فهرست مطالب

Public Health - Volume:51 Issue: 4, Apr 2022
  • Volume:51 Issue: 4, Apr 2022
  • تاریخ انتشار: 1401/02/15
  • تعداد عناوین: 30
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  • Esmaeil Sadri Damirchi, Afrasyab Kheirdast, Andrej M Grjibovski, Eslamali Khodabandehlou, Saeed Pireinaladin Pages 669-678
    Background

    We aimed to compare the performance of Tehran firefighting stations in the incidents of suicide attempt and threats among Tehran citizens using international standards.

    Methods

      A research method was a descriptive-analytical study based on library studies. The data were analyzed by descriptive and inferential methods such as single group t-test and independent t-test. The statistical population of this study included all citizens in 22 districts of Tehran City that committed or threated to commit suicide in the 2018 year. They were selected in a targeted manner. All data were extracted and analyzed through the fire department in the first half of 2018 in the action and threat of suicide.

    Results

    Men commit suicide more than women do. Moreover, the average time of exit from station and the average travel time are shorter than Iranian and world standards. The people saved by firefighters outnumber the people who died in suicide, which indicates the satisfactory performance of firefighters in relief and rescue operations. In suicide operations, according to the general results obtained from statistical calculations of departure time from the station and the average travel time, which are the two main factors in evaluating the performance of firefighters in suicide accidents, which in comparison with international standards. It was significantly lower and the performance of firefighters was positive.

    Conclusion

    The average duration of exit from station and the average travel time, are significantly lower than international standards, which demonstrates the good performance of firefighters.

    Keywords: Suicide, Rescue, relief, Firefighter, Iran
  • Ai-Phuong Hoang-Thi, Anh-Thu Dang-Thi, Sang Phan-Van, Thong Nguyen-Ba, Phuong Lan Truong-Thi, Tam Le Minh, Quoc-Huy Nguyen Vu, Tung Nguyen-Thanh Pages 710-723
    Background

    Global warming, lifestyle, or working in a high temperature environment leads to have increased health risk factors. This meta-analysis was conducted to determine the impact of high ambient temperature on male reproductive function.

    Methods

    Scientific articles were screened in the database including MEDLINE, EMBASE, National center for biotechnology information (NCBI) or Web of Science with relating keywords. Impact data of high ambient temperature on semen parameters were extracted and analyzed by STATA software according to the Random Effects Model. The high ambient temperature exposure group and Non-exposure group were compared using the standard mean difference (SMD). Publications were evaluated for publication bias by Egger test.

    Results

    Nine articles were finally selected from databases examining the effect of high ambient temperature on male reproductive health of 356 men from Iran, Italy, Thailand, China, Egypt. High ambient temperature showed a significant decrease in the seminal parameters, semen volume during each ejaculation (SMD = -0.74; 95% CI -1.11, -0.36), sperm concentration (SMD = -1.07; 95% CI -1.42, -0.72), total sperm count (SMD = -1.52; 95% CI -2.96, -0.08), sperm motility (SMD = -1.93; 95% CI -2.83, -1.04), sperm progressive motility (SMD = -1.65; 95% CI -2.39, -0.91) and normal morphology (SMD = -2.41; 95% CI -3.30, -1.52).

    Conclusion

    High ambient temperature negatively affects sperm quality, including decreased semen volume, sperm count, sperm concentration, motility and normal morphology. This might lead to protective strategies to avoid the adverse effects of high ambient temperature on male fertility.

    Keywords: Meta-analysis, Global warming, Temperature, Heat stress, Semen, Spermatogenesis
  • Dehui Kong, Jingjing Fu, Yan Hong, Siqi Liu, Yu Luo Pages 724-732

    As a result of improvements in life expectancy and reductions in fertility rate, the increasing world population ageing brings huge challenges for both developed and developing countries. Such factors as fewer children, migration of children and widowhood further increase the number of older people living alone. Older adults prefer age in place, which means care in the home. As the main place older people live in, care in community absolutely needs more attention. Optimizing health services for the elderly living in community is of positive significance to health promotion and happiness enhancement. But the traditional health service for the elderly has drawbacks of poor timeliness and high labor cost. The rapid development of modern science and technology make it possible to apply mHealth in health service for the elderly. At present, mHealth is relatively mature in the communities of developed countries. This article presents the application of mHealth in many developed countries, as references for developing countries.

    Keywords: Older people, mHealth, Live alone, Community
  • Emine Ergin, Belgin Akın, Deniz Kocoglu-Tanyer Pages 733-745
    Background

    One of the best ways to maintain and develop physical and psychosocial health is to make regular home visits. This meta-analysis aimed to determine (by subgroups) the effects of interventions based on nurses’ home visits on physical and psychological health outcomes of older people.

    Methods

     This search was carried out using the The CINAHL, Cochrane, MEDLINE, PubMed, Science Direct, Web of Science, and Turkish databases. Experimental and observational studies were included.

    Results

    The meta-analysis included 26 (with subgroups 50) out of 13110 studies. The minimum and maximum values of the effect size (Hedges g) were g = -0.708 and g = 0.525, respectively. The average effect size was g = 0.084 (SD = 0.21).

    Conclusion

    Home visit interventions are effective in reducing the frequency of hospitalization in the older adults, and improving physical and psychosocial health. They are negatively effective on falls and have no significant effect on the quality of life.

    Keywords: Older adults, Home visit, Systematic review, Meta-analysis, Health
  • Jinhang Zhang, Jing Yang Pages 746-757
    Background

    Intake of allium vegetables may modify the risk of breast cancer. The aim of this study was to examine the association between allium vegetables intake and breast cancer risk via a meta-analysis.

    Methods

    PubMed, Web of Knowledge, Scopus and Chinese National Knowledge Infrastructure (CNKI) were electronically searched up to June 2021 to identify relevant studies. We used random-effect models to calculate pooled risk estimates and their 95% confidence intervals (CIs) for risk of breast cancer with allium vegetables intake.

    Results

    A total of 17 studies were included in this meta-analysis on the association of total allium vegetables, garlic and onion intake with breast cancer risk. The combined risk estimate of breast cancer for the highest vs lowest category of total allium vegetables, garlic and onion intake was 0.70 (95% CI: 0.49-0.91, P < 0.001), 0.77 (95% CI: 0.61-0.93, P = 0.016) and 0.75 (95% CI: 0.53-0.98, P < 0.001), respectively. A significant heterogeneity was found among studies for all three pooled analyses.

    Conclusion

    High intake of allium vegetables may be protective against the development of breast cancer. Further well-designed prospective studies are needed to confirm the results.

    Keywords: Allium vegetables, Breast cancer, Garlic, Meta-analysis, Onion
  • Reza Ramazani, Abbaas Ostadtaghizadeh, Arezoo Yari, AhmadAli Hanafi-Bojd, Ahmad Soltani, Shah Bakhti Rostami, Ahad Heydari Pages 758-769
    Background

    We aimed to identify the indicators and criteria to locate temporary shelters for conflict refugees.

    Methods

    This systematic review evaluated the full-text of the related articles in international electronic databases, such as Web of Science, Scopus, PubMed, Cochran, and Google Scholar from the beginning and without time limit to 1 June 2019. In addition, this search was based on a strategy developed by the researchers. The studies were selected regardless of their methods and two data extraction forms were used to extract the most relevant and important information.

    Results

    Among 10124 cases of primary documents, 38 articles were selected, and 25 articles were analyzed in full-text. Totally, 45 indicators were identified and classified into two main categories of physical and non-physical indicators with six subcategories of land ownership, host government, access to infrastructures, site safety, land characteristics, and economic, social, and cultural considerations.

    Conclusion

    The selection of temporary shelters for the conflict refugees requires the identification of all the specific influential factors not properly addressed. The final indicators obtained in our review could be incorporated into the development of the models required in this regard.

    Keywords: Conflict, Locating, Refugees, Temporary shelters
  • Le Wang, Mi Chen, Min Liang, Qin Liu, Hua Yao Pages 770-778
    Background

    We aimed to investigate the demographic situation relating to people with hearing loss in Xinjiang, the largest province in China. The situation may vary between regions and races.

    Methods

    We conducted a population-based demographic study. We analyzed data obtained from 3931 people with hearing impairments (i.e., from the Han or Uyghur ethnic groups) including children and adults. We accounted for the survey design and sampling size in order to ensure that estimates were regionally representative. Basic characteristics were determined, and an ethnic distribution analysis was conducted based on age group, level of educational, marital status, and level of disability.

    Results

    Of the 3931 participants, 2228 (56.68%) were male and 1703 (43.32%) were female. The mean age of the participants was 46.02 (±19.46) years. Most of the participants (26.20%) were in the 45–59 yr age group. Illiterate people constituted the largest group (34.19%) in the Uyghur population, while a substantial proportion of participants of Han nationality had obtained a junior education (28.98%). The number of unmarried people in both ethnic groups accounted for the highest proportion (more than 70%). Grade 3 was the highest grade observed in the Uyghur population (32.35%), while Grade 1 hearing impairments were the most prevalent in the Han population (28.28%).

    Conclusion

    The difference in basic characteristics between participants of Uyghur and Han ethnicity revealed that different provinces should set different prevention and control targets. Different policy measures should be taken to allocate medical resources and provide rehabilitation services to assist people with hearing impairments in Xinjiang, China.

    Keywords: Demographics, Hearing impairment, Ethnic, Xinjiang, China
  • Moawiah Khatatbeh, Waleed Momani, Zaid Altaany, Reem Al Saad, Abdul Rahman Al Bourah, Omar Melhem, Omar AL Omari Pages 779-787
    Background

    Consumption of fast food is pervasive among young adults. This research aimed to assess the impact of consuming fast foods on total cholesterol level among university students in Northern Jordan.

    Methods

    Using a cross-sectional design, a blood sample to investigate cholesterol level was drawn from a sample of university students in Northern Jordan. Besides, students’ dietary habits and anthropometric measurements were obtained.

    Results

    Out of 201 participants, 57% (n=115) were male and 43% (n=86) were female. More than three quarters of the sample ate shawarma (Mediterranean fast food) at least once per week. About 44% of the study subjects had increased BMI and about 37% had increased serum cholesterol level. Participants’ gender, age, marital status, physical activity, BMI, living status, and daily pocket money significantly correlated with cholesterol level (P<0.05). In the regression analysis, eating fast foods and increased BMI were strong predictors of high cholesterol level. Students who ate shawarma more than 3 times a week had more than 8 folds to have hypercholesterolemia (OR=8.4; CI: 2.62-26.72), and obese students were more than 14 folds at higher risk to have hypercholesterolemia compared to those with normal BMI (OR=14.2; CI: 4.80-42.29). In addition, male students had doubled odds for having abnormal cholesterol level compared to females (OR=2.1; CI: 1.10-4.44).

    Conclusion

    Fast food consumption among university students in Jordan was significantly associated with increased total cholesterol level. Encouraging healthy diet and lifestyle are the basis for prevention of dyslipidemia.

    Keywords: Fast foods, Jordan, Mediterranean, Students
  • Feng Wei, Qin Li Pages 788-796
    Background

    Patients with leukemia easily develop negative emotions, such as anxiety and depression, during their treatment. To improve the available mental intervention measures for patients with tumors, we explored the influences of mental nursing based on Rosenthal effect on the post-traumatic growth, negative emotions, and coping style of patients after undergoing chemotherapy for leukemia.

    Methods

    A total of 90 patients who underwent chemotherapy for leukemia in The First Affiliated Hospital of Suzhou University from January 2019 to December 2020 were selected. They were randomly divided into the control group (n=45) and observation group (n=45). Patients in the observation group received mental nursing based on Rosenthal effect. The post-traumatic growth, negative emotions, and coping styles of these two groups were assessed using the Post-Traumatic Growth Inventory (PTGI), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Medical Coping Modes Questionnaire (MCMQ).

    Results

    After the intervention, patients in the observation group show higher scores in the dimensions of reflections on life, individual power, new possibilities, and self-transformation in PTGI, and their total scores are overall higher than those of the control group. The observation group also receive lower scores in SAS and SDS compared with the control group. While the observation group also receive significantly higher scores in some dimensions in MCMQ compared with the control group, the former received significantly lower scores in retreating and succumbing.

    Conclusion

    Mental nursing based on Rosenthal effect can positively promote the physical and psychological health of patients after receiving chemotherapy for leukemia.

    Keywords: Leukemia, Post-traumatic growth, Negative emotions, Coping style, Rosenthal effect, Mental in-tervention
  • Siwipa Pruitikanee, Jinda Kongcharoen, Supattra Puttinaovarat, Thotsaphon Yaifai, Sasikorn Chaitada Pages 797-807
    Background

    Cerebrovascular diseases or stroke tend to cause high mortality in Thailand. An essential responsibility of a hospital is the development of medical care to support the safety of patients. For this purpose, a smartphone application was developed for the risk assessment and emergency system for stroke treatment in a hospital in Thailand.

    Methods

    The proposed application involved the risk assessment related to the occurrence of stroke evaluated by the health status and face image using analytical geometry and face detection technology. The social network Application Programming Interface (API), LINE Notify API, and Global Positioning System (GPS) were used to inform the Stroke team in the Suratthani hospital about emergency cases, followed their requirement in 2020.

    Results

    From the testing, the facial angulation classification, calculated using a support vector machine (SVM), had 92.38% accuracy. The system also provided an emergency call and text messaging that includes patient’s current location and personal information to the stroke team directly, which gave an opportunity for the patient to receive treatment quickly.

    Conclusion

    The emergency system can help quickly perform the risk assessment of stroke. Our proposed system provides automated management.

    Keywords: Stroke, Support vector machine, Face detection, Application, Screening
  • Zhihui Xia, Youping Tan, Cui Ru Pages 808-813
    Background

    To study the application effect of doctor-nurse collaborative and hierarchical management combined with nursing risk management in nursing management of patients with postpartum hemorrhage.

    Methods

    Overall 200 patients with postpartum hemorrhage treated in Guangdong Second Provincial General Hospital (Guangzhou, China) from Mar 2018 to Mar 2019 were divided into the experimental group and the control group. The experimental group received the nursing model of doctor-nurse collaborative and hierarchical management combined with nursing risk management while the control group received nursing risk management to compare the satisfaction, medical record quality before and after nursing, incidence of nursing risk events and treatment effect between the two groups.

    Results

    After nursing management, the bleeding volume in the experimental group was significantly less than that in the control group (P<0.05). The quality score of nursing records in the experimental group was higher than that in the control group (P<0.01). The occurrence of nursing risk events in the experimental group was significantly less than that in the control group (P<0.05). The overall nursing satisfaction of the experimental group was higher than that of the control group (P<0.01). The treatment effect of the experimental group was significantly better than that of the control group (P<0.01).

    Conclusion

    Doctor-nurse collaborative and hierarchical management combined with nursing risk management had a significant effect in the nursing management of patients with postpartum hemorrhage, which is worthy of promotion and application.

    Keywords: Doctor-nurse collaboration, Hierarchical management, Nursing risk management, Postpartum
  • Xiaosu Ni, Xiao-Wen Rui, Jing Wu, Wenwen Zhao, Suyun Jiang, Rongjie Wang, Lichun Wang Pages 814-820
    Background

    To probe into the influence of evidence-based nursing (EBN) on clinical recovery and prognosis of patients with arrhythmia after acute myocardial infarction (AMI).

    Methods

    Totally, 240 AMI patients with arrhythmia treated in Taizhou People's Hospital(Jiangsu, China) from July 2019 to December 2020 were collected and randomly divided into the study group (n = 120) and control group (n = 120). The control group was received routine nursing, while the study group carried out EBN. The following indicators were evaluated and compared between the two groups: length of hospital stay, symptom disappearance time, cardiac function, psychological status, and incidence of adverse events after 6 months of follow-up were.

    Results

    Compared to the control group, the length of hospital stay, symptom disappearance time, LVEF (left ventricular ejection fraction), LVEDD (left ventricular end-diastolic diameter), SAS (self-rating anxiety scale) score and SDS (self-rating depression scale) score in the study group were significant improves (P < 0.05), and the incidence of adverse events after 6-month follow-up in the study group was also significantly lower than that in the control group (P < 0.05).

    Conclusion

    EBN intervention for AMI patients with arrhythmia can significantly improve the length of hospital stay and symptom disappearance time, adjust cardiac function and psychological status, and reduce the incidence of adverse events.

    Keywords: Evidence-based nursing, Acute myocardial infarction, Arrhythmia, Prognosis, Clinical effect
  • Gulbarshyn Mukasheva, Madina Abenova, Askhat Shaltynov, Oxana Tsigengage, Zhanna Mussabekova, Tolkyn Bulegenov, Gulnara Shalgumbaeva, Yuliya Semenova Pages 821-830
    Background

    We aimed to evaluate the impact of national health programs implemented in Kazakhstan from 2011 on CVD incidence and mortality.

    Methods

    Incidence and mortality rates from CVD were studied in Kazakhstan from 2004 to 2017. The official data obtained from “Medinform” company were analyzed based on the annual population statistics.

    Results

    There was an increase in the incidence of cardiovascular disease among the population of Kazakhstan from 1845.4 per 100,000 in 2004 to 2597.5 per 100,000 in 2017. This might be attributed to the implementation of the national health programs, which improved early CVD identification. Incidence of ischemic heart disease (IHD) was grown almost in all provinces of Kazakhstan during the study period. The mortality from cardiovascular disease had a considerable decline over the study period, in particular after 2010, it might be influenced by early diagnosis and provision of timely treatment.

    Conclusion

    The experience of Kazakhstan national health programs shows improved identification of CVD and IHD and timely treatment for cardiovascular disease. A significant variation in incidence and mortality rates of cardiovascular disease was observed between the country provinces.

    Keywords: Incidence, Mortality, Republic of Kazakhstan, Cardiovascular disease, Ischemic heart disease
  • Lijuan Guo, Xiaorong Yin, Xiaoqi Zeng, Lu Tang, Dengsuo Zhang Pages 831-838
    Background

    To explore the application of nursing practice combined with scene simulation teaching mode in standardized training and teaching for newly recruited nurses in Post Anesthesia Care Unit (PACU) and its impact on their emergency response ability and competence.

    Methods

    From Jan 2019 to Jan 2020, a total of 120 PACU nurses with professional qualification certificates in West China Hospital Sichuan University, Chengdu, China were enrolled and randomized into group A (n=60) and group B (n=60). Conventional standardized PACU training and teaching was applied in group B, and nursing practice combined with scene simulation teaching mode was applied in group A. After training for 12 weeks, the examination scores, competence and emergency response ability in the two groups were compared.

    Results

    After training, the scores of theoretical examination, comprehensive scene simulation and nursing document in group A were conspicuously higher than those in group B (P<0.001). After training, the competence and emergency response ability in group A were significantly higher than those in group B (P<0.001).

    Conclusion

    With a better training effect, nursing practice combined with scene simulation teaching mode can enhance the emergency response ability and competence for nurses in PACU, which should be promoted in practice.

    Keywords: Nursing practice, Scene simulation teaching mode, Post anesthesia care unit (PACU)
  • Dariush D. Farhud, Marjan Zarif-Yeganeh, Atefeh Mehrabi, Ali-Reza Afshari, MohammadBagher Rokni, Keyvan Majidi, Maryam Jalali, AliAkbar Amir Zargar, Abdolfattah Sarafnejad, Hamid Reza Sadeghipour, Shaghayegh Zokaei, Farideh Khosravi, Mahmoud Jalali, Mohammad Khazeni Pages 839-850
    Background

    Calcium is a necessary mineral for life to keep the body and bones healthy. Various factors including hormones, diet, age, and gender affect serum calcium status. The aim of this sturdy was to assess the serum calcium level (SCL) of Tehran population, which has about 10 million multi-Ethnic populations and represents from the whole country.

    Methods

    In this retrospective study, the measured SCL of 105,128 individuals referred to different laboratories of Tehran, Iran were evaluated and its relationship with the age, gender, seasons, and different years during 2009-2018, were analyzed.

    Results

    After excluding outliers, 91,257samples remained, which 61162 (58.64%) and 30,095 (41.36%) were female and male, respectively.  The mean SCL was 9.36 (9.35, 9.37) mg/dl (95%CI). The highest and lowest SCLs were 3.1 and 18.2mg/dl, respectively. From the total study population, 74127 (81.23%) had normal SCLs, 14110 (15.46%) had hypocalcemia, and 3020 (3.31%) had hypercalcemia. SCLs were normal in 83.6% of men and 79.66% of women. Women had a significantly higher frequency of hypocalcemia compared to men (17.2% vs. 12.83%, p<0.0001).

    Conclusion

    Normal and abnormal SCLs were significantly different in age groups and in both genders. It means that gender and age affect SCLs. Every year of increasing age, reduces the chance of hypercalcemia by 40%, significantly. Age seems to affect hypercalcemia more than hypocalcemia. Age in men increases the risk of hypocalcemia, and reduces the risk of hypocalcemia in women. Therefore, it is recommended to encourage dietary calcium intake among premenopausal women and older men.

    Keywords: Calcium, Hypocalcemia, Hypercalcemia, Iran
  • Minoo Heidari Almasi, Maryam Barzin, Sara Serahati, Majid Valizadeh, Amirabbas Momenan, Feridoun Azizi, Farhad Hosseinpanah Pages 851-859
    Background

    We aimed at evaluating the best body mass index (BMI) and percent body fat (PBF) cutoffs related to cardio-metabolic risk factors and comparing the discriminative power of PBF and BMI for predicting these risk factors.

    Methods

    In this cross-sectional study in phase V (2012-2015), 1271 participants (age ≥ 20 yr; 54.3% women) were enrolled. Bioelectrical impedance analysis (BIA) was used to estimate PBF. Joint Interim Statement criteria were used for defining metabolic syndrome (MetS). We compared PBF with BMI through logistic regression and area under the curve of the receiver operating characteristic (ROC) curve. Percent body fat cutoff points were > 25 in men and >35 in women.

    Results

    Percent body fat and BMI cutoff points for predicting MetS were 25.6% and 27.2 kg/m2 in men and 36.2% and 27.5 kg/m2 in women, respectively. There were no significant differences between BMI and PBF area under the ROC curves for predicting MetS and its components, except for abdominal obesity in men and low high-density lipoprotein (HDL) in women in favor of BMI. Logistic regression analysis indicated that BMI in women was better for predicting MetS and its components, except for abdominal obesity. Moreover, BMI was equal or superior to PBF in men, except for low HDL and high triglyceride levels.

    Conclusion

    Comparison of PBF with BMI showed that the use of PBF is not significantly better than BMI in predicting cardio-metabolic risks in the general population.

    Keywords: Body composition, Bioelectrical impedance analysis (BIA), Cardio-metabolic risk factor
  • Hamide Rahmani Seraji, MohmmadEsmaeil Akbari, Hamid Rezvani, Davood Bashash, Maryam Mabani, Atieh Akbari, Alireza Raeisi, Ghasem Janbabee, Sina Salari Pages 860-870
    Background

    The heterogeneity, high rate of mortality and lack of comprehensive diagnostic methods have categorized primary sarcomas of the thorax as a malignancy with dismal outcomes and unknown etiology. Given the fundamental role of epidemiological analysis in establishing management strategies, we designed a study with focus on the epidemiological characteristics of primary thoracic sarcomas in Iran. 

    Methods

    This national population-based cancer study was conducted on patients with histologically confirmed sarcoma of the thorax referred to the Iranian National Cancer Registry between 2009 and 2014. The incidence was calculated as number of cases per 100,000 person-years and was age-adjusted by the direct method using the weight of the 1960 world standard population. 

    Results

    Over a 6-year period, 1477 cases with pathologically confirmed thoracic sarcomas were registered in Iran, of which 896 were male and 581 were female. Khuzestan Province had the highest incidence of thoracic sarcomas as compared to other provinces. Malignant mesothelioma was the most common histological subtype (20.85%). Moreover, the age-standardized incidence rate (ASR) of the disease was 1.94 per 100,000 which was more common in males than females with the highest incidence rate in men aged more than 65 years.

    Conclusion

    Our study provided valuable epidemiologic data on characteristics of thoracic sarcomas. This data can be used for strategizing preventive measures.

    Keywords: Sarcoma, Thorax, Mesothelioma, Incidence, Iran
  • Bahman Pourhassan, Farideh Golbabaei, Somayeh Farhang Dehghan, MohammadReza Pourmand, Tahereh Mousavi, Ensieh Masoorian Pages 871-879
    Background

    We aimed to investigate the efficiency of neat polyacrylonitrile (PAN) nanofibers and photocatalytic PAN/TiO2 nanofibers for removal of airborne microorganisms.

    Methods

    Nanofibers were fabricated from 16 wt% of PAN dissolved in dimethyl formamide through the electrospinning technique. The efficiency of media for removal of Staphylococcus epidermidis and Bacillus subtilis was investigated at different conditions such as face velocity, relative humidity, air temperature and UVC radiation intensity. as face velocity (0.1 and 0.3 m/s), relative humidity (35±5% and 60±5%), air temperature (22±3 °C and 30±3 °C) and the UVC radiation intensity (dark, 1±0.09 mW/cm2 and 1.8±0.07 mW/cm2) using air sampling from upstream and downstream of media by cascade impactor containing blood agar culture medium.

    Results

    The mean diameter of electrospun fibers and coefficient of variation were 194 nm and 15%, respectively. The amount of immobilized TiO2 on the filter was 620±6.56 mg/m2. Photocatalytic nanofiber filter media presented the best performance for removal of airborne B. subtilis at 60±5% relative humidity, 0.1 m/s face velocity, air temperature 22 °C, and 1.8 ± 0.07 mW/cm2 UVC radiation.

    Conclusion

    The filtration efficiency of photocatalytic media was significantly higher than neat ones. Lower efficiency of media was found in the higher air velocity for all bioaerosols. High UVC radiation intensity increased filtration efficiency. Moreover, the increase in air temperature and relative humidity (except for TiO2-coated media under UVC radiation) did not significantly affect the filtration efficiency of all media.

    Keywords: Nanofiber, Electrospinning, Air filtration, Airborne microorganism, Photocatalytic
  • Majid Mesgartehrani, Mahin Kakolarimi, Dariush D Farhud, Maryam Shabany, Zainab Mesgartehrani, Dariush Norozian, Mohammad Mesgartehrani Pages 880-885
    Background

    Workplace problems can lead to psychosomatic complaints. We aimed to assess the relationship between general health and occurrence of musculoskeletal disorders along with psychosomatic complaints.

    Methods

    This was a cross-sectional study.  This research was conducted about the nurses who worked at the hospitals located in the northwest of Tehran, Iran (Valiasr, Farhikhtegan, and Khatam), and participated in this study from Aug 2019 to Feb 2020. The data were collected by the demographic and clinical information questionnaire. Goldberg's general health questionnaire and psychosomatic complaint scale were completed by nurses.

    Results

    In total, 158 nurses participated in this study. There was a significant relationship between the score of the general health questionnaire (GHQ) and psychosomatic complaints in three categories (low, moderate, and high) (P≤0.0001). There was a significant relationship between the mean score of GHQ and musculoskeletal discomfort in the neck, shoulder, forearm, hand and wrist, upper/lower back, knee, and ankle (P≤0.0001).

    Conclusion

    Continuity of psychosomatic complaints may be a risk factor for mental health in nurses and may affect the quality of care. Hence, health policymakers and hospital managers should consider it in service training for nurses.

    Keywords: Psychosomatic, Health, Nurses
  • Amin Doosti-Irani, Saiedeh Haji-Maghsoudi, Aliakbar Haghdoost, Sana Eybpoosh, Ehsan Mostafavi, Manoochehr Karami, Hossein Mahjub Pages 886-894
    Background

    We aimed to determine the generation time, the best model for estimating reproduction number (R), and to estimate the basic reproduction number (R0) and effective reproduction number (Rt) for COVID-19 in Iran.

    Methods

    We used the daily incidence cases of COVID-19, hospitalized due to a probable diagnosis of COVID-19 from 19 February 2020 to 17 November 2020 in Iran. Four models, including maximum likelihood (ML), exponential growth (EG), time-dependent (TD), sequential Bayesian (SB) were evaluated. The weekly reproduction number with a 95% confidence interval (CI) was calculated.

    Results

    TD model shows the best fit compared to other models for estimating reproduction number in Iran. The R0 in Iran in the first week of the epidemic, leading up to 21 February 2020 was 7.19, 95% CI: 5.56, 9.00.  The lowest value for the Rt was equal to 0.77 between 3 to 10 March 2020 and 4 to 11 December 2020. From 11 June 2020 up to13 August 2020, the Rt was more than one but after then to 24 September 2021 was less than one.

    Conclusion

    TD model was the best fit for estimating the R in Iran. The worst situation of the epidemic in Iran was related to the weeks leading up to 26 February 2020 and 28 October 2020, and better status was related to the weeks leading up to 10 March 2020 and 11 December 2020.

    Keywords: COVID-19, Basic reproduction number, Effective reproduction number, Iran
  • Navideh Nikmohammadi, Parvin Sarbakhsh, Mozgan Moazami Goudarzi, Mehdi Talebi, Majid Farshdousti-Hagh, Jamileh Malakouti, Neda Gilani Pages 895-903
    Background

    B-cell lymphoma 2 (BCL-2) and BCL-2 associated X (BAX) polymorphisms are important in the apoptosis process, response to treatment and survival in Acute Lymphoblastic Leukemia (ALL) patients. We aimed to investigate the effect of these genes with other predictors corresponding to the survival of ALL patients with an appropriate frailty survival model.

    Methods

    Our study was performed in 2020 on sixty-two cases of childhood aged 3-16 (year) with ALL disease who were selected by convenience sampling from the two hospitals of Tabriz, Iran. RFLPPCR method was used for genotyping the promoter region of the BAX and BCL-2 genes. We used different frailty survival models, to control heterogeneity between individuals due to unmeasured factors affecting their survival. All analyses were implemented using Stata 16.

    Results

     Based on the result of log-logistic model along with frailty gamma, the proportional odds (standard error) of survival for a CC allele of BCL-2 patient compared to a AA allele patient were 6.0 (1.47); P<0.001 and for a AC of BCL-2 allele patient were 0.57 (1.23); P=0.009. Patients with AG allele of BAX had 2.05 (1.26) times greater odds of surviving than a AA allele patient (P=0.003). The odds of survival of patients with abnormal white blood cell (WBC) were 92% less than normal WBC (P<0.001).

    Conclusion

    With controlling unmeasured factors affecting, the BCL-2 and BAX genes promoter polymorphism are effective in the survival rates for ALL.

    Keywords: Acute lymphoblastic leukemia, B-Cell Lymphoma 2, BCL2-Associated X, Frailty models, Survival
  • Javad Nazari, Parnia-Sadat Fathi, Nahid Sharahi, Majid Taheri, Payam Amini, Amir Almasi-Hashiani Pages 904-912
    Background

    Measles is a feverish condition labeled among the most infectious viral illnesses in the globe. Despite the presence of a secure, accessible, affordable and efficient vaccine, measles continues to be a worldwide concern.

    Methods

    This epidemiologic study used machine learning and time series methods to assess factors that placed people at a higher risk of measles. The study contained the measles incidence in Markazi Province, the center of Iran, from Apr 1997 to Feb 2020. In addition to machine learning, zero-inflated negative binomial regression for time series was utilized to assess development of measles over time.

    Results

    The incidence of measles was 14.5% over the recent 24 years and a constant trend of almost zero cases were observed from 2002 to 2020. The order of independent variable importance were recent years, age, vaccination, rhinorrhea, male sex, contact with measles patients, cough, conjunctivitis, ethnic, and fever. Only 7 new cases were forecasted for the next two years. Bagging and random forest were the most accurate classification methods.

    Conclusion

    Even if the numbers of new cases were almost zero during recent years, age and contact were responsible for non-occurrence of measles. October and May are prone to have new cases for 2021 and 2022.

    Keywords: Measles, Machine learning, Time series, Infection
  • Tahereh Alikhani, Roshanak Daie Ghazvini, Mehdi Mirzaii, Seyed Jamal Hashemi, Mozhgan Fazli, Zahra Rafat, Davoud Roostaei, Pegah Ardi, Hasti Kamali Sarvestani, Mahdi Zareei Pages 913-918
    Background

    Candida species are normal vaginal flora in healthy women, which can cause vulvovaginal candidiasis (VVC). The formation of biofilm is a cause of drug resistance in Candida species of vaginal origin. We aimed to specify Candida species cause VVC, detect their biofilm-forming ability, and antifungal susceptibility pattern.

    Methods

    Overall 150 vaginal samples were collected from suspected cases of referring to Bahar Hospital of Shahroud, Iran between Jan 2018 and Jan 2019. Samples were cultured on Sabouraud dextrose agar (SDA), Chrome gar Candida and Corn meal agar (CMA). PCR-RFLP was performed to confirm the identification. Biofilm formation of the identified species was measured by the Crystal Violet method. The susceptibility to fluconazole, clotrimazole, and miconazole was determined based on the CLSI document M27-A3.

    Results

    Of 50 women (33.3%) were suffering from VVC. C.albicans was the predominant species isolated in this study (n=39, 78%) followed by C. glabratia (n=11, 22%). In addition, in 25 (50%) of positive samples, biofilm formation was determined. The mean MIC of fluconazole and clotrimazole for C. albicans was 5.02 μg /mL and 3.92 μg /mL, respectively. Furthermore, the mean MIC related to these drugs for C. glabrata was 12.45 μg / mL and 4.1μg / mL, respectively. The mean diameter of miconazole inhibition zone for C. albicans and C. glabra isolates was 25.13 mm and 24.5mm, respectively and all of them were susceptible to this drug.

    Conclusion

    C.albicans was the predominant Candida species isolated from patients with VVC and also was the predominant biofilm producer species.

    Keywords: Vulvovaginal candidiasis, Biofilm, Candida albicans, Candida glabrata, Azole antifungals
  • Seyyed Reza Sobhani, Hassan Eini-Zinab, Arezoo Rezazadeh Pages 919-928
    Background

    Socioeconomic factors are major determinants of health and food consumption. The aim of the present study was assessing the changes in energy and different food groups consumption related to the socioeconomic status of Iranian households.

    Methods

    In this repeated cross-sectional study, 717432 households data from the Households Income and Expenditure Survey (HIES) conducted yearly by the Statistical Centre of Iran (SCI) from 1991 to 2017 was used. The food consumption outcome was modeled as a function of household head age, household head age-squared, socioeconomic variables, household size, place of residence, and household`s head sex. Principle Component Analysis (PCA) was used to extract a socioeconomic status variable based on the educational, occupational, and income status of households.  A cross-classified random effects modeling (CCREM) specifications of Hierarchical Age-Period-Cohort (HAPC) models was used in the present study.

    Results

    In the present study, by moving to the higher quartiles of SES had higher calorie intake increased. There was a positive relationship between “Vegetables”, “Fruits”, “Dairy”, “Meat, Poultry, Fish, Eggs, Legumes, and Nuts” and “Fats, Oils, Sugars, and Sweets” with socioeconomic statues category. In the case of “Bread, Cereal, Rice, and Pasta”, there was a reverse relationship, and lower SES quartile consumed a higher amount of this food group.

    Conclusion

    Lower income, education, and occupational status in lower SES quartile groups lead to lower calorie consumption and higher consumption of  “Bread, Cereal, Rice, and Pasta" food group, which had lower energy cost compared to the other food groups.

    Keywords: Food consumption, Socioeconomic status, Age-period-cohort model, Iran
  • Hassan Ebrahimpour Sadagheyani, Rahim Sharafkhani, Shahriar Sakhaei, Hamid Jafaralilou, Parviz Shahmirzalou Pages 929-938
    Background

    Beta Thalassemia Trait (BTT) and Iron Deficiency Anemia (IDA) were two common clinical problems with clinical hypochromic and microcytic manifestations, and their differentiation from each other was very important and needs innovative formulas and laboratory tests. Since the consideration of anemia as a pair with BTT leads to beta-thalassemia major birth in 25% of cases, offering prospective parents detailed information about the likelihood of their offspring developing BTT is essential. The present study aimed to investigate the performance of common equations in differentiation of BTT from IDA.

    Methods

    In the present cross-sectional study, twenty common equations were selected in the differentiation of BTT from IDA. To evaluate the equations, the tests of 292 individuals (73 individuals with BTT and 219 individuals with IDA) were compared with the initial diagnosis of hypochromic and microcytic anemia using the formulas. Descriptive and value indices and Roc curve were utilized for all equations to analyze the results.

    Results

    Among twenty differential equations, Bordbar, Kerman I, II and Srivastava equations had the highest area under Roc curve (AUC) of 0.841, 0.838, 0.836, and 0.830 respectively, but Kandhro I. equation had the lowest AUC (0.378).

    Conclusion

    Given the importance of AUC and value indices of differential equations in clinical decision making, and results of evaluating common equations in differentiation of BTT from IDA. It is essential to improve the values of the equations by re-examining the parameters involved in them.

    Keywords: Red blood cell, Thalassemia, Anemia, Mentzer index, Differentiation equation
  • Parya Jangipour Afshar, Hamid Najafipour, Mitra Shadkam Farokhi, Armita Shahesmaeili Pages 939-945
    Background

    We aimed to identify the level of known risk factors of diabetes associated with doubled likelihood of diabetes type 2.

    Methods

    In this cross-sectional study, an analysis was performed on the data of 9930 individuals aged 15 yr and older participating from 2014 to 2018 in the second phase of the Kerman coronary artery disease risk factors study (KERCADRS), Kerman, Iran. Data were collected using a standard questionnaire. Multivariable logistic regression was performed to identify factors associated with doubled chance of diabetes.

    Results

    The mean age of participants was 46.1±15.5 yr from which 59.5% were women. Overall, 1105 (11.1%) individuals had type 2 diabetes. An increase of 13.86 yr in age, an increase of 17.32 kg/m2 unit in the amount of body mass index, an increase of 0.17 in the waist-to-hip ratio, a 77 mmHg increase in systolic blood pressure and 6.07 unit increase in triglyceride to HDL ratio doubled the chances of developing type 2 diabetes.

    Conclusion

    Slight changes in the waist-to-hip circumference ratio (0.17), aging (14 yr), and increase in TG/HDL ratio (6.07 unit) were the most important risk factors, while intense physical activity was the most important protective factor associated with doubling of the chances of developing diabetes. Since most of these risk factors are modifiable, increase in physical activity and providing facilities to improve lifestyle in the community seems necessary.

    Keywords: Diabetes, Risk factor, Odds ratio
  • Jung Hun Lee, Tae Yeong Kim, Kyung-Min Jang, Jeong Ho Jeon, Young Bae Kim, Byeong Chul Jeong, Sang Hee Lee Pages 956-957
  • Bruna Da Silva, Carolina Ferraz, Filippe Soares, Fernando Tobias, Emy Hiura, Aline Del Carmem Lopez, Rodrigo Horta, José Antônio Lima, Samilla Sobral, Jackson De Araújo, Fabio Braga Pages 958-960
  • Jae Hee Choi, Ki Dong Ko, In Cheol Hwang, Hong Yup Ahn Pages 961-963
  • Hyejin Park, Kisok Kim Pages 964-966