Iranian Journal of Public Health
Volume:42 Issue: 10, Oct 2013

Population health, as defined by WHO in its constitution, is out «a physical, mental and social complete wellbeing». At the basis of human welfare is the human dignity. This dimension requires an integrated vision of health care. The ecosystemical vision of Bronfenbrenner allows highlighting the unexpected connections between social macro system based on values? and the micro system consisting of individual and family. Community nurse is aimed to transgression in practice of education and care, the respect for human dignity, the bonds among values? and practices of the community and the physical health of individuals. In Romania, the promotion of community nurse began in 2002, through the project promoting the social inclusion by developing human and institutional resources within community nursery of the National School of Public Health, Management and Education in Healthcare Bucharest. The community nurse became apparent in 10 counties included in the project. Considering the respect for human dignity as an axiomatic value for the community nurse interventions, we stress the need for developing a primary care network in Romania. The proof is based on the analysis of the concept of human dignity within health care, as well as the secondary analysis of health indicators, in the year of 2010, of the 10 counties included in the project. Our conclusions will draw attention to the need of community nurse and, will open directions for new researches and developments needed to promote primary health in Romania.

A simple emergency risk prediction tool should be developed for clinicians to quickly identify the prognosis of patients with acute aortic dissection. We enrolled 280 patients with acute aortic dissection admitted to emergency department between May 2010 and February 2013. Multivariate logistic regression analysis was performed to identify independent predictors of in-hospital death. The in-hospital mortality of our patients with acute aortic dissection was 32.5%, in-hospital deaths with surgery less than the survived (34.1% VS 54.5%). Multivariate analysis identified that age (?65 years old), Type A, blood pressure (mean systolic blood pressure? 90 mmHg), neutrophil percentage (? 80%) and serum D-dimer (? 5.0 mg/L) were significant predictors of death. With the simple emergency risk prediction tool, scores of all in-hospital deaths were? 3, whereas almost all of the survivors (97.9%) had scores < 15. A score of 10 offered the best threshold value, with the highest sensitivity (81.3%) and specificity (86.8%). The in-hospital mortality rate of patients with acute aortic dissection is high and can be predicted. Early surgery would be beneficial for in-hospital survive. This tool should be available for clinicians in the emergency department to quickly identify the prognosis of patients with acute aortic dissection.

The objective of this study was to assess the knowledge and views of faculty members on criteria for authorship by International Committee of Medical Journal Editors (ICMJE), their current practice of choosing the authors, views on gift authorship and problems they had faced concerning authorship. It was a cross sectional survey from January 2011 to July 2011 among faculty members of various private and public sector medical institutions of Pakistan through a self-administered questionnaire. Main outcome measures included awareness and use of ICMJE criteria, which contribution to research merit authorship and their perceptions about gift authorship. Two hundred eighteen faculty members (180 males, 38 females) participated in the study. One hundred twenty eight (58.7%) were from surgery and allied disciplines. Ninety six percent had published between one to five papers while 60(27.5%) had six to ten papers to their credit. One hundred eleven (50.9%) claimed they were aware about the authorship criteria, only twenty two (19.8%) could name this document. Only four (1.8%) could correctly state this. Only one hundred twenty (55.0%) said that all three criteria?s must be met to be eligible for authorship. Ninety three (42.7%) said that they were not included as authors though they deserved it while sixty three said they did not merit but were still included. Forty two (19.3%) said that they were not aware when they were listed as authors. A vast majority of young faculty members are not aware of the existence of authorship criteria and gift authorship is quite common.

Aging is becoming a more noticeable phenomenon in Poland and Europe. We analysed the perception of youth by elderly and compared attitudes of students of the University of the Third Age (SU3A) with nursing homes residents (NHR) to young people. Our questionnaire was distributed to 140 people over the age of 50 (70 SU3A and 70 NHR). 85. 0% of all respondents answered positively to the question «Do you enjoy contact with young people?», even though their contacts are usually limited and mostly confined to a few s a year. Vast majority of NHR (62. 9%) and almost half SU3A (48. 6%) believe that there is a need to integrate seniors and youth to achieve mutual benefits. Young people would benefit from the life experience of the elderly; the elderly could become more active in many areas of life.

Mental disorders are known to be an important cause of disabilities worldwide. Despite their importance, about two thirds of mentally ill people do not seek treatment, probably because of the mental health system''s inability to decrease the negative side effects of the interaction with the mental health services. The World Health Organization has suggested the concept of responsiveness as a way to better understand the active interaction between the health system and the population. This study aimed to explore the expectations of mental health service users and providers. Six focus group discussions were carried in Tehran, the capital of Iran. In total, seventy-four participants comprising twenty-one health providers and fifty-three users of mental health system were interviewed. Interviews were analyzed through content analysis. The coding was synchronized between the researchers through two discussion sessions to ensure the credibility of the findings. The results were then discussed with two senior researchers to strengthen plausibility. Five common domains among all groups were identified: accessibility, quality of interpersonal relationships, adequate infrastructure, participation in decisions, and continuity of care. The importance of cultural appropriateness of care was only raised by service users as an expectation of an ideal mental health service. Both users and providers identified the most relevant expectations from the mental health care system in Iran. More flexible community mental health services which are responsive to users? experiences may contribute to improving the process of care for mental health patients.

There is a good literature confirming the effects of social capital on different health domains. The increase in different types of cancer has caused scientists to encounter a number of issues regarding the reasons of affliction by this disease. The aim of this empirical research was to study the causal aspects of social capital of Iranian patients with cancer. The study was a causal-comparative study conducted in the spring and summer of 2010 in Tehran. The sample consists of 212 people selected based on affliction or no affliction to cancer. Social capital emphasizes two dimensions of structure and cognition. Social participation, social trust and sense of social solidarity are considered as different dimensions of social capital. The focus has been on personal social capital. The effect and association of social capital are not significant with any of stomach and colon cancers. The effect and association of social trust are not significant with any of stomach, colon and breast cancers. People with similar social capital in their life have different experiences of cancer-related stress and unhealthy behaviors. Thus a specific feature of a stressful social determinant is not a reliable criterion to determine the degree of stress and the extent of its effect on affliction to cancer.

Susceptibility pattern of organisms causing urinary tract infection (UTI) in neonate would potentially improve the clinical management by enabling clinicians to choose most reasonable first line empirical antibiotics. This study aimed to this end by studying isolated organisms from neonates with UTI in an inpatient setting. Current retrospective study has recruited all cases of neonatal UTI diagnosed through a suprapubic/ catheterized sample, admitted to Neonatal Division of Bahrami Children?s Hospital, Tehran, Iran, from June 2004 to June 2012. Escherichia coli was the dominant (64.4%) bacteria among a total of 73 cases (69.9% boys and 30.1% girls; aged 14.14? 7.68 days; birth weight of 3055.85? 623.00 g) and Enterobacter (19.2%), Klebsiella (12.3%), and Staphylococcus epidermdisis (4.1%) were less frequent isolated bacteria. E. coli was mostly resistant to ampicillin (93.6%), cefixime (85.7%) and cephalexin (77.3%), and sensitive to cefotaxime (63.6%). Enterobacter found to be most resistant to amikacin (100%), ampicillin (92.85%), and most sensitive to ceftizoxime (71.4%). A high ratio (> 92.85%) of resistance toward ampicillin was observed among common neonatal UTI bacterial agents. Having this finding along with previous reports of emerging resistance of neonatal uropathogens to ampicillin could be a notion that a combination of a third generation cephalosporin and an aminoglycoside would be a more reasonable first choice than ampicillin plus an aminoglycoside.

This study represents scientific production of Iran in medical sciences field at recent years, and the correlation between scientific productions with the number of indexed journals. Data extracted from SCOPUS database between years 2000 and 2011, and Iran?s performance measured in terms of different Scientometrics indexes including self-citations, percent of cited articles, number of articles with international collaboration and contribution of Iran in medical sciences in Middle East and world. Moreover correlation between the number of articles, citations, self-citations, and H-index and number of indexed journals for 50 countries in all fields is included. In 2011 year, Iran contributed 32.77 percent of the Middle East, and accounted for 1.57 percent of the world scientific production. The most frequent document type was original journal article published in English. Retrieved records revealed preferred subject areas, including medicine miscellaneous (14.53 percent of Iran publications in 2011 year). In 2011, according to the number of articles and citations to them, Iran was at 17th and 23th position between 226 countries, respectively. After adjustment for 19708 journals from 50 countries, Iran?s rank based on the number of journals in medical sciences was 24th. The number of indexed journals with number of articles, citations, self-citations, and H-index of each country showed significant correlation (P-value<0.01). In recent years, by favoring quality over quantity of researches, the new rules have proven to be more effective for discriminating Iranian scientific productions.

One of the most important factors affecting relapse of addiction is craving beliefs of substance use. The goal of the present study was assessment of the effectiveness of coping skills education program to reduce craving beliefs among opium addicts. In a randomized controlled trial, during September 2011 to August 2012, 70 opium addicted men referred to the Behavioral Disorders and Substance Abuse Research Center in Hamadan, western Iran were assigned to intervention group (receiving coping skills education program) and control groups. The study information was analyzed using SPSS software. Regarding craving beliefs for continuing drug use, the two groups had similar scales at the beginning of interventional program, while the level of these beliefs was significantly reduced in the intervention group (P= 0.002), but not in the control group (P= 0.105). Also, a significant correlation was also revealed between taking advantage of the educational program and increase awareness of the signs of relapse in the intervention group (P=0.003) that was not revealed in the control (P= 0.174).? On the other hand, executing coping skills education program led to reduce craving beliefs and improve knowledge towards signs of relapse. Our findings demonstrate positive impact of coping skills education program after detoxification process on decrease of craving beliefs among opium addicts.

The main purpose of this study was to determine which correlate, perceived motor competence or motor skill competence, best predicts girls? physical activity behavior. A sample of 352 girls (mean age=8.7, SD=0.3 yr) participated in this study. To assess motor skill competence and perceived motor competence, each child completed the Test of Gross Motor Development-2 and Physical Ability sub-scale of Marsh?s Self-Description Questionnaire. Children?s physical activity was assessed by the Physical Activity Questionnaire for Older Children. Multiple linear regression model was used to determine whether perceived motor competence or motor skill competence best predicts moderate-to- vigorous self-report physical activity. Multiple regression analysis indicated that motor skill competence and perceived motor competence predicted 21% variance in physical activity (R2=0.21, F=48.9, P=0.001), and motor skill competence (R2=0.15,? =0.33, P= 0.001) resulted in more variance than perceived motor competence (R2=0.06,? =0.25, P=0.001) in physical activity. Results revealed motor skill competence had more influence in comparison with perceived motor competence on physical activity level. We suggest interventional programs based on motor skill competence and perceived motor competence should be administered or implemented to promote physical activity in young girls.

Shigella sonnei is considered as a major cause of diarrheal disease in both developing and developed countries. Iran is one of the endemic areas of shigellosis. The present study was undertaken to investigate the antibiotic susceptibility and genetic relatedness of S. sonnei strains isolated from pediatric patients in Tehran, Iran. The study included all S. sonnei strains isolated from pediatric patients with diarrhea admitted to several hospitals in Tehran, Iran, during 2008-2010. Shigella spp. strains were recovered from patients using standard microbiological methods. S. sonnei strains were further studied by antimicrobial susceptibility testing and Enterobacterial Repetitive Intergenic Consensus (ERIC) - PCR analysis. Eighty nine Shigella isolates were isolated. S. sonnei was the most prevalent Shigella species (60.7%) followed by, S. flexneri (31.5%). Eleven antimicrobial resistance patterns (R1-R11) were identified among S. sonnei isolates. The majority of the strains were resistant to trimethoprim-sulfamethoxazole, tetracycline and streptomycin. All isolates were susceptible to ciprofloxacin, ceftizoxime and chloramphenicol. All strains were typable by ERIC-PCR. Five ERIC-PCR patterns (E1-E5) were found among S. sonnei isolates; however the half of the isolates was clustered in E4 pattern. The antibiotic resistance rates are increasing among S. sonnei strains. Moreover, a predominant clone or limited clones of S. sonnei were responsible for shigellosis caused by this Shigella species in pediatric patients in Tehran, Iran.

We aimed to compare acceptability of Levonorgestrel with the Yuzpe regimen among Iranian women based on their side-effects and resulting changes in the amount and pattern of menses. Five hundred twenty nine participants aged 15-49 having regular menses and one act of unprotected intercourse within 72 h were included in the double-blind, controlled trial in 2006-2007 and randomly assigned into LNG (n=263) and HD (n=266) groups, receiving Levonorgestrel 0.75 mg given 12 h apart and ethinyl estradiol 100? g plus 0.5 mg Levonorgestrel 0.5 mg repeated after 12 h, respectively. The participants receiving Levonorgestrel experienced significantly lower side-effects in the case of nausea, vomiting, and dizziness (P<0.05). The changes occurred in the amount and pattern of menses were the same for both groups (P>0.05). No significant difference was observed between the efficiencies of the treatments. Significantly lower side-effects of Levonorgestrel can be considered as greater acceptability and translated to higher efficiency.

Multiple Sclerosis (MS) is one of the autoimmune diseases with an unknown cause. The aim of this study was to explore the link between air quality and MS relapses in patients who suffer from MS. This time-series study was conducted on patients registered at the Iranian Multiple Sclerosis Society in 2011-2012. They were randomly selected from patients lived in Tehran in the last five years, and had at least one relapse in the last three years. The link between monthly mean air pollutant levels and the relapses of MS in the participants was studied. Among the registered 160 participants, at least 150 had one attack during 2009 and 2012. Most air pollutants such as NO2, NO and CO are in high levels in the rainy season. Others like Pm10 and Nox are in high levels in the dry season. The correlation between NO2 levels of all markers of air quality and MS relapses (P=0.03, r=0.27) is weak. Best ARIMA model (p,d,q; 1,0,1) was determined between number of monthly relapses and living place, although this model was not significant (P=0.3) (AR; P=0.000, MA;P=0.4). Air pollutants might be regarded as a risk factor for MS relapse.

Deafness is a common neural-sensory impairment which leads to lower life quality, withdrawal, social activities reduction, and rejection feeling. So, it is important to plan suitable training programs for mental health promotion of deaf children. Emotional intelligence training is one of these programs. The present study was aimed to determine the effectiveness of emotional intelligence training on the mental health of deaf students. In this semi-experimental study with pretest and posttest design, General Health Questionnaire (GHQ) was completed in 40 randomly selected boy deaf students with mean age of (12.48) years old before and after the intervention. The aim of the questionnaire was obtaining information of somatic symptoms, anxiety, social dysfunction, and depression as well as general health. The students were assigned in experimental and control group randomly and in equal. Experimental group participated in 12 sessions (each session lasts for 50 minutes; twice a week) and were trained by emotional intelligence program, but control group did not. Multivariate analysis of covariance (MANCOVA) was used for analyzing the data. There was a significant difference (P<0.001) between experimental and control group according to somatic symptoms, anxiety, social dysfunction, depression and general health as a whole after participation in intervention sessions. There was a significant decrease in somatic symptoms, anxiety, social dysfunction, depression and increase in general health of experimental group. Our findings showed that emotional intelligence training program led to promote of general health of boy deaf students.

The overwhelming rate of progress in biotechnological research especially in human genetics, as well as the high levels of power these researches provide us to intervene in human lives, brings serious concerns on the ethical problems that may rise from these research endeavors. To address this critical issue in Iran, we conducted a study issuing publishing authors of studies in human genetics from Iran, between years 2005 to 2011. We contacted 116 corresponding authors of articles issuing genetics research on human subjects, asking them that whether they have gotten either informed consent from their study subjects or ethical approval from their institutional ethics committee. Only 13% of the authors presented both documents; 52% had not gotten any of the documents; 19% of authors felt no need for getting the mentioned documents; 13% declared that they only gotten oral consent and 3% of authors did not remember whether they have gotten any documentation or not. The trend for informed consent taking was improving over time, from 5% in year 2006 to 24% in 2009. The result was not satisfactory but showed good trend towards improvement, recommending more serious follow up concerning ethical aspects of articles published in human genetics.?

The myelodysplastic syndrome (MDS) is a highly heterogenous disorder and karyotype analysis is helpful for diagnostic and prognostic estimation. Deletion in long arm chromosome 6 (6q del) as a sole abnormality is a rare event in MDS. This is the first case report of del (6q) as the only observed diagnostic change in Iran. We also reviewed the literature of this cytogenetic lesion.