[Review on road traffic injuries cost calculation methods]

To resource allocating at national levels as results of productivity, cost calculation helps to determine the size of the problem and revealed cost benefits of injury prevention and it can also ensure the better resource using and cost benefit assessment. This study was conducted to determine the method of calculating road traffic injuries cost. In a literature review study using internet searching and library resources' all references related to health cost determination was derived. Then among all the methods, methods of road traffic injury cost estimation were studied and a result with component of the two common methods is presented here. Findings showed that road traffic cost methods including: life insurance approach, court award [compensation], compensation method, the method of implicit public sector valuation, gross output method, using GDP [human capital] method, value change risk or willingness to pay. Mentioned methods have been used based on each section policies, but each method faced to its limitation and may be accompanied with under reporting. Among the stated methods willingness to pay is more accurate, but because of the complexity of the method, human capital method according to available resources and capacity to perform the higher permeability is recommended for low and middle income countries.

[ survey of the role of humans' risk factors in the severity of road traffic injuries on urban and rural roads]

This study was conducted to determine the role of human risk factors in the severity of road traffic accidents on urban and rural roads. All data from road traffic-injured subjects [census, 592168] which were registered by the Fava system [COM forms] were investigated. Human risk factors due to road traffic injuries and the Odds ratio were calculated using an ordinal regression model and adjusted to probable confounding risk factors such as age, gender and lighting system in urban and rural roads. The mean age of the subjects was 34.1 +/- 14.0 years. Among human risk factors, the highest percentage [69.9%] was allocated to the disregard of rules and legislation. The Odds ratio of an accident being fatal or non-fatal in inner city roads to alcohol users was 6.5 times more than for those who did not have this risk factor [OR: 6.5, CI: 4.88-8.65]. In outer city roads it was also the highest among other ratios [OR: 1.73, CI 1.22-3.29]. In spite of the fact that alcohol had the highest effect on the severity of road traffic injuries, but acknowledging the low prevalence of this factor and its outcome on lower attributable risks when compared to other factors, it is a better prevention program to focus on those factors which are more prevalent, such as the disregard of rules and legislation and speed.

[Comparison of characteristic property among Tehran offensive and non-offensive drivers using cloninger's treatment and character inventory]

Characteristic property among Tehran offensive and non- offensive drivers using Cloninger, s treatment and Character Inventory questionnaire was studied. A cross- sectional study was carried out after coordinating with traffic police. 300 drivers: 150 offensive [drivers with more than ten penalty points and 150 non- offensive drivers with less than ten penalty points in one year prior were selected randomly. Data was collected using Cloninger, s treatment and Character Inventory standard questionnaire by trained experts in three different routes of Tehran. The average age was 20-34 years [82% male, 18% female]. Based on Cloninger,s treatment and Character Inventory standard questionnaire, a significant differences was observed in novelty seeking, harm avoidance, reward dependence, self-directive ness, co- operation [p<0.001] and persistence [p<0.013] among offensive and non-offensive drivers. By one score increasing of novelty seeking the chance of to be offencer will be increased 4.5 times [OR= 4.520, p<0.007], in harm avoidance will be half [OR= 0.504, p<0.045] and in reward dependence will be one fourth [OR= 0.278, p<0.033]. Novelty seeking sub scale of Cloningers treatment and Character Inventory questionnaire was higher and harm avoidance and reward dependence was lower among offensive drivers.

[Study of road traffic injuries risk factors by geographic information system [GIS] in 2009]

Using Geographical Information System [GIS] can decreases the burden of road traffic injuries effectively by identification of hot spot to modification in hazardous areas. The aim of the study was determining geographical distribution of human risk factors associated with road traffic injuries by using Geographical Information System [GIS] in Iran. The national database of road traffic injuries registered by the Iranian traffic Police [Rahvar NAJA] was used. The human risk factors were investigated by recognition of the hazardous points and geographical distribution of associated risk factors. The Hot Spot Analysis and Map clustering approaches were employed to meet the objectives. The mean age of injured subjects was 34 years and the most affected age group was 20-39 years. Death and injury occurrence within out of cities ways were 0.3% and 28% respectively. Geographical distribution of risk factors also showed that roads of Northern provinces i.e. [Gilaan and Mazandaran] were the hazardous rising as well as Qazvin to Rasht and Qom to Tehran roads. Sistan and Balochestan Provinces and Tehran had the highest [4.8%] and the lowest [0.1%] rates of road traffic injuries leading to death in the country. Northern provinces and its leading axes by hazardous rising and Sistan and Balochestan province with fatal injuries need to identify the cause of injuries' and, if necessary, more tighten regulations and more controls by the traffic police must be applied.

[Relationship between quality of life and musculoskeletal disorders in car manufacturing workers]

Work-related musculoskeletal disorders are considered as major occupational health problems and undesirable posture during work is one of the most important causes of such problems. Therefore describing the effect of different levels of musculoskeletal system on healthrelated quality of life and work absence is essential for preventive strategy. In this study the health- related quality of life in personnel of an assembly line of a car manufacturing company who suffered musculoskeletal disorders was investigated and later compared with healthy subjects. A case control study was performed on workers of Saipa car manufacturing company who were exposed to musculoskeletal disorders. A total of 165 workers with musculoskeletal disorders and 165 controls were randomly selected. Musculoskeletal disorders were determined using valid and reliable Nordic and SF-36 questionnaires. Data were analyzed using, Chi Square, Odds Ratio, 95% Confidence Interval, and Logistic Regression. Comparison of physical indicators of quality of life such as physical pain, general health, physical function, and role limitation due to physical problems with indicators of musculoskeletal disorders showed a significant difference between two groups [P<0/001]. Musculoskeletal disorders were higher in those with lower quality of life [P<0.001, CI: 95% [0.32-0.82], OR=0.51]] There was a relationship between the indicator of quality of life and musculoskeletal disorders. Physical conditions and quality of life among workers of assembly line of the car manufacturing company affected the risk of chronic musculoskeletal disorders. Improving and optimizing such conditions play an important role in health- related quality of life

[Survey the knowledge, attitude and practice [KAP] and educational needs assessment of road traffic injuries among traffic police officers]

Road traffic injuries are a leading cause of death and disability worldwide. Determining knowledge, attitude and practice among traffic police about road traffic injuries, can improve the desired outcomes. Determination of KAP and educational needs assessment regarding road traffic injuries among traffic police officers. A descriptive study was conducted among 185 traffic police who was randomly selected from all traffic police officers list in 2008. Data was collected by using structural questionnaire [questionnaire was validated by content validity and reliability was determined by test re test r=0.8], after a formal consent by trained experts. Educational need assessment was determined by one open question. Scores was categorized due to statistical quartiles of the subject. Mean +/- SD of age, was 33.4 +/- 6.8 years. There was a significant deference about good knowledge between bachelor officers and other levels of education [p<0.01]. There was lowest rate about knowledge [0.6%] attitude [0.6%] and Practice [0.7%] in Ms Level in comparison with other levels. The rate of good knowledge 63% and good practice 76% was significantly difference among middle level officers [p<0.001]. There was significantly difference about good attitude between operational occupations with other occupations [p<0.005]. High priority allocated to improvement of scientific information about educational need assessment at the level of world. The findings showed; the traffic polices need to planning for improvement traffic injuries education especially in senior officers, MS and upper degree of officers. Suitable educational planning and its continuity is a key issue to reduction of traffic injuries reduction

Cost-benefit and effectiveness of newborn screening of congenital hypothyroidism: findings from a national program in Iran

In this study, the cost-benefit of a screening program based on the rial, the unit of currency used, was analyzed. The intelligence quotient [IQ], and height and weight were evaluated as indices for a population of children suffering from congenital hypothyroidism [CH]. The total cost for the screening program, including hormone tests, diagnosis, medicine, treatments and care was identified and calculated up to the age of seventy years and this was compared to the costs related to training and caring for patients suffering from mental retardation, who had not been screened. The screening test was done using S and S filter paper and thyroid stimulating hormone [TSH] was determined by the ELISA test. The future costs and benefits with an annual rate of 3% discount of their current value was estimated. To evaluate the effectiveness of the screening program, IQs of 32 patients were identified and compared to 36 healthy children between 2004-2005. The IQs were evaluated according to "Good Enough" and "Proteus Maze" tests. During 2008, 1165169 of 12489136 newborns [51% male, 49% female] underwent screening for CH, 92% cover-age of all newborns for that year. Four percent of recalled infants, with TSH>5 were subjected to diagnostic tests [T4, TSH, T3RU] and finally 2745 patients were identified. Benefit to cost ratios, based on a 3% annual discount rate, were 22, 41, 32, 34, 47 and 60 times lower, respectively. No significant differences were found with regard to differences in IQ scores between cases and controls [cases: 105 +/- 19.3, controls: 111 +/- 19.4], height [cases: 106 +/- 0.7, controls: 102 +/- 4.9 cm] and weight [cases: 15.6 +/- 4.6, control 15.3 +/- 3.2 kg]. The national Newborn Screening [NBS] program for CH has been successful and quite effective in Iran. The method not only has economical advantages but also reduces capital expenditures and preserves normal IQ of the patients under treatment and prevents mental retardation and growth complications

Epidemiological pattern of non-fatal injuries in Iran

To present the incidence rate and distribution of non-fatal injuries in Iran. A one- year study was carried out in all 28 provinces of Iran in 2002-3. Overall, 53,6624 individuals [1,11626 households] from all provinces of the country were randomly selected for the study. In each province about 2000 households in urban and 2000 families in rural areas were included in the study. The guardians or heads of the households were interviewed by using a questionnaire that included information about any accidental injuries taken medical cares within the year prior to the date of data collection and some other demographic information. It is estimated that more than 9.2 million injuries with about 8286 deaths and 74379 hospitalizations occurred in Iran each year. The incidence rate of all types of non-fatal injuries was [444.3 per 100,000]. The top three causes of non-fatal injuries were transport accidents [237 per 100,000], falls [106.2 per 100,000] and struck by thrown, projected of falling object [69.8 per 100,000]. The non-fatal injuries were more common among males than females [8039.6 vs. 2021.7 per 100,000] and nearly equivalent among residence of urban areas compared to those from rural areas [5024.1 vs. 5075.5 per 100,000]. In Iran injuries are one of the main leading causes of diseases and hospital admissions in both rural and urban areas, and this figure for transport accidents is quite high in the world

[Women occupation, marital status and non-communicable disease risk factors: findings from the Tehran lipid and glucose study]

To investigate the relationship between the presence of risk factors for non-communicable diseases and occupation and marital status in Tehran women. The sample was composed of 566 working women [210 single, 350 married] and 561 age-matched non-working subjects [151 single, 410 married], selected randomly from among 15005 participants in the Tehran Lipid and Glucose Study [TLGS]. Questionnaire were used to obtain demographic information. In addition, we recorded height, weight, waist circumference, systolic and diastolic blood pressures, body mass index [BMI], and waist to hip ratio [WHR]. Serum total cholesterol, triglycerides [TG], and high-density lipoprotein [HDL] levels were measured and oral glucose tolerance test [GTT] performed. Low-density lipoprotein [LDL] levels were calculated using the Friedwald formula. We used Student's t test and one-way analysis of variance [ANOVA] to compare working and non-working women. Variables entered in the model included occupation, marital status and education. The mean +/- SD age in single and married subjects in the working group was 34.3 +/- 8.4 and 34.7 +/- 9.0 years, respectively. The same values for single and married subjects in the non-working group were 34.4 +/- 8.0 and 35.0 +/- 9.0 years. There were significant associations between marital status and the prevalence of all non-communicable disease risk factors [P<0.01]. We also detected higher waist circumference and diastolic blood pressure in non-working women compared to those who had a job. The data show higher levels of some non-communicable disease risk factors in non-working as compared to working women. All non-communicable disease risk factors were higher among married subjects

[Patient satisfaction and its related factors in Ayatollah Taleghani Hospital in 2006]

Patient satisfaction survey is an instrumental component in monitoring the hospital's quality of care, in relation to cost and services. Many studies have been conducted throughout the world to determine the patient satisfaction and its related factors. This study was carried out to evaluate patient satisfaction and its related factors. A cross sectional study was based on in-hospital patient who attended the Taleghni hospital between April 2006 and August 2006. Sample size was determined as 476 from 5021 by randomized sampling. Sample sizes in each ward were according to the proportion of hospitalized patient. Participants were interviewed privately face to face in the hospital at discharge time. Interviews were conducted by trained interviewers using pre tested questionnaires [Verona Service Satisfaction Scale- VSSS 32]. Correlation between total satisfaction and Patient's age, education] was estimated by using Pearson's Correlation. Prevalence and confidence interval [CI] of unsatisfied patient was calculated. In majority, 83% of patients were quite satisfied with their care and 1.5% was dissatisfied [CI=0.7-2.2]. 93% of patient was most satisfied with physician communication and treatment. Only 49% of patients were satisfied with nutrition status. There was no relationship between age, educational status and total satisfaction. Percentage of patient-faithfulness was 66%. 65% of admitted subjects were recommending this hospital to their friends. Patients whose in-hospital course was between 11-15 days were more satisfied with hospitalization among both sexes. In general, patients were quite satisfied with their hospital care. Further studies similar to this survey is offer to improve the quality of care and overall health-care outcomes

[Study of the general mental health status in an area of Tehran: Tehran lipid and glucose study [TLGS]]

There are significant correlations between the mental health status of individuals and non-communicable mental or physical diseases. Epidemiological data regarding mental health indices plays an important part in the planning and designing of mental health programs. This study was conducted to evaluate the general mental health status of inhabitants in an area of Tehran as part of the TLGS. Materials and Method: In this cross-sectional study, 927 residents [20 years and older] of a specific area were randomly selected. Subjects completed the demographic data forms alongwith the General Health Questionnaires [GHQ], validated for the Iranian population. A cut off of 6 and above was used as threshold to identify the group suspected of having psychiatric disorders. To compare the scores of total GHQ and subscales between different demographic variables, the Chi square, Mann whitney and Kruskal wallis test were used. Logistic regression was used to identify variables related to the group that scored above threshold. The total sample studied consisted of 927 adults, of whom 401 [43.3%] were males and 526 [56.7%] females. Among them 489 [52.8%] were suspected of having psychiatric disorders. Mean score of total GHQ was 7.0 +/- 5.4 and regarding the subscales of the questionnaire including physical symptoms, anxiety and sleep disorders, social dysfunction and depression, mean scores were 1.2 +/- 1.7, 1.7 +/- 2.0, 3.4 +/- 2.0, 0.75 +/- 1.4 respectively and the median of mentioned subscales were 0, 1, 3 and 0 respectively. Frequency of women suspected of mental disorders was significantly higher than that of men [59.7% vs. 43.6%, p<0.001]. Taking into consideration the sample group and the method of gathering data, the frequency of those suspected of having psychiatric disorders in our study was higher as compared to other studies. Since mental health plays an important role in health promotion and community development, as well as the financial and psychological burden of illnesses, inplementation of policies in regard to implementation of related programs for prevention especially in women, seems vital

Comparison of menarche age between two generations of women [Tehran Lipid and Glucose Study]

The menarcheal age can be considered as an indicator of puberty. There is little information on the age of menarche among Tehranian daughters to compare with their mothers. This study was aimed at comparing the age of menarche in two generations. In this cross-sectional study 812 subjects [406 daughters and 406 mothers] out of 15005 participants in the longitudinal Tehran Lipid and Glucose Study were investigated. Demographic information and the age of menarche were recorded using a questionnaire. A minimum of 25-year period was considered as one generation. Distribution of the menarcheal age and the linear regression were performed for analytical studies. The mean age of menarche in daughters and their mothers were 13.2 +/- 1.4 and 13.6 +/- 1.5 years, respectively. There was significant correlation between mothers and daughters menarcheal ages [r=0.25, p<0.002]. 25[th], 50[th] and 75[th] percentile for menarcheal age in daughters and their mothers were 12.2, 13.1, 14/1 and 12/7, 13.5, 14.5 years respectively. Minimum and maximum ages of menarche were the same [10 and 18 years] in two groups. In agreement with other studies, a reduction in the average of menarcheal age was found over a 25-year period [one generation]. The health system must therefore focus on educational programming and also encouraging adolescent girls for changes in their present lifestyles

[Comparison of nutrient intakes in menopausal and perimenopausal women; Tehran lipid and glucose study [TLGS]]

Regarding the increasing number of women suffering from one or more chronic disease-associated risk factors following the cessation of their reproductive cycle, it is necessary to consider their needs over nutrient intake and lifestyle. To compare the nutrient intakes in menopausal and perimenopausal women. This was a cross-sectional study in which a total of 96 women [47 in menopausal and 49 in perimenopausal periods], aged 45 and over with no hormone therapy, were enrolled. The study was conducted within the framework of the TLGS, using anthropometric assessments and a 24-hour dietary recall for 2 days. Anthropometric indices were measured, using standard protocols. Mean intakes of nutrients were compared with EAR and DRI recommendations. The mean differences between two groups were analyzed for any statistical significance using a two-tailed unpaired student's t-test or a Mann-Whitney test whenever the assumption of normality was not met. Waist to hip ratio for the menopausal women was higher than perimenopausal group [p<0.01]. The menopausal group consumed less fat [p<0.01] and more fiber [p<0.05] than did the perimenopausal subjects [28% and 10+/-1 g/d vs. 32% and 7+/-2 g/d for fat and fiber, respectively]. Mean intake of vitamin C, thiamin, riboflavin, manganese, phosphorus, and potassium were within the optimal ranges for both groups. However, the mean intake of magnesium, copper, zinc, calcium, pyridoxine and vitamin D were lower than recommendations for menopausal and perimenopausal women, respectively [97 and 98% for magnesium, 91 and 92% for copper 89 and 94% for zinc 93 and 91% for calcium 93 and 98% for pyridoxine 61 and 50% for vitamin D]. Menopausal women met the recommendations for the nutrient intakes better than perimenopausal women, although both groups were found to have insufficient nutrient intakes