Iranian Journal of Public Health
Volume:45 Issue: 8, Agu 2016

UNICEF (United Nations International Children's Emergency Fund) and WHO estimate that if all babies were breastfed for at least the first six months of their lives, the rate of morbidity and malnutrition would significantly decrease all over the world. In this view, these two organizations promoted a worldwide campaign for breastfeeding, creating the Baby Friendly Hospital Initiative (BFHI) that encourages good practices for the promotion of breastfeeding in hospitals. The aim of our study was to review the available evidence regarding the positive effects of breastfeeding, in order to suggest to most appropriate strategy to support it.
The main databases including Scopus, PubMed, MEDLINE, Google scholar and Science Direct were researched to obtain the original papers related to breastfeeding education. The main terms used to literature search were "Breastfeeding education", Breastfeeding support", and “Breastfeeding healthcare policy”. The timeframe included the obtained articles was from 1980 to 2015.
Our analysis confirms that healthcare providers play a pivotal role in education and encouraging mothers to begin and continue breastfeeding. In this view, the adequate training of healthcare providers seems to be mandatory in order to support this practice. Moreover, adequate facilities are needed in order to promote and support breastfeeding.
Considering the available evidence, breastfeeding should be supported among all the mothers. Based on the positive data emerging from the public awareness campaign in different Countries of the world, we strongly encourage an accurate training for doctors and midwives and the implementation of adequate facilities in order to support breastfeeding.

Due to the increase in the elderly population in different societies, their primary needs, physical and mental health, and quality of life, is important. This study aimed to estimate the overall mean score of the QOL based on the Qol-Brief questionnaire in the elderly population of Iran.
The international and national databases, including; Medline, Scopus, Science Direct, MagIran, and SID were searched up to Feb 2015. All studies, addressed the quality of life among the healthy Iranian elderly population using WHO-QOL-BRIEF questionnaire, were included. The random effect model was used for data analysis and the results were reported with a 95% confidence.
Out of 2150 studies, seven studies involved 1366 elderly participants were included in the meta-analysis. The pooled mean score of total QOL was 60.1±4.6. The pooled mean score of quality of life for physical health was 55.13 [51.03, 59.22], for environmental was 51.80 [45.50, 58.10], for psychological was 56.68 [53.29, 60.08] and for the social relationship was 57.82 [55.79, 59.86]. The men had a better status and in two health domains, including; physical and psychological health.
The results of this study stress the necessity of attention to the quality of life in the domains of physical health (especially in women), and environmental health in the elderly population.

Hand Eczema (HE) is a dermatological disorder with frequent relapses and multiple causes such as atopic, allergic and irritant contact dermatitis. The management is complex because of the wide range of different pathogenesis. Efficacy of some of available treatments is not well established and it can affect patients’ quality of life significantly.
Reports on HE such as diagnosis, pathophysiology, pharmacological and nonpharmacological therapy that described in medieval Iranian medicine, were gathered and analyzed from selected medical and pharmaceutical textbooks of Iranian Traditional Medicine (ITM). The search of databases such as PubMed, EMBASE/Excerpta Medica, Science direct, Scopus, Google scholar, Web of science, Sid, Iran medex, Irandoc, was performed to reconfirm the efficacy of ITM remedies in conventional medicine from 1980-Jan-1 to 2015-Dec-30.
According to their opinion, HE is highly associated with liver function. This disorder was categorized into two main types as wet and dry ones. Most Iranian textbook explained signs of HE, as excessive skin itching, redness, burning and dryness. Treatments recommended by Iranian scientists were lifestyle modification, dietary intervention and performing the rules of prevention as well as herbal therapy and special manipulations.
Iranian practitioners believed that, six essential principles, diet therapy and medicinal plants have high impact on treatment of HE. These remedies based on Iranian scholar’s experiences might be useful for further studies to the management of HE.

In this study, we examined the status of Korean women’s alcohol consumption and identified the physical changes they undergo according to the level of consumption. The results of this study may thus be used as raw data to effectively control women’ drinking habits.
This study consists of a secondary analysis using data from female participants in the 6th Korea National Health and Nutrition Examination Survey, which was conducted by the Korea Centers for Disease Control and Prevention(2013-2014, V-2). In total, 863 women were finally selected to analyze their anthropometric data [height, body weight, body mass index (BMI), and waist circumference], blood parameters (total cholesterol, triglyceride, and feeding glucose), blood pressure profile (systolic/diastolic), and nutrients (carbohydrate, protein, lipid, and total energy intake).
Women’s alcohol consumption contributed significantly to an increase in body weight, body fat, and BMI as well as to an increase in total energy intake resulting from increased fat consumption. Further, the systolic blood pressure increased significantly when women were exposed to alcohol.
The results of this study suggest that alcohol consumption in women is associated with a range of adverse health implications. Notably, an increase in drinking frequency significantly affects their body weight, blood parameters, and nutrients, thus posing substantial health risks to the women, including obesity. Therefore, the Korean government should help women curve their drinking habits through regular training and campaigns.

Chronic cor pulmonale (CCP) is a disease of increasing frequency in Chinese people and profoundly influences their health. CCP is often accompanied by anxiety and other psychological problems, and patients may show signs of motor function decline. However, little attention has been paid to the impact of CCP-related psychological problems on motor function.
Patients with CCP receiving in- or outpatient treatment in the Respiratory Department of Xiangya Hospital of Central South University and the Second Xiangya Hospital of Central South University in Hunan Province between January and July 2015 were investigated. A total of 167 questionnaires were distributed, with 160 valid questionnaires ultimately collected from 95 male and 65 female participants of mean age (± standard deviation) of 68.2 ± 12.3 yr. Self-Rating Anxiety Scale (SAS) scoring was adopted to evaluate anxiety in the participants, and heart rate, blood pressure, breathing rate, 6-minute walk test and Borg index score were combined to detect the exercise capability of the participants.
Anxiety was present in 48.8% of patients. Heart rate, systolic blood pressure, breathing rate and the Borg score of CCP patients with anxiety were higher than in CCP patients without anxiety (P The rate of anxiety in patients with CCP is relatively high. Anxiety reduces motor function in CCP patients; therefore, in the process of treating patients with CCP, effort should be made to engage simultaneously patients in psychotherapy.

We examined epidemiological aspects of dynamic changes in incidence of ovarian cancer in women of Kazakh and Russian nationalities in Kazakhstan.
The material of investigation was primary data on registered patients with malignant ovarian tumors in the whole country. The study was conducted during the period of 1999-2009. Evaluation of changes in ovarian cancer incidence in the female population of Kazakhstan was performed using component analysis.
The number of patients with ovarian cancer in the whole country is increasing. This increase is due to several major reasons, including population growth (all females – ΔP=.1%, females of Kazakh nationality – ΔP=.0% and females of Russian nationality – ΔP=−259.3%), changes in the age structure (all females – ΔA=.7%, females of Kazakh nationality – ΔA=.1 and females of Russian nationality – ΔA=흽.8),and changes in risks of developing the disease (all females – ΔR=.0%, females of Kazakh nationality – ΔR=.1% and females of Russian nationality – ΔR=�.8%).
This investigation was the first epidemiological study of dynamics of ovarian cancer by component analysis in women of Kazakh and Russian nationalities in Kazakhstan. Implementation of the results of the study is recommended in management of anti-cancer activities for ovarian cancer.

The aim of this study was to verify a path model of job stress using Thai-JCQ.
The population of this cross-sectional study was 800 immigrant employees in the central region of Thailand in 2015 by stratified random sampling. Instruments used both the applied and standard questionnaires. Job stress was measured using Thai-JCQ dealt with psychosocial work factors. A path model of job stress using Thai-JCQ was verified using M-plus.
Variables could explain the job stress change by 22.2%. Working conditions, job securities, workloads had direct effect on job stress while, workloads had indirect effect as well. Wages did not have any significance.
The results of this study have implications for public health under occupational health research and practice by making public health and occupational health professionals aware of the importance a comprehensive approach to job stress prevention in the vulnerable population

Public Service Advertising (PSA) is a public interest message disseminated in the form of an advertisement communication and its main purpose is to promote public behavioral changes regarding a social issue. Korea Centers for Disease Control and Prevention (KCDC) has been delivering PSA by various media. However, the effect of PSAs has never been evaluated. The purpose of this study was to estimate the effects of broadcasted PSA produced by KCDC on cardiovascular disease (CVD).
One thousand adult participants throughout 15 provinces in Korea were chosen through the quota sampling method in 2012. A face-to-face research survey with 13 questions was conducted using a Computer Assisted Personal Interview (CAPI) system. Previous exposure to the PSA message, understanding, and behavioral intention to change was assessed.
After watching the PSA, about 75% of participants answered that they could understand the contents well and 70% had willingness to change their behaviors associated with CVD. However, only 24% of participants answered they watched the PSA during the past year.
The PSA had positive effects on increasing the level of understanding and intention to change behaviors regarding CVD. However, the level of exposure was low. KCDC should make an effort to increase the public exposure level, which could be an important success factor regarding the PSA. In addition, KCDC should consider customized PSA for vulnerable people such as multi-cultural families, the disabled, and the elderly.

Iron Deficiency Anemia (IDA) is an important health problem all around the world especially in developing countries. In the Mediterranean countries another prevelant reason of anemia is Thalassemia. Certain strategies had been established as a government policy to reduce prevalence in North Cyprus, such as pre-marital screening of Thalassemia. The prevalence of thalassemia trait has not been evaluated since then. The aim of this study was to detect the prevalence of IDA, thalassemia trait in infants under regular follow-up and to evaluate the compliance to prophylactic iron supplementation (PIS) and its effect on IDA.
Healthy children admitted to Department of Pediatrics, Near East University Hospital, in 2011–2013 were included. Data of anthropometric measurements, parental thalassemia trait status, duration of PIS usage, complete blood count, ferritin levels and hemoglobin electrophoresis were collected from hospital database program. Anemic children were grouped as IDA, thalassemia trait, both IDA and thalassemia trait and others.
Eıghty-nine infants with a mean age 13.52±2.09 mo were included. Compliance with PIS recommendation was 85.3% and, the mean duration of iron usage was 6.44±3.18 mo. IDA and thalassemia trait were found to be 11.2% and 4.5% respectively, while 3.4% of the infants had both IDA and thalassemia trait.
Prevalence of thalassemia trait was 7.9% demonstrating approximately a 50% decline within 5 decades. This result confirms the success of premarital screening policy in North Cyprus. In addition, prevalence of IDA was relatively low being 14.6% supporting the beneficial effect of PIS on prevention of IDA.

The analysis of heavy metals at trace level is one of the main toxicologists concern, due to their vital rules in human`s life. Cadmium is one of these toxic heavy metals, which released to the environment from various industries.
In order to determine Cd (II) ions in various matrices magnetic ion-imprinted polymer (IIP) method has been developed and applied. This nano-sorbent has been synthesized by coating an IIP compound on Fe3O4 nanoparticles core to achieve highest surface area. This polymer has been used to evaluate Cd (II) levels in food, river, and wastewater in Tehran, Iran.
Fe3O4@Cd-IIP was stable up to 300 ᵒC. The various factors such as sample pH (optimized as 7), elution/sorption time (5 min), eluent amount (4 mL HCL), and its concentration (2 mol L-1) were optimized. Analysis instrument in all steps was Flame Atomic Abortion Spectrophotometer (FAAS). In this study, the detection limit was determined down to 0.6 μg L-1.
This method was applied successfully for the preconcentration and determination of Cd (II) ions in environmental samples obtained from rivers, various foods and wastewater. In addition, the accuracy of the method was confirmed by analyzing a certified reference material (Seronorm LOT NO2525) and spiked real samples.

Collagen-based three-dimensional (3D) in vitro systems have been introduced to study the physiological states of cells. As a biomolecule, collagen is usually extracted from terrestrial animals whilst aquatic animals like squid contain large amounts of collagen.
In order to make effective use of marine organisms, we selected Persian Gulf squid in 2015 to extract the required collagen. Then, a 3D culture system based on the extracted collagen was applied to investigate cellular mechanisms in a native microenvironment. The formed collagen gel was used to investigate the growth of MDA-MB-231 breast cancer cells as well as responses to pectic acid.
The results revealed that the extracted collagen contained α, ß and γ components with high water holding capacity. This collagen formed a gel-like structure, which could promote the proliferation of MDA-MB-231 breast cancer cells. The MDA-MB-231 cells’ viability in presence of pectic acid, demonstrating the cells’ behavior in a 3D culture system.
It seems that the collagen extracted from squid skin has type I collagen properties. It might be used as a substrate in 3D cell culture systems.

Epidemics of mosquito-borne viral infections such as dengue, chikungunya, West Nile and Rift Valley fevers in neighbouring countries and risk of introduction of exotic vectors into Iran have placed this country at a significant risk for these mosquito-borne diseases.
After the first dengue case reported in Iran in 2008, active entomological surveillance of Aedes albopictus (Skuse) and Ae. aegypti (Linnaeus) were conducted in May/Jun, Sep, and Oct/Nov, 2008-2014. Based on occurrence of dengue cases and the presence of potential entry sides including ports and boarder gates, 121 sites in eight provinces were monitored for mosquito vectors. Larval collections were carried out using droppers or dippers and adult collections with CDC light traps, human landing catches, aspirator and Pyrethrum spray space catches.
A total of 8,186 larvae and 3,734 adult mosquitoes were collected belonging to 23 Culicinae species, including 13 of the genus Culex, 1 Culiseta, 1 Uranotaenia, and 8 of the genus Aedes. Five Aedes albopictus larvae were identified from the Sistan & Baluchestan province bordering Pakistan in 2009. In 2013, seven Ae. albopictus adult mosquitoes were also collected in a coastal locality near the city of Chabahar in the same province.
The detection of larvae and adults of this species in different parts of this province reveal its probable establishment in southeast Iran, which has implications for public health and requires active entomological surveillance as well as the implementation of vector control to prevent the further spread of this critical vector.

The present paper focuses on approaching the context and the actual manner of applying a method, known to be efficient and with a solid scientific background, on the institutional level of healthcare in Romania.
The analyses and correlations developed by the author have taken into account the latest editions of the journals and publications of these institutions, such as statistical papers, standards, procedural guidebooks, reports. Most of the data (easily identifiable in the electronic environment) have been selected to enable the subsequent further investigation.
The payments made in 2012 for the audited NHP1-4, have increased by 82 282.66 thousand € (39.2%) as compared to 2010, and by 50578.22 thousand € (20.9%) as compared to 2011. The amounts paid for NHP1-4 have had an ascending trend starting with 2010, but, during 2010-2012, as the contribution of the Ministry of Health from the state budget has decreased from 152590.66 thousand € to 95328.22 thousand €, CNAS’s funding from the FNUASS resources has increased by 2.4 times.
Following the analysis conducted on the NHP1-4, the findings based on representative samples are: (i) the specific legal standards related to the development of the NHP1-4, did not provide all the mechanisms that would ensure the certain procurement of medication and medical supplies as needed and did not ensure the efficient use of the allocated funds; (ii) clear discontinuities have been identified in the funding of NHP1-4, etc.

Nutritional status is very important especially in older adults because of its effects on quality of life. Phytobezoar, for instance, that can lead to small bowel obstruction has risk factors such as excessive consumption of foods with high fiber content and inadequate chewing. These factors are related to dietary habits. Furthermore, aging process and some of related physiologic changes can predispose one to phytobezoar formation. We describe a 61-yr-old man presented to the Emergency Department of Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran, in 2015 with small bowel obstruction due to phytobezoar following large amount of pomegranate seeds intake a few days before admission as an example of increased morbidity relating to unusual dietary habit.