Iranian Journal of Public Health
Volume:41 Issue: 5, May 2012

Air pollution is one of the most important problems in urban areas that always threaten citizen's health. Photochemical smog is one of the main factors of air pollution in large cities like Tehran. Usually smog is not only a part of nature, but is being analyzed as an independent matter, which highly affects on the nature. It has been used as relationship between atmospheric elements such as temperature, pressure, relative humidity, wind speed with inversion in the time of smog forming and weather map in 500 Hpa level during 9 years descriptive static by using correlation coefficient in this analyze. Results show that there is a meaningful correlation between atmospheric elements and smog forming. This relation is seen between monthly average of these elements and monthly average of smog forming. However, when temperature decreases, corresponding pressure will increase and result of this will be smog forming. Usually smog increases in cold months of year due to enter cold high pressure air masses in Iran during December and January that is simultaneous with decreasing temperature and air pressure increases and inversion height distance decreases from the earth surface which cause to integrate air pollution under its surface, will cause to form smog in Tehran. It shows a meaningful and strong relation, based on resultant relations by correlation coefficient from inversion height and smog forming, so that obtained figure is more than 60%.

Because many diseases are multifactorial disorders, the scientific progress in genomics and genetics should be taken into consideration in public health research. In this context, genomic databases will constitute an important source of information. Consequently, it is important to identify and characterize the State's role and authority on matters related to public health, in order to verify whether it has access to such databases while engaging in public health genomic research. We first consider the evolution of the concept of public health, as well as its core functions, using a comparative approach (e.g. WHO, PAHO, CDC and the Canadian province of Quebec). Following an analysis of relevant Quebec legislation, the precautionary principle is examined as a possible avenue to justify State access to and use of genomic databases for research purposes. Finally, we consider the Influenza pandemic plans developed by WHO, Canada, and Quebec, as examples of key tools framing public health decision-making process. We observed that State powers in public health, are not, in Quebec, well adapted to the expansion of genomics research. We propose that the scope of the concept of research in public health should be clear and include the following characteristics: a commitment to the health and well-being of the population and to their determinants; the inclusion of both applied research and basic research; and, an appropriate model of governance (authorization, follow-up, consent, etc.). We also suggest that the strategic approach version of the precautionary principle could guide collective choices in these matters.

Air pollution in Tehran is widely recognized as a serious environmental challenge, posing significant threats to the health of the resident population. Improving air quality will be difficult for many reasons, including climate and topography, heavy dependence on motor vehicles for mobility, and limited resources to reduce polluting emissions. Consequently, it is useful to have information regarding the scale of the health threat and the economic value of reducing that threat. This paper integrates information on air quality, population, economic valuation, and health science to assess the most serious impact of fine particle pollution on humans, which is increased mortality risk, and provides estimates of the costs of present pollution levels, both in terms of risk and in terms of economic value relative to attaining air quality standards. Mid-range results indicate that mortality risk for the population aged 30 and over would be reduced from 8.2 per 1,000 residents annually to 7.4 per 1,000 and that the estimated annual economic benefits of this reduced risk would be $378.5 million, if health-based World Health Organization-recommended annual average PM2.5 standards were met. The potential public health benefits of reducing particulate air pollution are significant, and will increase with growing population.

The current study aimed to test the hypothesis: Is suicide predictable? And try to classify the predictive factors in multiple suicide attempts. A cross-sectional study was administered to 223 multiple attempters, women who came to a medical poison centre after a suicide attempt. The participants were young, poor, and single. A Logistic Regression Analiysis was used to classify the predictive factors of suicide. Women who had multiple suicide attempts exhibited a significant tendency to attempt suicide again. They had a history for more than two years of multiple suicide attempts, from three to as many as 18 times, plus mental illnesses such as depression and substance abuse. They also had a positive history of mental illnesses. Results indicate that contributing factors for another suicide attempt include previous suicide attempts, mental illness (depression), or a positive history of mental illnesses in the family affecting them at a young age, and substance abuse.

With regard to the willing and starting tobacco smoking among young people in Iran. The aim of the study was to model the underlying factors in predicting the behavior of tobacco smoking among employed youth and students in Iran. In this analytical cross-sectional study, based on a random cluster sampling were recruited 850 high school students, employed and unemployed youth age ranged between 14 and 19 yr from Iran. The data of demographic and tobacco smoking related variables were acquired via a self-administered questionnaire. A series of univariate and multivariate logistic regressions were performed respectively for computing un-adjusted and adjusted Odds Ratios utilizing SPSS 17 software. A number of 189 persons (25.6%) were smoker in the study and the mean smoking initiation age was 13.93 (SD= 2.21). In addition, smoker friend, peer persistence, leaving home, and smoking in one and six month ago were obtained as independent predictors of tobacco smoking. The education programs on resistance skills against the persistence of the peers, improvement in health programs by governmental interference and policy should be implemented.

One of the main and basic pillars of health system promotion is the equitable distribution of health facilities in order to ensure fair access of people in the community to the health services. The goal of this study was to classify the health structural indicators in Golestan Province using Scalogram analysis model. A descriptive study was conducted in 2010. Data related to indicators in 3 categories of institutional, human resources and rural health and their indicators were collected using statistical yearbook. Data analysis was done using SPSS software and scalogram analysis model. There is large gap between health structural indicators in cities of Golestan Province. Aq Qala City with 97 score and Azad Shahr City with 41 score were the most and lowest scores respectively from enjoyment of health structural indicators. Generally, 18% of cities were in less developed level and only 27% of cities were developed level. To achieve a fair and balanced healthcare status in different provinces based on their state of development, plans should be arranged in order to reduce the gap in the access to healthcare facilities.

The prevalence of diabetes mellitus among Iranian aged 25-64 estimated to be about 7.7%. The aim of current study was the assessment of socioeconomic status of diabetic patients and their complications. A cross sectional study was conducted on type 2 diabetic patients with complications in four major teaching hospitals affiliated to Tehran University of Medical Sciences (TUMS) during July 2009 to March 2010. All patients (530) were interviewed through a questionnaire with 85% response rate (450 patients). Skilled nurses were assigned as responsible for data collection. Collected data analyzed by Exact Fisher and χ2 tests using SPSS version 11.5. The majority of patients had experienced one or more complications. Findings revealed that 50%, 33.6% and 16.4% of the patients suffered from one, two, and three complications of type 2 diabetes, respectively. Patients with cardiovascular complications included 22.2%, with both cardiovascular and eye complications (12.7%), and with cardiovascular, eye and foot ulcer together 14% of the respondents. Frequency of complications demonstrated significant relation with sex, age, educational level, type of occupation, duration of diabetes (P<0.001) and social class (P=0.002). The majority of patients (54.2%) belonged to low income group. It seems patients with low socioeconomic status face more challenges in their social environment together with less psychological support. Health care systems are responsible to empower them to control their illness and feel a better life to live.

Rotaviruses cause diarrhea in infants and young children worldwide. Rotavirus outer capsid protein, VP7 is major neutralizing antigen that is important component of subunit vaccine to prevent rotavirus infection. Many efforts have been done to produce recombinant VP7 that maintain native characteristics. We used baculovirus expression system to produce rotavirus VP7 protein and to study its immunogenicity. Simian rotavirus SA11 full-length VP7 ORF was cloned into a cloning plasmid and then the cloned gene was inserted into the linear DNA of baculovirus Autographa californica Nuclear Polyhedrosis Virus (AcNPV) downstream of the polyhedrin promoter by in vitro recombination reactions. The expressed VP7 in the insect cells was recognized by rabbit hyperimmune serum raised against SA11 rotavirus by Immunofluorescence and western blotting assays. Rabbits were immunized subcutaneously by cell extracts expressing VP7 protein. Reactivity with anti-rotavirus antibody suggested that expressed VP7 protein had native antigenic determinants. Injection of recombinant VP7 in rabbits elicited the production of serum antibodies, which were able to recognize VP7 protein from SA11 rotavirus by Western blotting test and neutralized SA11 rotavirus in cell culture. Recombinant outer capsid glycoprotein (VP7) of rotavirus expressed in insect cells induces neutralizing antibodies in rabbits and may be a candidate of rotavirus vaccine.

Organizational Citizenship Behavior (OCB) is defined as "individual behavior that is discretionary, not directly or explicitly recognized by the formal reward system, and that in the aggregate, promotes the effective functioning of organization". OCB, enhance job satisfaction among nursing employees. According to several findings, nurse's OCB have a positive and significant influence on job satisfaction. This research is aimed to study OCB among Iranian nurses. A cross-sectional, descriptive and analytical study was conducted among 510 nurses working in 15 teaching hospitals in Tehran, Iran to be selected by stratified random sampling. The respondents were asked to complete Netemeyer's organizational citizenship behavior questionnaire that encompassed four dimensions of OCB including Sportsmanship, Civil Virtue, Conscientiousness, Altruism and selected each item of OCB dimensions and identified their attitudes about OCB items were observed in hospitals of Tehran. The data was analyzed by T-test, ANOVA and Pearson statistical methods. The results of this research showed that most of the nurses who studied in this study, had OCB behaviors. Also, we found that there was significant correlation between Iranian nurse's marriage status, qualifications and gender with sportsmanship, altruism and civic virtue. This research demonstrates the existence of OCB among Iranian nurses that are essential in developing patient - oriented behavior. The results can be used to develop further nursing management strategies for enhancement of OCB. Finally, the present study indicates new possibilities for future researches such as analysis and comparison of OCB between different hospitals and how nursing policy-makers can enhance these behaviors in Iranian hospitals.

Knowledge of the magnitude of avoidable burden by risk factors is needed for health policy, priority setting, and preventing stroke. The aim of this study was to estimate the contribution of selected risk factors including hypertension, overweight, obesity, tobacco use, and physical inactivity to the attributable burden of stroke in Iran. The World Health Organization Comparative Risk Assessment (CRA) methodology was employed to calculate the Potential Impact Fraction (PIF) and percentage of avoidable burden of stroke, which attributed to its risk factors among Iranian adults in 2009. Prevalence of risk factors was obtained from the 5th STEPS survey of chronic disease risk factors which conducted in 2009. PIF was estimated on both theoretical minimum and feasible minimum risk. A simulation procedure incorporating sources of uncertainty was used to estimate the uncertainties for the attributable burden. About 15.7% (95% uncertainty intervals: 5.8- 23.5) of attributable Disability Adjusted Life Years (DALYs) to stroke in adult males and 15.8% (95% uncertainty intervals: 5.8- 23.5) in adult females are avoidable after changing the current prevalence (16.0% and 16.1% for males and females, respectively) of hypertension to 10% in both sexes. This work highlighted the important role of hypertension and overweight. Accordingly, policy makers are advised to consider these risk factors once implementing interventional program in Iran.

Genetic diversity of three polymorphic markers in the phenylalanine hydroxylase (PAH) gene region including PvuII (a), PAHSTR and MspI were investigated. Unrelated individuals (n=139) from the Iranian populations were genotyped using primers specific to PAH gene markers including PvuII(a), MspI and PAHSTR. The amplified products for PvuII(a), MspI were digested using the appropriate restriction enzymes and separated on 1.5% agarose. The PAHSTR alleles were identified using polyacrylamide gel electrophoresis followed by silver staining. The exact size of the STR alleles was determined by sequencing. The allele frequency and population status of the alleles were estimated using PHASE, FBAT and GENEPOP software. The estimated degree of heterozygosity for PAHSTR, MspI and PvuII (a) was 66%, 56% and 58%, respectively. The haplotype estimation analysis of the markers resulted in nine informative haplotypes with frequencies ≥5%. Moreover, the results obtained from Ewens-Watterson test for neutrality suggested that the markers were under balancing selection in the Iranian population. These findings suggested the presence of genetic diversity at these three markers in the PAH gene region. Therefore, the markers could be considered as functional markers for linkage analysis of the PAH gene mutations in the Iranian families with the PKU disease.

Pemphigus vulgaris is a life threatening, blistering skin disease. It is an autoimmune abnormality. Due to involvement of oral cavity and pharynx, patients are at risk of nutrients deficiency. The aim of this study was to evaluate the status of selenium, copper, and zinc in these patients. In a case-control study, 43 newly diagnosed pemphigus vulgaris patients were compared with 58 healthy people from 2009 to 2010. The severity of the disease was estimated according to Harman's scores. Serum selenium was measured with atomic absorption but serum zinc and copper concentrations were determined spectrophotometrically. Data were compared with independent t test. Correlations were evaluated by Pearson correlation test. Both groups were the same based on sex, age, and weight and body mass index. The mean duration of disease was 5.6 month. The oral and skin severities were 1.79 and 2.3 respectively, based on Harman's scores. Serum selenium of pemphigus patients was significantly less than that of healthy people (P<0.001). Serum copper was negatively correlated with duration of disease in males (P=0.02, r=-0.5). Pemphigus vulgaris negatively affects on serum selenium, copper and zinc. It seems that serum selenium, copper and zinc decrease as the disease lasts longer.

Prognostic models have clinical appeal to aid therapeutic decision making. Two main practical challenges in development of such models are assessment of validity of models and imputation of missing data. In this study, importance of imputation of missing data and application of bootstrap technique in development, simplification, and assessment of internal validity of a prognostic model is highlighted. Overall, 310 breast cancer patients were recruited. Missing data were imputed 10 times. Then to deal with sensitivity of the model due to small changes in the data (internal validity), 100 bootstrap samples were drawn from each of 10 imputed data sets leading to 1000 samples. A Cox regression model was fitted to each of 1000 samples. Only variables retained in more than 50% of samples were used in development of final model. Four variables retained significant in more than 50% (i.e. 500 samples) of bootstrap samples; tumour size (91%), tumour grade (64%), history of benign breast disease (77%), and age at diagnosis (59%). Tumour size was the strongest predictor with inclusion frequency exceeding 90%. Number of deliveries was correlated with age at diagnosis (r=0.35, P<0.001). These two variables together retained significant in more than 90% of samples. We addressed two important methodological issues using a cohort of breast cancer patients. The algorithm combines multiple imputation of missing data and bootstrapping and has the potential to be applied in all kind of regression modelling exercises so as to address internal validity of models.

This study aimed at revaluating the psychosocial disabilities in schizophrenic patients. In an analytic-descriptive setting, schizophrenic patients were evaluated in Razi University Hospital during a one-year period (2009-10). The study group consisted of male and female patients aged 18-65 years, with the onset of disease for a minimum of 2 years and at least one psychological hospitalization in their medical record. The demographic data, as well as the results of the SANS, SAPS, GARF and SOFAS questionnaires were determined in each patient. Two hundred and eight patients, 53 females, and 155 males with the mean age of 36.96±11.55 (18-65) years were enrolled. Vocational, educational, social, familial, and self-hygiene related disabilities were seen in 63.5%, 21.2%, 93.8%, 13.9%, and 48.1% of the patients, respectively. Totally, psychosocial disabilities were reported in 98.1% of these patients. The mean age of the patients with educational or social disabilities was lower. Vocational problems were more common in male patients. Familial and social disabilities were positively related to the severity of positive and negative symptoms, with the predominance of the latter. Positive and negative symptoms were more frequent in patients with social and self-care related disabilities, respectively. The duration of the disease was significantly correlated with the positive symptoms and familial-social disabilities. The current study described the high prevalence of psychosocial disabilities in patients with schizophrenia and may have implications for public health interventions.