تهران

The present study was designed to investigate the spatial and temporal (hourly, daily, monthly, and seasonal) variations in ambient fine particulate matter (PM2.5) concentrations in Tehran from 21 March, 2023, to 19 March, 2024, and estimate the number of premature deaths attributable to PM2.5.

Hourly PM2.5 data were obtained from 41 air quality monitoring stations across Tehran. Subsequently, 29 validated stations were identified for assessing spatial changes in pollutant concentrations and estimating the associated health effects. The latest version of the AirQ+ software (version 2.2.4) was employed to estimate health impacts attributable to PM2.5. Additionally, updated baseline data and the population of Tehran were used to assess the health effects of air pollution.

The annual average concentration of ambient PM2.5 in Tehran over the study period was approximately 32 µg/m³ for the entire city. At validated monitoring stations and across neighborhoods, the concentrations ranged from 20.8–47.5 µg/m³ and 22.2–46.3 µg/m³, respectively. These levels were approximately 4 to 9 times higher than the World Health Organization's (WHO) annual air quality guidelines and 2 to 4 times higher than the NAAQS. The number of deaths attributable to long-term exposure to ambient PM2.5 in adults aged 30 and above in Tehran during the study period was estimated to be 9,321 (95% confidence interval: 7,232–10,313) for concentrations exceeding 5 µg/m³.

The results of this study highlight that ambient PM2.5 concentrations in Tehran over the study period consistently exceeded the WHO air quality guideline and the NAAQS. Furthermore, a comparison of pollutant concentrations across all validated monitoring stations and neighborhoods reveals that residents in all parts of Tehran experienced poor air quality. However, concentrations were significantly higher in some areas, particularly the central and southern parts of the city, compared to the northern regions.

Health insurance literacy (HIL) is the knowledge, ability, and confidence of people to find and evaluate information about insurance plans, choose the best plan and how to use it. This study was conducted to examine the level of HIL among the insured person of the Iran Health Insurance Organization in Tehran.

This cross-sectional study was conducted in 2023 with the participation of 309 insured person. The data were collected using a 27-item questionnaire that included three dimensions of access, insurance terms, and performance skills. The validity and reliability of the questionnaire were confirmed. Data analysis was performed in SPSS.24 using T-test and One-way ANOVA.

The mean score for access was 8.5±1.91, insurance terms 10.21±2.46 and performance skill was 22.94±3.23. The overall mean HIL score was 41.64±6.22. The HIL status of 60% of the insured person was intermediate and 40% was low. The mean score of HIL was higher among people living in the northern region, those covered by the special diseases fund, those with a monthly less income, and those without supplementary insurance. The HIL level was also higher among people whose source of insurance information was friends and acquaintances (P<0.05).

The majority of people had relatively low levels of HIL. Knowing the level of HIL and the factors that influence it can guide policy makers in developing educational interventions to remove barriers and improve HIL. Educational interventions through public media such as television, short videos on the websites and applications of insurance organizations and social media, and the provision of insurance information on waiting room monitors in medical centers are suggested to improve HIL.

Given the crucial role of milk and its products in human diets, it is imperative to implement effective measures to ensure the safety of milk by minimizing the presence of hazardous pollutants. This study aims to assess the concentration and potential risks associated with lead in raw milk produced in Tehran province.

This cross-sectional descriptive study involved the collection of raw milk samples from 24 diverse livestock farms in Tehran province during the winter season of 1401. The samples were analyzed for lead contamination using flame atomic absorption spectrometry. Statistical tests were applied to compare the results with international standards, and subsequent risk assessment was conducted based on the average amounts.

The study revealed that none of the samples exceeded the permissible limit for lead. The mean and standard deviation of lead concentration in the samples was 7 ± 5.8 (ppb), well below the international standard. There was no significant variation in lead levels among the tested livestock farms. The Hazard Quotient (HQ) values for both children and adults were calculated to be less than 1.

The concentration of lead in all samples remained below the permissible limits set by Codex and the Iran Standards Organization, indicating no non-carcinogenic risks associated with milk consumption in terms of lead contamination, as suggested by the calculated HQ values.

 One of the air pollutants is Particulate Matter, and the existence of a relationship between Particulate Matter and increased mortality and respiratory diseases related to air pollution in the past decade has been proven by various epidemiological studies. The aim of this study was to investigate the risk of respiratory tract carcinogenesis by Particulate Matter with an aerodynamic diameter of less than 2.5 microns in different areas of Tehran in the 90’s decade.

 In this study, information on the concentration of Particulate Matter (PM2.5) was collected from 24 air quality control stations in Tehran, and information on the incidence of respiratory tract cancer was also extracted from the national report of the National Cancer Registry Program. Population data in 22 districts of Tehran during the studied years were prepared from Iran Statistics Center. Ethical considerations were observed in all stages of the study.

 There observed that the average annual concentration of PM2.5 in 22 areas of Tehran metropolis has exceeded the standards of the World Health Organization as well as the national standard. The highest attributable share of the incidence of respiratory tract cancer due to suspended particles (PM2.5) is related to 2013 (0.18), and the 19th district of Tehran municipality has the highest mentioned risk among other districts (0.19). In 2016, the highest incidence of respiratory tract cancer attributed to suspended particles (PM2.5) has been observed in Tehran (152), which most are related to district 4 of Tehran municipality (13).

 The results of this research showed that the increase in the concentration of Particulate Matter with an aerodynamic diameter of less than 2.5 microns and the population density in polluted areas increases the risk of respiratory tract cancer.

 The quality of work life is a sign of an organizational culture based on which employees feel self-sufficiency and self-esteem. Considering that such a study has not been conducted among the operating room staff, the present study aimed to determine the quality of work life among the operating room staff of selected hospitals in Tehran in 2021.

 The current research is a descriptive-cross-sectional study. Sampling was done as a cluster and the samples were selected from the operating room staff of selected government hospitals in Tehran in 2021. In total, 231 participants answered questions related to demographic information and Walton's quality of work life questionnaire (35 options) in the form of self-report. The data were analyzed with the help of descriptive and inferential statistical methods in SPSS-24 software at a significance level of 0.05.

 The participants age averaged (standard deviation) at 31.69 (6.35). The mean (standard deviation) of the quality of work life of operating room workers was 96.04 (18.28), so that 23.8% had low levels of work life quality, 73.2% had average and 3% had high work life quality. The overall work life environment and safe and healthy work environment revealed the lowest and highest scores, respectively.

 It seems that the quality of working life of the operating room staff is not at the optimal level. Therefore, the treatment officials should provide the necessary platforms to improve the quality of work of the operating room staff in different areas, so that the staff can serve with more motivation.

One of the undesirable consequences of the aging process is the feeling of loneliness and decrease in general health. Nowadays aging people are one of the most problems of sustainable development in each country in the world. Therefore, current research was aimed to determine the impact of loneliness on elderly health in west health care center of Tehran.

This was descriptive- analytical research conducted cross- sectionally in 2020-2021. The research population was elderly people over 60 years old covered by west health center of Tehran. Determining the sample size was conducted by Krejcie and Morgan table to the number of 300. The list of elderly people extracted from Sib system, and selected by random table of numbers. The research tool were two questionnaires including GHQ-28 of Goldberg and loneliness feeling of elderly population (SELSA- S) that confirmed their validity and reliability. Descriptive results were reported by frequency, average, and also analytical results reported using by Pearson and variance analysis, and also linear regression.

Increased feeling of loneliness and poor mental health and social function were observed elderly people. Negative and significant feeling of loneliness and its components impacted on mental health among elderly people. There was no significant relationship between feeling of loneliness and gender.

Decreased feeling of loneliness among elderly people might lead to improved mental health among elderly people. Therefore, due to the increasing elderly population in Iran, it is so important to design interventions and trainingprograms in order to create supportive conditions forelderly people.

Older people are exposed to the risk of decline in mobility and social relations. While evidence indicates that recreational travel can have biopsychosocial benefits for older adults and improve their quality of life. The aim of the current study is to investigate the feasibility of one day tours for Tehranian older adults.

This study has utilized the cost-benefit analysis method, developed and introduced by Dupuit. First, the demographic, geographic and economical capacities related to tourism in Tehran were searched, identified and reported, then the expenses and income of one unit of the tours were calculated. Finally, the profit of project's implementation was analyzed.

With a population of over one million older adults and access to a significant number of cultural, historical, and recreational sites, Tehran is considered as a suitable place for senior tourism. The minimum profit margin for the implementation of one-day tours for older adults is estimated at 31%.

The implementation of one-day tours for Tehranian older adults can improve their quality of life and be profitable for investors. It is suggested that the state sector supports these activities by subsidiary payments.

Contract therapy is a significant aspect of treatment that establishes a connection of empathy between the therapist and client. It is known to be a major indicator of the effectiveness of psychotherapy and therapeutic outcomes. The purpose of this study was to evaluate the psychometric properties of the Persian version of the California Therapeutic Alliance Questionnaire (CALPAS) among individuals who were referred to the Tehran Counseling Center.

This is a descriptive-analytical research study. The statistical population of the study included all individuals who visited the Tehran Counseling Center between 2017-2018. A sample size of two hundred participants was selected using convenience sampling based on the inclusion criteria. Participants completed a demographic checklist and a CALPAS questionnaire. Data was analyzed using exploratory and confirmatory factor analysis, Cronbach's alpha coefficient, and divergent validity.

The results indicated strong validity P<0.001 and favorable fit of the CALPAS four-dimensional questionnaire.

Due to the questionnaire's favorable psychometric properties, it is a suitable tool for individualized contractual therapy.

Contaminated foods with Shiga toxigenic serotypes of Escherichia coli (STEC) can cause diarrhea and severe diseases in consumers. The aim of this study was to investigate frequency of Shiga toxigenic Escherichia coli serotypes and their antibiotic resistance patterns in vegetable samples from Tehran, Iran.

In this study, a total of 97 vegetable samples from 22 urban areas of Tehran, Iran, were investigated, July 2018 to March 2019. To identify Shiga toxigenic Escherichia coli strains, standard method of enrichment and culture in selective media and polymerase chain reaction for verifying presence of stx1 and stx2 genes were used. Presence of eae and ehxA genes was investigated in Shiga toxigenic Escherichia coli isolates. Antibiotic resistance was assessed using disk diffusion method for 15 antibiotics and the multidrug resistance phenotype was assessed.

Shiga toxigenic Escherichia coli strains were isolated in 14/4% of vegetable samples (stx1, stx2, stx1/stx2 of 8, 1 and 5%, respectively). Presence of eae and ehxA genes was shown in 1 and 2% of Shiga toxigenic Escherichia coli isolates, respectively. The highest resistance was detected to trimethoprim-sulfamethoxazole (100%), erythromycin (73.33%) and tetracycline (85.7%) and the lowest against meropenem (0%) and imipenem/ceftazidime (7/7%).

In this study, contamination of vegetables with multidrug resistant Shiga toxigenic Escherichia coli was verified in Tehran, Iran. Further studies on human samples can clarify this contamination.

Agricultural lands around Tehran may become contaminated due to their proximity to pollution sources and such pollution should be investigated. Therefore, the main objectives of this study were to determine the pollution levels of some trace elements in the agricultural soils around Tehran and to assess the attributed health risks.

In this study, 43 soil samples were collected from agricultural lands around Tehran. The soil samples were prepared and acid-digested and the concentrations of Vanadium (V), Lithium (Li), Lanthanum (La), Molybdenum (Mo), and Antimony (Sb) were measured by ICP-OES. Based on the concentrations of the elements in soil, the pollution indices and non-carcinogenic risk (based on Monte Carlo simulation) were assessed.

Among the studied elements, V had the highest concentration (131 mg/kg) followed by La > Li > Sb > Mo. The values of the geoaccumulation index (Igeo) and enrichment factor (EF) were in the ranges of -1.9 to 0.8 and 0.5 to 3.1, respectively. The Nemerow integrated pollution index (NIPI) values were in the range of 1.3 to 2.0. The values of non-carcinogenic risk for Li, Mo, Sb, and V were negligible, but it exceeded the threshold limit for La.

This study showed that the agricultural lands around Tehran are contaminated with studied trace elements to a low to moderate extent. However, an unacceptable non-carcinogenic risk attributed to La was estimated. Therefore, it is essential to pay special attention to the La pollution of agricultural soils around Tehran.

Today, one of the goals to improve the quality of life (QoL) of the elderly is to achieve successful aging. This study aims to investigate the determinants of successful aging in Tehran, Iran.

This is a quantitative cross-sectional study. Participants were 637 older people over 60 years of age who were collected using a multi-stage cluster sampling method from 22 districts of Tehran, according to the number of older people in each district. Chi-square test and multiple logistic regression were used for analyze the collected data.

Prevalence of successful aging in Tehran was 19.6%. The results of multivariable logistic regression analysis showed that younger people and non-smokers had a higher chance of successful aging (Odds ratio=1.8 and 1.9, respectively). Those with elementary/secondary education and further and higher education (respectively with 2.9 rand 3.4 odds ratio) and daily exercise (odds ratio=2.4) had also a higher chance of successful aging.

Improving the level of education and improving a healthy lifestyle, including not smoking and doing physical activities, leads to a successful aging, which requires long-term planning and special attention.

Since professional development is one of the goals of any medical school, an essential element in this regard will be the evaluation of professional behavior which is important as one of the most important competencies in the medical profession. Therefore, the present study was conducted with the aim of determining the level of observance of behavior and professional commitment of specialized physicians from the perspective of patients in 2020.

This descriptive study was performed on 150 patients admitted to Imam Khomeini Hospital in Tehran who were selected by simple random sampling. Data collection tools included two sections: demographic variables and 18-item 5-point Likert scale professional behavior and commitment. Data were analyzed using descriptive statistics, Pearson and Spearman correlation tests and multiple linear regression.

The mean and standard deviation of the score of the instrument for observing the behavior and professional commitment of specialized physicians from the patients' point of view was 70.55 ± 9.68 with the lowest score of 49 and the highest score of 90. More than half of the patients 67.3% (101 people) determined the level of professional behavior and commitment at a good level and 32.7% (49 people) at a moderate level.

  Based on the results of this study, professional commitment and behavior are at a good level. The lowest level of compliance was related to not accepting responsibility for diagnostic and treatment errors. Therefore, the relevant authorities should pay attention to identifying the causes of these shortcomings and taking measures to gain experience from the errors.

Lack of financial protection in health is known as a disease of health systems. Households suffer not only from the burden of disease but also from the burden caused by the destruction and economic poverty, in other words, facing back-breaking costs and poverty caused by financing their health. The aim of the current research is to investigate the impact of different dimensions of inequality on the financial financing of household health.

This is a descriptive, cross-sectional, and applied study, which examines the impact of inequality on the financing of household health expenses. The research tool is the financing inequality questionnaire (2008) by Saito. All out-of-pocket costs related to inpatient care, outpatient care, diagnostic tests, and medical expenses due to illness have been estimated for one year. Experts have confirmed validity and reliability.

The dimensions of inequality among households in Tehran are higher than the average (1.329), which has a significant impact on the financing of household health expenses. The direct effect of justice on the financing of household health expenses is rejected. With the increase in the back-breaking cost, equal opportunity, economic status, insurance coverage, and financing of household health expenses increases. According to P<0.001 and P=0.005, the age of the head of the household is not related to justice and gender in the financing of household health expenses.

There is a direct relationship between back-breaking expenses, equal opportunity, economic status, insurance coverage, and financing of household health expenses.

Air pollution is generally mixture of complex and toxic compounds that particles (Particulate Matter: PM) are always a part of this mixture, that exposure to them leads to a wide range of health effects. The aim of the current study is to evaluate the health effects of reducing the level of PM2.5 in Tehran during ten years (2017-2025) to the WHO recommended level based on the Breath Life campaign، using the WHO AirQ+ model.

after collecting data on the population and concentration of particles in 2017 from the relevant centers and performing calculations to reduce the concentration to ten micrograms per cubic meter (recommended by WHO) with Excel software، the attributed deaths were estimated by AIRQ+ software.

with a 30.8% decrease in the concentration of PM2.5 during 10 years، death with all causes 25.22%، death due to chronic obstructive pulmonary disease 9.97%، death due to lung cancer 49.29%، death due to acute lower respiratory infection 34.36%، death due to ischemic heart disease 22.26% and death due to stroke brain decreased by 25.09%.

based on the results, reducing the concentration of PM2.5 by achieving the goal of the Breathe Life Campaign (10) and using air quality reduction strategies, will lead to a significant reduction of premature deaths caused by PM2.5 in Tehran.

Air pollution and the damages caused by it in the city of Tehran are considered as one of the main problems of the urban area in the shadow of the existing laws in this field. One of the causes of damage to the environment is air pollution due to human activities. Actions that sometimes take place intentionally and with awareness and sometimes unintentionally in nature and cause its change or destruction. From a legal point of view, it is important to check the existence of responsibility for these actions. Responsibility for air pollution in regulations and laws guarantees civil and criminal enforcement. Looking at the existing laws and the necessity of interdisciplinary legal debates and the lack of research in this field, constructive suggestions are made to solve the problems of this field.

The present research was carried out using a descriptive-analytical method and by collecting information in a library form, and it is trying to investigate the guarantee of legal and criminal executions for the causes of air pollution.

Ethical Considerations:

 Despite the lack of sufficient internal resources, while respecting the authenticity of the texts, honesty and trustworthiness have been observed.

One of the causes of damage to the environment is air pollution due to human actions. It should be mentioned that the responsibility due to air pollution exists in civil and criminal regulations and laws. However, it seems that due to the importance of this issue, the guarantee of enforcement in the laws is not enough, and new regulations should be established regarding liability cases in the civil field and punishments in the criminal field.

In the field of air pollution, which is one of the main causes of damage to the environment, there are many provisions in Iran's laws and regulations. This provision exists both in the main laws such as the Constitution and in other criminal and civil laws, but more than the existence of laws, the possibility of implementation and the manner of implementation of these laws are important. From the civil point of view, the area of responsibility for the factors that cause air pollution is possible through the general rules of civil liability, such as the existence of damage and the relationship of causation, it is possible to file a lawsuit and claim damages. First, in many cases in this field, it is difficult and sometimes impossible to prove the three cases of civil responsibility. In the criminal field, there are also laws related to air pollution punishing by imprisonment and closing the polluting center or preventing the traffic of polluting vehicles. In addition, some punishments such as fines can be combined with other punishments to have a better effect. In addition to the mentioned cases, it can help a lot due to the intertwining of the law and ethics of culture in the field of this issue.

To-date, no studies have assessed phenotypes of frail in the elderly people living in Tehran and their relationships with nutritional status. The aim of this study was to investigate prevalence of frailty and its relationships with malnutrition in elderly people living in Tehran, 2021–2022.

In this cross-sectional study, 508 elderly people over 60 years old living in Tehran were selected using systematic random cluster sampling method. General information were collected using general questionnaires, physical function using two-part questionnaire of activities of daily living and daily activity with the help of instrumental activities of daily living tool validated for the elderly and quality of life using valid 12-item SF12 questionnaires. The 12-item questionnaires on quality of life; validity and reliability of which were verified in the Iranian society was applied. Frailty was carried out using Fried et al. 5-indices, including 1) slow walking, 2) muscle weakness, 3) fatigue, 4) low physical activity, and 5) unintentional weight loss. Muscle strength was assessed using hand grip dynamometer. Malnutrition assessment was carried out using standard 2-part MNA (mini nutritional assessment) questionnaire. Anthropometric measurements (height and weight) were carried out using standard methods and body mass index was calculated.

The mean and standard deviation of the age of the elderly people were 71.09 y ±6.88 years. The number of men and women participating in the study was almost equal (50.6% men and 49.4% women). In total, 51.4% of the participants were pre-frail and 23% were frail. More than half of the participants had low muscle strength (54.3%). After adjusting effects of confounders in comparison with healthy individuals, the probability of frailty in people at risk of malnutrition (95% CI: 1.63–5.67; OR = 3.04) and the probability of pre-frailty in the two groups of at risk of malnutrition (95% CI: 5–11/21–04; OR = 10.37) and malnutrition (95% CI: 5.31–5.31; OR = 7.18) were significantly higher (p < 0.05).

In this study, nutritional status was strongly associated to frailty. Identifying nutritional problems associated with muscle weakness and malnutrition can be used in health and nutrition planning of this age group.

The critical step of policymaking and planning for the local governments to select appropriate waste management methods, is comprehensive information on solid waste generation. Waste generation rate and composition may vary from year to year because many factors influence it. This research identified the most important factors influencing the future of household waste generation and composition in Tehran, and how these factors affect each other.

This research is based on future studies methods which are carried out using a combination of quantitative and qualitative models. Due to the nature of this research, structural analysis, Micmac software and Delphi survey were used.

In this regard, after holding many meetings with 22 of the experts as the statistical population of the research, 14 effective factors were identified. The influential factors were then analyzed in the framework of the Cross-impact matrix in the Micmac software. The results showed that what can be understood from the state of the dispersion page of the variables indicated the system instability, with most of the variables dispersed around the diagonal axis of the screen.

Finally, considering the high scores received by direct and indirect influences, 10 key factors were identified. “Economic Growth”, “Digital Transformation and Technological Advances”, “Amendment of Existing laws, Enactment and Implementation of New and Specialized Laws”, and “Increased Awareness about waste and Attraction of Citizen Participation through Education and Provision of Information” were identified among these 10 factors as the driving forces influencing generation and composition, of household waste in Tehran in the Next Twenty Years.

COVID-19 pandemic caused a lot of severe problems in the world. This study investigated the epidemiology of the disease in Tehran in the first quarter of the epidemic's beginning.

The available information recorded for patients from 20 February 2020 to 20 May 2020 in Tehran was used. To prepare disease-related distribution maps, the addresses of patients' residences in Google Earth were called to ARC-GIS version 10-4. The methods used in GIS include IDW, Hotspot and also software development.

Overall, 3699 individuals whose PCR results were positive in Tehran were included in the study. Out of the total number of them, 550 people died and the fatality rate of the disease in hospitalized patients was 14.9%. One thousand five hundred thirty patients (41.4%) have recovered, and the remaining 1619 patients were under treatment until data collection. Of the total, 1479 confirmed cases were women (40%). The average age was 57.4 years (SD=16.5). The density of cases in areas 4, 8 and 13, and the existence of some cluster diseases in neighborhoods such as Tehran Pars, Ayat and Pirouzi streets are noteworthy points.

The trend of the COVID-19 epidemic is dire and requires long-term measures. Nevertheless, to control this disease, the health system, the policy of isolating patients and suspicious people, wear masks especially in densely populated areas, are the most important controlling factors.

The purpose of this research is to study theopportunities and limitations of the globalization of Tehran metropolis. According to experts, globalization is not a choice, but a wave that has started in all fields and fields and is moving fast, and countries are not able to deal with it or stop it, and the only solution is to consciously and actively join this wave. The metropolis of Tehran, as the capital of Iran and the most populous city in the country, has the capacity and, at the same time, many limitations among other cities in the country for globalization. This transformation or transition to globalization requires conditions, platforms, opportunities, threats, expertise and huge scientific, financial and social cultural resources.

The method of this research is foundational data theory. The data required for this research is the result of a semi-structured interview with 14 knowledgeable and experienced experts in urban management. The method of selecting the participants is targeted and accessible and determining their number upon reaching the saturation stage has been specified.

Based on the results of the research, the central phenomenon of "Crisis management" was chosen as the central phenomenon. One of the causes of this phenomenon is managerial incoherence and decentralized decision-making.

The research results show that crisis management has led to managerial-situational regressions.