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BACKGROUND@#Need to a simple, available, accurate, comprehensive, and valid indicator is felt to assess thermal effects. Therefore, the present study was aimed to develop and validate the environmental heat strain risk assessment (EHSRA) index using structural equation modeling (SEM) based on empirical relations.@*METHODS@#This cross-sectional study was performed on 201 male workers in environments with various climatic conditions. The heart rate and tympanic temperature of the individuals were monitored at times of 30, 60, and 90 min after beginning the work. At these times, values of dry temperature, wet temperature, globe temperature, and air velocity were also measured and metabolism rate and clothing thermal insulation value were estimated. At the end, a theoretical model was depicted in AMOS software and obtained coefficients were applied to develop a novel index. The scores of this indicator were categorized into four risk levels via ROC curves and validate using linear regression analysis.@*RESULTS@#Indirect effect coefficients of the globe temperature, dry temperature, wet temperature, air velocity, metabolism, and clothing thermal insulation variables on the tympanic temperature were computed by 0.77, 0.75, 0.69, 0.24, 0.49, and 0.39, respectively. These coefficients were applied to develop the index. Optimal cut-off points of boundaries between risk levels included 12.02, 15.88, and 17.56. The results showed that the EHSRA index justified 75% of the variations of the tympanic temperature (R@*CONCLUSIONS@#The novel index possesses appropriate validity. It was suggested that this indicator is applied and validated in various environments in the next studies.
Subject(s)
Adult , Humans , Male , Middle Aged , Young Adult , Environmental Health/methods , Heat-Shock Response , Hot Temperature/adverse effects , Iran , Latent Class Analysis , Risk Assessment/methodsABSTRACT
Objective: To determine the significance of temperature, rainfall and humidity in the seasonal abundance of Anopheles stephensi in southern Iran. Methods: Data on the monthly abundance of Anopheles stephensi larvae and adults were gathered from earlier studies conducted between 2002 and 2019 in malaria prone areas of southeastern Iran. Climatic data for the studied counties were obtained from climatology stations. Generalized estimating equations method was used for cluster correlation of data for each study site in different years. Results: A significant relationship was found between monthly density of adult and larvae of Anopheles stephensi and precipitation, max temperature and mean temperature, both with simple and multiple generalized estimating equations analysis (P<0.05). But when analysis was done with one month lag, only relationship between monthly density of adults and larvae of Anopheles stephensi and max temperature was significant (P<0.05). Conclusions: This study provides a basis for developing multivariate time series models, which can be used to develop improved appropriate epidemic prediction systems for these areas. Long-term entomological study in the studied sites by expert teams is recommended to compare the abundance of malaria vectors in the different areas and their association with climatic variables. Abbasi Madineh 1 Deparment of Medical Entomology & Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran; Infectious and Tropical Diseases Research Center,Tabriz University of Medical Sciences, Tabriz Rahimi Foroushani Abbas 2 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran Jafari-Koshki Tohid 3 Molecular Medicine Research Center; Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz Pakdad Kamran 4 Department of Parasitology & Mycology, Paramedical School, Shahid Beheshti University of Medical Sciences, Tehran Vatandoost Hassan 5 Deparment of Medical Entomology & Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran Hanafi-Bojd Ahmad 6 Deparment of Medical Entomology & Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran WHO. Malaria report 2019. Geneva: WHO; 2019. Vatandoost H, Raeisi A, Saghafipour A, Nikpour F, Nejati J. Malaria situation in Iran: 2002-2017. Malar J 2019; 18: 200. Hanafi-Bojd AA, Azari-Hamidian S, Vatandoost H, Charrahy Z. Spatio-temporal distribution of malaria vectors (Diptera: Culicidae) across different climatic zones of Iran. Asian Pac J Trop Med 2011; 6: 498-504. Vatandoost H, Oshaghi MA, Abaie MR, Shahi M, Yaghoobi F, Baghaii M, et al. Bionomics of Anopheles stephensi Liston in the malarious area of Hormozgan Province, southern Iran. Acta Trop 2006; 97(2): 196-203. Faulde MK, Rueda LM, Khaireh BA. First record of the Asian malaria vector Anopheles stephensi and its possible role in the resurgence of malaria in Djibouti, Horn of Africa. Acta Trop 2014; 139: 39-43. Gayan Dharmasiri G, Yashan Perera A, Harishchandra J, Herath H, Aravindan K, Jayasooriya HTR, et al. First record of Anopheles stephensi in Sri Lanka: A potential challenge for prevention of malaria reintroduction. Malar J 2017; 16: 326. Carter TE, Yared S, Gebresilassie A, Bonnell V, Damodaran L, Lopez K, et al. First detection of Anopheles stephensi Liston, 1901 (Diptera: Culicidae) in Ethiopia using molecular and morphological approaches. Acta Trop 2018; 188: 180-186. Zhou G, Munga S, Minakawa N. Spatial relationship between adult malaria vector abundance and environmental factors in western Kenya highlands. Am J Trop Med Hyg 2007; 77(1): 29-35. Bashar K, Tuno N. Seasonal abundance of Anopheles mosquitoes and their association with meteorological factors and malaria incidence in Bangladesh. Parasites Vectors 2014; 7: 442. Gardiner LS. Climate change and vector-borne disease. University Corporation for Atmospheric Research. 2018. [Online]. Available from: https://scied.ucar.edu/longcontent/climate-change-and-vector-borne- disease [Accessed on 9 June 2019]. Patz JA, Lindsay SW. New challenges, new tools: The impact of climate change on infectious diseases. Curr Opin Microbiol 1999; 2(4): 445-451. Khormi HM, Kumar L. Future malaria spatial pattern based on the potential global warming impact in South and Southeast Asia. Geospat Health 2016; 11(3). doi: 10.4081/gh.2016.416. Ren Z, Wang D, Ma A, Hwang J, Bennett A, Sturrock HJW, et al. Predicting malaria vector distribution under climate change scenarios in China: Challenges for malaria elimination. Sci Rep 2016; 6: 20604. Campbell-lendrum D, Woodruff R. Climate change: Quantifying the health impact at national and local levels. Geneva: World Health Organization; 2007. Hanafi-Bojd AA. Using of remote sensing and geographical information system for estabiling a malaria monitoring system in the Bashadgard endemic focus, Hormozgan Province, Iran. Ph.D. Thesis. Tehran University of Medical Sciences; 2010. No. 4526. Mohammadkhani M, Khanjani N, Bakhtiari B, Sheikhzadeh K. The relation between climatic factors and malaria incidence in Kerman, South East of Iran. Parasite Epidemiol Control 2016; 1: 205-210. Statistical Center of Iran. Country statistical yearbook. 1st ed. Iran: Management & Planning Organization; 2018, p.100-120. Basseri HR, Moosakazemi SH, Yosafi S. Mohebali M, Hajaran H, Jedari M. Anthropophily of malaria vectors in Kahnouj district, south of Kerman, Iran. Iran J Public Health 2005; 34(2): 27-35. Fathian M, Vatandoost H, Moosa-Kazemi H, Raeisi A, Yaghoobi-Ershadi MR, Oshaghi MA, et al. Susceptibility of Culicidae mosquitoes to some insecticides recommended by WHO in a malaria endemic area of Southeastern Iran. J Arthropod-Borne Dis 2015; 9(1): 22-34. Mojahedi A, Basseri HR, Raeisi A, Pakari A. Bioecological characteristics of malaria vectors in different geographical areas of Bandar Abbas County, 2014. J Prev Med 2016; 3(1): 18-25. Nedjati J. The study on some bioecological characteristics of malaria vectors and monitoring of their suseptibility levels to some insecticides in Sarbaz county, Sistan va Baluchestan province. MSc. Thesis. Tehran University of Medical Sciences; 2011. No. 5046. Poudat A. Epidemiological survey of malaria in Bandar Abbas County, 1998-2002. MSc. Thesis. Tehran University of Medical Sciences; 2003. No. 3375. Yeryan M, Basseri HR, Hanafi-Bojd AA, Raeisi A, Edalat H, Safari R. Bio-ecology of malaria vectors in an endemic area, Southeast of Iran. Asian Pac J Trop Med 2016; 9(1): 32-38. Iran Meteorological Organization. Specialized products and services weather. 2019. [Online]. Available from: https://data.irimo.ir/ [Accessed on 10 April 2019]. Cui J. QIC program and model selection in GEE analyses. Stata J 2007; 7(2): 209-220. Aytekin S, Aytekin AM, Alten B. Effect of different larval rearing temperatures on the productivity (R0) and morphology of the malaria vector Anopheles superpictus Grassi (Diptera: Culicidae) using geometric morphometrics. J Vec Ecol 2009; 34: 32-42. Lardeux FJ, Tejerina RH, Quispe V, Chavez TK. A physiological time analysis of the duration of the gonotrophic cycle of Anopheles pseudopunctipennis and its implications for malaria transmission in Bolivia. Malar J 2008; 7: 141. Simon-Oke IA, Olofintoye LK. The effect of climatic factors on the distribution and abundance of mosquito vectors in Ekiti State. J Biol Agri Healthcare 2015; 5(9): 142-146. Jemal Y, Al-Thukair AA. Combining GIS application and climatic factors for mosquito control in Eastern Province, Saudi Arabia. Saudi J Biol Sci 2016; 25(8):1593-1602. Msugh-Ter MM, Aondowase DA, Terese AE. Association of meteorological factors with two principal malaria vector complexes in the University of Agriculture Makurdi community, Central Nigeria. Am J Entomol 2017; 1(2): 31-38. [31 ]Kabbale FG, Akol AM, Kaddu JB, Ambrose W. Biting patterns and seasonality of Anopheles gambiae sensu lato and Anopheles funestus mosquitoes in Kamuli District, Uganda Onapa. Parasit Vectors 2013; 6: 340. Paaijmans KP, Wandago OM, Githeko AK, Takken W. Unexpected high losses of Anopheles gambiae larvae due to rainfall. PLoS One 2007; 2(11): e1146. Gillooly JF, Brown JH, West GB, Savage VM, Charnov EL. Effects of size and temperature on metabolic rate. Science 2001; 293: 2248-2251. Koenraadt CJ, Paaijmans KP, Schneider P, Githeko AK, Takken W. Low level vector survival explains unstable malaria in the western Kenya highlands. Trop Med Int Health 2006; 11(8): 1195-1205. Munga S, Minakawa N, Zhou G, Githeko AK, Yan G. Survivorship of immature stages of Anopheles gambiae s.l. (Diptera: Culicidae) in natural habitats in western Kenya highlands. J Med Entomol 2007; 44: 758-764. Afrane YA, Zhou G, Lawson BW, Githeko AK, Yan G. Effects of microclimatic changes due to deforestation on the survivorship and reproductive fitness of Anopheles gambiae in Western Kenya Highlands. Am J Trop Med Hyg 2006; 74: 772-778. Afrane YA, Githeko AK, Yan G. The Ecology of Anopheles mosquitoes under climate change: Case studies from the effects of environmental changes in East Africa highlands. Ann Acad Sci 2012; 1249: 204-210. Abbasi F, Babaeian I, Malboosi SH, Asmari M, Mokhtari LG. Climate change assessment over Iran during future decades, using statistical downscaling of ECHO-G model. J Geogr Res 2012; 104: 205-230 (In Persian).
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OBJECTIVES: The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan. METHODS: This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test. RESULTS: A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection. CONCLUSIONS: Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients’ adherence to treatment, and to reduce contact with MDR-TB patients.
Subject(s)
Humans , Body Weight , Case-Control Studies , Logistic Models , Odds Ratio , Risk Factors , Smoking , Sudan , Tuberculosis , Tuberculosis, Multidrug-Resistant , WaterABSTRACT
OBJECTIVES: The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan.METHODS: This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test.RESULTS: A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection.CONCLUSIONS: Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients' adherence to treatment, and to reduce contact with MDR-TB patients.
Subject(s)
Humans , Body Weight , Case-Control Studies , Logistic Models , Odds Ratio , Risk Factors , Smoking , Sudan , Tuberculosis , Tuberculosis, Multidrug-Resistant , WaterABSTRACT
OBJECTIVES@#The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan.@*METHODS@#This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test.@*RESULTS@#A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection.@*CONCLUSIONS@#Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients' adherence to treatment, and to reduce contact with MDR-TB patients.
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OBJECTIVES: Consecutive community health assessments revealed that water-pipe smoking in women and impaired growth in children were among the main health concerns in suburban communities in southern Iran. The aim of the present study was to identify the effects of water-pipe smoking during pregnancy on birth weight.METHODS: Data from a population-based prospective cohort study of 714 singleton live pregnancies in the suburbs of Bandar Abbas in southern Iran in 2016–2018 were used in this study. Data about water-pipe smoking patterns and birth weight were collected by questionnaires during and after the pregnancy. Low birth weight (LBW) was defined as a birth weight below 2,500 g. Statistical analyses were performed using generalized linear models, and the results were presented in terms of relative risk (RR) and 95% confidence intervals (CI).RESULTS: Fifty (8.2%) of the study subjects smoked water-pipe. The adjusted risk of LBW increased 2-fold in water-pipe smokers (adjusted RR [aRR], 2.09; 95% CI, 1.18 to 3.71), and by 2.0% for each 1-year increase in the duration of water-pipe smoking (aRR, 1.02; 95% CI, 0.99 to 1.05).CONCLUSIONS: Our results showed that water-pipe smoking during pregnancy was an important risk factor for LBW in this population sample from southern Iran. The introduction of regulations onto prevent water-pipe smoking and the implementation of community health action plans aiming at empowering women and increasing women's knowledge and awareness regarding the health consequences of water-pipe smoking are proposed.
Subject(s)
Child , Female , Humans , Infant, Newborn , Pregnancy , Birth Weight , Cohort Studies , Infant, Low Birth Weight , Iran , Linear Models , Parturition , Prospective Studies , Risk Factors , Smoke , Smoking , Social Control, Formal , Suburban PopulationABSTRACT
OBJECTIVES: Consecutive community health assessments revealed that water-pipe smoking in women and impaired growth in children were among the main health concerns in suburban communities in southern Iran. The aim of the present study was to identify the effects of water-pipe smoking during pregnancy on birth weight. METHODS: Data from a population-based prospective cohort study of 714 singleton live pregnancies in the suburbs of Bandar Abbas in southern Iran in 2016–2018 were used in this study. Data about water-pipe smoking patterns and birth weight were collected by questionnaires during and after the pregnancy. Low birth weight (LBW) was defined as a birth weight below 2,500 g. Statistical analyses were performed using generalized linear models, and the results were presented in terms of relative risk (RR) and 95% confidence intervals (CI). RESULTS: Fifty (8.2%) of the study subjects smoked water-pipe. The adjusted risk of LBW increased 2-fold in water-pipe smokers (adjusted RR [aRR], 2.09; 95% CI, 1.18 to 3.71), and by 2.0% for each 1-year increase in the duration of water-pipe smoking (aRR, 1.02; 95% CI, 0.99 to 1.05). CONCLUSIONS: Our results showed that water-pipe smoking during pregnancy was an important risk factor for LBW in this population sample from southern Iran. The introduction of regulations onto prevent water-pipe smoking and the implementation of community health action plans aiming at empowering women and increasing women's knowledge and awareness regarding the health consequences of water-pipe smoking are proposed.
Subject(s)
Child , Female , Humans , Infant, Newborn , Pregnancy , Birth Weight , Cohort Studies , Infant, Low Birth Weight , Iran , Linear Models , Parturition , Prospective Studies , Risk Factors , Smoke , Smoking , Social Control, Formal , Suburban PopulationABSTRACT
OBJECTIVES@#Consecutive community health assessments revealed that water-pipe smoking in women and impaired growth in children were among the main health concerns in suburban communities in southern Iran. The aim of the present study was to identify the effects of water-pipe smoking during pregnancy on birth weight.@*METHODS@#Data from a population-based prospective cohort study of 714 singleton live pregnancies in the suburbs of Bandar Abbas in southern Iran in 2016–2018 were used in this study. Data about water-pipe smoking patterns and birth weight were collected by questionnaires during and after the pregnancy. Low birth weight (LBW) was defined as a birth weight below 2,500 g. Statistical analyses were performed using generalized linear models, and the results were presented in terms of relative risk (RR) and 95% confidence intervals (CI).@*RESULTS@#Fifty (8.2%) of the study subjects smoked water-pipe. The adjusted risk of LBW increased 2-fold in water-pipe smokers (adjusted RR [aRR], 2.09; 95% CI, 1.18 to 3.71), and by 2.0% for each 1-year increase in the duration of water-pipe smoking (aRR, 1.02; 95% CI, 0.99 to 1.05).@*CONCLUSIONS@#Our results showed that water-pipe smoking during pregnancy was an important risk factor for LBW in this population sample from southern Iran. The introduction of regulations onto prevent water-pipe smoking and the implementation of community health action plans aiming at empowering women and increasing women's knowledge and awareness regarding the health consequences of water-pipe smoking are proposed.
ABSTRACT
Aim: This work aims to isolate and perform comparative studies of a phages active against a Salmonella enteritidis strain from Iran. Also, suitable phage candidates for therapy of mice will be selected
Background: Bacteriophage is of particular interest as a biocontrol agent in the prevention of food-borne illnesses. In recent years tend to use bacteriophages to control pathogenic bacteria has increased. A bacteriophage is considered to be a potent antibiotic alternative for treating bacterial infections
Methods: the specific phages against Salmonella Enteritidis was isolated and candidates for therapy of mice will be selected. Mouses divided into the six specific groups. Groups of mice were as follows: A: Bacteri [control] B: Bacteri+ bacteriophage [Simultaneous], C: Bacteri + bacteriophage Four days later, D: Bacteriophage + bacteri four days later E: Bacteri+ Ciprofloxacin [Simultaneous] F: Bacteri+ ciprofloxacin+ bacteriophage [Simultaneous]
Results: In this study, a lytic bacteriophage is isolated and it shows that phage has a head size of 46 nm and without a tail, by using an electron microscope. Oral administration of a single dose of 2 × 109 PFU/mouse bacteriophage enable to protect mouse against salmonellosis and it causes treatment of salmonellosis in mice
Conclusion: The use of this phage compared to ciprofloxacin shows that in addition of the treatment of mouse, it also prevents weight loss
ABSTRACT
Self-care activities during pregnancy can be effective in reducing adverse pregnancy outcomes. Health Belief Model [HBM] is one of the most applicable models in educational need assessment for planning and implementation of educational interventions. The purpose of this study was to measurement of the constructs of HBM related to self-care during pregnancy in women referred to South Tehran health network. In this cross-sectional study 270 pregnant women who referred to health centers of South Tehran Health Networks participated. Demographic, knowledge and attitude questionnaires based on constructs of HBM was used to measure the status of knowledge and attitude of women. Data were analyzed using statistical software SPSS18. Results showed that 92.2% of women had the knowledge scores in good level. The scores of perceived severity, perceived self-efficacy and cues to action were in good level in almost of women but almost of women obtained weak point in perceived susceptibility, perceived benefits and barriers. HBM can be used as an appropriate tool for assessment the status of pregnant women in the field of self-care behaviors during pregnancy and planning and implementation of educational interventions
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Considering the increased production of free radicals and inflammatory factors in rheumatoid arthritis [RA] and the effects of bioflavonoid quercetin on reducing oxidative stress, inflammation and blood pressure, the present study examined the effects of bioflavonoid quercetin on total antioxidant capacity [TAC] of plasma, lipid peroxidation and blood pressure in women with RA. The current study was a randomized double-blind clinical trial in which 51 women with RA aged 19-70 years, were participated. Patients were assigned into quercetin [500 mg/day] or placebo groups for 8 weeks. Dietary intake was recorded using 24-h dietary recall questionnaire and the physical activity was assessed through an international short questionnaire of physical activity at the beginning and end of the study. Plasma TAC and malondialdehyde [MDA] using colorimetric method, oxidized low density lipoprotein [ox-LDL] and high sensitivity C-reactive protein [hs-CRP] using enzyme-linked immunosorbent assay method and also blood pressure were measured at the beginning and end of intervention. After 8 weeks there were no significant differences in TAC of plasma, ox-LDL, MDA, hs-CRP, systolic and diastolic blood pressure between quercetin and placebo groups and in each group comparing before and after. In this study, quercetin had no effect on oxidative and inflammatory status of plasma and blood pressure in patients with RA. Further studies are needed to ensure the effect of quercetin on oxidative stress and inflammation in human
Subject(s)
Humans , Female , C-Reactive Protein , Blood Pressure , Arthritis, Rheumatoid , Antioxidants , Lipid Peroxidation , Double-Blind MethodABSTRACT
The present study aimed to provide better insight on methodological issues related to time preference studies, and to estimate private and social discount rates, using a rigorous systematic review and meta-analysis. We searched PubMed, EMBASE and Proquest databases in June 2013. All studies had estimated private and social time preference rates for health outcomes through stated preference approach, recognized eligible for inclusion. We conducted both fixed and random effect meta-analyses using mean discount rate and standard deviation of the included studies. I-square statistics was used for testing heterogeneity of the studies. Private and social discount rates were estimated separately via Stata11 software. Out of 44 screened full texts, 8 population-based empirical studies were included in qualitative synthesis. Reported time preference rates for own health were from 0.036 to 0.07 and for social health from 0.04 to 0.2. Private and social discount rates were estimated at 0.056 [95% CI: 0.038, 0.074] and 0.066 [95% CI: 0.064, 0.068], respectively. Considering the impact of time preference on healthy behaviors and because of timing issues, individual's time preference as a key determinant of policy making should be taken into account. Direct translation of elicited discount rates to the official discount rates has been remained questionable. Decisions about the proper discount rate for health context, may need a cross-party consensus among health economists and policy makers
Subject(s)
Health , Meta-Analysis as Topic , Time FactorsABSTRACT
Despite significant reduction in global disease prevalence, leprosy still has a high rate of disability while its determinants are unfair and many of them are amendable. The objective of this study was to measure inequality of disability in leprosy in Iran. This was a cross-sectional study [2006-2007] on all living people affected by leprosy registered in W. Azerbaijan province health center, Western North of Iran. The outcome of the study was the socio-economic inequality considering presence or absence of grade 2 disability [G2D] based on the WHO classifications. An extended concentration index decomposition approach was used for analysis. Among 452 cases, 65.3% were male and 67% were affected by the multi bacillary type. Overall G2D was 65.3%. The estimated Concentration Index was -0.0782, showing presence of pro-poor socio-economic inequality of G2D, while extended CI estimation [v = 5] was -0.163. Achievement index with coefficiently = 5] revealed that G2D mean was 16% more than classic mean in the poorest group. The result of decomposition of the existing inequality revealed that, some of the determinants such as receiving mono-therapy, education, urbanization, and bacillus calmette ; guerin [BCG] vaccination had shared contribution [67.4%, 61.8%, 59.2%, and 57.5% respectively]. This study provided new perspective for the health j system to leprosy control considering the significant gap between; rich and poor [inequality] regarding G2D disability, and its effective elements in socio-economic strata. Some effective actions can be considered to reduce the scale of existing inequality
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Low birth weight [LBW] is considered as an important outcome of birth and pregnancy, which is associated with long-term consequences and health-care problems. Maternal lifestyle and health care during pregnancy are powerful predictors of BW of infants. The purpose of this study was to assess the effect of a self-care educational program based on the Health Belief Model [HBM] on reducing LBW among a sample of pregnant Iranian women. In this randomized controlled trial, we recruited 270 pregnant women referred to prenatal clinics in the south of Tehran, Iran. The participants were randomly allocated to two intervention and control groups. Women in the intervention group received an educational program to promote self-care behaviors during pregnancy. The control group received routine care. BW was compared between the two groups. Baseline demographic characteristics and knowledge and attitude scores before the intervention in both groups were compared using the Chi-square test for categorical variables. Logistic regression analysis was conducted to control the effect of demographic variables on BW. The results showed that LBW was reduced significantly in the intervention group at the follow-up measurement [5.6 vs. 13.2%, P = 0.03]. After controlling for demographic characteristics, we found a significant decrease in the risk of LBW in the intervention group [odds ratio [OR]: 0.333; 95% confidence interval [CI]: 0.12-0.88, P = 0.02]. Implementation of a self-care educational program designed on the basis of an HBM on pregnant women was effective in reducing the rate of LBW
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The present study aimed to explore some risk factors affected the mean of the number of tuberculosis [TB] in West Azerbaijan Province, Iran between 2001 and 2010. Our time series study analyzed the data of 2,560 TB patients as registered with TB Patients Care System in West Azerbaijan Province from early 2001 to 2010. A checklist was prepared for collecting the data and they were then analyzed in SPSS V.16 software. The percentage of male and percentage of female were close to each other [52.2% against 47.8%, respectively]. A significant increasing trend of TB rate was found over the years of 2001and 2010 with a pick at 2008 [P<0.001]. A Poisson log-linear analysis showed that the most important risk factor of the trend of rate was the level of education so that people with primary level or with illiterate level had a statistically significant TB rate of 5.21 [4.66-5.81], adjusted for years. The next risk factor was type of TB and place of residency, i.e., pulmonary TB cases had higher rate than External pulmonary TB cases [RR=1.67; [1.54-1.80]. The last factor with the lowest risk was BCG with RR=1.29 [1.20-1.40] for people who received BCG compared to the people who had not received it. Although the co morbidity of AIDS and TB was not a major problem, it is necessary that special attention be paid to the way of implementing the TB control program based on the demographic risk factors of the study population
Subject(s)
Humans , Male , Female , Risk Factors , Surveys and QuestionnairesABSTRACT
Hysterectomy is a common gynecologic surgery leading to great concerns in women. This study aimed to determine the effect of foot massage on anxiety level after hysterectomy. In this double-group randomized clinical trial, 60 women undergone hysterectomy were selected using convenience sampling method and were randomly allocated into two intervention or control groups. Patients in the intervention group received foot massage three sessions during three consecutive days [every session lasted 20 minutes]. In the control group, the researcher was only beside the women for 20 minutes. The Spilberger anxiety questionnaire was used to measure the anxiety level. Data were analyzed using repeated measures ANOVA and independent t-test. The mean of the anxiety score was not significantly different between the two groups before the intervention [P=0.21]. After the intervention, there was significant difference between the two groups in the anxiety scores [P<0.001]. There was also significant difference between the two groups in the anxiety scores one week after the surgery [P0.001]. Foot massage can reduce anxiety in patients who underwent hysterectomy
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The human amniotic membrane is the inner most layer of placenta and has antimicrobial effect, due to the presence of human beta-defensins and elafins. The purpose of this study is to investigate the effect of dilution reduction of 0.5 McFarland prepared from standard bacterial strains of Salmonella enterica BAA-708, Escherichia coli ATCC25922, Pseudomonas aeruginosa ATCC27853, Klebsiella pneumoniae ATCC7881, and Enterococcus faecalis ATCC29212 on antibacterial effect of human amniotic membranes in vitro. Amniotic membranes were obtained from the bank of organ transplantation in Imam Khomeini hospital, of women with elective cesarean section whose HIV, HBV, HCV and VDRL serological tests were negative. They were cut to 1.5x1.5 cm pieces. Then 0.5 McFarland suspensions of 1.5x10[8], 0.5x10[7] and 1.5x10[6] dilutions were prepared from bacteria which then were spread on Mueller Hinton medium agar and a piece of membrane was put in the center of each plate. After 24 hours incubation at 37[degree]C, the results were observed. In 0.5 McFarland standard dilution an inhibition zone was created in three standard strains of Pseudomonas aeruginosa, Escherichia coli, and Salmonella enterica unlike the other two strains. There was no change in the above results with two other dilutions and inhibition zone of sensitive strains was not created. Dilution reduction of microbial strains does not affect the antibacterial impact of amniotic membrane and dilution reduction does not yield to a false positive response and the conversion of resistant to sensitive strains
ABSTRACT
Dental caries is one of the most preventable yet prevalent chronic diseases worldwide. Our objective was to evaluate the effect of family structure and behavioral and eyesight problems as they relate to caries severity in schoolchildren. This research was carried out on 845 primary schoolchildren aged 9 yr in Kerman, Iran, in 2012. Ten variables, including health records, family structure information and a dmft / DMFT index, were collected. Children were categorized into three groups based on the WHO caries severity classification. Low caries level was defined as dmft/DMFT<2.6, moderate as dmft/DMFT of 2.7-4.4 and high as dmft/DMFT>4.4. The Cochran-Armitage test and ordinal logistic regression were employed for data analysis. Almost half of pupils had moderate or high caries severity. The odds of being in a higher caries severity category in pupils with behavioral problems [OR=2.37, 95% CI: 1.29-4.38] and girls [OR=1.6, 95% CI: 1.22-2.06] were higher than in other categories. In addition, pupils with eyesight problems [OR=0.58, 95% CI: 0.37-0.90] and overweight pupils [OR=0.46, 95% CI: 0.31-0.71] had lower caries severity than others. The effects of parents' education, birth rank, living with parents and consanguineous relationship between parents were not significant on caries severity [P>0.05]. Female pupils with behavioral problems were at a higher risk of caries severity than other pupils. These pupils need to be educated and coached on proper dental care. In addition, overweight pupils and those with eyesight problems had less caries severity than others. Family structure in this study did not have an effect on the severity of dental caries
Subject(s)
Humans , Male , Female , Family , Behavior , Logistic Models , Child , Schools , DMF IndexABSTRACT
To evaluate the effectiveness of relapse prevention cognitive-behavioral model, based on Marlatt treatment approach, in Opioid-dependent patients participating in the Methadone Maintenance Treatment [MMT] in Iran. The study consisted of 92 individuals treated with methadone in Iranian National Center of Addiction Studies [INCAS]. Participatns were randomized into two groups: educational intervention group [N=46] and control group [N=46]. The intervention was comprised of 10 weekly 90 minute sessions, done during a period of 2.5 months based on the most high risk situations determined using Inventory Drug Taking Situation instruments. Relapse was defined as not showing up for MMT, drug use for at least 5 continuous days, and a positive urinary morphine test. While, only 36.4% of the intervention group relapsed into drug use, 63.6% of the control group relapsed. The result of the logistic regressions showed that the odd ratio of the variable of intervention program for the entire follow up period was 0.43 [P<0.01]. Further, the odd ratio of this variable in one month, three months, and 195 days after the therapy were 0.48 [P<.03], 0.31 [P<.02], and 0.43 [P<.02] respectively that revealed that on average, the probability of relapse among individuals in the intervention group was lower than patients in control group. Relapse prevention model based on Marlatt treatment approach has an effective role in decreasing relapse rate. This model can be introduced as a complementary therapy in patients treated with methadone maintenance
Subject(s)
Humans , Male , Cognitive Behavioral Therapy , Methadone , Opiate Substitution Treatment , RecurrenceABSTRACT
Research and planning to improve the quality of life for elderly seems to be essential, as the population of this age group has shown an increasing trend. Any chronic disease including diabetes has an impact on lifestyle of the patient. The objective of this study was to compare the quality of life between two groups of elderly diabetic patients who were residence of home as well as nursing home. A descriptive analytical random study was conducted during 2010-2011 on two groups of 93 elderly diabetic patients, who were living in Kahrizak nursing home of Tehran [Iran], and home residents as well by interview for their demographical information and one standard questionnaire provided by world health organization. SPSS 16 was employed for data analysis. Significant differences were found in physical, psychological and social domains between two groups [P<0.05]. In physical and social domains the elderly diabetic patients of nursing home had a higher mean score but in psychological domain the result was in contrast. Regarding the difference between scores in two studied groups it is necessary to study the weak points of each group individually and try to resolve the problems