Consecuencias psicológicas del abuso sexual infantil cometido por representantes de la Iglesia Católica: Una revisión sistemática de la literatura / Psychological consequences of child sexual abuse by Catholic Church representatives: A systematic review of literature

El objetivo de esta revisión sistemática de la literatura sobre abuso sexual eclesiástico fue identificar el impacto psicológico de este tipo de violencia en las víctimas. Las búsquedas iniciales se realizaron entre el 10 de octubre de 2020 y el 17 de diciembre de 2020. Así, la actualización de búsquedas se realizó entre el 26 de octubre de 2020 y el 23 de enero de 2021. Los artículos incluidos se obtuvieron desde las bases de datos PsycINFO, Web of Science (WoS) y Scopus. Se establecieron criterios de inclusión, y se realizó una selección inicial por medio de los títulos y resúmenes, los cuales, fueron examinados por dos revisores de forma independientes. Los documentos seleccionados se examinaron utilizando el mismo proceso de revisores. Se incluyeron 18 estudios de 2.189 títulos y resúmenes revisados. En general, los estudios evidenciaron un impacto psicológico negativo posterior al abuso sexual infantil ocurrido en contextos eclesiásticos. Destacando el daño espiritual como una característica específica del abuso sexual eclesiástico, lo que, sumado, a las consecuencias habituales del abuso sexual, sitúa a las víctimas en una posición compleja al presentar un espectro más amplio de efectos negativos posteriores al abuso. Los hallazgos del presente estudio permiten una mejor comprensión de este problema y entregan antecedentes para el desarrollo de estrategias de recuperación adecuadas a las necesidades de estas víctimas.

The objective of this systematic review of the literature on ecclesiastical sexual abuse was to identify the psychological impacts of this type of violence on victims. The initial literature searches were conducted between October 10, 2020 and December 17, 2020. Thus, the update of searches was conducted between October 26, 2020 and January 23, 2021. The articles included were obtained from the PsycINFO, Web of Science (WoS) and Scopus databases. Inclusion criteria were established, and an initial selection was made by means of titles and abstracts, which were examined by two reviewers independently. The selected papers were examined using the same reviewer process. Eighteen studies were included out of 2,189 titles and abstracts reviewed. Overall, the studies evidenced a negative psychological impact following child sexual abuse occurring in church settings. Highlighting spiritual harm as a specific feature of ecclesiastical sexual abuse, which, in addition to the usual consequences of sexual abuse, places victims in a complex position of presenting a broader spectrum of negative effects following abuse. The findings of the present study allow a better understanding of this problem and provide background for the development of recovery strategies appropriate to the needs of these victims.

Sacerdotes, apropiación del discurso médico y experiencia mística en la Francia del siglo XIX / Priests, the appropriation of medical discourse and mystical experience in nineteenth-century France

Resumen El artículo explora la apropiación de la terminología psiquiátrica por parte de teólogos y párrocos franceses, en el contexto de la patologización de la religión del siglo XIX. Esta apropiación le sirvió al clero para demarcar la experiencia mística "auténtica" de la simulada o "desviada". En primer lugar, analizamos manuales médico-teológicos pensados para crear una oposición entre la histeria y la santidad, útil desde el punto de vista eclesiástico. En segundo lugar, presentamos los informes de tres párrocos sobre presuntas místicas y estigmatizadas. Concluimos que la apropiación de la retórica médica por parte del clero podía servir para definir los límites de la experiencia religiosa aprobada por la Iglesia católica.

Abstract This article explores the appropriation of psychiatric terminology by French theologians and priests, within the context of the pathologizations of religion in the nineteenth century. This appropriation allowed the clergy to differentiate "authentic" mystical experience from feigned or "deviant" ones. Firstly, it analyzes medical and theological manuals that sought to create an opposition between hysteria and saintliness, which was useful from the ecclesiastical point of view. Secondly, it presents the reports of three priests on supposed female mystics with stigmata. It concludes that the appropriation of medical rhetoric by the clergy could be used to define the limits of religious experience approved by the Catholic church.

An optimization method of weighted network module partition based on TCM theory of "monarch, minister, assistant and guide" / 中国中药杂志

The disease-gene-drug multi-level network constructed by network pharmacology can predict drug targets and has been widely used in the study of material basis and mechanism of action of Chinese medicinal prescriptions. However, most of the current studies have normalized the efficacies of Chinese herbal medicines in the compounds during the construction of the network. There is also a lack of in-depth exploration of the mechanism of synergy among multiple components. This study proposed a network module partition method based on group collaboration and the pharmacological network was weighed according to the traditional Chinese medicine(TCM) theory of "monarch, minister, assistant and guide". Taking the Tanyu Tongzhi Prescription as an example, we constructed its pharmacological network for the treatment of myocardial ischemia-reperfusion injury. The group collaboration module in the network was identified and the network changes before and after the weighting were compared based on the network topology analysis to explore a new method to find the core nodes of the network as well as the core drugs that affected the efficacy of the compounds. The results showed that the module partition method based on group collaboration could be used to identify and partition group collaboration mo-dules in pharmacological networks of compounds. The proposed weighted network based on the TCM theory of "monarch, minister, assistant, and guide" could identify and partition the modules based on the characteristics of the pharmacological network. The identification and partition results of modules of Tanyu Tongzhi Prescription in the weighted network were superior to those in the unweighted network. The weighted closeness centrality(WCC) evaluation method was conducive to finding key nodes and relations in the network as compared with traditional methods, thereby providing a basis for analyzing the core components of drugs and extracting more accurate drug components and targets.

The First Comprehensive Plan of National Health Insurance / 보건행정학회지

On May 1, 2019, the Minister of Health and Welfare announced publicly the first Comprehensive Plan of National Health Insurance (NHI). The Comprehensive Plan which is the 5-year plan including expenditure and revenue aspect of NHI, is desirable in 42 years of introduction of NHI and 30 years of universal coverage of NHI, though the Plan was late and had some conflict process. The Comprehensive Plan was established without evaluation of Moon's Care Plan, did not included to relationship with NHI and other health security systems, and did not have the blue print of NHI. The Plan was not sufficient in content of adequate health care utilization and relationship with service benefit and cash benefit. The Comprehensive Plan should be modified in considering the blue print of NHI and national healthcare system with participating stakeholder in turbulent environment-low fertility, rapid ageing, low economic growth rate, era of non-communicable diseases, unification of the Korean Peninsula, and 4th industrial revolution. Therefore, I suggest to establish the President's Committee of Improving Healthcare System for the blue print of health care and NHI.

Comparison of Limberg Flap and Karydakis Flap Surgery for the Treatment of Patients With Pilonidal Sinus Disease: A Single-Blinded Parallel Randomized Study

PURPOSE: Pilonidal sinus disease is a common condition, which mostly affects young men. While various surgical techniques have been introduced for treating intergluteal pilonidal disease (IPD), controversies still exist regarding the best surgical approach. The purpose of this study was to compare the efficiency and the short-term outcomes of Limberg flap and Karydakis flap surgeries for the treatments of patients with IPD.METHODS: A total of 80 patients with IPD who had underwent either Karydakis flap (KF group: n = 37) or Limberg flap (LF group: n = 27) surgery between January 2015 and January 2016 at Imam Khomeini Hospital of Sari in the North of Iran were recruited for inclusion in this randomized, single-blind study.RESULTS: Compared to the KF group, the LF group showed faster complete wound healing, longer duration of surgery and hospital stay, larger wound size, and shorter period of incapacity for work. The overall patient satisfaction in the LF group was significantly higher than that in the KF group. The visual analogue scale score of pain was lower in the LF group than in the KF group. Also, the overall frequency of postoperative complications was higher in the KF group than in the LF group. Recurrence was reported in one patient from the KF group.CONCLUSION: Given the lower rate of postoperative complications and greater cosmetic satisfaction of patients, the Limberg flap procedure should be selected, instead of the Karydakis flap procedure, as the standard technique for treating patients with IPD.

Analysis of the Prescription Patterns of Medications that List Suicide in Use Cautions using the HIRA Claims Data

OBJECTIVE: Suicide has recently become an important social problem. Thus, we analyzed prescription drugs that cause suicidal ideation. METHODS: Of 156 drugs on the the Minister of Food and Drug Safty (MFDS) EZ-Drug site that had “suicide” listed as a side effect, 78 had “suicide” listed as a warning or contraindication; those 78 drugs were analyzed using data from the 2016 Health Insurance and Review and Assessment Services National Patient Sample (HIRA-NPS). RESULTS: 51 “suicide risk” drugs was identified. Of all patients, 5.2% had received such drugs. The prescription rate was 0.8% of all prescriptions, accounting for 1.6% of all prescription days. From logistic regression analysis, the prescription rate for the drugs was approximately 1.1 times higher for women than for men. With regard to age, the prescription rate for patients 66 years and older was 15.5 times higher than those for patients 25-years and lower. With regard to medical departments, the prescription rates in psychiatry and dermatology departments were 8.1 times higher and 0.6 times lower than those in internal medicine departments, respectively. With regard to region, the prescription rates in Daegu and Jeju were 1.3 times higher and 0.79 times lower than those in Seoul, respectively. CONCLUSION: Drug-induced suicidal behavior is possible, and therefore efforts are needed to prevent it.

Risco vocal em pastores: quantidade de fala, intensidade vocal e conhecimentos sobre saúde e higiene vocal / Vocal risk in preachers: talkativeness, vocal loudness, and knowledge about vocal health and hygiene

RESUMO Objetivo O objetivo do estudo foi investigar o conhecimento de pastores religiosos sobre aspectos de saúde e higiene vocal e avaliar a quantidade de fala e a intensidade da voz autorrelatadas, tanto nas atividades de uso laboral, quanto extralaboral, para se compreender a possibilidade de risco vocal nestes profissionais. Método Foram avaliados 50 pastores, do gênero masculino, com idade entre 22 e 73 anos. Após o preenchimento do Termo de Consentimento Livre e Esclarecido, todos responderam a dois questionários de autoavaliação vocal, a saber: Questionário de Saúde e Higiene Vocal e Quantidade de Fala e Intensidade Vocal. Os resultados foram submetidos à análise estatística. Resultados Os pastores apresentaram escores satisfatórios no Questionário de Saúde e Higiene Vocal, porém a quantidade de fala e a intensidade vocal mostraram-se elevadas na situação laboral, quando comparadas à extralaboral. As variáveis tempo de carreira pastoral, quantidade de fala e intensidade de voz extralaborais também estiveram associadas ao conhecimento sobre saúde e higiene vocal. Conclusão Os pastores mostraram bom conhecimento sobre saúde e higiene vocal e podem ser considerados como uma população de elevado risco vocal devido ao uso de grande quantidade de fala e intensidade da voz no ambiente laboral.

ABSTRACT Purpose The objective of this study was to investigate the knowledge of preachers about aspects of vocal health and hygiene and evaluate talkativeness and vocal loudness self-perceived during labor and extra-labor situations aiming to understand the possibility of vocal risk in these professionals. Methods Fifty male preachers aged 22 to 73 years were evaluated. They responded to two self-assessment questionnaires on vocal health and hygiene and talkativeness and vocal loudness. The results were submitted to statistical analysis. Results The preachers presented satisfactory scores in the Vocal Health and Hygiene Questionnaire; however, their scores in the Scale of Vocal Loudness and Talkativeness were lower in the labor situation compared with the extra-labor situations. The variables length of professional experience as a preacher and extra-labor talkativeness and vocal loudness were also associated with knowledge about vocal health and hygiene. Conclusion Preachers show good knowledge about vocal health and hygiene but are at high risk of vocal disorders due to excessive use of talkativeness and vocal loudness in the work environment.

Challenges and Supports of Breastfeeding at Workplace in Indonesia / 대한소아소화기영양학회지

Due to increased number of women workers in Indonesia in the last decade, numbers of women living as a worker and a housewife have increased. This also increases the potential risk of breastfeeding discontinuation. Three months of maternal leave policy and inadequate lactation promotion support in workplace have been identified as factors that hinder lactating practices. The World Health Organization recommendation of 6 months of exclusive breastfeeding and joined regulation of three Indonesia ministers (Ministry of Health, Ministry of Labour, and Ministry of Women Empower) have failed to improve the exclusive breastfeeding rate among female workers in Indonesia due to the lack of a standardized guideline on lactation promotion at workplace. In addition, very limited or no studies have been conducted to evaluate the impact of workplace-based lactation intervention programs on exclusive breastfeeding rate among female workers. This is because the relationship of lactation with working performance and productivity could not motivate employer to invest in workplace-based lactation promotion facility or program.

Mortality from aluminum phosphide poisoning in Kermanshah Province, Iran: characteristics and predictive factors / 한국역학회지

OBJECTIVES: Aluminum phosphide (ALP), also known in Iran as rice tablets, is one of the most effective rodenticides used to protect stored grain. However, ALP poisoning regularly causes mortality in humans. The aim of this study was to evaluate the characteristics and predictive factors of mortality from ALP poisoning. METHODS: This study evaluated all patients with ALP poisoning referred to Imam Khomeini Hospital in Kermanshah Province, Iran from 2014 to 2015. For each patient, the following information was recorded: age, sex, the number of tablets consumed, the number of suicide attempts, the time elapsed from consumption to treatment, blood pressure, blood pH, HCO3 levels, and PCO2. Differences between the survivors and non-survivors of ALP poisoning were analyzed using univariate logistic regression and multivariate analysis. RESULTS: In this study, 48 patients were male and 29 patients were female (total: 77 patients). The average age of the survivors and non-survivors was 28.7 and 31.3 years, respectively. All cases (100%) of ALP poisoning were intentional, with the goal of committing suicide. The main predictive variables of mortality from ALP poisoning were blood pressure, blood pH, and time elapsed from consumption to treatment. CONCLUSIONS: The likelihood of mortality in patients with ALP poisoning can be predicted using blood pressure, blood pH, and time elapsed from consumption to treatment. These findings may help healthcare providers take more effective measures to treat patients with ALP poisoning.

K-Sunshine Act: Submission of an Expense Report on Details of Economic Interest / 임상당뇨병

(1) A drug provider shall prepare an expense report on economic interests, etc. to be provided to pharmacists, oriental medicine pharmacists, medical personnel, medical institution founders, or persons working for a medical institution, within three months after the termination of each fiscal year, as prescribed by Ordinance of the Ministry of Health and Wealth, and shall retain the relevant expense report, books related thereto, and base data for five years. (2) Where deemed necessary, the Minister of Health and Wealth may request the submission of the expense report, books related thereto, and base data under paragraph (1). In such cases, a drug provider shall comply therewith without justifiable grounds.

The Effect of the Degree of the Spiritual Nursing Care Performance on the Spiritual Nursing Care Ability of Nursing Students / 의료커뮤니케이션

BACKGROUND: This study was to survey the effect of the degree of spiritual nursing care performance on the spiritual nursing care ability of the nursing studentsMETHODS: The researcher sampled 130 nursing students for a questionnaire survey conducted from September 17 until September 27, 2018. The data of analysis used SPSS 23.0 program.RESULTS: The spiritual nursing care ability was 4.4±0.8(total score 6) and the degree of spiritual nursing care performance was 2.9±1.8(total score 4). The spiritual nursing care ability differed significantly depending on religion(F=7.570, p < .001), the level of spiritual nursing knowledge(F=19.873, p < .001), education type(F=14.626, p < .001), necessity of hospice(t=2.280, p=.024). The degree of spiritual nursing care performance differed significantly depending on spiritual nursing education time(F=2.932, p=.036). The correlation of two variable was statistically significant difference(r=.206, p=.019). The influencing factors on the spiritual nursing care ability was religion, the level of spiritual nursing knowledge, education type, dying experience(R2=0.378, Adj R2=0.353), the degree of spiritual nursing care performance was spiritual nursing education time(R2=0.065, Adj R2=0.043).CONCLUSION: These results show that nursing students are not able to perform spiritual nursing care properly to subjects who need spiritual nursing care. Therefore, it is necessary to develope programs to meet the spiritual nursing care needs of nursing students and to provide practical education in accordance with the program by cooperating with the nursing education staff, clergy and clinical nurse etc. And spiritual nursing care should be taught as a required subjects in the curriculum.

Mortality from aluminum phosphide poisoning in Kermanshah Province, Iran: characteristics and predictive factors / 한국역학회지

OBJECTIVES: Aluminum phosphide (ALP), also known in Iran as rice tablets, is one of the most effective rodenticides used to protect stored grain. However, ALP poisoning regularly causes mortality in humans. The aim of this study was to evaluate the characteristics and predictive factors of mortality from ALP poisoning.METHODS: This study evaluated all patients with ALP poisoning referred to Imam Khomeini Hospital in Kermanshah Province, Iran from 2014 to 2015. For each patient, the following information was recorded: age, sex, the number of tablets consumed, the number of suicide attempts, the time elapsed from consumption to treatment, blood pressure, blood pH, HCO3 levels, and PCO2. Differences between the survivors and non-survivors of ALP poisoning were analyzed using univariate logistic regression and multivariate analysis.RESULTS: In this study, 48 patients were male and 29 patients were female (total: 77 patients). The average age of the survivors and non-survivors was 28.7 and 31.3 years, respectively. All cases (100%) of ALP poisoning were intentional, with the goal of committing suicide. The main predictive variables of mortality from ALP poisoning were blood pressure, blood pH, and time elapsed from consumption to treatment.CONCLUSIONS: The likelihood of mortality in patients with ALP poisoning can be predicted using blood pressure, blood pH, and time elapsed from consumption to treatment. These findings may help healthcare providers take more effective measures to treat patients with ALP poisoning.

Elimination of Causative Antibody by Plasma Exchange in a Patient with an Acute Hemolytic Transfusion Reaction / 대한수혈학회지

An ABO-incompatible transfusion is a very rare event but it can cause severe adverse effects, including death. The prognosis is affected by various factors, such as the volume of infusion, underlying diseases, and immunologic state. Until now, however, there has been no consensus regarding the treatment of an ABO-incompatible transfusion except for conservative treatment. A 57 year-old male patient visited the authors' emergency unit with multiple trauma due to a car accident. He had a deep laceration on his left neck accompanied by severe bleeding. Because of his low blood pressure and low hemoglobin level due to bleeding, an emergency transfusion was attempted. Unfortunately, one unit of RBC was transfused incorrectly into the patient due to a clerical error during the identification of the patient. The patient was typed as O, RhD positive; the RBC administered was A, RhD positive. After the transfusion, the patient showed an acute hemolytic transfusion reaction due to gross hematuria. Plasma exchange was attempted and medical treatment with high dose steroid with diuretics was done simultaneously. Two cycles of plasma exchange were done and the patient appeared to recover from the acute adverse effects of the transfusion. The plasma exchange was stopped and medical treatments for the transfusion reactions were maintained for ten days. The patient recovered fully and was discharged after one month. Based on this case, although more studies are necessary for approval as a standard therapy, this case suggests that immediate plasma exchange with medical treatment can be very helpful for eliminating the isoagglutinins in ABO-incompatible transfusions.

The Overview of Hospice Care as Urologist

The average life expectancy in Korea is increasing with new medical technology and complete understanding of pathophysiology of diseases in human. Physician should provide good and appropriate treatment to patients and also are responsible for offering medical services. Also, needs to improve the quality of life and death for patients with end-of-life have been increased. Urologists are interested in the prevention, diagnosis and treatment of the urogenital system disease but are not interested in the end of terminal cancer patients. Cancer is the most common cause of mortality rate in Korea. Cancer affects individuals, families, and society. Hospice and palliative care is a kind of portion of medicine to take care patients with far-advanced diseases and short-life expectancy, especially less than 6 months, for whom the focus of care is relief of suffering physical problems, social problems, and mental problems, and improvement of the quality of life. It takes a lot of efforts to finish the end-of life in patient. Physician alone can hardly provide all parts of end-of-life cares and cares can be provided through hospice care team including physician, social worker, volunteer, and priest. Hospice and palliative care still take a care for only a small group for dying patients. There have been few data for hospice and palliative care in urology. This review is to summary the concept of hospice for end-of life care and to help understanding hospice and the laws related to hospice to urologists who take care of patient with urogenital tract cancer.

The relationship between spontaneous abortion and female workers in the semiconductor industry

BACKGROUND: This study investigated the relationship between job type and the risk for spontaneous abortion to assess the reproductive toxicity of female workers in the semiconductor industry. METHODS: A questionnaire survey was administered to current female workers of two semiconductor manufacturing plants in Korea. We included female workers who became pregnant at least 6 months after the start of their employment with the company. The pregnancy outcomes of 2,242 female workers who experienced 4,037 pregnancies were investigated. Personnel records were used to assign the subjects to one of three groups: fabrication process workers, packaging process workers, and clerical workers. To adjust for within-person correlations between pregnancies, a generalized estimating equation was used. The logistic regression analysis was limited to the first pregnancy after joining the company to satisfy the assumption of independence among pregnancies. Moreover, we stratified the analysis by time period (pregnancy in the years prior to 2008 vs. after 2009) to reflect differences in occupational exposure based on semiconductor production periods. RESULTS: The risk for spontaneous abortion in female semiconductor workers was not significantly higher for fabrication and packaging process workers than for clerical workers. However, when we stratified by time period, the odds ratio for spontaneous abortion was significantly higher for packaging process workers who became pregnant prior to 2008 when compared with clerical workers (odds ratio: 2.21; 95% confidence interval: 1.01–4.81). CONCLUSIONS: When examining the pregnancies of female semiconductor workers that occurred prior to 2008, packaging process workers showed a significantly higher risk for spontaneous abortions than did clerical workers. The two semiconductor production periods in our study (prior to 2008 vs. after 2009) had different automated processes, chemical exposure levels, and working environments. Thus, the conditions prior to 2008 may have increased the risk for spontaneous abortions in packaging process workers in the semiconductor industry. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40557-017-0204-x) contains supplementary material, which is available to authorized users.

Reticulocytosis in screen-printing workers exposed to 2-butoxyethanol and 2-ethoxyethanol

BACKGROUND: Studies on the hematologic toxicity of ethylene glycol ethers in humans are limited. Therefore, the aim of this study was to examine the association between exposure to solvents (containing 2-butoxyethanol and 2-ethoxyethanol) and hematological effects. METHODS: Thirty-four screen-printing workers who were exposed to 2-butoxyethanol and 2-ethoxyethanol and 37 non-exposed clerical workers were selected using data from the health care facilities that provided regular health screening services. Student's t-tests and Pearson's chi-square tests were used to compare differences in hematological parameters between the exposed and the control groups. A multivariate analysis was performed using the multiple logistic regression models to adjust for other variables. RESULTS: The chi-square test showed the reticulocyte percentages and corrected reticulocyte counts to be significantly higher in the exposed group. The t-tests showed a significant increase in white blood cell counts, reticulocyte percentages, and corrected reticulocyte count (i.e., reticulocyte index) in the exposed group, with p-values of 0.002, 0.004, and 0.002, respectively. Multivariate analysis showed the odds ratio for the corrected reticulocyte counts to be 16.30 for the exposed group, when compared with that of the control group. CONCLUSIONS: Exposure to 2-butoxyethanol and 2-ethoxyethanol was significantly associated with reticulocytosis, necessitating the implementation of preventive measures for workers prone to occupational exposure to ethylene glycol ethers.

Comparison of Three Internship Training Sites for an Undergraduate Health Information Management Program in Saudi Arabia / 대한의료정보학회지

OBJECTIVES: While internship training is well established for medical records and for healthcare quality improvement, it is not quite so for training related to IT/health informatics. A comparison was made on the hospital-based IT/health informatics internship training received by students completing their training at the Imam AbdulRahman Bin Faisal University (IAU) in the Eastern province of Saudi Arabia. METHODS: The three hospitals studied all have the Joint Commission International accreditation and advanced Electronic Health Record (EHR) systems. Over the period from 2011 to 2015, interns from the IAU prepared 120 reports based on their training at these three hospitals. Data abstraction was done on the internship reports, and the results were summarized and interpreted. RESULTS: The study found wide differences in the training received at these hospitals. The main reason for the differences is whether or not the EHR system used in the hospital was a commercial one or developed in-house. CONCLUSIONS: The hospital that had developed its own EHR system made more use of health information management interns during their IT rotation in comparison to hospitals which had adopted commercial EHR systems. Recommendations are made of both local relevance and of international relevance.

Dietary Diversity Score and Its Related Factors among Employees of Kermanshah University of Medical Sciences

Dietary diversity score (DDS) is known as an indicator of food quality. Dietary diversity can promote health status. The aim of this study was determined DDS and its related factors in Kermanshah University of Medical Sciences (KUMS) employees. This cross-sectional study was conducted on 190 employees of KUMS in 2015. According to the population of KUMS centers which were selected randomly (Paramedical, Public Health faculties, Imam Reza Hospital and province health center), subjects were selected by convenience sampling method. Food frequency questionnaire (FFQ) was used to calculate DDS. Foods were divided into 5 main groups: grains, vegetables, fruits, meat, and dairy products. The main groups had 23 subgroups. Total DDS divided to 4 quartiles: less than 3.0, 3.0–5.5, 5.6–8.5, and more than 8.5. Anthropometric parameters including: weight, height, waist circumference (WC), and hip circumference were measured. Data were analyzed by Kolmogorov-Smirnov test, χ² test, and analysis of variance (ANOVA) test with SPSS 20 software (IBM Corp., Chicago, IL, USA). The mean ± standard deviation of DDS and body mass index (BMI) were 5.68 ± 1.73 and 25.1 ± 3.42 kg/m², respectively. The average of the waist-to-hip ratio (WHR) in men and women was 0.92 ± 0.04 and 0.86 ± 0.06, respectively. There was statistically significant difference between DDS and self-reported economic status (p < 0.022). No significant difference was observed between DDS and BMI or WC. However, significant negative correlation was observed between DDS and WHR in men (p < 0.019). This study showed that DDS had a negative correlation with the WHR. Therefore, dietary diversity may improve health status by effect on fat distribution in body.

Intravenous caffeine citrate vs. magnesium sulfate for reducing pain in patients with acute migraine headache; a prospective quasi-experimental study

BACKGROUND: Current evidence suggests that intravenous magnesium sulfate might be effective for reducing migraine pain. In a recent pilot study, we showed that intravenous caffeine citrate could reduce the severity of migraine headache. The objective of this study is to investigate the efficacy of intravenous caffeine citrate vs. magnesium sulfate for management of acute migraine headache. METHODS: We conducted a prospective quasi-experimental study from January until May 2016 in two educational medical centers of Shahid Beheshti University of Medical Sciences (Shoahadaye Tajrish Hospital and Imam Hossein Hospital), Tehran, Iran. The study included patients who were referred to the emergency department and met the migraine diagnosis criteria of the International Headache Society. Patients were allocated into 2 groups receiving either 60 mg intravenous caffeine or 2 g intravenous magnesium sulfate. The pain scores, based on the visual analog scale, were recorded on admission, as well as one and two hours after receiving the drug. A Chi-Square test and student t-test were used for analysis of baseline characteristics. A Mann-Whitney U test and Wilcoxon singed rank test were used to analyze differences in the visual analogue scale (VAS) score between and within the groups respectively. RESULTS: In total, 70 patients (35 patients in each group) with the mean age of 33.1 ± 11.3 years were included (64.3% female). For the Caffeine citrate group, the median pain score decreased from 9.0 (2.0) to 5.0 (4.0) after one hour and to 3.0 (4.0) after two hours. For the magnesium sulfate group, the pain score decreased from 8.0 (2.0) to 2.0 (2.0) after one hour and to 0.0 (1.0) after two hours. Both intravenous caffeine citrate and intravenous magnesium sulfate reduced pain scores significantly but the magnesium sulfate group showed more improvement than the Caffeine citrate group after one hour (P < 0.001) and after two hours (P < 0.001). CONCLUSIONS: It is likely that both intravenous caffeine and intravenous magnesium sulfate can reduce the severity of migraine headache. Moreover, intravenous magnesium sulfate at a dose of 2 g might be superior to intravenous caffeine citrate 60 mg for the short term management of migraine headache in emergency departments.

Risk assessment of di(2-ethylhexyl) phthalate in the workplace

OBJECTIVES: A hazard assessment of di(2-ethylhexyl) phthalate (DEHP), a commonly used workplace chemical, was conducted in order to protect the occupational health of workers. A literature review, consisting of both domestic and international references, examined the chemical management system, working environment, level of exposure, and possible associated risks. This information may be utilized in the future to determine appropriate exposure levels in working environments. METHODS: Hazard assessment was performed using chemical hazard information obtained from international agencies, such as Organization for Economic Cooperation and Development-generated Screening Information Data Set and International Program on Chemical Safety. Information was obtained from surveys conducted by the Minister of Employment and Labor (“Survey on the work environment”) and by the Ministry of Environment (“Survey on the circulation amount of chemicals”). Risk was determined according to exposure in workplaces and chemical hazard. RESULTS: In 229 workplaces over the country, 831 tons of DEHP have been used as plasticizers, insecticides, and ink solvent. Calculated 50% lethal dose values ranged from 14.2 to 50 g/kg, as determined via acute toxicity testing in rodents. Chronic carcinogenicity tests revealed cases of lung and liver degeneration, shrinkage of the testes, and liver cancer. The no-observed-adverse-effect level and the lowest-observed-adverse-effect level were determined to be 28.9 g/kg and 146.6 g/kg, respectively. The working environment assessment revealed the maximum exposure level to be 0.990 mg/m³, as compared to the threshold exposure level of 5 mg/m³. The relative risk of chronic toxicity and reproductive toxicity were 0.264 and 0.330, respectively, while the risk of carcinogenicity was 1.3, which is higher than the accepted safety value of one. CONCLUSIONS: DEHP was identified as a carcinogen, and may be dangerous even at concentrations lower than the occupational exposure limit. Therefore, we suggest management of working environments, with exposure levels below 5 mg/m³ and all workers utilizing local exhaust ventilation and respiratory protection when handling DEHP.