Iranian Journal of Public Health
Volume:48 Issue: 1, Jan 2019

The aim of our study was to identify the association between Human papillomavirus (HPV) positive rate and smoking in lung cancer (LC) patients. Meanwhile, to analyze differences among gender, age differences on HPV infection rate in LC patients. We performed a systematic literature search through PubMed, Wan Fang, China National Knowledge Infrastructure (CNKI), MEDLINE, EMBASE (OVID), and Web of Science databases from 1991-2017, and we searched these keywords such as “lung cancer”, “HPV”, “smoking”, and “human papillomavirus”. Review Manager 5.3 software was used to analyze. An estimate of the odds ratio (OR) with 95% confidence intervals (CI) was calculated. In China, a statistical significance was observed between HPV positive rate and smoking in LC patients (OR=2.34, 95%CI: 1.76–3.09, P<0.001; I2 =25%). However, after stratified by region, no significance was observed in other regions, gender, and age. HPV infections are associated with smoking in LC patients. The association between HPV infection and smoking in LC patients may relate to different regions. There were no differences between gender and age among HPV infection rates in LC patients. To identify the etiology of smoking, HPV, and LC, a further experimental research needs to be conducted.

During the past 20 years, the prevalence of gestational diabetes mellitus (GDM) has increased by ∼10%-100% in several race/ethnicity groups. There is an association between ambient air pollution (AAP) and GDM. This study aimed to summarize the evidence about the association between AAP and GDM. PubMed, Embase, Scopus, Web of Science and Cochrane Library were searched from inception till Oct 2017. Studies about the association between ambient air pollutants levels and GDM were included. Pooled effect estimates and their 95% confidence interval (CI) were calculated using R. Eight studies met the inclusion criteria. The odds of developing GDM upon exposure to CO (per 1 ppm), NO (per 1 ppb), NO2 (per 10 µg/m3), NOx (per 1 ppb), O3 (per 10 ppb), SO2 (per 10 ppb), PM10 (per 10 µg/m3) and PM2.5 (per 10 µg/m3) were 1.47 (95% CI 0.88-2.06), 1.04 (95% CI 1.03-1.06), 1 (95% CI 0.93-1.08), 1.02 (95% CI 1-1.04), 1.05 (95% CI 0.94-1.16), 1.39 (95% CI 1.04-1.73), 0.97 (95% CI 0.94-0.99) and 1.12 (95% CI 0.93-1.31), respectively. The current literature showed evidence for an association between AAP and GDM. However, further well-designed studies are needed.

Zika virus infection has recently attracted the attention of medical community. While clinical man-ifestations of the infection in adult cases are not severe and disease is not associated with high mortality rates, Zika virus infection can have an impact on fetal development and lead to severe neurodevelopmental abnormali-ties. To gain insight into different aspects of Zika virus infection, a comprehensive literature review was performed. With regard to epidemiology and geographical distribution of Zika virus infection, relevant infor-mation was extracted from CDC and WHO websites. In this review, we discuss different basic and clinical aspects of Zika virus infection including virology, epidemiology and pathogenesis of disease. Laboratory methods required for the diagnosis of disease together with ethical issues associated with Zika virus infection will also be discussed in detail. Herein, we have tried to provide a multi-faceted view of Zika virus infection, with greater emphasis on disease status in Eastern Mediterranean Region.

National plans have an important role in defining vision, goals, priorities, and action plans. The present paper examined the international experience in developing upstream documents concerning women's health; it regards the necessity of developing Iranian women's health plan. This review, conducted with search in electronic databases and literature of no limitation in terms of years conducted. The phrases such as "woman health policy", "woman health promotion", "woman health strategy" and "woman health plan” were searched. The criteria based on which the countries were chosen were the degree to which they were developed in health system, health indexes, the accessibility of required infor-mation, and the possibility of benchmarking the new methods. Emphasize on gender as a determinant of health, increasing the economic activities of women, de-creasing the violence against women, gender-based researches, and inter-sectorial approach are some common items in the women’s health plans in selected countries. The main upstream documents about women health in Iran such as ‘Research policies and principles of women issues’, “Women Charter of Rights in Iran” were not developed and implemented in form of a comprehensive plan so we need to formulate a full women health national plan that summarizes all previous policies with addition of new needed strategies inclusion. Developing a national plan for Iranian women’s health regarding with selected countries experi-ences makes a long-term vision for health and obtains the institutional and organizational efforts and resources necessary for women health promotion in Iran.

Religious obligation helps people to develop mental health by creating internal commitment to special rules􀀑 This meta-analysis aimed to determine the relationship between religious orientation and anxiety among college students. Major scientific databases including PubMed, Web of Science, Science Direct, EBSCO, ProQuest and PsycINFO were searched for original research articles published 1987-2016. A random effect model was used to combine Correlation coefficient. All analyses were performed using Stata MP. After screening of 7235 documents, 13 articles including 5620 participants met inclusion criteria in this meta-analysis. Correlation coefficient was -0.08 (95% CI= -0.19, -0.03) which indicated with increasing religious orientation, anxiety and depression reduced (P<0.001). Characteristics such as sex, geographic region, and type of religions were potential sources of heterogeneity. Based on fill-and-trim method the adjusted pooled r was obtained, -0.06 (95% CI= -0.16, -0.04). There was a weakness relationship between religious orientation and mental anxiety and de-pression. Therefore, it needs to improve knowledge of student about advantages of religious orientation.

The problem consists in the lack of knowledge of the factors that tourists choose the clinics of a foreign city for their aesthetics treatments, especially at a frontier where a developed and developing country co-exist and interact. The information was obtained on 2016, by applying an exit pool survey to a selected sample of 385 visitors- patients from clinics in the Tijuana, Mexico. Sixteen items were included in the exploratory factor analysis. Four key factors influenced the decision: Quality & Prestige of Clinic and Surgeon, Integration with Tourism Sector, Destination Image and Border Interaction. All the elements had a load factor greater than 0.56 which proved the actual fit in the factor analysis and none of the included variables is trivial. Allow maintaining or increasing the attractiveness of a border city for aesthetic tourism, the administra-tors of the clinics establish cooperation agreements with entrepreneurs of the tourism sector to benefit their patients.

This study aimed to explore the clinical characteristics of noninfectious fever in patients with systemic lupus erythematosus (SLE) and the underlying causes through multivariate analysis. Clinical data of 128 patients with SLE who were admitted to Affiliated Hospital of Nanjing Universi-ty of TCM, Nanjing 210029, P.R. China from January 2015 to December 2017 were retrospectively analyzed. The following factors were closely associated with fever: patient age, treatment history, SLEDAI score, enlarged liver, spleen and lymph nodes, low hemoglobin, leukopenia, CRP, complement C3, albumin, anti-dsDNA antibody, glucocorticoids, and cyclophosphamide. Multivariate logistic regression analysis showed that factors, such as enlarged liver, spleen and lymph nodes, digestive system involvement, low hemoglobin, leuko-penia, CRP, decreased albumin, anti-dsDNA antibody, glucocorticoids and cyclophosphamide, were closely as-sociated with noninfectious fever in SLE. Noninfectious fever is a common clinical manifestation of SLE. Factors, such as enlarged liver, spleen and lymph nodes, digestive system involvement, low hemoglobin, leukopenia, CRP, decreased albumin, anti-dsDNA antibody, glucocorticoids, and cyclophosphamide, were independent risk factors for noninfectious fever in SLE.

This study aimed to identify percent body fat cut-off points related to metabolic syndrome in a large sample of Korean adolescents. The subjects (n=2120; boys=1107, girls=1013) were middle and high school students aged 12–17 yr who participated in the Korean National Fitness Award Project in 2013. Percent body fat was estimated via eight-polar bioelectrical impedance analysis. Metabolic syndrome was classified using established standards based on the National Cholesterol Education Program with the definition modified for age. Age- and sex-specific percent body fat z-scores were calculated for every adolescent using skewness, median, and coefficient of variation curves to account for growth and development. Receiver operating characteristic curve analysis was used to identify the percent body fat cut-off points using percent body fat z-scores from skewness, median, and coefficient of variation curves as the test and metabolic syndrome as the criterion. Based on the modified National Cholesterol Education Program criteria for metabolic syndrome, the areas under the receiver operating characteristic curve for percent body fat were 0.882 and 0.893 for boys and girls, respectively. The percent body fat percentiles were 82.2 and 87.3 for boys and girls, respectively. According to the skewness, median, and coefficient of variation curves, the percent body fat cut-off points based on the modified National Cholesterol Education Program criteria were 23.6%-25.7% for boys and 32.8%-37.3% for girls, both aged 12-17 yr. Age- and sex-specific percent body fat cut-off points were identified in relation to the metabolic syndrome status of Korean adolescents. These percent body fat cut-offs might be useful for identifying metabolic abnormality due to obesity in Korean adolescents.

The study aimed to detect critical metabolites in acute lung injury (ALI). A comparative analysis of microarray profile of patients with sepsis-induced ALI compared with sepsis patients with was conducted using bioinformatic tools through constructing multi-omics network. Multi-omics composite networks (gene network, metabolite network, phenotype network, gene-metabolite associa-tion network, phenotype-gene association network, and phenotype-metabolite association network) were con-structed, following by integration of these composite networks to establish a heterogeneous network. Next, seed genes, and ALI phenotype were mapped into the heterogeneous network to further obtain a weighted composite network. Random walk with restart (RWR) was used for the weighted composite network to extract and prioritize the metabolites. On the basis of the distance proximity among metabolites, the top 50 metabo-lites with the highest proximity were identified, and the top 100 co-expressed genes interacted with the top 50 metabolites were also screened out. Totally, there were 9363 nodes and 10,226,148 edges in the integrated composite network. There were 4 metabolites with the scores > 0.009, including CHITIN, Tretinoin, sodium ion, and Celebrex. Adenosine 5'-diphosphate, triphosadenine, and tretinoin had higher degrees in the composite network and the co-expressed network. Adenosine 5'-diphosphate, triphosadenine, and tretinoin may be potential biomarkers for diagno-sis and treatment of ALI.

This study determined the occupational exposure and health problems experienced by nursing and midwifery students during their clinical internships. The study population consisted of 1719 nursing and midwifery students studying at the health sci-ences faculties of six Turkish universities in 2016. Data were collected using a questionnaire prepared by re-searchers, namely Occupational Exposure and Health Problems in Clinical Environment Questionnaire, and the State-Trait Anxiety Scale. The data were analyzed using Mann Whitney U test, Kruskal Wallis variance analysis, and Spearman correlation analysis. Significance was accepted in a 95% confidence interval and a level of P<0.05. The students had a mean age of 20.86 yr (1.72), and 48.6% had midwifery and 51.4% had nursing major. More than 17.8% of the students were experienced occupational exposure during their clinical intern-ships. Total score for students was 2.15 ±0.71. The scores of the students examined for exposure to hazards and verbal violence was 2.13 ± 1.17, for needle stick injury it was 2.10 ± 1.13. In addition, when the scores of the students' health problems were examined, insomnia 3.57 ± 1.22, low back pain 2.84 ± 1.29, shoulder or arm pain 2.68 ± 1.29 were determined statistically. There was a positive significant relationship between the mean clinical occupational hazardous exposure and health problems and state-trait anxiety scores (P<0.01). Approximately one-fifth of the students were exposed to occupational hazardous at the hospital while they were on their clinical internship programs. Students rarely experience occupational exposure, but often suffer from insomnia, sometimes musculoskeletal pains (back, shoulder arm, neck), rarely have skin problems.

During reports of emergency events, journalists experience psychological crisis and negative emotions aroused by the events. The psychological endurance of journalists, which is induced by high risks of the career, has attracted widespread attention. Emotional state and coping style are important factors that influ-ence the psychological endurance of individuals. This study aimed to analyze the relationship of psychological endurance with anxiety and coping style among journalists engaged in emergency events. A total of 296 journalists in Hubei Province of China who participated in reports on emergency events from August to December 2017 were selected. Journalists were assessed using the Psychological Endur-ance Scale, Self-rating Anxiety Scale, and Simple Coping Style Questionnaire. The total score of the psychological endurance of journalists engaged in emergency events is slightly lower than that of the Chinese norm. Score of anxiety of highly educated journalists is significantly higher than that of lowly educated journalists. Psychological endurance of journalists is negatively correlated with negative coping style and anxiety, but it is positively correlated with positive coping style. Positive coping style of jour-nalists engaged in emergency events partially mediates the effects of psychological endurance on anxiety. Among journalists engaged in emergency events, the highly educated group presents obvious anx-iety and negative coping style. Psychological endurance indirectly affects through positive coping style and di-rectly affects anxiety of journalists.

Elderly falls increase dramatically with age and are a leading cause of injury, carrying a risk of loss of independence and death. We studied the effects of a health education program on fall-risk prevention among urban elderly persons in the municipality of Khon Kaen, Thailand. A quasi-experimental study was conducted in 2 communities. The calculated sample size was 216 individuals: 108 for intervention and 108 for control, all of whom were 60 or older, and registered at the Sam-lium Primary Care Unit (SPCU). The educational intervention was a fall risk intervention program by an elderly buddy. A structured questionnaire that incorporated questions from the Thai Fall Risk Assessment Tool (Thai-FRAT) was used to collect general and specific information. Data were analyzed using the independent sample t-test and 􀁆2, with P<0.05 being statistically significant. The response rate was 94.4%. More than half of the respondents were at risk of a fall. The prevalence of risk of a fall among the intervention group was slightly less than that for those within the control group [In-tervention group=52.9% (95%CI: 42.85, 62.81, P<0.001); Control group=60.8% (95%CI: 50.59, 70.15, P=0.016)]. After 6 months of intervention, the balance impairment, medicine usage, and overall proportion with risk of fall were decreased. The difference between the intervention and control groups was statistically significant (P<0.05). The provision of a health education program designed for fall risk prevention among the elderly would be a useful public health initiative.

This study aimed to evaluate the characteristics of faculty and research activities of basic stem cell research groups in China. A questionnaire was administered to persons who knew the information among 46 basic stem cell research groups in China. Multiple linear regression models and repeated-measures analyses of variance were used. Repeated-measures analyses of variance were used. Of the 46 groups, 39.1% did not have any faculty recruited from abroad from 2009 to 2013, 37.0% did not have any faculty with junior-level title, 34.8% had ≤25.0% faculty with either M.D. or Ph.D. degree. Papers published in SCI journals per faculty and having faculty recruited from abroad were positively associated with research funding per faculty. The groups with faculty recruited from abroad had significantly higher research funding per faculty over time compared with the group without faculty recruited from abroad. Repeated-measures analyses of variance showed the group with faculty recruited from abroad had significantly higher research funding per faculty over time compared with the group without faculty recruited from abroad. To increase the development of basic stem cell research, some characteristics of human resources should be improved, and the groups should recruit more faculty with overseas experience.

High-quality prenatal care services could decrease maternal-neonatal mortality and morbidities. The aim of this study was to compare institutional and unplanned home deliveries with regard to the use and content of prenatal care services. The study was conducted in 2011 with two hundred and twenty-nine mothers with unplanned deliver-ies at home as study group and 458 mothers having institutional deliveries as controls living in Istanbul. The content of prenatal care was evaluated in accordance with the national ministry of health prenatal care manage-ment guidelines and the data was collected by a questionnaire with face to face interview. Women with unplanned deliveries at home use prenatal care services less frequently. Percentage of mothers that had home deliveries and did not use prenatal care services was 16.2% while this was only 3.4% in women having institutional deliveries (P=0.001). Moreover, all parameters of prenatal care were poor in content compared to women with institutional deliveries. Adequate prenatal care services in terms of quantity and quality can promote institutional deliveries.

We aimed to assess the frequency and structure of chromosomal abnormalities as well as the distribution of the indications of prenatal diagnosis in 4206 cases of high-risk pregnant women. A retrospective analysis of cytogenetic studies of 4206 pregnant women with indications of amniocentesis, referred to Linyi Women and Children’s Hospital, Shandong Province, Linyi, China in 2016-2017, was performed. Among those, 4191 amniotic fluid specimens were successfully extracted and cultured, and received karyotype diagnosis. A total of 358 abnormal karyotypes were detected and the abnormal rate was 8.54%. Among them, autosomal aneuploidy was the most common pattern occupied 64.53% and the detection rate was 5.51%, of which 173 (48.32%) cases were 21-trisomy, which was the main type of abnormal karyotypes, followed by 18-trisomy (14.25%). There were 38 cases with sex chromosome aneuploidy, including 47, XXY, 47, XXX, 47, XYY, 69, XXX and 45, X0, accounting for 10.61% of the total chromosome abnormalities and the detection rate was 0.91%. Chromosome structural disorders occupied 10.61% (38/358) of the chromosome abnormalities, including Robertson translocation (16 cases), balance translocation (14 cases), inversion (3 cases), deletion (3 cases), and so on. Chromosome polymorphism was 10.61% too. Other uncommon abnormal karyotypes included mosaicism (11/358), marker chromosome (1.3%). Advanced age and serological screening for high risk were the major prenatal diagnostic indications for pregnant women with chromosomal abnormalities. The karyotype analysis of amniotic fluid cells in pregnant women with different amniocentisis indications can effectively prevent the birth of fetuses with chromosomal diseases and reduce the risk of fetal malformation.

Brucellosis as a zoonotic disease is widespread among human and animal that it continues to be a major public health problem. Due to the shortage of recent epidemiologic data regarding the brucellosis distribu-tion in Iran, we convinced to evaluate the prevalence of brucellosis in provinces of Iran. In this descriptive study, data were collected from brucellosis suspected patients referred to Noor Pathobiology Laboratory, Tehran, Iran from 18 out of 31 provinces of Iran during 2013-2015. Overall, 2635 out of 17103 attending cases (15.4%) were recognized as brucellosis patients. The most prevalent rate was found in patients aged 20-39 yr old (41%) which of them 67% were male. Patients with bru-cellosis were significantly diagnosed in spring season (Apr to late May). Among included provinces, Hamadan Province had the highest (25%) prevalence followed by Markazi and Mazandaran with 24.7% and 22.5%, respec-tively. Brucellosis is still considered as an important infectious disease with a high prevalence in many provinces of Iran. It is necessary to implement a national brucellosis control program by increasing medical edu-cation, public knowledge and various controlling plans for preventing, controlling and eradicating of brucellosis.

Antiretroviral therapy has significantly reduced the prevalence of diseases and mortality rate caused by HIV; therefore, recognition of the factors affecting the antiretroviral therapy is of great importance. We aimed to investigate the relationship between antiretroviral medication adherence and CD4 with posttrau-matic stress disorder (PTSD) and depression in patients with HIV. This was a descriptive, cross-sectional, quantitative, and correlational study􀀑 The statistical popula-tion included all of the patients with HIV in Shiraz, Fars Province, southwest of Iran in 2013, of whom 220 were selected from the Behavioral Diseases Consultation Center using the convenience sampling method. The measures included Mississippi Post Traumatic Stress Disorder Questionnaire, Beck-II Depression, and ACTG Adherence (ACTG). The results were analyzed using the Pearson correlation method and stepwise hierarchical multivariate regression. Regression analysis showed that of two mediating variables (age & educational level), only age could predict 5% (P<0.001) and of two predictive variables (depression & PTSD) only PTSD could predict 53% (P<0.001) of medication adherence's variance. Moreover, of two mediating variables (age & disease duration), only age could predict 3% (P<0.004) and of two predictive variables (depression & PTSD) only PTSD could predict 4% (P<0.001) of CD4 variance. The posttraumatic stress disorder symptoms could predict the medication non-adherence and lower CD4 levels.

For overcoming the existing problems and finding a pathway for realization of universal health care, health complexes were implemented in the form of a pilot project in Tabriz suburban area. Tabriz Health Complex Project was designed in 2013 in the provincial health center of East Azer-baijan. In terms of execution schedule, this intervention had 4 phases including 1) study phase, 2) planning phase, 3) pilot phase, and 4) implementation phase. Each health complex covers a population of 40,000 to 120,000 in a defined geographic area and consists of a Comprehensive Health Center (CHC) including health centers and a management center, which usually located in CHC. The important features of this project are as follows: people-centered primary health care, special attention to health promotion and prevention and estab-lishment of a referral system within the region (organic connection between the first and second levels). An accountable and responsive health care system has been established to deliver integrated care ser-vices to people in a defined catchment area against identified per capita payment, under district health centre policies and regulations. Each health team consisted of a general practitioner and a family health nurse who covered around 4000 people to deliver prevention, promotion, and treatment services especially in and NCDs field. Health complex as a model of public-private participation and practical solution to address many of the problems in the primary care system of the country􀀑 The project can organize the PHC system and fami-ly medicine program.

Candiduria in hospitalized patients may represent contamination, colonization, or urinary tract in-fections. On the other hand, candidemia and upper urinary tract infection could be the complications of can-diduria. The aim of this study was to determine candiduria in hospitalized patients and identify isolated Candida species by conventional and molecular methods. This cross-sectional study was conducted on hospitalized patients in Imam Khomeini and Mostafa Khomeini hospitals in Ilam, western Iran from Jan to Dec 2016. Urine samples of hospitalized patients were col-lected during a period of 4 months for diagnosis of candiduria. Primary identification was done by conventional methods. PCR profile was carried out using phenol-chloroform method and confirmed using restriction fragment length polymorphism (PCR-RFLP) technique by MspI restriction enzyme. Candiduria was diagnosed in 18 (9.2%) cases from a total of 195 patients. Isolated yeasts were identified as C. albicans (n: 13), C. glabrata (n: 5), and C. parapsilosis (n: 1) in the one case both C. albicans and C. glabrata were isolated from a urine sample. Candida urinary tract infection is becoming increasingly common in hospitalized patients but, differentia-tion fungal colonization from infection and identification of etiologic agents for optimal treatment is necessary.

The aim of this study was calibration of a nitrate (NO3)/nitrite (NO2) database for estimated its dietary intakes. Overall, 250 healthy Tehranian adults were assessed in 2015 for dietary intakes of NO3 and NO2 and its serum and urine concentration. Food composition values for NO3 and NO2 were derived from a recent sur-vey conducted on frequently consumed food items among Iranians. The correlation of dietary intakes of NO3/NO2 and its urinary and serum values was evaluated. Mean (±SD) intakes of dietary NO3 and NO2 were 505±160 and 7.7±2.2 mg/d, respectively. The cor-relation coefficient of intake and urinary NO3 was 0.83 (95% CI=0.56-0.91) and 0.57 (95% CI=0.49-0.67) in men and women, respectively. A moderate agreement was also observed between NO2 intake and its urinary levels (r=0.27, 95% CI=0.13-0.37, and 0.29, 95% CI=0.17-0.41, in men and women, respectively). Using a national database of NO3 and NO2 content of food items along with a valid food frequen-cy questionnaire could provide a valid estimation of dietary intakes of NO3 in the target population.