Iranian Journal of Public Health
Volume:43 Issue: 8, Aug 2014

Addiction to the illicit and prescribed use of opiate is an alarming public health issue. Studies on addictive disorders have demonstrated severe nutritional deficiencies in opiate abusers with behavioral, physiological and cognitive symptoms. Opiate addiction is also link with a significant number of diseases including Human Immunodeficiency Virus (HIV), Hepatitis C Virus (HCV) and other blood borne diseases generally stem from the use of needles to inject heroin. The use of medication assisted treatment for opioid addicts in combination with behavioural therapies has been considered as a highly effective treatment. Methadone is a long-lasting μ-opioid agonist and a pharmacological tool which attenuates withdrawal symptoms effectively replacement therapies. This review article aims to explain opiate addiction mechanisms, epidemiology and disease burden with emphasis on dietary and nutritional status of opiate dependent patients in methadone maintenance therapy.

The aim of the current investigation was to evaluate the sedentary lifestyle of thePolish population and its link with prolonged sitting in light of individual and environmental factors. The sample consisted of 1505 Polish people between 18 and 64 years old. The Computer-Assisted Telephone Interview (CATI) survey was conducted with the Polish version of International Physical Activity Questionnaire (IPAQ-LF) and the survey of the determinants of a sport activity among the Polish population. The relationships between the time spent sitting and the individual and environmental factors among Polish citizens were investigated through log-linear analysis. The total time Polish people spent sitting was 2812.4±1593.9 min/week. During the weekend, men (Chi2 =45.0; P=0.04) spent significantly more time sitting than women (251.1±170.1min/week, 230.9±155.0 min/week, respectively). Despite the relatively high proportion of people declaring participation in the Sport for All initiative (67.8%), only 9.6% of Polish people undertake a physical activity on a daily basis. The odds ratios above the median (>2545 min/week) are higher (OR=1.33; 95% CI=1.03–1.72) for those who are not physically active(54.5% vs. 45.5%). There was no relationship between prolonged sitting time and the environmental factors. It is necessary to increase consistent efforts to create an environment that would successfully promote anactive lifestyle among Polish citizens in their place of residence and prevent sedentary behaviours within this population. The recommendations for physical activity should include the guidelines intervening in the time people spend sitting.

This study aimed to develop an index that can rank welding workplace that associate well with possible health risk of welders. Welding Fumes Health Index (WFHI) were developed based on data from case studies conducted in Plant 1 and Plant 2. Personal sampling of welding fumes to assess the concentration of metal constituents along with series of lung function tests was conducted. Fifteen metal constituents were investigated in each case study. Index values were derived from aggregation analysis of metal constituent concentration while significant lung functions were recognized through statistical analysis in each plant. The results showed none of the metal constituent concentration was exceeding the permissible exposure limit (PEL) for all plants. However, statistical analysis showed significant mean differences of lung functions between welders and non-welders. The index was then applied to one of the welding industry (Plant 3) for verification purpose. The developed index showed its promising ability to rank welding workplace, according to the multiple constituent concentrations of welding fumes that associates well with lung functions of the investigated welders. There was possibility that some of the metal constituents were below the detection limit leading to '0' value of sub index, thus the multiplicative form of aggregation model was not suitable for analysis. On the other hand, maximum or minimum operator forms suffer from compensation issues and were not considered in this study.

Peak bone mineral density (PBMD) is influenced by both genetic and environmental factors, genes explains most of variation. As the novel candidate genes CATSPERB and NR5A2 may have been associated with spinal PBMD in adult. This study was to investigate the relationship among these two genes、PBMD and the life style factors in young female. The rs1298989 single nucleotide polymorphism (SNP) of the CATSPERB gene and the rs3762397 SNP of the NR5A2 gene were genotyped using SNaPshot® in 359 students from Xinjiang. The prospective study included 203 Han and 156 Uyghur subjects. PBMD was measured using quantitative computed tomography (QCT). Calcium, phosphate and alkaline phosphatase were measured by ELISA method. Physical activity, dietary calcium and life styles were assessed by questionnaire. Both SNPs showed differences in genotype and allele frequencies (P < 0.05) between the Han and Uyghur subjects. Total calcium intake, energy intake, tea and milk intake were also significantly different between two groups(P < 0.05). Multiple regression analysis showed an association between PBMD and vitamin D intake (P = 0.000), milk (P = 0.000), exercise (P = 0.029), rs1298989 (P = 0.028), energy intake (P = 0.043). This study demonstrated the polymorphisms of the rs1298989 and rs3762397 are associated with PBMD both in Han and Uyghur subjects. PBMD, in Xinjiang, appears to be associated with several known factors that are well described in the literature. While the genotypes of rs1298989 and rs3762397 do not appear have a strong effect on the PBMD.

The purpose of this study was to examine the relation between daily steps and aerobic steps, and anthropometric variables, using the waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). The participants in this cross-sectional study were taken the measurements of by a trained anthropologist and then instructed to wear an Omron pedometer for seven consecutive days. A series of statistical tests (Mann-Whitney U test, Kruskal-Wallis ANOVA, multiple comparisons of z’ values and contingency tables) was performed in order to assess the relation between daily steps and aerobic steps, and anthropometric variables. A total of 507 individuals (380 females and 127 males) participated in the study. The average daily number of steps and aerobic steps was significantly lower in the individuals with risky WHR and WHtR as compared to the individuals with normal WHR (P=0.005) and WHtR (P=0.000). A comparison of age and anthropometric variables across aerobic steps activity categories was statistically significant for all the studied parameters. According to the contingency tables for normal steps, there is a 5.75x higher risk in the low-activity category of having WHtR>0.50 as compared to the high-activity category. Both normal and aerobic steps are significantly associated with central obesity and other body composition variables. This result is important for older people, who are more likely to perform low-intensity activities rather than moderate- or high-intensity activities. Our results also indicate that risk of having WHtR>0.50 can be reduced by almost 6x by increasing daily steps over 8985 steps per day.

Network scale-up is an indirect method for estimating the size of hidden, hard-to-count or high risk populations. Social network size estimation is the first step in this method. The present study was conducted with the purpose of estimating the social network size of the Tehran Province residents and its determinants. Maximum Likelihood Estimation was applied to estimate people’s network sizes by using populations of known sizes and the scale-up method. Respondents were selected from Tehran province through convenience sampling in 2012. Out of thirteen selected subpopulations with known size, ten had minimum accuracy which used in our analysis. Of the 1029 respondents in this study, 46.7% were male. The social network size of Tehran Province residents was estimated to be 259.1 (CI95%: 242.2, 276) based on the ten known populations remained in this study. This size was 291.8 in men and 230.4 in women. Younger people (18-25 years old) had larger network sizes compared to the other age groups (P<0.001). Our estimation for social network size of Tehran inhabitants was smaller than that previously estimated size for the whole country (c=380). In addition, we found that the social network of subpopulations was different. This difference means that we need local estimations for sub-populations to improve the accuracy of population size estimation using network scale up method.

An important aspect of microarray studies includes the prediction of patient survival based on their gene expression profile. To deal with the high dimensionality of this data, use of a dimension reduction procedure along with the survival prediction model is necessary. This study aimed to present a new method based on wavelet transform for survival relevant gene selection. The data included 2042 gene expression measurements from 40 patients with Diffuse Large B-Cell Lymphomas (DLBCL). The pre-processing gene expression data is decomposed using third level of the 1D discrete wavelet transform. The detail coefficients at levels 1 and 2 are filtered out and expression data reconstructed using the approximation and detailed coefficients at the third level. All the genes are then scored based on the t score. Then genes with the highest scores are selected. By using forward selection method in Cox regression model, significant genes were identified. The results showed wavelet-based gene selection method presents acceptable survival prediction. Using this method, six significant genes were selected. It was indicated the expression of GENE3359X and GENE3968X decreased the survival time, whereas the expression of GENE967X, GENE3980X, GENE3405X and GENE1813X increased the survival time. Wavelet-based gene selection method is a potentially useful tool for the gene selection from microarray data in the context of survival analysis.

With rapid economic development and industrialization, the construction industry continues to rank among the most hazardous industries in the world. Therefore, construction safety is always a significant concern for both practitioners and researchers. The objective of this study was to create a structural modeling of components that influence the safety performance in construction projects. We followed a two-stage Structural Equation Model based on a questionnaire study (n=230). In the first stage, we applied the Structural Equation Model to the proposed model to test the validity of the observed variables of each latent variable. In the next stage, we modified the proposed model. The LISREL 8.8 software was used to conduct the analysis of the structural model. A good-fit structural model (Goodness of Fit Index=0.92; Root Mean Square Residual=0.04; Root Mean Square Error of Approximation=0.04; Comparative Fit Index=0.98; Normalized Fit Index=0.96) indicated that social and organizational constructs influence safety performance via the general component of the safety climate. The new structural model can be used to provide better understanding of the links between safety performance indicators and contributing components, and make stronger recommendations for effective intervention in construction projects.

Immune responses play critical roles in the leishmaniasis eradication. IL-10 is a key regulator of immune responses, and the polymorphisms within its promoter region are associated with alteration in its expression. Therefore, this study was designed to examine the correlation between polymorphism at the -1082 position of the IL-10 gene and visceral leishmaniasis (VL). The IL-10 -1082 polymorphism and anti-Leishmania antibody titration were examined in 110 patients with clinical presentation of VL and seropositive for the Leishmania (group 1), 74 seropositive patients but without clinical presentation (group 2) and 113 healthy controls (group 3) using the PCR-RFLP and immunofluorescence techniques, respectively. The polymorphism at IL-10 -1082 (A/G) position was significantly associated with VL and A/G genotype was significantly higher in VL patients when compared to the groups 2 and 3 (P< 0.001). However, the results demonstrated that the A and G alleles were not associated with VL (P= 0.263). Previous investigations have shown that the polymorphism at the -1082 position of the IL-10 gene can influence its expression and also it has been proved that IL-10 level was increased during VL. Our results suggest that the A/G genotype may be considered as a risk factor for VL.

Measuring and comparing grip and pinch strengths with their normative data is a valid method to detect intensity of the numerous damages of hand. This research was carried out with the aim of establishing normative data of grip strength and three types of pinch strengths (Tip, Key and Palmar) in healthy Iranian adults. In this cross-sectional study, the study population was formed of 1008 people (526 men and 482 women) from healthy Fars race adults of over 20 years old in five cities of Iran. American Society of Hand Therapists (ASHT) recommendations were followed to establish normative data of grip and pinch strengths. Normative data of grip and pinch strengths were developed based on sex, 12 different age groups and dominant and non-dominant hands. Jamar dynamometer and Seahan pinch gauge were used to measure grip and pinch strengths, respectively. Normative data of grip and pinch strengths were provided. Grip and pinch strengths of men were significantly stronger than women. The maximum grip strength of men was obtained in the group of 20-24 years and among women it was in the age group 35-39 years. Regardless of gender, grip and pinch strengths were declined with aging. Normative data of grip and pinch strengths were developed for Iranian population.

The current preliminary study aimed to explore the reasons that a group of opiate-dependent patients reported for entry into opium tincture treatment (OTT). Through examinations of 52 qualitative focus group interviews with patients from six OTT centers and 10 health providers (in key informant interviews) in Tehran, this study highlights the factors that participants reported as the reasons associated with entry into OTT. Quantitative data including demographic data and details of drug use were analyzed by using SPSS.v.18.0. Qualitative data was analyzed by using Atlas-ti software. 86.5% of patients were male and 13.5% were female. The median age of patients was 39 yr. The most frequently reasons associated with entry into OTT included methadone misconceptions including dissatisfaction with taking methadone as a chemical medication, methadone dependence, and long duration of MMT. The other reasons included the recommendation of other people in treatment and OT-related characteristics and expectations including the herbal compound of OT, treating opiate craving and withdrawal symptoms, and improving general health. The study findings preliminarily showed the reasons associated with entry into OTT in a sample of treatment seekers. Longitudinal studies with more representative samples and follow-up stages are required to evaluate the clinical effectiveness of OTT as a maintenance treatment in comparison with methadone and buprenorphine. Patient-centered program and policy implications are discussed.

Natural disasters result in numerous economic, social, psychological and cultural consequences. Of them, psychological consequences of disasters will affect the lives of people long after the critical conditions finish. Thus, concerning the importance of psychological support in disasters, this study has identified problems and weaknesses in dealing with the psychological effects of the disasters occurred in Iran. This qualitative study was carried out using semi-structured in-depth interviews and focus groups. Sample volume consisted of 26 experts in the field of disaster management. Content analysis was used to analyze data. Nine major problems were identified as weaknesses in handling the psychological effects of the disaster. These weaknesses include: rescuers’ unfamiliarity with the basic principles of psychosocial support, shortage of relevant experts and inadequate training, paying no attention to the needs of specific groups, weaknesses in organizational communications, discontinuation of psychological support after disaster, unfamiliarity with native language and culture of the disaster area, little attention paid by media to psychological principles in broadcasting news, people’s long-term dependence on governmental aid. Disaster management has various aspects; in Iran, less attention has been paid to psychological support in disasters. Increasing education at all levels, establishing responsible structures and programming seem necessary in dealing with the psychological effects of disasters.

Aflatoxin M1 (AFM1), a carcinogenic substance is found in milk and dairy products. The effect of season and type of dairy products on AFM1 level in northern Iran was investigated in this study. Three hundred samples (each season 75 samples) including raw and pasteurized milk, yoghurt, cheese, and cream samples were collected from three distinct milk producing farms. The samples were subjected to chemical and solid phase extractions and were analyzed by using HPLC technique. Recovery percentages, limit of detection and limit of quantification values were determined. Seventy percent and 98% were the minimum and maximum recoveries for cheese and raw milk, respectively and 0.021 and 0.063 ppb were the limit of detection and limit of quantification values for AFM1. We found that in autumn and winter the highest level (0.121 ppb) of AFM1 in cheese and cream samples and failed to detect any AFM1 in spring samples. Interestingly, our data showed that the yoghurt samples had the lowest level of AFM1 in all seasons. There are significant differences between the AFM1 levels in dairy products in various seasons and also various types of products, suggesting spring and summer yoghurt samples as the safest products from AFM1 level point of view.

Warty dyskeratoma is a rare tumor that presents mainly as an isolated papule or nodule on the scalp, face or neck in the adults. Warty dyskeratoma frequently arises as a single lesion with a central keratotic plug on the skin of middle-aged or elderly people. Multiple warty dyskeratomas are very rare cutaneous lesions which are mostly seen on the scalp. We herein report a multiple warty dyskeratoma in a female patient.