International Journal of Preventive Medicine
Year:2012 | Volume:3 | Issue:2|Papers Count:13

The socioeconomic (SE) status is considered to be one of the most important health risk factors nowadays. A simple search showed that only in 2011, more than 1100 articles were cited in Pubmed about the relationship of health and SE status. However, there are many inquiries about this association. The SE status is a complex and multidimensional issue, and there is no gold standard method to measure it, More importantly, the impact of SE status on different aspects of health is not clear.

Background: Evaluating the tuberculosis (TB) status of the Economic Cooperation Organization (ECO) member countries relation to goal 6-c of the third millennium, which includes that TB incidence, prevalence, and death rates should be halved by 2015, compared with their level in 1990.Methods: In 2009, we have critically reviewed the countries’ Millennium Development Goals (MDGs) reports and extracted the data from the surveillance system and published and unpublished data. The main stakeholders, from both governmental and international organizations in the country have been visited and interviewed by the research team as part of the data validation process.Results: The TB incidence is very heterogeneous among ECO countries, which differ from 21.7 in Iran to 230.7 per 100, 000 in Tajikistan. TB incidence (per 100, 000) is more than 100 in six countries and is from 50 to 100 in two countries and is less than 30 in two countries. Only in two countries the crude death rate (CDR) is higher than 70%. In seven countries the death rate is higher than 10 per 100, 000. Two countries are among the 20 top world countries with the highest tuberculosis burden.Conclusion: There are some signs and signals indicating the bad condition of an ECO member including: incidence of more than 50 per 100000, CDR of less than 70%, death rate more than 10 per 100, 000, and rating two member countries among 20 top countries with the highest burden in the world. Iran and Turkey could achieve MDGs by 2015, but if other countries do not prepare urgent intervention programs, they will not be able to fulfill the goals.

Background: This article is a report of psychometric testing of the Farsi version of Resources and Support for Chronic Illness Self-management (RSSM) scale.Methods: In this cross-sectional study, a convenience sample of 160 patients with type 2 diabetes, registered with the Charity Foundation for Special Diseases’ team-focused diabetes clinic, were recruited (response rate=83.7%; n=134). Participants older than 18 years who had active medical files in the system completed the questionnaire. Content validity was established using translation and back-translation procedures, pilot testing of the instrument, and getting views of the expert panel. Construct validity was determined using explanatory factor analysis. Internal consistency was ascertained using Cronbach’s alpha. The stability was confirmed using intra-class correlation coefficients.Results: Using exploratory factor analysis, a five-factor model emerged, which explained 75.24% of the total variance. Internal consistency reliability was sufficient (a=0.70; range=0.66 – 0.87). The intra-class correlation coefficient was 0.74 – 0.81 for individual items.Conclusion: The RSSM-Farsi seems to be a valid and reliable instrument to measure outcomes of diabetes self-management education programs in Farsi. The RSSM-Farsi version scale could be a useful, comprehensive, and culturally sensitive scale for assessing resources and support for self-management between type 2 diabetic patients.

Objectives: A Public health course has an important role in the undergraduate education of pharmacy and dentistry in terms of emphasizing preventive care. The purpose of this study is to evaluate the views of pharmacy and dentistry students on a public health course and preventive health care.Methods: 173 students enrolled at Ege University, Faculties of Pharmacy and Dentistry completed a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis and replied to 18 Likert type question to determine their perceptions on a public health course and preventive health care. The comments of the students were reviewed and categorized into key themes.Results: SWOT analysis and the results of quantitative Likert type questions supported each other. According to the quantitative results, there was no significant difference between the scores of students from both schools in terms of their statements about the public health course and preventive care. Both groups of students mentioned the contribution of the public health course to their professions in the future. They also appreciated the importance of preventive care in the health services.

Background: Sleep apnea is associated with increased risk of diabetes mellitus. However, no studies have compared sleep apnea symptoms in diabetic patients and their first degree relatives. The purpose of our study was to investigate high risk for sleep apnea syndrome, in diabetics and their first degree relatives for prevention of diabetes in family.Methods: As a part of a cohort study, all of diabetic and their first degree relatives who came for glucose control in diabetes clinic were invited to take part in the survey. Two thousand, four hundred and sixty-two individuals (82% of invited) agreed to fill out the Berlin and Epworth sleep questionnaire. Participants consisted of 2462 subjects of 15–70 years of age, both males and females with diabetes and family history of type 2 diabetes mellitus. A total of 1234 participants had diabetes and 11, 231 were relatives of diabetic patients. High risk for sleep apnea regarding Berlin questionnaire and Epworth sleepiness scale, diabetic and relative were analyzed.Results: Prevalences of high risk for sleep apnea were higher among diabetics than relatives (P -value<0.001). In a multiple regression analysis, ‘‘age, body mass index, education, high blood pressure’’ were risk factor for sleep apnea symptoms while isolated blood glucose level was not by Berlin questionnaire. By Epworth sleep scale only education level was a risk factor for sleep apnea symptoms while isolated blood glucose level was not risk factor.Conclusions: Sleep apnea symptoms may not have significant difference between diabetics and their relatives. We need more study on sleep apnea in the family of diabetic patients. We hope that more studies on mentioned field may help prevention of diabetes in their family.

Background: Thus study aimed to test the hypothesis that positive emotion can quell or undo the lingering worry and rumination following induced negative emotion.Methods: 32 female students in grade 1 of high school were randomly recruited and assigned in two experimental and control groups. They completed questionnaires in a pretest that are listed herewith: (1) Rumination questionnaire; (2) Two scales of the big five factorial questionnaire (extraversion - introversion; (3) MMPI2; (4) Penn-state worry questionnaire. Then for the first group a sad movie, for the second group a cheerful movie, and for the third group a neutral movie was played, and the fourth group remained without intervention. Next day, all the group members completed the worry and rumination questionnaire again. Research findings were analyzed using covariance analysis and multivariate analysis of variance (MANOVA).Results: Those participants whose attention was turned toward the cheerful movie recovered from negative emotions (rumination and worry) more than those who saw either a neutral or sad movie or remained without intervention.Conclusions: Positive emotion is effective on negative emotion like worry and rumination. This effect is called the undoing effect of positive emotions.

Background: Most patients with superficial bladder cancer who undergo transurethral resection of bladder tumor show recurrence of the disease. So far, there have been numerous studies on ways to decrease bladder cancer recurrence, including the intake of vitamins and antioxidants. The goal of this study was to investigate the effect of vitamin E on the recurrence of non-invasive bladder cancer.Methods: In this randomized controlled trial, 46 patients with a single, low-grade, superficial bladder cancer, less than 3 cm in diameter, were randomly divided into two groups of vitamin E intake (400 IU daily) and no intake of vitamin E. Ultrasound and urinalysis were performed every three months to detect bladder cancer recurrence.Results: There was no significant difference between the groups in age, tumor size, mean time to recurrence, and follow-up time. There recurrence rate was 28.3% throughout the follow-up period (19% in the study group and 36% in the controls) (CI=0.19 - 0.92, RR=0.53, CI=0.11 - 0.94, OR=0.42, P=0.04). In both groups, most (69.2%) of the recurrences occurred during the first year. The rate of recurrence decreased in smokers from 50% in the study group to 25% in the control group (P=0.06) and from 26.7% to 15.4% in the non-smokers in the control and study groups, respectively (P=0.15).Conclusion: Intake of vitamin E significantly decreased bladder cancer recurrence, especially among smokers, possibly due to higher levels of oxidants, which vitamin E may target in smokers.The trial registry code: IRCT201105235527N2

Background: Maternal mortality (MM) is an avoidable death and there is national, international and political commitment to reduce it. The objective of this study is to examine the relation of MM to socioeconomic factors and its inequality in Iran’s provinces at an ecologic level.Methods: The overall MM from each province was considered for 3 years from 2004 to 2006. The five independent variables whose relations were studied included the literacy rate among men and women in each province, mean annual household income per capita, Gini coefficients in each province, and Human Development Index (HDI). The correlation of Maternal Mortality Ratio (MMR) to the above five variables was evaluated through Pearson’s correlation coefficient (simple and weighted for each province’s population) and linear regression – by considering MMR as the dependent variable and the Gini coefficient, HDI, and difference in literacy rate among men and women as the independent variables.Results: The mean MMR in the years 2004-2006 was 24.7 in 100, 000 live births. The correlation coefficients between MMR and literacy rate among women, literacy rate among men, the mean annual household income per capita, Gini coefficient and HDI were 0.82, 0.90, -0.61, 0.52 and -0.77, respectively. Based on multivariate regression, MMR was significantly associated with HDI (standardized B=-0.93) and difference in literacy rate among men and women (standardized B=-0.47). However, MMR was not significantly associated with the Gini coefficient.Conclusion: This study shows the association between socioeconomic variables and their inequalities with MMR in Iran’s provinces at an ecologic level. In addition to the other direct interventions performed to reduce MM, it seems essential to especially focus on more distal factors influencing MMR.

Background: This study aimed to investigate the impact of internet addiction on some psychiatric symptoms among university students.Methods: This cross-sectional study was conducted among 250 students selected via quota sampling from universities in Isfahan, Iran. Participants completed demographic questionnaire, Young Diagnostic Questionnaire, Internet Addiction Test and Symptom Checklist-90-Revision (SCL-90-R). Finally, the means of psychiatric symptoms of internet addicted and non-addicted subjects were compared. Also, t-test and multivariate analysis of covariance were used through SPSS16 software for data analysis.Results: The mean ± standard deviation (SD) of psychiatric symptoms such as somatization, obsessive–compulsive disorder, interpersonal sensitivity, depression, anxiety, aggression (hostility), phobic anxiety, paranoid ideation and psychoticism in the addicted group were 11.27±6.66, 14.05±7.91, 10.5±6.20, 15.61±8.88, 10.77±5.52, 6.77±4.88, 6.05±4.47, 7.61±4.28, and 9.66±6.87, respectively, and in the non-addicted group were 6.99±6.42, 7.49±5.23, 5.46±4.95, 9.27±7.92, 6.35±6.69, 3.57±3.35, 2.41±2.79, 5.47±4.1, and 5.29±4.95, respectively. There were significant differences between the means of psychiatric symptoms in all SCL-90-R subscales and Global Severity Index, Positive Symptom Distress Index, Positive Symptom Total in the addicted and non-addicted individuals (P<0.05). Also, internet addiction (with controlling sex variable) seemed to affect psychiatric symptoms.Conclusion: Psychiatrists and psychologists involved in the field of mental health need to be well informed about mental problems due to internet addiction, such as anxiety, depression, aggression, and job and educational dissatisfaction.

Background: Considering the role of maternal thyroid stimulating hormone (TSH) receptor blocking antibody (TRAb) in the etiology of congenital hypothyroidism (CH), this study aimed to determine TRAb among patients with CH in Isfahan, Iran.Methods: In this case-control study, patients with CH and their mothers were compared with a group of healthy neonates and their mothers. Venous blood samples were obtained for measurement of TRAb using enzyme-linked immunosorbent assay (ELISA) method among mothers and their neonates. TSH of mothers was also determined.Results: The case group consisted of 65 patients with CH and their mothers; controls were 148 healthy neonates and their mothers. The prevalence of positive TRAb in patients with CH and their mothers was higher than in the control group (81.5% vs. 1.3% in mothers and 80% vs.0% in neonates, respectively, P<0.05). The relationship between the TRAb and occurrence of CH was significant (P<0.05), whereas the corresponding figure was not significant for TRAb and the level of maternal and neonatal TSH in case and control groups (P>0.05).Conclusion: It seems that autoimmunity has an important role in the etiology of CH. Further studies are necessary to determine other autoantibodies in CH patients.

White matter lesions (WMLs) are commonly observed in stroke patients with small vessel disease (SVD) and are thought to result from a progressive, irreversible disease process following arteriolosclerosis. In this study, we report a case of partial disappearance of WMLs 1 year after a lacunar stroke in a 69-year-old man with evidence of SVD. We also discuss possible mechanisms associated with this observation.

DEAR EDITOR: Recently, I have read with interest the article by Mosayebiet al. entitled "The Effects of Cardiac Tertiary Prevention Program after Coronary Artery Bypass Graft Surgery on Health and Quality of Life" in your esteemed journal. The cardiac rehabilitation (CR) program significantly improves the functional capacity in postmyocardial infarction patients, especially those revascularized by coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI). I would like to attract the authors’ and readers’ attention to some points that can be helpful in having high quality research.

DEAR EDITOR: In 2004, Klasterskyet al. reported that fever is a common finding in patients with hematologic malignancies, occurring in more than 80% of the patients during or after chemotherapy. He and his colleagues also reported that the most feared infection in neutropenic patients is bloodstream infection (BSI), which significantly increases the mortality rate of these patients. In 2009, Viscoli et al. and 10 years later Bodey came into the same conclusion that the identification of the BSI by clinical means is complicated due to the fact that in neutropenic patients, the common signs of infection are usually absent and the only clinical sign of BSI is fever.