in 70% of CNDs. Average time spent on the inventory per week decreased and the time required to procure MCs reduced. Moreover, the average satisfaction score with MCs management increased, reaching 100%. Average space occupied by MCs decreased significantly, reducing by 1.2444m3. Overall, 100% of the respondents concluded that the management of MCs improved effectively and the inventory turnover rate had accelerated. The cost of MCs decreased by 15% with more than 10% increase in in-hospital amount, and the average daily cost of MCs also showed decrease. Conclusion: SPD can improve the efficiency of MCs management in CNDs, reducing medical risks and disputes, saving hospital operating costs, and decreasing capital occupation.     https://ijph.tums.ac.ir/index.php/ijph/article/view/17816 https://ijph.tums.ac.ir/index.php/ijph/article/download/17816/6471

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1418 1427 Marita MOHAMMADSHAHI Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Minoo ALIPOURI SAKHA Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Atefeh ESFANDIARI Department of Health Policy, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran Maryam SHIRVANI Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Ali AKBARI SARI Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2019 07 18 Background: Mobile technologies are widely used in healthcare. The purpose of this study was to compare the effectiveness and cost-effectiveness of fixed computed tomography (CT) and magnetic resonance imaging (MRI) with the mobile ones. Methods: In this systematic review, PubMed, Cochrane Library, Scopus and CRD database were searched from 1995 to 2015. The data on safety and effectiveness of technologies were extracted from included studies. Because the review showed no significant differences in the performance of mobile CT and MRI compared to the fixed ones, then a cost minimization approach was used to explore the cost-effectiveness of three scenarios.   Results: Twenty two articles were included in the review that showed no statistically significant differences in the performance of mobile MRI and CT scan compared to the fixed ones. The cost minimization approach showed that the third scenario based on purchasing a common mobile MRI and CT scan; and using it by two or more hospitals that are in rational distance from each other is associated with the lowest costs, so it is the most cost-effectiveness strategy. Conclusion: The performance of Mobile CT and mobile MRI is comparable to the fixed ones; and using a combined mobile CT and MRI by two or three hospitals is the most cost-effective approach.     https://ijph.tums.ac.ir/index.php/ijph/article/view/17811 https://ijph.tums.ac.ir/index.php/ijph/article/download/17811/6466

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1537 1538 Yujeong KIM College of Nursing, Kyungpook National University, 680, Gukchabosang-ro, Jung-gu, Daegu, South Korea Eunmi LEE Department of Nursing, Hoseo University, 79-20, Hoseo-ro, Baebang-eup, Asan-si, Chungcheongnam-do, South Korea Mee Kyung LEE School of Nursing, University of Washington, Washington, Seattle, WA, USA Mi Young KIM College of Nursing, Eulji University, South Korea 2019 07 18 No Abstract#### https://ijph.tums.ac.ir/index.php/ijph/article/view/17831 https://ijph.tums.ac.ir/index.php/ijph/article/download/17831/6485

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1461 1468 Yong YANG Department of Vascular Mammary Surgery (Thyroid and Hernia), Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang 330006, P.R. China Yanqin JIAO Department of Nursing, Jiangxi Health Vocational College, Nanchang 330052, P.R. China Jieqing YU Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, P.R. China Chenxiu WANG Department of Endocrine, Jiangxi Provincial People's Hospital, Nanchang University, Nanchang 330006, P.R. China 2019 07 18 Background: To investigate the treatment efficacy of radioactive iodine therapy on patients after total thyroidectomy and its effect on the quality of life. Methods: A retrospective analysis of clinical data of 120 thyroid cancer patients admitted to Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China from February 2014 to February 2017 was performed. According to different treatment methods, they were divided into observation group of 62 cases and control group of 58 cases. Both groups were treated with total thyroidectomy. The control group was treated with anti-infection and prevention of complications after operation, the observation group with radioactive iodine therapy. Treatment efficacy, quality of life score, recurrent laryngeal nerve injury and postoperative survival rate were compared between the two groups. Results: The total effective rate of treatment in the test group was 98.39%, significantly higher than 72.41% in the control group, with a statistically significant difference (P<0.05). Compared with the control group, the fatigue score of the test group was lower, but the score in the area of emotion function and the overall health status score were higher, with a statistically significant difference (P<0.05). There was no significant difference in the recurrent laryngeal nerve injury between the two groups of patients. The postoperative survival rate of the test group of patients was 96.77%, significantly higher than 86.21% of the control group.      Conclusion: The effect of radioactive iodine therapy after total thyroidectomy is remarkable, which can significantly improve the clinical treatment efficacy and postoperative quality of life of patients, worthy of clinical application.   https://ijph.tums.ac.ir/index.php/ijph/article/view/17817 https://ijph.tums.ac.ir/index.php/ijph/article/download/17817/6472

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1428 1438 Majid TAHERI Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad TAVAKOL Department of Sociology, School of Social Sciences, University of Tehran, Tehran, Iran Mohammad Esmaeil AKBARI Cancer Research Center (CRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran Amir ALMASI-HASHIANI Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran AND Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran Mahmoud ABBASI Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2019 07 18 Background: Despite our awareness of the significant effect of Social Determinant of Health (SDoH) such as Socio Economic Status (SES), income and education on breast cancer survival, there was a serious lack of information about the effect of different level of these factors on breast cancer survival. So far, no meta-analysis has been conducted with this aim, but this gap was addressed by this meta-analysis. Methods: Main electronic databases such as PubMed, Web of Science, and Scopus were investigated up to January 2019. Epidemiological studies focusing on the association between SDoH and breast cancer were singled out. Q-test and I2 statistic were used to study the heterogeneity across studies. Begg's and Egger's tests were applied to explore the likelihood of the publication bias. The results were reported as hazard ratio (HR) with 95% confidence intervals (CI) through a random-effects model. Results: We identified 7,653 references and included 25 studies involving 1,497,881 participants. The HR estimate of breast cancer survival was 0.82 (0.67, 0.98) among high level of SES, 0.82 (0.70, 0.94) among high level of income and 0.72 (0.66, 0.78) among academic level of education. Conclusions: The SES, income, and education were associated with breast cancer survival, although the association was not very strong. However, there was a significant association between the levels of these factors and breast cancer survival.     https://ijph.tums.ac.ir/index.php/ijph/article/view/17812 https://ijph.tums.ac.ir/index.php/ijph/article/download/17812/6467

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1539 1540 Xiaolin LIU Department of Chronic Disease Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention Fudan University Institute of Preventive Medicine, Shanghai, China Xianfeng ZHOU Department of Chronic Disease Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention Fudan University Institute of Preventive Medicine, Shanghai, China Juzhong KE Department of Chronic Disease Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention Fudan University Institute of Preventive Medicine, Shanghai, China Hua QIU Department of Chronic Disease Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention Fudan University Institute of Preventive Medicine, Shanghai, China Kang WU Department of Chronic Disease Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention Fudan University Institute of Preventive Medicine, Shanghai, China Xiaonan WANG Department of Chronic Disease Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention Fudan University Institute of Preventive Medicine, Shanghai, China Siyu YU Department of Chronic Disease Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention Fudan University Institute of Preventive Medicine, Shanghai, China Zhitao LI Department of Chronic Disease Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention Fudan University Institute of Preventive Medicine, Shanghai, China Tao LIN Department of Chronic Disease Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention Fudan University Institute of Preventive Medicine, Shanghai, China Xiaonan RUAN Department of Chronic Disease Control and Prevention, Shanghai Pudong New Area Center for Disease Control and Prevention Fudan University Institute of Preventive Medicine, Shanghai, China Li PENG Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China 2019 07 18 No Abstract### https://ijph.tums.ac.ir/index.php/ijph/article/view/17832 https://ijph.tums.ac.ir/index.php/ijph/article/download/17832/6486

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 8 2019 07 18 1469 1477 Ali ALAMI Department of Public Health, School of Public Health, Gonabad University of Medical Sciences, Gonabad, Iran AND Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran Mahbobeh NEJATIAN Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran Elaheh LAEL-MONFARED Student Research Committee, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Alireza JAFARI Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran 2019 07 18 Background: Suicide/suicide attempt, as a major public health problem, has been included among anti-social behaviors. We aimed to investigate the epidemiology of suicide and some associated individual, family, and social factors. Methods: A historical cohort study was conducted among all cases (748 persons) reports related to suicide/suicide attempt that register in hospital reporting system and health care center in Gonabad and Bajestan, Iran, from 2009 to 2014. The required data were extracted> Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Samad GOLSHANI Department of Cardiology, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran Ameneh YAGHOOBZADEH Department of Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran John Henry NOBLE Board of Directors Alliance for Human Research Protection (AHRP), New York, NY, USA Roghieh NAZARI Department of Nursing, Amol School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran Amir Hossein GOUDARZIAN Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran Farhad AREFINIA Amol School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran 2018 03 12 2018 08 04 Background: The prevalence of Acute Myocardial Infarction (AMI) varies from region to region caused by seasonal climate changes and temperature variation. This study aimed to assess the relationship between changing meteorological conditions and incidence of AMI in Iran. Methods: This retrospective prevalence study was based on medical records of the heart center of Mazandaran Province on all patients diagnosed with AMI in Mazandaran, northern Iran between 2013 and 2015. Patients’ sex and the day, month, year and time of hospital admission were extracted from patients’ records. Moreover, the meteorological reports were gathered. Results: A statistically significant difference was found between the distributions of AMI cases across 12 months of the year (P < 0.01). Fuzzy clustering analysis using 16 different climatic variables showed that March, April, and May were in the same cluster together. The other 9 months were in different clusters. Conclusion: Significant increase in AMI was seen in March, April and May (cold to hot weather). https://ijph.tums.ac.ir/index.php/ijph/article/view/12769 https://ijph.tums.ac.ir/index.php/ijph/article/download/12769/6914

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 5 2020 05 01 1012 1013 EN Marina VUKOTIC Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro 2019 12 24 2020 01 12 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/19271 https://ijph.tums.ac.ir/index.php/ijph/article/download/19271/6929

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 5 2020 05 01 931 939 Maryam ROUHANI Department of Nano-Biotechnology, New Technologies Research Group, Pasteur Institute of Iran, Tehran, Iran Vahideh VALIZADEH Department of Nano-Biotechnology, New Technologies Research Group, Pasteur Institute of Iran, Tehran, Iran Sara MOLASALEHI Department of Nano-Biotechnology, New Technologies Research Group, Pasteur Institute of Iran, Tehran, Iran Dariush NOROUZIAN Department of Nano-Biotechnology, New Technologies Research Group, Pasteur Institute of Iran, Tehran, Iran 2018 12 03 2018 12 30 Background: Serratiopeptidase is a bacterial metalloprotease, which is useful for the treatment of pain and inflammation. It breaks down fibrin, thins the fluids formed during inflammation and acts as an anti-biofilm agent. Because of medicinally important role of the enzyme, we aimed to study the cloning and the expression optimization of serratiopeptidase. Methods: The heat-stable serratiopeptidase (5d7w) was selected as the template. Cloning into pET28a expression vector was performed and confirmed by colony PCR and double restriction enzyme digestion. The recombinant protein was expressed in Esherichia coli BL21 and confirmed by SDS-PAGE and Western blot analysis. Different parameters such as expression vector, culture media, post-induction incubation temperature, inducer concentration, and post-induction incubation time were altered to obtain the highest amount of the recombinant protein. Results: Serratiopeptidase was successfully cloned and expressed under optimized conditions in E. coli which confirmed by western blot analysis. The optimal conditions of expression were determined using pQE30 as vector, cultivating the host bacteria in Terrific Broth (TB) medium, at 37º C, induction by IPTG concentration equal to 0.5 mM, and cells were harvested 4 h after induction. Conclusion: As serratiopeptidase is a multi-potent enzyme, the expressed recombinant protein can be considered as a valuable agent for pharmaceutical applications in further studies. https://ijph.tums.ac.ir/index.php/ijph/article/view/15488 https://ijph.tums.ac.ir/index.php/ijph/article/download/15488/6915

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 5 2020 05 01 1014 1015 EN Rasoul SHAKIBA Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran AND School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran Bagher MINAII Department of Histology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Jale ALIASL Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran AND Traditional Medicine Clinical Trial Research Center, Shahed University, Tehran, Iran Mahdad SHAKIBA School of Pharmacy, International Campus, Tehran University of Medical Sciences, Tehran, Iran Roshanak GHODS Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran AND School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran 2018 09 01 2018 09 12 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/14615 https://ijph.tums.ac.ir/index.php/ijph/article/download/14615/6930

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 5 2020 05 01 940 948 EN Efat MOHAMADI Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran Alireza OLYAEEMANESH Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran AND National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran Arash RASHIDIAN Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Abbas RAHIMI FOROUSHANI Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Ali HASSANZADEH Health Insurance Organization of Iran, Tehran, Iran Mojtaba HASUMI Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Mohammadreza MOBINIZADEH National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran Sara MOHAMADI Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2018 09 01 2018 11 06 Background: This study aimed to identify the public preference in health services, the principles that Iranian people consider important, and the aspects of trade-offs between different values in resource allocation practices. Methods: This quantitative study was conducted to investigate public preferences on Health Insurance Benefit Package (HIBP) in 2017. A structured questionnaire was used for data collection, including the preferences of the people who live in Tehran, were above 18 year, and were covered by basic insurance for the HIBP contents and premium. The sample size was calculated 430 subjects and SPSS Statistics was used for data analyzing. Results: 81.6% of the sample population agreed with government allocating more money to the health sector compared to other sectors and organizations and 55% were willing to pay higher premiums for expanding the HIBP coverage. The highest and lowest score regarding prioritization of budget allocation between health services was related to hospitalization services (28.6%) and rehabilitation services (1.6%), respectively. The first priority of respondents regarding health care and life cycle, was "prevention in newborns" (15.9%), the second priority was "prevention in children" (14.6%), the third priority was "prevention in adults" (9.5%), and the last priority was "short-term care in newborns" (0.9%). Conclusion: Iranian people believe that not only the principle of health maximization but also equal opportunities to access health care and a fair allocation of resources should be considered by authorities for effective health insurance policymaking. In this case, given the scarcity of resources, setting priorities for alternative resources is inevitable. https://ijph.tums.ac.ir/index.php/ijph/article/view/14619 https://ijph.tums.ac.ir/index.php/ijph/article/download/14619/6916

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 5 2020 05 01 1016 1017 EN Alireza KHAMMAR Department of Occupational Health Engineering, School of Health, Zabol University of Medical Sciences, Zabol, Iran Mohammad YARAHMADI Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran Farzan MADADIZADEH Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran AND Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2018 08 06 2018 08 11 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/14362 https://ijph.tums.ac.ir/index.php/ijph/article/download/14362/6931

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 5 2020 05 01 949 958 Fatemeh KHORASHADIZADEH Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Hamed TABESH Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mahboubeh PARSAEIAN Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Habibollah ESMAILY Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Abbas RAHIMI FOROUSHANI Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2018 10 23 2018 12 30 Background: The present study aimed to estimate the survival of HIV-positive patients and compare the accuracy of two commonly used models, Shared Random-Effect Model (SREM) and Joint Latent Class Model (JLCM) for the analysis of time to death among these patients. Methods: Data on a retrospective survey among HIV-positive patients diagnosed during 1989-2014 who referred to the Behavioral Diseases Consultation Center of Mashhad University of Medical Sciences was used in this study. Participants consisted of HIV-positive high-risk volunteers, referrals of new HIV cases from prisons, blood transfusion organization and hospitals. Subjects were followed from diagnosis until death or the end of study. SREM and JLCM were used to predict the survival of HIV/AIDS patients. In both models age, sex and addiction were included as covariates. To compare the accuracy of these alternative models, dynamic predictions were calculated at specific time points. The receiver operating characteristic (ROC) curve was used to select the more accurate model. Results: Overall, 213 patients were eligible that met entry conditions for the present analysis. Based on BIC criteria, three heterogeneous sub-populations of patients were identified by JLCM and individuals were categorized in these classes (“High Risk”, “Moderate Risk” and “Low Risk”) according to their health status. JLCM had a better predictive accuracy than SREM. The average area under ROC curve for JLCM and SREM was 0.75 and 0.64 respectively. In both models CD4 count decreased with time. Based on the result of JLCM, men had higher hazard rate than women and the CD4 counts levels of patients decreased with increasing age. Conclusion: Predicting risk of death (or survival) is vital for patients care in most medical research. In a heterogeneous population, such as HIV-positive patients fitting JLCM can significantly improve the accuracy of the risk prediction. Therefore, this model is preferred for these populations. https://ijph.tums.ac.ir/index.php/ijph/article/view/15083 https://ijph.tums.ac.ir/index.php/ijph/article/download/15083/6917

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 5 2020 05 01 19101 19101 Ahad HEYDARI Department of Health in Emergency and Disaster, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Saeed FALLAH-ALIABADI Department of Health in Emergency and Disaster, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2019 12 03 2020 04 05 no abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/19101 https://ijph.tums.ac.ir/index.php/ijph/article/download/19101/6932

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 5 2020 05 01 959 967 EN Ahmad FARAJZADEH SHEIKH Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran AND Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Mojtaba SHAHIN Department of Medical Laboratory Sciences, Faculty of Medical Sciences, Arak Branch, Islamic Azad University, Arak, Iran Leili SHOKOOHIZADEH Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamedan, Iran Fahimeh GHANBARI Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Hamid SOLGI Department of Bacteriology, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran Fereshteh SHAHCHERAGHI Department of Bacteriology, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran 2018 04 14 2018 08 11 Background: New Delhi metallo-beta-lactamase-1 (NDM-1) is one of the most important emerging antibiotic resistance. Co-harboring three or four carbapenemases is rare and only a few reports exist in the literature. We described the characteristics of the large epidemic outbreaks and reports co-producing blaNDM-1 with the other carbapenemase genes in P. aeruginosa isolates. Methods: This present cross-sectional research was conducted on 369 P. aeruginosa isolates obtained from burn and general hospitals within years 2013 to 2016. Beta-lactamase classes A, B and D genes were identified by PCR method. Modified hodge test (MHT), double-disk potentiation tests (DDPT) and double disk synergy test (DDST) were performed for detection carbapenemase and metallo beta-lactamase (MBL) production of blaNDM-1 positive P. aeruginos isolates. Results: From 236 carbapenem-resistant P. aeruginosa (CRPA), 116 isolates have had MBL genes and twenty-nine isolates were found positive for blaNDM-1. In CRPA isolates, blaIMP-1, blaVIM-2 and blaOXA-10 were identif