Iranian Journal of Public Health
Volume:43 Issue: 3, Mar 2014

The aim of this study was to evaluate the effectiveness of individual-focused stress management training namely Deep Breathing Exercise (DBE) on self-perceived occupational stress among male automotive assembly-line workers. A quasi-experimental study was conducted at 2 automotive assembly plants in Malaysia over 9 months, from January 2012 to September 2012. Assembly-line workers from Plant A received DBE training while Plant B acted as a control by receiving pamphlets on stress and its ill-effects. Intention-to-treat analysis was conducted among the self-voluntary respondents in Plant A (n=468) and Plant B (n=293). The level of stress was measured using Depression Anxiety Stress Scales-21 (DASS-21) stress subscale. Significant favorable intervention effects were found in Plant A (Effect size=0.6) as compared to Plant B (Effect size=0.2) at the end of the study in those receiving DBE. Time and group interaction effects were examined using the repeated measure ANOVA test in which there was a significant group *time interaction effect [F (1, 1) = 272.45, P<0.001]. The improvement in stress levels showed the potential of DBE training as part of Employee Assistance Program in the automotive assembly plant. Future studies should be carried out to assess the long term effects of an on-site relaxation training to provide stronger evidence for the introduction of DBE among assembly-line workers as a coping strategy to alleviate occupational stress.

Nurses have long been relied as the major labor force in hospitals. Featured with complicated and highly labor-intensive job requirement, multiple pressures from different sources was inevitable. Success in identifying stresses and accordingly coping with such stresses is important for job performance of nurses, and service quality of a hospital. Purpose of this research is to identify the determinants of nurses’ capabilities. A modified Analytic Hierarchy Process (AHP) was adopted. Overall, 105 nurses from several randomly selected hospitals in southern Taiwan were investigated to generate factors. Ten experienced practitioners were included as the expert in the AHP to produce weights of each criterion. Six nurses from two regional hospitals were then selected to test the model. Four factors are then identified as the second level of hierarchy. The study result shows that the family factor is the most important factor, and followed by the personal attributes. Top three sub-criteria that attribute to the nurse’s stress-coping capability are children’s education, good career plan, and healthy family. The practical simulation provided evidence for the usefulness of this model. The study suggested including these key determinants into the practice of human-resource management, and restructuring the hospital’s organization, creating an employee-support system as well as a family-friendly working climate. The research provided evidence that supports the usefulness of AHP in identifying the key factors that help stabilizing a nursing team.

Hepatitis B Virus (HBV) DNA polymerase transactivated protein 1 (HBVDNAPTP1) is a novel protein transactivated by HBV DNA polymerase, screened by suppression subtractive hybridization technique (GenBank accession no: AY450389). The biological function of HBVDNAPTP1 was investigated in this study. We constructed a vector pcDNA3.1 (-)/myc-His A-HBVDNAPTP1 and used it to transfect acute monocytic leukemia cell line THP-1. HBVDNAPTP1 expression was detected by western blot analysis in the cells. A cDNA library of genes transactivated by HBVDNAPTP1 in THP-1 cells was made in pGEM-T Easy using suppression subtractive hybridization (SSH). The cDNAs were sequenced and analyzed with BLAST search against the sequences in GenBank. Some sequences, such as CIP4, might be involved in apoptosis development. mRNA and protein expression of CIP4 was identified by Real time RT-PCR and western blot in THP-1 cells. HBVDNAPTP1 could down-regulate the expression of CIP4 at both transcription and translation levels. HBVDNAPTP1 may be involved in the positive regulation on the initiation of monocyte apoptosis. The result contribute to reveal the HBVDNAPTP1 biological functions and provide new evidences for further exploration of the regulatory mechanism of HBVDNAPTP1.

The objective of this study was to determine the distribution of an economically–important class of mycotoxins, the aflatoxins (AFs) in Pakistani Brown Rice. A total of 262 of brown rice samples were collected from different vendors during July 2006 to June 2011. Samples were analyzed for the occurrence of aflatoxin B1 (AFB1), B2 (AFB2), G1 (AFG1) and G2 (AFG2) by thin layer chromatography (TLC) technique. AFB1 was detected in 250 (95.4%) samples, whereas AFB2 was detected in 20 (7.6%) samples. Furthermore, AFG1 and AFG2 were not found in any sample. The contamination range of AFB1 and AFB2 was found 1.07–24.65 µg/kg and 0.52–2.62 µg/kg, respectively. Total AFs were quantified in 250 (95.4%) samples with an average of 3.89 µg/kg and contamination range was noted to be between 1.07–27.27 µg/kg. The overall results indicated that in 12 (4.6%) samples, AFs were not found within detectable limits. Furthermore, in 188 (71.7%) samples, AFs level was found below than maximum tolerated levels (MTL) as recommended by the European Union (4 µg/kg). Moreover, in 61 (23.3%) samples, AFs range was found between 4–20 µg/kg, which were fit for human consumption as per MTL (20 µg/kg) assigned by USA (FDA and FAO) and Pakistan (PSQCA). While only one sample (27.27 µg/kg) exceeded the above mention regulation limits. Low level of AFs occurs frequently in brown rice, and can be improved using proper harvesting practices, storage and transportation conditions. The small quantities of AFs warrant performing further investigation, monitoring and routine analysis on regular basis.

There have been many studies that evidence the health hazards of sunlight exposure, but less study on sun safe intervention model, especially in China. Our aim was to evaluate the cognitive and behavioral effects of a peer education model-based intervention to sun safe in children. Cluster random control intervention was conducted in one district in Chongqing, China. Two primary schools, selected through stratified clustered sampling approach (two grades in each school, three classes in each grade) were designated as intervention (n=304) and control schools (n=305) randomly. 36 students, selected as peer educators in intervention group, were trained for one month. Educational activities such as discussions were organized by peer educator for one month. There was no sun safe education to participants in control school during the project period. The evaluation of changes of sun safe knowledge (the primary outcome), attitude and behavior (the secondary outcome measures) were conducted before intervention and at months of 0, 1 and 6 of the intervention to two groups using quantitative and qualitative methods. After the intervention, sun safe knowledge score which gained by the students from intervention group has been remarkably improved, compared to baseline survey (24.48±6.17 vs. 29.51±6.75) (P<0.001), and it kept this high level (29.02±7.96 and. 28.65±8.96), while control group students’ scores have made no difference (P=0.410). Most of students have changed their sun safe behavior after the intervention. Peer education program is somewhat effective in some dimensions for improving children’s understanding of sun safe knowledge and behavior.

The aim of the present study was to evaluate the capability of helminths to absorb heavy metals in comparison with that of the host tissues. We compared the concentration of cadmium (Cd) and chromium (Cr) in urban rats and in their harboring helminthes —Moniliformis moniliformis, Hymenolepis diminuta and larval stage of Taenia taenaeiformis (Cysticercus fasciolaris). The heavy metal absorption was evaluated in 1g wet weight of parasites and tissues digested in nitric acid, using Inductivity Coupled Plasma (ICP_OES). A higher concentration of heavy metals was revealed in the helminths than in the host tissues. Bioconcentration factor (BF= C in parasite/C in tissue) for both Cd and Cr absorption was more than 10-fold higher in M. moniliformis than in the three compared host tissues. The BF of Cd in M. moniliformis compared to the liver, kidney and muscle of the host was 9.16, 14.14 and 17.09, respectively. BF in Cr in the same parasite and the same host tissues ranged from 10.67, 7.06 and 4.6. High level of absorption in H. diminuta was significantly likewise; the individual BF of Cd and Cr in H. diminuta compared to the liver, kidney and muscle of the hosts was 4.95, 5.94 and 4.67 vs. 2.67, 11.56 and 5.59. The mean concentration of Cd and Cr in C. fasciolaris was also significantly higher than that in the rat livers (P<0.007 and P<0.004, respectively). This study claims that parasites of terrestrial animals exposed to heavy metals can be more accurate indicators than the host tissues as new environmental monitoring agents.

Renal transplantation is a therapy for end-stage renal disease. During the study of recipients’ survival after renal transplantation, there are some events as intermediate events that not only affect the recipients’ survival but also events which are affected by various factors. The aim of this study was to handle these intermediate events in order to identify factors that affect recipients’ survival by using multi-state models. This retrospective cohort study included 405 renal transplant patients from Afzalipour Hospital, Kerman, Iran, from 2004 to 2010. The survival time of these recipients was determined after transplantation and the effect of various factors on the death hazard with and without renal allograft failure and hazard of renal allograft failure was studied by using multi-state models. During 4.06 years (median) of follow-up; 28 (6.9%) recipients died and allograft failure occurred in 51 (12.6%) recipients. Based on the results of multi-state model, receiving a living kidney transplantation decreased the hazard of renal allograft failure (HR=0.38; 95% CI: 0.17- 0.87), pre-transplant hypertension (HR=2.94; 95% CI: 1.54- 5.63) and serum creatinine levels >1.6 upon discharge from the hospital (HR=7.38; 95% CI: 3.87- 7.08) increased the hazard of renal allograft failure. Receiving living kidney transplantation decreased the hazard of death directly (HR=0.18; 95% CI: 0.04- 0.93). It was concluded that the effect of donor type, pre-transplant hypertension and having serum creatinine >1.6 upon discharge from the hospital was significant on hazard of renal allograft failure. The only variable that had a direct significant effect on hazard of death was donor type.

Community assessment is one of the core competencies for public health professionals; mainly because it gives them a better understanding of the strengths and drawbacks of their jurisdictions. We planned to recognize an appropriate model that provides a conceptual framework for the Iranian community. This study was conducted in Tehran, during 2009-2010 and consisted of two parts: a review of the literature and qualitative interview with selected experts as well as focus group discussion with health field staff. These steps were done to develop a conceptual framework: planning for a steering committee, forming a working committee, reviewing community assessment models and projects, preparing the proposed model draft, in-depth interview and focused group discussions with national experts, finalizing the draft, and preparing the final model. Three different models published and applied routinely in different contexts. The 2008 North Carolina Community Assessment model was used as a reference. Ten national and 18 international projects were compared to the reference and one and six projects were completely compatible with this model, respectively. Our final proposed model takes communities through eight steps to complete a collaborative community assessment: form a community assessment team, solicit community participation and gain inter-sectoral collaboration, establish a working committee, empower the community, collect and analyze community’s primary and secondary statistics, solicit community input to select health priorities, evaluate the community assessment and develop the community assessment document, an develop the community action plans.

The goal of this study was to describe the hospital-based incidence of traumatic spinal cord injury in Tehran, Iran. We retrospectively reviewed the hospital records of traumatic spinal cord injury patients, admitted between March 2010 and July 2011 in 61/68 hospitals of Tehran. Overall, 138 cases of traumatic spinal cord injury were identified. The majority of patients were male (84.8%). The mean age was 33.2 ± 14.3 years. 54.3% patients were residing in Tehran and the others were referred from other cities. The mean annual incidence of hospitalized traumatic spinal cord injury patients of Tehran was 10.5/1,000,000/year (95% confidence interval: 9-12). Fall was the leading cause of injury (45.7%), followed by road traffic crash (40.6%). The most common cause of tetraplegia (cervical traumatic spinal cord injury) was road traffic crash. The duration of hospital stay for tetraplegia and paraplegia (thoracic and lumbar traumatic spinal cord injury) was 22.7±23.7 and 12.5±7.5, respectively (P<0.001). Early surgery (surgical decompression within 24 h) was done for 19% of the patients. The median day of hospitalization for early and late surgery was 7.5 and 12, respectively (P=0.044). Preventing traumatic spinal cord injury should focus on males, age group of 21-30 years, falls and road traffic crash. More studies are suggested to evaluate the incidence of non-hospitalized traumatic spinal cord injury patients.

In Iran, more than 25% of women suffer from mental disorders. Mental disorders and subclinical problems are associated with socioeconomic problem. At the community level, mental health promotion can reduce social damage. The aim of this study as a part of community based mental health promotion intervention was to explore how mental health in Iranian women is viewed. According to a qualitative method in 2012, participants were selected by purposeful sampling from married women 18 to 65 years who are residents in Tehran. Fifteen in depth individual interviews were conducted with regard to the concept of mental health, causal pathway and help-seeking behavior according to explanatory model. Mental health was perceived as the same of emotional well-being. It conceptualized not only lack of mental disorder but also sense of satisfaction and healthy functioning. According to participant`s view, the causal pathway of mental health problems were classified to individual, familial and social factors. Physical and behavioral problems were related to individual factor, Lack of marital adjustment was one of the most important issues in familial item and in social factor, cultural context and socio- economic problems were extracted. In help seeking process, all of the participants believed that the religion has important effect in mental health. Marital adjustment is an important stage in process of mental health in women.

The aim of this study was examination the relationship between mindfulness and drug craving in addicts undergoing methadone maintenance treatment. The subjects of this research were 80 addicts undergoing methadone maintenance treatment selected through available sampling from four addiction treatment center in Ahvaz from March 2012 to September 2012. Two questionnaires to examine the variables of this study were the five facets mindfulness questionnaire (FFMQ) and heroin craving questionnaire (HCQ). The data were analyzed using SPSS version 16. The Pearson correlational results indicated significant reverse relation between mindfulness factors and craving sub scales (P<0.05). Besides, the regression results indicated that four factors of mindfulness such as observation, describing, acting with awareness and non-reactivity to inner experience can totally predict 48 percent of craving variance (P<0.01). There is a reverse relation between mindfulness and craving. Therefore we advise the researchers in addiction fields that in line with various studies that indicated effectiveness of mindfulness based interventions in improving various psychological problems, be researcher in effectiveness of this intervention in addiction fields. Moreover, we advise the addiction therapists to use mindfulness based interventions and technics in order to reduction of emotional and cognitive problems co morbidities with addiction such as craving that is one of potential factors affecting survival and relapse to drug abuse.

The aim of this study was to determine heat stress effect on physical capacity of semi-professional footballers in Iran by means of oxygen consumption measurement, heart rate monitoring and WBGT assessment environmental conditions. This study compared two different thermal environmental conditions related to sub-maximal exercise and its effect on human physical capacity. Thirty two male footballers (age 25.9 ± 1.4 year; height 176 ± 2.9 cm and weight 71 ± 9.8 kg) were investigated under four workloads (50,100,150 & 200 W) in two different thermal conditions in the morning (WBGT=21 oC) and afternoon (WBGT=33 oC) in summer. Each test cycle lasted for 10 minutes with a 10 min interval for recovery and rest between every workload. In the end of each stage, the heart rate, blood pressure, skin temperature and oral temperature were measured and recorded. Expired air was collected and its volume was measured using standard Douglas bags. The WBGT index was also used to monitor the stressful heat condition. Heart rate and VO2 consumption findings for different workload showed a significant difference between morning and afternoon (P<0.001). HR and VO2 consumption in both morning and afternoon courses showed a liner relation (r=0.88, r=0.9 respectively). With increasing work load beside heat stress, heart rate and oxygen consumption increased. It is recommended that with Ta>35 0C or WBGT>28 0C, physical activates and performing exercises should be avoided in order to reduce the risk of heat stress-related conditions in athletes

The objective of this study was to investigate the validity and reliability of the Farsi version of the perceived benefits/barriers scale of physical activity in Iranian elderly. Overall, 388 elderly subjects (60 yr and over) completed the demographic characteristics questionnaire, the Exercise Benefits/Barriers Scale (EBBS) and the Yale physical activity scale. Data were analyzed through of exploratory factor analysis, using Varimax rotation, Cronbach''s alpha and Pearson correlation. The matrix table of rotated elements of Farsi version of EBBS showed ten components, and 41 items predicted 61.83% of variance. 28 items in 5 components for benefits of, and 13 items in 5 components for barriers to physical activity were identified. Cronbach''s alpha for internal consistency in the whole scale and its subscales was 0.83, 0.94 and 0.68. In addition, positive and significant correlation was found between overall benefits and their subscales as well as between overall barriers and their subscales. Moreover, there was significant and positive correlation between physical activity and the benefits (r=0.209, P=0.005) and significant negative correlation between physical activity and the barriers (r=-0.231, P=0.001). The results showed acceptable reliability and validity of the Farsi version of Exercise Benefits/Barriers Scale among Iranian elderly.

The use of the internet as a source of information gathering, self-help and support is becoming increasingly recognized. Parents and professionals of children with hearing impairment have been shown to seek information about different communication approaches online. Cued Speech is a very new approach to Persian speaking pupils. Our aim was to develop a useful website to give related information about Persian Cued Speech to parents and professionals of children with hearing impairment. All Cued Speech websites from different countries that fell within the first ten pages of Google and Yahoo search-engines were assessed. Main subjects and links were studied. All related information was gathered from the websites, textbooks, articles etc. Using a framework that combined several criteria for health-information websites, we developed the Persian Cued Speech website for three distinct audiences (parents, professionals and children). An accurate, complete, accessible and readable resource about Persian Cued Speech for parents and professionals is available now.

A 38-year-old man with a history of recurrent genital ulceration initially diagnosed as genital herpes was admitted after presenting with paroxysmal nocturnal dyspnea. Echocardiography revealed aneurysm formation of the sinus of Valsalva. On diagnosis of an aneurysm of the sinus of Valsalva associated with Behçet''s disease (BD), surgeon repaired the affected sinus only, and continuous steroid therapy maintained the integrity.

Measles is a highly contagious viral disease that remains an important cause of mortality among children despite the availability of a safe and effective vaccine around the world. We aimed this study to show a measles outbreak occurring. In early 2012, a report of measles outbreak was recorded on center for disease control (CDC) of Fars province, south of Iran. With this case-series study, characteristics of cases and network transition model were described. The primary case was an Afghan refugee who is likely to carry the measles virus from its country or from anywhere in Iran to Koordeh, a small village in south of Iran. Followed by the Afghan case, 6 secondary and tertiary cases including rural health worker, were occurred. Except a case of 35 year old, in which her vaccination status was unknown, all cases has had adherence to vaccination protocol. More immunologic and vaccine quality investigations are needed to find the main cause of the outbreak. Nonetheless, due to the warm weather, probable bad temperature management of cold chain and technical problem in vaccination are the main suspicious reasons of the outbreak.