2018 7 2 24 133

Environmental and Personal Factors Associated with Addiction Relapse in Referral patients to Marand Treatment Centers عوامل محیطی و شخصی مرتبط با اعتیاد در بیماران مراجعه کننده به مراکز درمانی مرند 2 1 مقدمه: یکی از مسایلی که پدیده ی اعتیاد را پیچیده تر کرده است مسئله بازگشت به مواد بعد از ترک است چرا که حدود 80 درصد از معتادان در طی شش ماه اول مجددا به مصرف مواد روی می آورند. هدف این مطالعه تعیین عوامل موثر بر عود اعتیاد در معتادان مراجعه کننده به مراکز ترک اعتیاد شهرستان مرند بود. روش: این پژوهش مطالعه ای مورد شاهدی بود که بر روی 306 نفر از بیماران معتاد شهرستان مرند انجام شد. روش نمونه گیری بصورت سرشماری بود بطوری که با مراجعه به کمپ های ترک اعتیاد، (153 نفر برای گروه مورد و 153 نفر برای گروه شاهد) وارد مطالعه شدند. بعد از تدوین پرسشنامه و تعیین روایی و پایایی، پرسشنامه ها در میان معتادان گروه مورد و گروه شاهد توزیع و در حضور پژوهشگر تکمیل گردیدند. در نهایت اطلاعات با استفاده از نرم افزار آماری -21 SPSS و با بهره گیری از آزمون های آماری مناسب (کای دو، t مستقل و آنوا) مورد تجزیه و تحلیل قرار گرفت. یافته ها: در این پژوهش تحصیلات بیشتر افراد مورد بررسی هم در گروه مورد و هم در گروه شاهد دیپلم و دیپلم به پایین بود (به ترتیب 2/90 و 8/90 درصد). و میانگین سنی در گروه شاهد 23/8±14/35سال و در گروه مورد 48/10±72/3۲ بود. در گروه مورد بیشتر افراد علت عود اعتیاد را اصرار خانواده (5/25 درصد موارد) و گروه شاهد بیشترین علت موفقیت در آخرین ترک را مشکلات اجتماعی ذکر کرده اند (9/22 درصد) . از مجموع متغییرهای مورد سنجش، متغییرهای بعد خانوار، وضعیت اشتغال، سیگارکشیدن، مشاجرات خانوادگی، تاهل، امیدواری فرد و مشغولیت ذهنی نسبت به مصرف مواد،بین دوگروه مورد و شاهد اختلاف معنی دار آماری مشاهده شد.  نتیجه گیری: برای پیشگیری و درمان اعتیاد صرفا سم زدایی در کانون های ترک اعتیاد کافی نبوده و برای پیشگیری و کاهش از عود اعتیاد برنامه ریزی و انجام مداخلات بر پایه عوامل خطر اصلی شناخته شده (مانند وضعیت اشتغال، سیگارکشیدن، مشاجرات خانوادگی، تاهل، امیدواری فرد و ...) لازم به نظر می رسد.   2 Introduction: The problem of relapse makes addiction treatment complicated because almost 80% of addicts relapse after treatment completion during the first six months. The purpose of this study was to determine the factors affecting relapse in addicts referred to addiction treatment centers in Marand. Methods: This study was a cross-sectional study that was performed on 306 patients in the city of Marand. The stratified sampling method was used. After collecting the questionnaire and determining its validity and reliability, questionnaires were distributed among an addicted group and as well as a non-addicted group. In the presence of the researcher, the patients answered the questions. Finally, the data were analyzed using statistical tests (chi-squared, independent t and ANOVA) applying SPSS software, version 21.0 for Windows. Results: In this study, the majority of participants in the addicted group and in the non-addicted group had a lower diploma and diploma respectively (90.2% and 90.8%). The mean age was the non-addicted group for 35.14 ± 8.23 years and in the non-addicted group and 32.72 ± 10.48 for the addicted group. According to the findings of this study, in the addicted group, the main reasons addiction relapse was family insistence (25.5% of cases). The non-addicted group mentioned the social conditions as the most common reason of success in the last quitting (22.9%). Based on the findings, a significant difference was found between the two variables including family size, employment status, smoking, family disputes, person's hopes and obsession to use drugs. Conclusion: For preventing and treating addiction, it is not enough to detoxify in treatment centers. It seems planning and interventions is necessary for preventing and reducing relapse, based on known major risk factors (such as employment status, smoking, family disputes, marriage, individual hope, and mental engagement with drug use).   63 73 2017/12/3 1396/9/12 2018/02/17 1396/11/28 مرتضی حقیقی Morteza Haghighi Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran Iran haghighy.m@gmail.com فریبا علیزاده Fariba Alizadeh Department of Nursing, Lectureship of Nursing, lslamic Azad University, Marand, lran Iran falizadeh@yahoo.com طیبه رضائی Tayebe Rezaei Department of Nursing, Marand center of higher Health Education, Tabriz University of Medical Sciences, Tabriz, Iran Iran tayebe.rezayi86@gmail.com حامد رضا خانی مقدم Hamed RezakhaniMoghaddam Research Committee, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran Iran alizadehm@tbzmed.ac.ir حبیب الله سودایی زنوزق Habiballah Sodaei Zenoozagh Marand Health Center, Tabriz University of Medical Sciences, Tabriz, Iran. Iran soda1343@gmail.com اصغر محمدپور اصل Asghar Mohammadpoorasl Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran Iran Addiction Recurrence Substance Abuse Treatment Centers اعتیاد سوء مصرف مواد مراکز ترک اعتیاد 1. Termorshuizen F, Krol A, Prins M, et al. Prediction of relapse to frequent heroin use and the role of methadone prescription: an analysis of the Amsterdam Cohort Study among drug users. Drug and Alcohol Dependence. 2005; 79(2): 231-240.##2. Hunt WA, Barnett LW, Branch LG. Relapse rates in addiction programs. Journal of Clinical Psychology. 1971; 27(4): 455-456.##3. Skiba D, Monroe J, Wodarski JS. Adolescent substance use: reviewing the effectiveness of prevention strategie. Social Work. 2004; 49(3): 343-353.##4. Mohammadpoorasl A, Fakhari A, Akbari H, et al. Addiction relapse and its predictors: a prospective study. Journal of Addiction Research and Therapy. 2012; 3(1): 1-3.##5. Assarian F, Omidi A, Akbari H. Psychological and personality characteristics of young addicted subjects in Kashan, 1379. Feyz Journal of Kashan University of Medical Sciences. 2004; 8(1): 37-42 [Persian].##6. Shargh A, Shakibi A, Nisary R, et al. Survey of related factors with relapse of drug addiction in centers of drug addiction in Western Azarbaijan. The Journal of Urmia University Medical Sciences. 2012; 22(2):129-136 [Persian].##7. Mirzaei T, Ravary A, Hanifi N, et al. Addicts' perspectives about factors associated with substance abuse relapse. Iran Journal of Nursing. 2010; 23(67): 49-58 [Persian].##8. Rahimi MA, Sharifi V, Mohammadi M, et al. Researches on substance use in Iran; 3 decades evaluation. Hakim Health Systems research journal . 2006; 8(4): 37-44[Persian].##9. Tol A, Azam K, Shahmirzadi SE, et al. Relation between empowerment of diabetes control and adoption of self-management behaviors and its related factors among type 2 diabetic patients. Razi Journal of Medical Sciences. 2012; 19(98): 11-18[Persian].##10. McKay JR, Franklin TR, Patapis N, et al. Conceptual, methodological, and analytical issues in the study of relapse. Clinical Psychology Review. 2006; 26(2): 109-127.##11. Witkiewitz K, Marlatt GA. Relapse prevention for alcohol and drug problems: that was Zen, this is Tao. American Psychologist. 2004; 59(4): 224-235.##12. Domino KB, Hornbein TF, Polissar NL, et al. Risk factors for relapse in health care professionals with substance use disorders. JAMA. 2005; 293(12): 1453-1460.##13. Friedmann PD, Saitz R, Samet JH. Management of adults recovering from alcohol or other drug problems: relapse prevention in primary care. JAMA. 1998; 279 (15):1227-1231.##14. Xie H, McHugo GJ, Fox MB, et al. Special section on relapse prevention: substance abuse relapse in a ten-year prospective follow-up of clients with mental and substance use disorders. Psychiatric Services. 2005; 56(10): 1282-1287.##15. Fadayi F. Percent of addicts after 6 months return to addiction. Iranian National Drug Control Headquarters. 2008.##16. Brown BS. Drug Use–Chronic and Relapsing or a Treatable Condition? Substance Use & Misuse. 1998; 33(12): 2515-2520.##17. Rahmati M M. The Factors Affecting Drug Abuse Among Addicted Women. Journal of Research on Addiction. 2002; 1;131-150 [Persian].##18. Jackson R, Wernicke R, Haaga DA. Hope as a predictor of entering substance abuse treatment. Addictive Behaviors. 2003; 28(1): 13-28.##19. Fallahzadeh H, Hosseini N. The Study of the Causes of Relapse in Addicts Referning to Behzisti of Yazd,1381. Toloo-e-Behdasht Journal. 2007; 5(1-2): 67-73 [Persian].##20. Sadeghieh Ahari S, Azami A, Barak M, et al. Factors Affecting the Relapse among the Patients Referring Voluntarily to Addiction-abandoning Centers, 2000. Journal of Ardabil Medical University. 2004; 4(2):36-41[Persian].##21. Rezakhani Moghaddam H, Habibi A, Fezollahi E, et al. An investigation of mental health and its relationship with social capital among the students of Islamic Azad University-Khalkhal. Archives of Hygiene Sciences. 2014; 3(4):177-183.##22. Shahrabadi R, Moeini B, Roshanai GH, et al. Assessing Hamadans nurses perceptions of patient safety cultures dimensions. Journal of Hospital. 2014; 12(4): 83-90 [Persian].##23. Meysamie AP, Faramarzi B, Naieni KH. How addicts think about addiction and community problems?. Tehran University Medical Journal TUMS Publications. 2006; 64(5): 34-43 [Persian].##24. Solati Dehkordi K. Relationship between drug abuse and dependence on drugs with mental disorders family members. Journal of Shahrekord University of Medical Sciences. 2004; 6(2): 1-8 [Persian].##25. Rimaz S, Dastoorpour M, Merghati khoii e, et al. Demographic variables associated with relapse in women and men referred to the selected addiction treatment centers in Tehran, 2009: A case- control study. Razi Journal of Medical Sciences. 2013; 20 (107): 63-72 [Persian].##26. Seraji A, Momeni H, Salehi A. The investigation of factors affecting dependence on narcotics and reappearance of drug usage in narcotics anonymous population in Khomein. Arak Medical University Journal. 2010; 13(3): 68-75.##27. Aghabakhshi H. Addiction and Pathology of Family: A Social Work. Tehran: University of Social Welfare and Rehabilitation Sciences 1998 [Persian].##28. Washton AM. Structured outpatient group therapy: In: Lowinson JH, editor. Substance abuse: a comprehensive textbook. 3rd ed Baltimore: Lippincott Williams & Wilkins; 1996: 215-217.##29. Walton MA, Blow FC, Booth BM. A comparison of substance abuse patients' and counselors' perceptions of relapse risk: Relationship to actualrelapse. Journal of Substance Abuse Treatment. 2000;19(2):161-169.##30. Zhou X, Nonnemaker J, Sherrill B, et al. Attempts to quit smoking and relapse: factors associated with success or failure from the ATTEMPT cohort study. Addictive Behaviors. 2009; 34(4): 365-373.##31. Tarrahi M, Ansari H, Heydari K, et al. Viewpoint of care providers and self-reported substance drug addicts referring to withdrawal centers about etiology of re-addiction in Khoramabad, 2010. Journal of Rafsanjan University of Medical Sciences. 2013; 12(4): 299-308 [Persian].##32. Mattoo S, Chakrabarti S, Anjaiah M. Psychosocial factors associated with relapse in men with alcohol or opioid dependence. Indian Journal of Medical Research. 2009; 130(6): 702-708.##33. McCarthy WJ, Collins C, Hser YI. Does cigarette smoking affect drug abuse treatment?. Journal of Drug Issues. 2002; 32(1): 61-79.##34. de Dios MA, Vaughan EL, Stanton CA, et al. Adolescent tobacco use and substance abuse treatment outcomes. Journal of Substance Abuse Treatment. 2009; 37(1): 17-24.##35. Kurst-Swanger K, weather DS. Maintaining addiction: tobacco cessation policy and substance abuse treatment for youth. Journal of Child & Adolescent Substance Abuse. 2003; 12(3): 71-86.##36. Chong J, Lopez D. Predictors of relapse for american Indian women after substance abuse treatment. American Indian and Alaska Native Mental Health Research: The Journal of the National Center. 2008; 14(3): 24-48.##37. Golestan S. The Role of Family factors on the Relapse Behaviour of Male Adolescent Opiate Abusers in Kerman. Asian Culture and History. 2010; 2(1): 126-131.##38. Madu S, Matla M. Correlations for perceived family environmental factors with substance useamong adolescents in South Africa. Psychological Reports. 2003; 92(2): 403-415.##39. Marlatt GA, Donovan DM. Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York London: Guilford Press; 2005.##40. Carvajal SC, Clair SD, Nash SG, et al. Relating optimism, hope, and self-esteem to social influences in deterring substance use in adolescents. Journal of Social and Clinical Psychology. 1998; 17(4): 443-465.##41. Colvin CR, Block J. Do positive illusions foster mental health? An examination ofthe Taylor and Brown formulation. Psychological Bulletin. 1994;116(1): 3-20.## ##

The Effect of Implementation of Elderly Respect Training Program in Families on Elder Abuse in Yazd بررسی تاثیر اجرای برنامه آمورش تکریم سالمندان درخانواده ها بر میزان سوء رفتار نسبت به سالمندان شهر یزد در سال 1395 2 1 مقدمه : سالمندان از جمله گروههای آسیب پذیر درجامعه می باشند و پدیده سالمند آزاری از جمله چالش های مطرح درحیطه مراقبت و حمایت از سالمندان است. مطالعه حاضر با هدف بررسی تاثیر اجرای برنامه تکریم سالمندان در خانوادهها بر میزان سوءرفتار نسبت به سالمندان شهر یزد درسال 1395 به انجام رسید. روش : مطالعه حاضر یک مطالعه تجربی از نوع Field Trial بود که بر روی 80 نفر از سالمندان بالای 65 سال که تحت پوشش مراکز خدمات جامع سلامت شهر یزد بودند در دو گروه مداخله (n=40) و غیرمداخله (n=40) انجام گرفت. از سالمندان منتخب طی دعوتنامه تلفنی توسط پژوهشگر یا مراقبین سلامت جهت مراجعه به مرکز و تکمیل پرسشنامه دعوت بعمل آمد. سپس پرسشگر پس از معرفی خود و توضیح در مورد هدف از انجام این پژوهش،  پرسشنامه را تکمیل نمود. ابزار جمع آوری اطلاعات؛ مقیاس سوء رفتار در سالمندان شامل 49 عبارت در هشت زیر مقیاس غفلت مراقبتی، سوء رفتار روانشناختی، سوء رفتار جسمی، سوء رفتار مالی، سلب اختیار، طرد شدگی، غفلت مالی و عاطفی بود. در مرحله بعد از خانواده سالمندان گروه مداخله بصورت تلفنی جهت شرکت در برنامه آموزشی دعوت بعمل آمد، پروتکل برنامه آموزشی شامل انواع سوءرفتار با سالمند، اهمیت تکریم سالمندان درخانواده و جامعه، نقش خانواده ها درحمایت و حفاظت فرد سالمند  بود . یک ماه پس از پایان دوره آموزشی جهت خانواده ها، مجدداً از سالمندان مورد مطالعه دعوت بعمل آمد و پرسشنامه مذکور جهت سالمندان گروه مداخله تکمیل شد تا تأثیر اجرای برنامه آموزش تکریم سالمندان ارزیابی گردد. برای گروه غیرمداخله نیز همزمان با گروه مداخله پرسشنامه تکمیل گردید. تجزیه و تحلیل اطلاعات با استفاده از نرم افزار SPSS و آزمون های تی مستقل و کای دو استفاده شد. یافته ها : بررسی میانگین ابعاد سوءرفتار در بین سالمندان نشان داد درگروه مداخله نشان داد، اختلاف معنی داری بین نمرات قبل و بعد از مداخله وجود دارد (05/0>P). بیشترین میزان سوءرفتار نیز در بعد غفلت عاطفی( قبل: 5/42، بعد: 5/2) وکمترین سوءرفتار در بعد طردشدگی (قبل: 87/1، بعد: 5/2) مشاهده شد. بیشترین اثر بخشی در بعد غفلت عاطفی و کمترین اثر بخشی در بعد طرد شدگی مشاهده شد. در گروه غیر مداخله اختلاف معنی داری قبل و بعد از مداخله مشاهده نشد(05/0<P). بیشترین میزان سوء رفتار نیز در بعد غفلت عاطفی و کمترین سوء رفتار در بعد طرد شدگی مشاهده شد. نتیجه گیری: یافته های پژوهش مؤید اثر بخشی اجرای برنامه تکریم سالمندان بر کاهش سوءرفتار بود. بنابراین،پیشنهاد می شود مداخله برنامه تکریم سالمندان در حوزه سالمندی آموزش داده شود و درصورت مشاهده موارد سالمندآزاری از آن بهره گرفته شود. همچنین شفاف سازی این پدیده از جنبه های مختلف آن را باید از اولویتهای اساسی در این خصوص به شمار آورد.     2 Introduction: The elderly are among the most vulnerable group in the society, and elder abuse is poses a challenge in the domain of elderly care and support. The present study was conducted with the aim of exploring the effect of implementation of an elderly respect education program in families on the elder mistreatment in the city of Yazd in 2016. Methods: The present study was an experimental study of the field trial type that was conducted on 80 elderly people over the age of 65 years who were covered by Yazd Comprehensive Health Service Centers. This sample was randomly divided into two groups: the intervention group (n= 40) and non-intervention group (n= 40).The sampling units were invited for participating in the study through phone call by healthcare providers. Then, the interviewer completed the questionnaire, after introducing himself and giving explanations on the objective of the study. The data collection tool was the Elder Abuse Scale that included 49 items in eight subscales: care neglect, psychological abuse, physical abuse, financial abuse, authority deprivation, rejection and financial and emotional neglect. In the next step, the families of the elderly in the intervention group were invited to participate in the educational program. The content of this program included different elder abuse subjects, the importance of respecting the elderly in the family and the society, and the role of families in supporting and protecting the elderly. One month after the end of the educational program for families, the elderly in both the intervention group and non-intervention group were invited to be interviewed and the questionnaire was completed. Data analysis was done using software SPSS and through the independent t-test and chi-squared test. Results: Analysis of the mean of elder abuse dimensions in the intervention group indicated that there was a significant difference between the scores before and after the intervention (P< 0.05).The study of the mean of abuse dimensions in the elderly non-intervention group, no significant difference was seen before and after the intervention (P> 0.05). The highest level of abuse was seen in the dimension of emotional neglect and the lowest in the dimension of rejection. Conclusion: The findings indicated that the implementation of the program for educating elderly respect in family was effective in abuse reduction. Therefore, training elderly respect programs are recommended. Also, clarification of this phenomenon from different aspects is better to be considered as a priority 74 84 2017/12/32018/05/26 1397/3/5 2018/02/172018/05/26 1397/3/5 علی اکبر واعظی Aliakbar Vaezi Department of Nursing ,School of of Nursing & Midwifery, Research Center for Nursing & Midwifery Care in Family Health, Shahid Sadughi University of Medical Science, Yazd, Iran Iran محمدحسن لطفی Mohammad Hassan Lotfi Department of Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran مریم شاکر Maryam Shaker International campus, Shahid Sadoughi University Of Medical Sciences, Yazd, Iran Iran Aged Aged Abuse Elderly Respect سوءرفتار سالمندان تکریم سالمندان 1. Mohtasham amiri Z, Farazmand A, Toloei M. Causes of patients'hospitalization in Guilan university hospitals. Journal of Guilan University of Medical Sciences. 2002; 11(42): 28-32 [Persian].##2. Farhadi A, Foroughan M, Mohammadi F. The quality of life among rural elderlies; a cross-sectional study. Iranian Journal of Ageing. 2011; 6(20): 38-46 [Persian].##3. Salarvand S, Abedi H. The elders' experiences of social support in nursing home: a qualitative study. Iran Journal of Nursing. 2008; 20(52): 39-50 [Persian].##4. Glicken MD. Social Work in the 21st Century: An Introduction to Social Welfare, Social Issues, and the Profession: SAGE Publications; 2010.##5. Brindel P, Hanon O, Dartigues JF, et al. Prevalence, awareness, treatment, and control of hypertension in the elderly: the Three City study. Journal of Hypertension. 2006; 24(1): 51-58.##6. Melzer D, McWilliams B, Brayne C, et al. Profile of disability in elderly people: estimates from a longitudinal population study. British Medical Journal. 1999; 318(7191): 1108-1111.##7. Van Haastregt J, Diederiks JP, van Rossum E, et al. Effects of preventive home visits to elderly people living in the community: systematic review. BMJ. 2000; 320(7237): 754-758.##8. Fulmer T. Elder abuse and neglect assessment. Journal of Gerontological Nursing. 2003; 29(6): 4-5.##9. Helm A. Nursing malpractice: Sidestepping legal minefields. Lippincott Williams & Wilkins; 2003.##10. Allender JA, Spradley BW. Community health nursing: Concepts and practice: Lippincott Williams & Wilkins; 1996.##11. Farzanegan S, Fadaye Vatan R, Mobasheri M, et al. Explanation People and Their Family Care Explanation of Them. Iranian Journal of Ageing. 2012;6(2):52-7[Persian].##12. Collins KA, Sellars K. Vertebral artery laceration mimicking elder abuse. The American Journal of Forensic Medicine and Pathology. 2005;26(2):150-4.##13. Hudson MF, Carlson JR. Elder abuse: Its meaning to Caucasians, African Americans, and Native Americans. Understanding Elder Abuse in Minority Populations. 1999:187-204.##14. Krug EG, Mercy JA, Dahlberg LL, et al. The world report on violence and health. The lancet. 2002;360(9339):1083-8.##15. Taylor DK, Bachuwa G, Evans J, et al. Assessing barriers to the identification of elder abuse and neglect: a communitywide survey of primary care physicians. Journal of the National Medical Association. 2006;98(3):403.##16. Cooper C, Selwood A, Livingston G. The prevalence of elder abuse and neglect: a systematic review. Age and ageing. 2008;37(2):151-60.##17. Haghighatian M, Fotouhi M. Sociocultural Factors Affecting Elderly Abuse. Health System Research. 2012;8(7):1117-26.##18. McCormack B. Editorial: Nurses need to prevent the abuse of older people. International Journal of Older People Nursing. 2006;1(4):193-193.##19. Morowatisharifabad MA, Rezaeipandari H, Dehghani A, et al. Domestic elder abuse in Yazd, Iran: a cross-sectional study. Health Promotion Perspectives. 2016;6(2):104-10.##20. Kosberg JI. Preventing elder abuse: Identification of high risk factors prior to placement decisions. The Gerontologist. 1988;28(1):43-50.##21. Khanlary Z, Maarefvand M, Heravi Karimoo M, et al. Study of the Effect of Social Work Intervention on the Elderly Abuse Reduction. Iranian Journal of Ageing. 2016;10(4):102-11.##22. Vahdaninia M, Goshtasbi A, Montazeri A, et al. Health-related quality of life in an elderly population in Iran: a population-based study. 2005.##23. Heravi KM, Rejeh N, Montazeri A. Health-related quality of life among abused and non-abused elderly people: a comparative study. Payesh. 2013;12(5):479-88 [Persian].##24. Lachs MS, Pillemer K. Elder abuse. The Lancet. 2004;364(9441):1263-72.##25. Penhale B. Older women, domestic violence, and elder abuse: a review of commonalities, differences, and shared approaches. Journal of Elder Abuse & Neglect. 2003;15(3-4):163-83.##26. Comijs HC, Smit JH, Pot AM, et al. Risk indicators of elder mistreatment in the community. Journal of Elder Abuse & Neglect. 1999;9(4):67-76.##27. O’Neill D, McCormack P, Walsh J, et al. Elder abuse. Irish Journal of Medical Science. 1990;159(2):48-9.##28. Hirsch RD, Brendebach C. Violence against the aged within the family: results of studies by the" Bonner HsM (treating vs. mistreating) Study. Zeitschrift fur Gerontologie und Geriatrie. 1999;32(6):449-55.##29. Anme T, McCall M, Tatara T. An exploratory study of abuse among frail elders using services in a small village in Japan. Journal of elder abuse & neglect. 2006;17(2):1-20.##30. Wang JJ. Psychological abuse and its characteristic correlates among elderly Taiwanese. Archives of Gerontology and Geriatrics. 2006;42(3):307-18.##31. Oh J, Kim HS, Martins D, et al. A study of elder abuse in Korea. International Journal of Nursing Studies. 2006;43(2):203-14.##32. Erlingsson CL, Carlson SL, Saveman BI. Perceptions of elder abuse: voices of professionals and volunteers in Sweden–an exploratory study. Scandinavian Journal of Caring Sciences. 2006;20(2):151-9.##33. Chokkanathan S, Lee AE. Elder mistreatment in urban India: A community based study. Journal of Elder Abuse & Neglect. 2006;17(2):45-61.##34. Yan EC-W, Tang CS-K. Elder abuse by caregivers: A study of prevalence and risk factors in Hong Kong Chinese families. Journal of Family Violence. 2004;19(5):269-77.##35. Garre‐Olmo J, Planas‐Pujol X, López‐Pousa S, et al. Prevalence and risk factors of suspected elder abuse subtypes in people aged 75 and older. Journal of the American Geriatrics Society. 2009;57(5):815-22.##36. Karimi M, Elahi N. Elderly abuse in Ahwaz city and its relationship with individual and social characteristics. Iranian Journal of Ageing. 2008;3(1):42-7.##37. Moon A. Perceptions of elder abuse among various cultural groups: Similarities and differences. Generations. 2000;24(2):75-83.##38. Owens C, Cooper C. The relationship between dementia and elder abuse. Working with Older People. 2010;14(1):19-21.##39. Nowrouzi S. Assessment of Elder Abuse in Tehran. Master’s Degree. Tehran: University of Social Welfare and Rehabilitation Sciences. 2009 [Persian].##40. Dong X, Simon MA, Gorbien M. Elder abuse and neglect in an urban Chinese population. Journal of Elder Abuse & Neglect. 2007;19(3-4):79-96.##41. Manoochehri H, Ghorbi B, Hosseini M, et al. Degree and types of domestic abuse in the elderly referring to. Advances in Nursing & Midwifery. 2008;18(63);39-45##42. Pérez-Cárceles M, Rubio L, Pereniguez J, et al. Suspicion of elder abuse in South Eastern Spain: the extent and risk factors. Archives of gerontology and geriatrics. 2009;49(1):132-7.##43. Amstadter AB, Zajac K, Strachan M, et al. Prevalence and correlates of elder mistreatment in South Carolina: the South Carolina elder mistreatment study. Journal of Interpersonal Violence. 2011;26(15):2947-72.##44. Pillemer K, Finkelhor D. The prevalence of elder abuse: A random sample survey. The gerontologist. 1988;28(1):51-7.##45. Nori A, Rajabi A, Esmailzadeh F. Prevalence of elder misbehavior in northern Iran (2012). Journal of Gorgan University of Medical Sciences. 2015;16(4);93-98 [Persian].##46. Heravi Karimoei M, Reje N, Foroughan M, et al. Elderly abuse rates within family among members of senior social clubs in Tehran. Iranian Journal of Ageing. 2012;6(4):37-50.##47. Yan E, Tang CS-K. Proclivity to elder abuse: A community study on Hong Kong Chinese. Journal of Interpersonal Violence. 2003;18(9):999-1017.##48. Kissal A, Beşer A. Elder abuse and neglect in a population offering care by a primary health care center in Izmir, Turkey. Social work in health care. 2011;50(2):158-75.##49. Nahmiash D, Reis M. Most successful intervention strategies for abused older adults. Journal of Elder Abuse & Neglect. 2001;12(3-4):53-70.##50. Wang JJ, Lin MF, Tseng HF, et al. Caregiver factors contributing to psychological elder abuse behavior in long-term care facilities: a structural equation model approach. International psychogeriatrics. 2009;21(2):314-20.##51. Fialho PP, Koenig AM, Santos MD, et al. Positive effects of a cognitive-behavioral intervention program for family caregivers of demented elderly. Arquivos de neuro-psiquiatria. 2012;70(10):786-92.##52. Schulman L. The skills of helping individuals, families and groups. Itasca, IL: FE Peacock. 1992.##53. Scogin F, Beall C, Bynum J, et al. Training for abusive caregivers: An unconventional approach to an intervention dilemma. Journal of Elder Abuse & Neglect. 1990;1(4):73-86.##54. Brownell P, Heiser D. Psycho-educational support groups for older women victims of family mistreatment: A pilot study. Journal of gerontological social work. 2006;46(3-4):145-60.## ##

Metabolic Syndrome and 10-year Cardiovascular Diseases Risk Among Male Taxi Drivers in 2016: A Cross-sectional Study in Yazd, Iran سندرم متابولیک و خطر 10 ساله بیماری قلبی عروقی در میان رانندگان تاکسی مرد در سال 2016: یک مطالعه مقطعی در یزد 2 1 مقدمه: شواهد موجود حاکی از ابتلای رانندگان به ویژه رانندگان تاکسی به سندروم متابولیک است، همچنین خطر وقایع قلبی عروقی در رانندگان تاکسی بیشتر از سایر مشاغل است. با این وجود مطالعات کمی در جهت تعیین شیوع سندروم متابولیک در رانندگان تاکسی شهری صورت گرفته است. هدف مطالعه ی حاضر برآورد شیوع سندروم متابولیک و خطر ابتلا به بیماری های قلبی عروقی در رانندگان تاکسی مرد شهر یزد در ده سال آینده است. روش: در این مطالعه که به روش مقطعی انجام شد ۱۲۰نفر از رانندگان تاکسی مرد در شهر یزد در سال ۱۳۹۵ مورد مطالعه قرار گرفتند. برای تعیین شیوع سندروم متابولیک از معیارهای ATP III و برای تعیین خطر ده ساله ی وقایع قلبی عروقی از تابع فرامینگهام استفاده شد. آنالیز آماری داده ها با استفاده از نرم افزار spss و آزمون های کای دو و تی مستقل انجام شد. یافته ها: شیوع سندروم متابولیک ۳۷/۵ % بود و افزایش تری گلیسیرید شایعترین جز سندروم متابولیک بود. نتایج این مطالعه نشان داد که رانندگانی که مبتلا به سندروم متابولیک بودند در مقایسه با رانندگان بدون سندروم متابولیک، خطر بیشتری برای ابتلا به وقایع قلبی عروقی داشتند. نتیجه گیری: بر اساس یافته های این مطالعه، شیوع سندروم متابولیک و خطر وقوع حوادث قلبی عروقی در رانندگان تاکسی مورد مطالعه بالا بود. برنامه های پیشگیری مناسب با هدف جلوگیری از ابتلا به عوامل خطر بیماری های قلبی عروقی و همچنین تشخیص زودرس و مداخلات مناسب و به موقع توصیه می گردد.   2 Introduction: The evidence indicates that drivers -- including taxi drivers – are involved have high rates of metabolic syndrome and also have a higher risk of cardiovascular events than other occupations. Only few studies have been conducted to assess the prevalence of metabolic syndrome among urban taxi drivers. The aim of this research was to estimate prevalence of metabolic syndrome and risk of cardiovascular disease in the next 10 years among a group of Iranian male taxi drivers in Yazd.   Methods: In this cross-sectional survey, 120 male taxi drivers in Yazd, Iran in 2016 were selected using simple random sampling and studied to evaluate the prevalence of metabolic syndrome using Adult Treatment panel III criteria and 10-year risk of cardiovascular events by Framingham risk score. Statistical analysis was performed by SPSS software using the chi-squared test and Student’s t-test. Results: The prevalence of metabolic syndrome was 37.5%. Mean and standard deviation of number of MetS components was 2.09±1.30 among drivers. Hypertriglyceridemia was the most prevalent component of MetS.  This study showed that 40% of drivers with MetS had an intermediate 10-year risk of cardiovascular events, and 4.4% of them had a high 10-year risk. The results of this study indicated that drivers with metabolic syndrome had a higher risk of cardiovascular events than drivers without MetS. Conclusion: Based on the findings, the prevalence of metabolic syndrome and risk of cardiovascular events were high among Iranian taxi drivers in Yazd. In this regard, proper preventive programs should be conducted for early diagnosis and appropriate interventions are recommended. 85 94 2017/12/32018/05/262018/02/10 1396/11/21 2018/02/172018/05/262018/05/7 1397/2/17 ویدا رضائی هاچه سو vida rezaei hachesu Department of occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran vidarezaei93@yahoo.com زهره سادات سنگ سفیدی Zohre sadat SangSefidi Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran sangsefidi.zsadat@gmail.com مریم عسکری Maryam askari Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran Askarim204@gmail.com شادی نادریان فعلی shadi Naderyan Feli Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran Naderyan67@gmail.com Metabolic Syndrome Risk Cardiovascular Disease Iran سندروم متابولیک رانندگان تاکسی بیماری های قلبی عروقی خطر ایران 1. Grundy S. American heart association, national heart, lung, and blood institute. definition of metabolic syndrome: report of the national heart, lung, and blood institute/American heart association conference on scientific issues related to definition. Circulation. 2004;109: 433-438.##2. McNeill AM, Rosamond WD, Girman CJ, et al. The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. Diabetes Care. 2005; 28(2): 385-390.##3. Expert Panel on Detection E. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001; 285(19): 2486-2497.##4. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third national health and nutrition examination survey. JAMA. 2002; 287(3): 356-359.##5. Eapen D, Kalra GL, Merchant N, et al. Metabolic syndrome and cardiovascular disease in South Asians. Vasc Health Risk Manag. 2009; 5: 731-743.##6. Nestel P, Lyu R, Low LP, et al. Metabolic syndrome: recent prevalence in East and Southeast Asian populations. Asia Pacific Journal of Clinical Nutrition. 2007; 16(2): 362-367.##7. Amirkalali B, Fakhrzadeh H, Sharifi F, et al. Prevalence of metabolic syndrome and its components in the Iranian adult population: A systematic review and meta-analysis. Iranian Red Crescent Medical Journal. 2015; 17(12): e24723.##8. Hajian-Tilaki K. Metabolic syndrome and the associated risk factors in Iranian adults: A systematic review. Caspian Journal of Internal Medicine. 2015; 6(2): 51-61.##9. Shin JA, Lee JH, Lim SY, et al. Metabolic syndrome as a predictor of type 2 diabetes, and its clinical interpretations and usefulness. Journal of Diabetes Investigation. 2013; 4(4): 334-343.##10. Ebrahimi MH, Delvarianzadeh M, Saadat S. Prevalence of metabolic syndrome among Iranian occupational drivers. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2016; 10(1): S46-S51.##11. Mohebbi I, Saadat S, Aghassi M, et al. Prevalence of metabolic syndrome in Iranian professional drivers: results from a population based study of 12,138 men. PloS One. 2012; 7(2): e31790.##12. Saberi HR, Moravveji AR, Fakharian E, et al. Prevalence of metabolic syndrome in bus and truck drivers in Kashan, Iran. Diabetology & Metabolic Syndrome. 2011; 3(1): 8.##13. Chen SC, Chang JM, Lin MY, et al. Association of metabolic syndrome and albuminuria with cardiovascular risk in occupational drivers. International Journal of Molecular Sciences. 2013; 14(11): 21997-22010.##14. Siu S, Wong K, Lee K, et al. Prevalence of undiagnosed diabetes mellitus and cardiovascular risk factors in Hong Kong professional drivers. Diabetes Research and Clinical Practice. 2012; 96(1): 60-67.##15. National Cholesterol Education Program Adult Treatment Panel III. Third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002; 106(25): 3143-3421.##16. Mansur AdP, Rocha MA, Leyton V, et al. Risk factors for cardiovascular disease, metabolic syndrome and sleepiness in truck drivers. Arquivos Brasileiros De Cardiologia. 2015; 105(6): 560-565.##17. Mohebbi I, Matinkhah M, Nabizadeh F, et al. The metabolic syndrome and its association with over time driving in Iranian professional bus drivers. International Journal of Occupational Hygiene. 2010; 2(1): 37-41.##18. Rezaei Hachesu V, Naderyan Feli S, Zare Sakhvidi MJ. Prevalence of cardiovascular risk factorsamong taxi drivers in Yazd, Iran, 2016. Journal of Community Health Research. 2017; 6(4): 200-206.##19. Shin SY, Lee CG, Song HS, et al. Cardiovascular disease risk of bus drivers in a city of Korea. Annals of Occupational And Environmental Medicine. 2013; 25(1): 34-42.##20. Chen J, Chen Y, Chang W, et al. Long driving time is associated with haematological markers of increased cardiovascular risk in taxi drivers. Occupational and Environmental Medicine. 2005; 62(12): 890-894.##21. Elshatarat RA, Burgel BJ. Cardiovascular risk factors of taxi drivers. Journal of Urban Health. 2016; 93(3): 589-606.##22. Kurosaka K, Daida H, Takashi M, et al. Characteristics of coronary heart disease in Japanese taxi drivers as determined by coronary angiographic analyses. Industrial Health. 2000; 38(1): 15-23.##23. WHO. Waist circumference and waist-hip ratio: Report of a WHO expert consultation, Geneva, 8-11 December 2008. Available at: [URL: http://apps.who.int/iris/bitstream/handle/10665/44583/9789241501491_eng.pdf;jsessionid=19BCBA340FE4B2BBFCFDB06D5EA3B087?sequence=1.] Accessed May 24, 2018. ##24. Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003; 289(19): 2560-2571.##25. Apantaku-Onayemi F, Baldyga W, Amuwo S, et al. Driving to better health: cancer and cardiovascular risk assessment among taxi cab operators in Chicago. Journal of Health Care for the Poor and Underserved. 2012; 23(2): 768-780.##26. Association AD. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010; 33(Suppl 1): S62-S69.##27. National Heart L, Institute B. Estimate of 10-year risk for coronary heart disease Framingham point scores. 2014.##28. Sadrbafoghi S, Salari M, Rafiee M, et al. Prevalence and criteria of metabolic syndrome in an urban population&58; Yazd Healthy Heart Project. Tehran University Medical Journal. 2007; 64(10): 90-96 [Persian].##29. Mabry JE, Hosig K, Hanowski R, et al. Prevalence of metabolic syndrome in commercial truck drivers: A review. Journal of Transport & Health. 2016; 3(3): 413-421.##30. Nasri H, Moazenzadeh M. Coronary artery disease risk factors in drivers versus people in other occupations. ARYA Atheroscler. 2010; 2(2): 75-78.##31. Sadeghi M, Roohafza H, Shirani S, et al. Relationship between hematological factors and metabolic syndrome in an Iranian population Isfahan healthy heart program. Journal of Rafsanjan University of Medical Sciences. 2006; 5(2): 109-116 [Persian].##32. Wannamethee SG, Shaper AG, Lennon L, et al. Metabolic syndrome vs Framingham risk score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus. Archives of Internal Medicine. 2005;165(22): 2644-2650.##33. Tüchsen F, Hannerz H, Roepstorff C, et al. Stroke among male professional drivers in Denmark, 1994–2003. Occupational and Environmental Medicine. 2006; 63(7): 456-460.##34. Lee J, Choi YS, Jeong YJ, et al. Poor-quality sleep is associated with metabolic syndrome in Korean adults. The Tohoku journal of Experimental Medicine. 2013; 231(4): 281-291.##35. Uludag A. The effect of working conditions to the health status in taxi and bus drivers in Canakkale, Turkey; community based study. Journal of Clinical and Analytical Medicine. 2016; 6(157): 835-838.##36. Vangelova K. The excretion rates of stress hormones under mental work. Central European Journal of Public Health. 2005;13(1): 47-50.## ##

Investigating Risk Factors for Low-Birth-Weight Infants Born to Mothers Referring to Community Health Centers in the City of Yazd بررسی عوامل خطر تولد نوزادان کم وزن در مادران مراجعه کننده به مراکز خدمات جامع سلامت شهر یزد 2 1 مقدمه: وزن کم هنگام تولد  یکی از باارزش ترین نشانگرهای تعیین وضعیت بهداشتی جامعه محسوب میشود. لذا پژوهش حاضر با هدف بررسی عوامل خطر تولد نوزادان کم وزن در مادران مراجعه کننده به مراکز خدمات جامع سلامت شهر یزد انجام شده است.  روش: این تحقیق یک مطالعه هم گروهی گذشته نگر  بر روی280مادر مراجعه کننده به مراکز خدمات جامع سلامت شهر یزد در دو گروه مادران دارای نوزاد با وزن هنگام تولد کمتر از2500گرم(مورد) و مادران دارای نوزاد با وزن هنگام تولد بیشتر از گرم2500 (شاهد) بوده که داده ها بامصاحبه از مادران و مشاهده اطلاعات مندرج  در پرونده بهداشتی آنان جمع آوری و سپس وارد نرم افزار SPSS 19 شده و از طریق  کای دو ،tمستقل  و رگرسیون لجستیک تجزیه و تحلیل شد. یافته ها: میانگین و انحراف معیار وزن هنگام تولد در گروه مورد85/339±4/2171 گرم  ودر گروه شاهد 78/390±5/3222 گرم بوده و نتایج تحلیل نشان داد که تحصیلات مادر، نوع زایمان، رتبه تولد،شغل مادر،فشارخون بالا دوران بارداری و سن حاملگی با تولد نوزاد کم وزن ارتباط دارد (P<0.05). نتیجه گیری:با توجه به اینکه وزن کم هنگام تولد با عواملی مرتبط است که در اکثر مواقع قابل کنترل می باشن، لذا اقداماتی مانندآموزش مادران و ارتقای کیفیت مراقبتهای دوران بارداری و برنامه ریزی جهت فرزند آوری مادران  توصیه می گردد 2 Introduction: One of the most valuable indicators determining the health status of a community is the birth weight of infants. Thus, the purpose of this study was to investigate risk factors affecting low-birth-weight infants born to mothers visiting community health centers in the city of Yazd in Iran. Methods: The present study was a retrospective cohort research on 280 mothers visiting to community health centers in two groups of mothers with infants weighing less than 2500 grams (case) and those with babies weighing more than 2500 grams (control). The data were also collected by interviewing mothers and reviewing the information inserted in their health records. Such data were then entered into the SPSS software (Version 19) and analyzed through Chi-square test, independent t-test, as well as logistic regression analysis. Results: The mean and the standard deviation of birth weight in the case group were 2171.4 ± 339.85 grams and they were equal to 3222.5±390.78 grams in the control group. Besides, the results of the analysis revealed that maternal education (P= 0.05), type of delivery (P= 0.02), birth order (P= 0.02), maternal occupation (P= 0.03), pregnancy-induced hypertension (P= 0.008), and gestational age (P= 0.000) were correlated with low-birth-weight infants. Conclusion: Considering that low birth weight was related to factors that could be controllable in most circumstances, measures such as training mothers, promoting quality of prenatal care, and planning for childbearing among mothers are recommended. 96 104 2017/12/32018/05/262018/02/102018/02/18 1396/11/29 2018/02/172018/05/262018/05/72018/05/7 1397/2/17 علی دهقانی Ali Dehghani Department of Statistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran wiza206@gmail.com مرضیه سبحانی Marzieh Sobhani Department of Statistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran sobhani9469@gmail.com محمود نوری شادکام Mahmoud Nouri Shadkam Maternal and Neonatal Health Research Center, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran wiza206@gmail.com حسین فلاح زاده Hossein Falahzadeh Research Center of Prevention and Epidemiology of Non-Communicable Disease, Departments of Biostatistics and Epidemiology, School of Pablic Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran wiza206@gmail.com مسعود محمدی Masoud Mohammadi Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran Iran masoud.mohammadi1989@yahoo.com ابوالفضل شریفی Aboalfazl Sharifi Department of Statistics and Epidemiology, Faculty of Health, Zahedan University of Medical Sciences, Zahedan, Iran Iran wiza206@gmail.com Community Health Centers Infants Low Birth Weight Risk Factors وزن کم هنگام تولد عوامل خطر مراکز خدمات جامع سلامت نوزادان 1. Zeyghami B, Tabatabaee H, Parisay Z. A study on correlation of mother's risk factors with low birth weight of newborns at a multiple regression model in Kohghiloyeh and Boyerahmad province in 2004-2005. Armaghane Danesh. 2006;10(4): 37-45 [ Persian].##2. Esmaeili Dooki M, Haji Ahmadi M, Asgardoon GH, et al. Effect of risk factors on low birth weight neonates. Journal of Babol University Of Medical Sciences. 2004; 6(2):18-24 [Persian].##3. Soleimani F, Zaheri F, Abdi F. Developmental outcome of low birth-weight and preterm newborns: a re-view of current evidence. Tehran University Medical Journal. 2013;71(9): 551-561[Persian].##4. Tavasoli A, Aliabadi F, Eftekhari R. Motor developmental status of moderately low birth weight preterm infants. Iranian Journal of Pediatrics. 2014; 24(5): 581-586.##5. Daliri s, karimi A, Sayehmiri k, et al. The relationship between mothers demographic factors with low birth weight in Iran: a meta-analysis study. Journal of Nursing and Midwifery Urmia University of Medical Sciences. 2017; 14(12): 990-1002 [ Persian].##6. Mahram M, Mousavinasab N, Urimei AG. Intelligence Quotient (IQ) and growth indices in children with the history of low birth weight. Iranian Journal of Pediatrics. 2009; 19(4): 387-392.##7. Fallah R, Islami Z, Mosaviav T. Developmental status of NICU admited low birth weight preterm neonates at 6 and 12 months of age using ages and stages questionaire. Iranian Journal of Child Neurology. 2011; 5(1): 21-28.##8. Ghavi A, Fadakar K, Niknami M, et al. Survey associated maternal‌ ‌factors with low-weight infants in women referred ‎to health centers in Rasht. Journal of Holistic Nursing and Midwifery. 2011; 21(2): 35-39 [ Persian].##9. Abdeyazdan Z, Ehsanpour S, Hemmati E. Developmental millstones in children with normal, low, and very low birth weights. Journal of Nursing and Midwifery Urmia University of Medical Sciences. 2013; 11(8): 570-577 [Persian].##10. Boskabadi H, Bagheri F, Askari Hosseni Z. Developmental disorders in preterm neonates during the first two years of life using the ages and stages questionnaire. Journal of Babol University Of Medical Sciences. 2016; 18(2): 7-13 [Persian].##11. Khalilian A, Hamta A, Farhadi R, et al. Investigation factors of low birth weight infants with structural equation model approach. Journal of Mazandaran University of Medical Sciences. 2012; 21(86): 108-114 [Persian].##12. Karimi A, Daliri S, Sayeh Miri K, et al. The relationship between some demographic characteristics of the mother during pregnancy with low birth weight in Iran: A systematic review and meta-analysis. The Iranian Jounal of Obstetrics Gynecology and Infertility. 2017; 19(40): 79-90 [Persian].##13 .Baghaie M, Adlshoar M, Pakseresht S, et al. Survey predictive factors of neonatal low birth weight in mothers visiting to ‎hospitals in Rasht. Journal of Holistic Nursing and Midwifery. 2005; 15(2): 33-38 [Persian].##14. Zarei M, Paydar Z, Irandoost A. Maternal risk factors contributing to preterm birth. Journal of North Khorasan University of Medical Sciences. 2016; 7(4): 793-799 [Persian].##15. Taheri F, Kazemi T. Risk factors for low birth weight in Birjand, Iran (a case-control study). Journal of Birjand University of Medical Sciences. 2007; 14(3): 9-15 [Persian].##16. Shahri P, Jivad F, Maraashi T, et al. Effect of season of birth and some related variables on birth-weight in children who admitted to health care of West Ahvaz. The Iranian Jounal of Obstetrics Gynecology and Infertility. 2012; 15(20): 28-35 [Persian].##17. Koohdani F, Rezaie M, Dabiran S, et al. Relationship between maternal nutrition status and infants' birth weight. Payesh. 2011; 10(1): 21-25 [Persian].##18. Bahrami N, Soleimani M, Chan Y, et al. Study of some determinants of birth weight in Qazvin. Journal of Clinical Nursing and Midwifery. 2015; 3(4): 56-64 [Persian].##19. Firouzi Jahantigh F, Nazarnejad R, Firouzi Jahantigh M. Investigating the risk factors for low birth weight using data mining: a case study of Imam Ali hospital, Zahedan, Iran. Journal of Mazandaran University of Medical Sciences. 2016; 25(133): 171-182 [Persian].##20. Bahrami N, Soleimani M. Study of some related factors with fetal macrosomia and low birth weight. Journal of Nursing and Midwifery Urmia University of Medical Sciences. 2014; 12(2): 136-143 [Persian].##21. Delaram M. The incidence and related factors of low birth weight. Iran Journal of Nursing. 2010; 23(64): 29-36 [Persian].##22. Badshah S, Mason L, McKelvie K, et al. Risk factors for low birthweight in the public-hospitals at Peshawar, NWFP-Pakistan. BMC Public Health. 2008; 8: 197-206.##23 .Hoffman MC, Jeffers S, Carter J, et al. Pregnancy at or beyond age 40 years is associated with an increased risk of fetal death and other adverse outcomes. American Journal of Obstetrics And Gynecology. 2007; 196(5): e11-e3.##24. Mohammad K, Kassab M, Gamble J, et al. Factors associated with birth weight inequalities in Jordan. International Nursing Review. 2014; 61(3): 435-440.##25. Eslami Z, Aflatounian A. A study to determine the prevalence of low birth weight (LBW) infants in Yazd. Journal of Shahid Sadoughi University of Medical Sciences and Health Services. 2002; 1(2): 3-8.##26. Takimoto H, Yokoyama T, Yoshiike N, et al. Increase in low‐birth‐weight infants in Japan and associated risk factors, 1980–2000. Journal of Obstetrics and Gynaecology Research. 2005; 31(4): 314-322.##27. Vaktskjold A, Trí D, Odland J, et al. Parity and birth weight in the Khanh Hoa Province, Vietnam. Open Women’s Health Journal. 2010; 4:1-4.##28. Gisselmann M. Education, infant mortality, and low birth weight in Sweden 1973—1990: Emergence of the low birth weight paradox. Scandinavian Journal of Social Medicine. 2005; 33(1): 65-71.##29. Hosseini SZ, Bahadori MH, Fallah Bagher Shaidaei H. Incidence of low birth weight and associated risk factors during March 2002-2003 in Tonekabon, Iran. Journal of Mazandaran University of Medical Sciences. 2005; 15(49): 110-113 [Persian].##30 .Col-Araz N. Evaluation of factors affecting birth weight and preterm birth in southern Turkey. JPMA The Journal of the Pakistan Medical Association. 2013; 63(4): 459-462.##31. Zarbakhsh Bhari M, Hoseinian S, Afrooz G, et al. The comparison of many biological characteristics, economical conditions, general health(mental), of mothers with low and normal birth weight at Guilan Province. Journal of Payavard Salamat. 2012; 5(5): 67-78 [Persian].##32. Deshpande J, Phalke D, Bangal V, et al. Maternal risk factors for low birth weight neonates: a hospital based casecontrol study in rural area of western maharashtra, India. National Journal of Community Medicine. 2011; 2(3): 394-398.##33. Mirzaei M, Moayedallaie S, Jabbary L, et al. Prevalence of hypertension in Iran 1980–2012: a systematic review. Journal of Tehran University Heart Center. 2016; 11(4):159-167.##34. Mohammadi M. The concept of population attributable fraction (PAF), and the potential impact fraction (PIF) in epidemiology: letters to the editor. Tehran University Medical Journal TUMS Publications. 2016; 74(1): 75-75 [Persian].##35. Mohammadi M, Mirzaei M, Barati H. The estimated joint impact of obesity and abdominal obesity in the prevalence of hypertension of males of Qom city: the study of population attributable fraction. Military Caring Sciences (MCS). 2016; 3(2): 133-138 [Persian].##36. Mohammadi M, Mirzaei M. Population-attributable fraction of hypertension associated with obesity, abdominal obesity, and the joint effect of both in the Central Provinces of Iran. Journal of Epidemiol Glob Health 2017; 7(1): 71-79.##37. Mohammadi M, Mirzaei M. The effect of obesity, abdominal obesity and joint effect of them on high blood pressure in men of Mazandaran Province, Iran (population attributable fraction study): brief report. Tehran University Medical Journal TUMS Publications. 2017; 74 (10):735-740 [Persian].##38. Mohammadi M, Mirzaei M. Population attributable fraction of hypertension associated with obesity in the Western Iran. Razi Journal of Medical Sciences. 2016; 23(144): 81-88 [Persian].##39. Mohammadi M, Mirzaei M. Population attributable fraction of hypertension associated with obesity in Iran. Journal of Community Health Research. 2016; 5(4): 249-259.## ##

Socioeconomic Status and Osteoporosis Risk: A Case-control Study in Outpatient Women in Yazd وضعیت اجتماعی اقتصادی و خطر پوکی استخوان : مطالعه مورد- شاهدی در زنان بیمار سرپایی در یزد 2 1 مقدمه: پوکی استخوان یک اختلال اسکلتی است که باعث کاهش قدرت استخوانی می شود؛ و در نهایت خطر شکستگی را افزایش می دهد.  وضعیت اجتماعی و اقتصادی یکی از عوامل موثر بر سلامت، و به عنوان یک پیش بینی کننده از بیماری و مرگ می باشد. این مطالعه با هدف تعیین ارتباط بین پوکی استخوان و وضعیت اجتماعی-اقتصادی انجام شد. روش کار : این مطالعه به شکل مورد-شاهدی که شامل 270 زن که از مرکز تراکم استخوان خاتم النبیا در یزد انتخاب شدند، انجام شد. زنان به طور تصادفی برای هر دو گروه افراد دارای پوکی استخوان و بدون پوکی استخوان با همسان کردن سن( 2  سال) شدند. پرسشنامه اجتماعی و اقتصادی ساختاری برای آنها پرشد.  و با استفاده از از روش خوشه بندی، رگرسیون لجستیک، آزمونهای آماری کای دو و t مستقل داده ها تجزیه و تحلیل شدند. یافته ها: این مطالعه شامل 135 زن مبتلا به پوکی استخوان و 135 نفر غیرمبتلا به پوکی استخوان بود. نسبت شانس پوکی استخوان در گروه های اجتماعی-اقتصادی کم و متوسط (50/7 – 57/2 : CI و 39/4 = OR) و( 6 – 97/0 : CI و 42/2 = OR) بدست آمد . که بین دو گروه اختلاف آماری معناری وجود داشت (001/0 ). نتیجه گیری : در این مطالعه، بهبود سطح اجتماعی و اقتصادی موجب افزایش تحصیلات شده و نقش پیشگیرانه در ابتلا به  پوکی استخوان داشت 2 Introduction: Osteoporosis is a skeletal disorder that reduces bone strength and ultimately increases the risk of fractures. The socioeconomic status is one of the important factors affecting health, and it is confirmed as a predictor of various diseases and deaths. This study aimed to determine the relationship between osteoporosis and socioeconomic status. Methods: This study was a case-control study that included 270 women who were selected from Khatam-ol-Anbia Bone Density Center in Yazd, in which women were randomly selected for both groups, with and without Osteoporosis, by matching their age (± 2 years old). A structured socio-economic questionnaire was filled up for them. We used clustering method, logistic regression, Chi-square and independent t-tests in SPSS 16 software. Results: In this study, 135 women with osteoporosis and 135 with non-osteoporosis were included. The odds ratio for osteoporosis in low and moderate e socioeconomic groups respectively (OR=4.39 , CI : 2.57-7.50) and (OR=2.42 , CI : 0.97-6). Which had a significant difference between the two groups (P <0.001). Conclusion: In this study, the improvement of socioeconomic level, increasing the level of education had a preventive role in the development of osteoporosis.   105 111 2017/12/32018/05/262018/02/102018/02/182018/02/27 1396/12/8 2018/02/172018/05/262018/05/72018/05/72018/05/7 1397/2/17 محمد حسن لطفی Mohammad Hassan Lotfi Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mhlotfi56359@gmail.com حسین فلاح زاده Hossein Fallahzadeh Research Center of Prevention and Epidemiology of Non-Communicable Disease, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran fallahzadeh.ho@gmail.com محمد باقر اولیا Mohammad Bagher Owlia Department of Rheumatology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mbowlia2@ yahoo.com انیشه حامدی Andishe Hamedi Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran ahamedi1364@gmail.com شادی نادریان فعلی Shadi Naderyan Fe'li Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran مریم عسکری Maryam Askari Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran askarim204@gmail.com Bone Density Osteoporosis Social Class پوکی استخوان وضعیت اجتماعی اقتصادی تراکم استخوان 1. Wright N, Saag K, Dawson-Hughes B, et al. The impact of the new national bone health alliance (NBHA) diagnostic criteria on the prevalence of osteoporosis in the USA. Osteoporosis International. 2017; 28(4): 1225-1232.##2. Wright NC, Looker AC, Saag KG, et al. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. Journal of Bone and Mineral Research. 2014; 29(11): 2520-2526.##3. Vestergaard P, Rejnmark L, Mosekilde L. Hip fracture prevention. Pharmacoeconomics. 2001; 19(5): 449-468.##4. Sànchez-Riera L, Carnahan E, Vos T, et al. The global burden attributable to low bone mineral density. Annals of the Rheumatic Diseases. 2014; 73(9): 1635-1645.##5. Wade S, Strader C, Fitzpatrick L, et al. Estimating prevalence of osteoporosis: examples from industrialized countries. Archives of Osteoporosis. 2014; 9(1):182-191.##6. Larijani B, Hossein-Nezhad A, Mojtahedi A, et al. Normative data of bone mineral density in healthy population of Tehran, Iran: a cross sectional study. BMC Musculoskeletal Disorders. 2005; 6(1): 38-43.##7. Montazerifar F, Karajibani M, Alamian S, et al. Age, weight and body mass index effect on bone mineral density in postmenopausal women. Health Scope. 2014; 3(2): e14075.##8. Mojibian M, Oulia M, Beiki bandarabadi O, et al. Osteoporosis in postmenopausal women. Iranian Journal of Surgery. 2006; 14(1): 71-78 [Persian].##9. Hamidi Z, Majdzadeh R, Soltani A, et al. The contribution of risk factors to the burden of osteoporosis. Journal of Medical Council of Islamic Republic of Iran. 2006; 24(4): 381-392 [Persian].##10. Moradzadeh R, Nadrian H, Golboni F, et al. Economic inequalities amongst women with osteoporosis-related fractures: an application of concentration index decomposition. Health Promotion Perspectives. 2016; 6(4):190-195.##11. Derakhshan S, Salehi R, Reshadmanesh N. Prevalence of osteoporosis, osteopenia and their related factors in post-menopausal women referring to Kurdistan densitometry center. Scientific Journal of Kurdistan University of Medical Sciences. 2006; 11(2): 59-67 [Persian].##12. Heidari B, Heidari P, Ghazi Mir Said M, et al. Evaluation of bone mass in postmenopausal women presenting with back pain. Iranian Journal of Endocrinology and Metabolism. 2005; 7(4): 341-346 [Persian].##13. Jamshidian-Tehrani M, Kalantari N, Azadbakht L, et al. Osteoporosis risk factors in Tehrani women aged 40-60 years. Iranian Journal of Endocrinology and Metabolism. 2004; 6(2): 139-145 [Persian].##14. Nam GE, Cho KH, Park YG, et al. Socioeconomic status and dyslipidemia in Korean adults: the 2008–2010 Korea national health and nutrition examination survey. Preventive Medicine. 2013; 57(4): 304-309.##15. Esmaeili Shahmirzadi S, Shojaeizadeh D, Azam K, et al. A survey on quality of life in the elderly with osteoporosis. Payavard-Salamat. 2012; 6(3): 225-232 [Persian].##16. Kim J, Lee J, Shin JY, et al. Socioeconomic disparities in osteoporosis prevalence: different results in the overall Korean adult population and single-person households. Journal of Preventive Medicine and Public Health. 2015; 48(2): 84-93.##17. Brennan S, Leslie W, Lix L. Associations between adverse social position and bone mineral density in women aged 50 years or older: data from the Manitoba Bone Density Program. Osteoporosis International. 2013; 24(9): 2405-2412.##18. Demeter S, Leslie W, Lix L, et al. The effect of socioeconomic status on bone density testing in a public health-care system. Osteoporosis International. 2007; 18(2): 153-158.##19. Keshtkar A, Ranjbaran M, Soori H, et al. Is the relationship between individual-and family-levels socioeconomic status with disease different? analyzing third stage data of IMOS. Koomesh. 2015; 17(1): 27-36 [Persian].##20. Navarro M, Sosa M, Saavedra P, et al. Poverty is a risk factor for osteoporotic fractures. Osteoporosis International. 2009; 20(3): 393-398.## ##

Preliminary Survey of Aflatoxins in Mashhad’s Roasted Red Skin Peanut Kernels during February to May 2016 بررسی میزان آفلاتوکسین در دانه‌های بادام زمینی پوست قرمز در خراسان رضوی 2 1 مقدمه: فراوانی آفلاتوکسین­ها در 32 نمونه بادام زمینی سرخ شده بو داده با استفاده از دستگاه کروماتوگرافی مایع با کارایی بالا مجهز به ستون کرومولیت تعیین شد. تمام نمونه­ها از فروشگاه­ها و بازارهای محلی در استان خراسان رضوی خریداری شده است. روش: روش بر اساس استخراج نمونه­ها با محلول متانول: هگزان (25:75 حجمی/حجمی) بود. اندازه­گیری بر پایه مشتق­سازی آفلاتوکسین­ها با کبراسل و استفاده از آشکارساز فلورسانس به ترتیب در طول موج­های تحریک و تهییج 365 و 435 نانومتر بود. یافته ها: میانگین سطح آفلاتوکسین­های  B1­، B2، G1،G2  و کل آفلاتوکسین­ها به ترتیب به ترتیب 17/57، 56/2، 51/12، 42/1 و 16/85 نانوگرم بر گرم بود. آفلاتوکسین B1 در 12 نمونه (5/37 درصد) با میانگین 32/90 ± 17/57 نانوگرم بر گرم و حداکثر مقدار 61/243 نانوگرم بر گرم تشخیص داده شد. غلظت آفلاتوکسین B1 در 7 نمونه از حداکثر حد مجاز پذیرفته شده توسط استاندارد ملی ایران (5 نانوگرم بر گرم) تجاوز کرد. میزان آفلاتوکسین کل در هفت نمونه (8/21%) از نمونه­های بادام زمینی، از حداکثر حد مجاز توسط کدکس و ایران (15 نانوگرم بر گرم) بیشتر بود. نتیجه گیری: بر اساس نتایج به دست آمده، برای کنترل سطح افلاتوکسین در نمونه­های بادام زمینی در استان خراسان رضوی، تلاش بیشتری لازم است. این بررسی اطلاعات ارزشمندی را در مورد آلودگی آفلاتوکسین در محصولات بادام زمینی که در ایران عرضه می­شود نیز ارائه می­دهد. 2 Introduction: Aflatoxins (AFs) are a group of mycotoxins created as metabolic items for the most part by three types of Aspergillus including Aspergillus flavus, Aspergillus parasiticus and the uncommon Aspergillus nomius. Eighteen aflatoxins have been identified up to now, but only six of them have been found in food and feed. Methods: The occurrence of aflatoxins in 32 samples of roasted red skin peanut was determined using HPLC with a Chromolith column. All samples were purchased from retail shops and local markets in Mashhad city. The method was based on the extraction of samples and aflatoxins determination after post-column derivatization by Kobra Cell and fluorescence detection at excitation and emission wavelengths of 365 and 435 nm, respectively. Results: Mean levels of aflatoxins B1, B2, G1, G2 and total aflatoxins were found to be 57.17, 2.56, 12.51, 1.42 and 85.16 ng g-1, respectively. Aflatoxins B1 (AFB1) was detected in 12 samples (37.5%) with a mean value of 57.17 ± 90.32 ng g-1 and a maximum level of 243.61 ng g-1. AFB1 levels exceeded Iran maximum tolerate limit (5 ng/g) in 7 out of 32 peanut samples. 21.8% of these peanut samples exceeded the maximum tolerate limit set for total aflatoxins by codex and Iran (15 ng g-1). Conclusion: According to the obtained results, more effort is needed to control aflatoxin levels in Mashhad’s peanut. This survey provides valuable information on aflatoxin contamination in peanut products marketed in Iran as well.  112 118 2017/12/32018/05/262018/02/102018/02/182018/02/272018/03/2 1396/12/11 2018/02/172018/05/262018/05/72018/05/72018/05/72018/05/7 1397/2/17 زهره باخرد Zohreh Bakherad Food and drug laboratories research center, Ministry of health and medical education, Tehran, Iran Iran zbakherad1@yahoo.com جواد فیضی Javad Feizy Department of Food Chemistry, Research Institute of Food Science and Technology, Mashhad, Iran Iran feizy.j@gmail.com Chromatography High Pressure Liquid Aflatoxin Arachis Khorasan Razavi Mashhad کروماتوگرافی مایع با کارایی بالا آفلاتوکسین بادام زمینی خراسان رضوی مشهد 1. Huang B, Han Z, Cai Z, et al. Simultaneous determination of aflatoxins B1, B2, G1, G2, M1 and M2 in peanuts and their derivative products by ultra-high-performance liquid chromatography-tandem mass spectrometry. Analytica Chimica Acta. 2010; 662(1): 62-68.##2. Feizy J, Beheshti HR, Khoshbakht Fahim N, et al. Survey of aflatoxins in rice from Iran using immunoaffinity column clean-up and HPLC with fluorescence detection. Food Additives & Contaminants. 2010; 3(4): 263-267.##3. Papp E, Hotta K, Zarag G, et al. Liquid chromatographic determination of aflatoxins. Microchemical Journal. 2002; 73(1-2): 39-46.##4. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Some naturally occurring substances: food items and constituents, heterocyclic aromatic amines and mycotoxins, [Lyon]: World Health Organization, International Agency for Research on Cancer. (1993) 56: 445.##5. Yazdanpanah H. Mycotoxin contamination of foodstuffs and feedstuffs in Iran. Iranian Journal of Pharmaceutical Research. 2006; 5(1): 9-16.##6. Food And Agriculture Organization (FAO) worldwide regulations for mycotoxins in food and feed in 2003. FAO food and nutrition paper 81. 2004; Available at: http://www.fao.org/docrep/007/y5499e/y5499e00.htm##7. European Commission (EC). Commission Regulation, 165/2010 of February 26th setting maximum levels for certain contaminants in foodstuffs as regards aflatoxins. Officials Journal European ::union::. 2010:L50/8. Available at: https://www.fsai.ie/uploadedFiles/Reg165_2010.pdf##8. Younis YH, Malik KM. TLC and HPLC assays of aflatoxin contamination in Sudanese peanuts and peanut products. Kuwait Journal of Science. 2003; 30(1): 79-93.##9. Razzazi-Fazeli E, Noviandi CT, Porasuphatana S, et al. A survey of aflatoxin B1 and total aflatoxin contamination in baby food, peanut and corn products in Indonesia by ELISA and HPLC. Mycotoxin Research. 2004; 20(2): 51-58.##10. Ghosia L, Arshad H. Studies on contamination level of aflatoxins in some dried fruits and nuts of Pakistan. Food Control. 2011; 22(3-4): 426-429.##11. Norhayati A, Noorhasani H, Takumi Y. Evaluation and application of a simple and rapid method for the analysis of aflatoxins in commercial foods from Malaysia and the Philippines. Food Additives & Contaminants. 1999; 16(7): 273-280.##12. Juan C, Zinedine A, Molto JC, et al. Aflatoxins levels in dried fruits and nuts from Rabat-Sale, Morocco. Food Control. 2008; 19(9): 849-853.##13. Arzandeh S, Salamat J, Hnifa L. Aflatoxin in raw peanut kernels marketed in Malaysia. Journal of Food and Drug Analysis. 2010;18(1): 44-50.##14. Chun HS, Kim HJ, Ok HE, et al. Determination of aflatoxin levels in nuts and their products consumed in South Korea. Food Chemistry. 2007; 102(1): 385-391.##15. Feizy J, Beheshti HR, Fakoor Janati SS, et al. Survey of aflatoxins in watermelon seeds from Iran using immunoaffinity column cleanup and HPLC with fluorescence detection. Food Additives & Contaminants. 2011; 4(2): 106-109.##16. Var I, Kabak B, Gök F. Survey of aflatoxin B1 in Helva, a traditional Turkish food by TLC. Food Control. 2007; 18(1): 59-62.##17. Lee NA, Wang S, Allan RD, et al. A rapid aflatoxin B1 ELISA: development and validation with reduced matrix effects for peanuts, corn, pistachio and soybeans. Journal of Agricultural and Food Chemistry. 2004; 52(10): 2746-2755.##18. European Commission (EC). Commission Regulation, 401/2006 of February 23t laying down the methods of sampling and analysis for the official control of the levels of mycotoxins in foodstuffs. Official Journal of European ::union::.2006: L 70/12. Available at: https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=celex%3A32006R0401##19. Institute of Standards and Industrial Research of Iran. Food and Feed. Determination of aflatoxins B&G by HPLC method using immunoaffinity column clean up-Test method. 1st Edition. ISIRI No. 6872. 2011. ##20. Institute of Standards and Industrial Research of Iran. Food and Feed. Mycotoxins-Maximum tolerated level. 1st Edition. ISIRI No. 5925. 2002.##21. Dorner JW, Cole RJ, Connick WJ, et al. Evaluation of biological control formulation to reduce aflatoxin contamination in peanuts. Biological Control. 2003; 26(3): 318-324.##22. Ostadrahimi A, Ashrafnejad F, Kazemi A, et al. Aflatoxin in raw and salt-roasted nuts (pistachios, peanuts and walnuts) sold in markets of Tabriz, Iran. Jundishapur Journal of Microbiology. 2013; 7(1): e8674.##23. Siahi Shadbad MR, Ansarin M, Tahavori A, et al. Determination of aflatoxins in nuts of Tabriz confectionaries by ELISA and HPLC methods. Advanced Pharmaceutical Bulletin. 2012; 2(1):123-126.##24. Hong GL, Yusof N. Determination of Aflatoxins B1 and B2 in Peanuts and Corn Based Products. Sains Malaysiana. 2010; 39: 731-735.##25. Bakhiet SEA, Musa AAA. Survey and Determination of Aflatoxin Levels in Stored Peanut in Sudan. Jordan Journal of Biological Sciences. 2011; 4(1):13-20.## ##

The Epidemiological and Clinical Aspect of Pulmonary Tuberculosis in Elderly: A Comparison with None-elderly in Yazd مقایسه خصوصیات اپیدمیولوژیک و بالینی سل ریوی در مسلولین سالمند و غیر سالمند بالای 16 سال شهرستان یزد طی سالهای 94-1390 2 1 مقدمه:  سیر طبیعی عمر با افزایش سن سبب بروز تغییراتی در سیستم تنفسی و ایمنی سالمندان  می گردد که استعداد ابتلا به بیماری سل را در سالمندان افزایش می دهد. خصوصیات بالینی و سیر طبیعی  سل در سالمندان متفاوت می باشد. هدف از این مطالعه بررسی ومقایسه مقایسه خصوصیات اپیدمیولوژیک وسیر بالینی بیماری  سل ریوی در مسلولین سالمند و غیر سالمند بالای 16 سال شهرستان یزد در یک دوره پنج ساله می باشد.         روش : دراین مطالعه کوهورت تاریخی ، مندرجات پرونده  بیماران شامل سن،جنس،علایم بالینی بیماری، سابقه درمان، مقاومت دارویی،  نتایج درمان سل ریوی در طی سالهای 94-1390 بررسی گردید. یافته ها : از 177 بیمارمبتلا به سل ریوی دارای شرایط ورود به این مطالعه، 107 نفر65 سال وبالاتر( 60درصد) و 70نفرسن بین 16 تا 64سال(40 درصد)داشته اند. سالمندان بصورت معناداری کمتر دچارتب می گردند (02/0=p)  ولی نسبت به غیرسالمند از تنگی نفس  (01/0=p)  و بی اشتهایی،(04/0=p) شکایت بیشتری دارند. بروز مجموعه عوارض دارویی  بطور معنی داری در سالمندان  بیشتر ثبت شده بود . عوارض دارویی بویژه خارش پوستی  (001/0=p) در سالمندان بیشتر می باشد. در طول دوره درمان در سالمندان مقاومت دارویی ، مرگ ومیر و عود بیشتری همراه است که معنی دار نمی باشد. آنالیز  Mantel-Haenszelنشان داد صرف نظر از مقاومت دارویی  افراد سالمند  نسبت به غیر سالمند بیشتر فوت می کنند (58/0±37/1OR=)(85/0p=). میزان بهبودی در هردوگروه  به هدف استراتژی  بیشتر از 85 درصد رسیده است.  نتیجه گیری: علایم بالینی و تشخیص و درمان سل در سالمندان بطور قابل توجهی متفاوت از سایرین است. افراد سالمند بطور معنی داری با تب کمتر وتنگی نفس وبی اشتهایی بیشتر از غیر سالمند مراجعه می نمایند. اطلاع از این تفاوت ها ما را در تشخیص و درمان موثرتر ایشان یاری خواهد داد. 2 Introduction: The nature of life course, with aging, triggers changes in the respiratory and immune system of the elderly, which increases the susceptibility to Tubercle Bacilli (TB) in the elderly. Clinical characteristics and the natural course of TB in older adults are different. This study aimed to compare the epidemiological and clinical features of pulmonary TB in elderly and non-elderly patients over 16 years old in Yazd city in a five-year period. Methods: Within this historical cohort study, recorded of patient's data, including age, gender, clinical symptoms of the disease, history of treatment, drug resistance, and treatment results examined during 2012-2016. Results: From 177 patients with pulmonary TB, who admitted to this study, 107 were 65 years and older (60.5%), and 70 were aged 16-64 (39.5%). Elderly experienced fever significantly fewer (p = 0.02), nonetheless they are more complaining about dyspnea (p = 0.01) and anorexia (p = 0.04) than non-elderly people. The incidence of drug complications was significantly higher among the elderly. Drug side effects, especially dermal itching (p = 0.001), are higher for older people. The number of drug resistance associated with larger mortality and recurrence in the elderly, which is not significant. Mantel-Haenszel evaluation showed that irrespective of drug resistance, the elderly died more than non-elderly (OR = 1.37 ± 0.88) (p = 0.85). Conclusion: Clinical symptoms, diagnostic criteria and treatment outcome and complications of TB in the elderly are significantly different from others. Elderly people are considerably more likely to anorexia than non-elderly. Fever is not common among elderly people. The incidence of drug complications was significantly higher among the elderly. Considering these differences will help us to diagnose and treat them more effectively.   119 126 2017/12/32018/05/262018/02/102018/02/182018/02/272018/03/22018/04/16 1397/1/27 2018/02/172018/05/262018/05/72018/05/72018/05/72018/05/72018/05/7 1397/2/17 محمد شهرادیان mohammad shahradian Department of Ageing Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mohammad.shahrad@chmail.ir سیده مهدیه نماینده Seyedeh Mahdiah Namayandeh Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Statistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran drnamayandeh@Gmail.com مسعوده مجاهد Masudah Mojahed Department of infectious diseases, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mohammad.shahrad@chmail.ir محمد علی مروتی شریف آباد Mohammad Ali Moravati Sharifabad Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mohammad.shahrad@chmail.ir وحید برزگرپور Vahid Barzegarpour Department of Health Education, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mohammad.shahrad@chmail.ir Epidemiology Tuberculosis Elderly Treatment Outcome Yazd اپیدمیولوژی بیماری سل سالمند نتایج درمان یزد 1. World Health Organisation(WHO).Tuberculosis (TB).Global Tuberculosis Control Surveillance, Planning, Financing, Who Report. 2008. Available at: http://www.who.int/tb/ publications/global_report/2008/en.##2.Mandell G, Bennett J, Dolin R. Principles and practice of infectious diseases. 5th ed, Philadelphia: Churchill Livingstone. 2000.##3. Siribaddane S, Wigesundera A. Autoimmune Haemolytic Afiaemia Responding to Anti-Tuberculous Treatment. Trop Doc. 1997;27:243– 4.##4.World Health Organization (WHO). Global tuberculosis report 2015 -2016. Available at: www.who.int/tb/publications/global_report/##5. World Health Organization (WHO). World report on ageing and health: World Health Organization; 2015. Available at: http://www.who.int/ageing/events/world-report-2015-launch/en/##6.Statistical Center of Iran. The detailed results of general census of population and housing in 2006. Availiable at: https://www.amar.org.ir/. 2015.##7. Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium tuberculosis. In: Mandell GL, Bennett JE, Dolin R, editors. Principle and practice of infectious diseases. 7th ed. Philadelphia, USA: Churchill Livingstone; 2010: 3129–63. ##8.,Kasper DL, Braunwald E, Hauser S, et al. Harrison’s principles of internal medicine. 16th. New York: McGraw-Hill Professional. 2004.##9.Alavi SM, Salami N. The causes of death among patients with tuberculosis in Khuzestan, Iran. Pakistan Journal of Medical Sciences. 2008;24(2):217.##10.den Boon S, Borgdorff MW, Verver S, et al. Association between smoking and tuberculosis infection: a population survey in a high tuberculosis incidence area. Thorax. 2005;60(7):555-7.##11.Lemos AC, Matos E, Bittencourt CN. Prevalence of active and latent TB among inmates in a prison hospital in Bahia, Brazil. Journal Brasileiro de Pneumologi. 2009 Jan;35(1):63-8.##12.Leung CC LT, Chan WM, Yew WW, et al. Diabetic control and risk of tuberculosis: a cohort study. American Journal of Epidemiology. 2008;167(12):1486-94.##13.Organisation PAH. Tuberculosis in the Region of the Americas Regional Report 2011: Epidemiology CaFIPAHO, Washington DC. 2011.##14.Quantrill SJ WM, Bell CE, Hutchison AJ, et al. Peritoneal tuberculosis in patients receiving continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant. 2001; 16(5):1024-7.##15.Hocking WG, Golde DW. The pulmonary-alveolar macrophage. New England Journal of Medicine. 1979;301(11):580-7.##16.Maurya V ,Vijayan V, Shah A. Smoking and tuberculosis: an association overlooked. The International Journal of Tuberculosis and Lung Disease. 2002;6(11):942- 51.##17. Tubercolusis. Center for Diseases Control (CDC), Iranian Ministry of Health and Medical Education, 2004 [Persian]. ##18.World Health Organisation (WHO).Tuberculosis (TB).Global Tuberculosis Control Surveillance P, Financing, Who, Available at: URL: http://www.who.int/tb/publications/global_report/2008/en/.##19. Dutt AK, Stead WW. Tuberculosis in the elderly. Med Clin North Am 1993;77:1353–1368.##20.Rezaei-talab F ,Akbari H, Rezaei-talab GH. Smooking associated with pulmonary TB. Med J Mashhad Univ Med Sci 2007;50(95):75-80. [Persian].##21 Guya M, editor Diabetes and hypothyroidism. Annual Conference of Diabetes and Hypothyroidism Screening Center for Diseases Control (CDC), Iranian Ministry of Health and Medical Education; 2006 Persian].##22. Nissapatorn V, Kuppusamy I, Josephine FP, et al. Tuberculosis: a resurgent disease in immunosuppressed patients. The Southeast Asian Journal of Tropical Medicine and Public Health. 2006; 37sup: 153-160.##23. World Health Organisation (WHO). World Population Aging 2013. In United Nations. Available at : URL:http://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing; 2013 ##24. CDC Reported tuberculosis in the United States 2013. Available at : URL: https://www.cdc.gov/tb/statistics/reports/2013/pdf/report; 2013##25.Mirhaghani L, Nasehi M. National tuberculosis program in Iran. Iran, Tehran: Ministry of Health, Nashre Seda; 2002 [Persian].##26.Korzeniewska-Kosela M, Krysl J, Müller N, et al. Tuberculosis in young adults and the elderly: a prospective comparison study. Chest Journal. 1994;106(1): 28-32.##27.Pérez-Guzmán C, Vargas MH, Torres-Cruz A, et al. Does aging modify pulmonary tuberculosis?: A meta-analytical review. Chest Journal. 1999; 116(4): 961-967.##28.Lee JH, Han DH, Song JW, et al. Diagnostic and therapeutic problems of pulmonary tuberculosis in elderly patients. Journal of Korean Medical Science. 2005; 20(5): 784-789.##29.Van Den Brande P, Vijgen J, Demedts M. Clinical spectrum of pulmonary tuberculosis in older patients: comparison with younger patients. Journal of Gerontology. 1991; 46(6): 204-209.##30. Talebi-Taher M, Javad-Moosavi SA, Pourghasemian M. Comparing pulmonary tuberculosis between elderly patients and young adults. Razi Journal of Medical Sciences. 2011; 18(88): 30-35[Persian]. ##31.Rizvi N, Shah RH, Inayat N, et al. Differences in clinical presentation of pulmonary tuberculosis in association with age. Journal of Pakistan medical Association. 2003; 53(8).##32.Evans JG. General medicine and geriatrics, where is the difference? The example of infective disease. Schweizerische Medizinische Wochenschrift. 1995; 125(40): 1847-1854.##33.Jeon CY, Murray MB. Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Medicine. 2008; 5(7): 1091-1101.##34. Brode SK, Jamieson FB, Ng R, et al. Increased risk of mycobacterial infections associated with anti-rheumatic medications. Thorax. 2015; 70(7): 677–682.##35.Dixon WG, Hyrich KL, Watson KD, et al. Drug-specific risk of tuberculosis in patients with rheumatoid arthritis treated with anti-TNF therapy: results from the British Society for Rheumatology Biologics Register (BSRBR). Annals of the Rheumatic Diseases. 2010; 69(3): 522-528.##36. Tubach F, Salmon D, Ravaud P, et al. Risk of tuberculosis is higher with anti-tumor necrosis factor monoclonal antibody therapy than with soluble tumor necrosis factor receptor therapy:The three-year prospective French Research Axed on Tolerance of Biotherapies registry. Arthritis & Rheumatology. 2009; 60(7): 1884–1894.##37. Jick SS, Lieberman ES, Rahman MUm et al. Glucocorticoid use, other associated factors, and the risk of tuberculosis. Arthritis & Rheumatology. 2006; 55(1): 19–26.##38. Lai CC, Lee MT, Lee SH, et al. Risk of incident active tuberculosis and use of corticosteroids. The International Journal of Tuberculosis and Lung Disease. 2015; 19(8): 936–942.##39.Schaberg T, Rebhan K, Lode H. Risk factors for side-effects of isoniazid, rifampin and pyrazinamide in patients hospitalized for pulmonary tuberculosis. European Respiratory Journal. 1996; 9(1): 2026–2030.##40. Yee D, Valiquette C, Pelletier M, et al. Incidence of serious side effects from first-line antituberculosis drugs among patients treated for active tuberculosis. American Journal of Respiratory and Critical Care Medicine. 2003; 167(11): 1472–1477.##41.Teale C, Goldman J, Pearson S. The association of age with the presentation and outcome of tuberculosis: a five-year survey. Age and Ageing. 1993; 22(4): 289-293.##42. Alvarez S, Shell C, Berk SL. Pulmonary tuberculosis in elderly men. The American journal of medicine. 1987; 82(3) :602–606.##43. Counsell SR, Tan JS, Dittus RS. Unsuspected pulmonary tuberculosis in a community teaching hospital. Archives of Internal Medicine. 1989; 149(6): 1274–1278.#### ##

Impact of Financial Development on CO2 Emissions: Panel Data Evidence from Iran’s Economic Sectors تاثیر توسعه مالی بر انتشار CO2: شواهدی از پنل دیتا برای بخش های اقتصادی ایران 2 1 مقدمه: روندهای ملی نشان می دهد که استان های مختلف ایران به موازات فرآیند رشد اقتصادی، آلودگی های زیست محیطی را تجربه کردند. بدیهی است تاثیرات انتشارCO2  روی شاخص های سلامت از قبیل نرخ مرگ و میر، نرخ مرگ و میر نوزادان و مخارج بهداشت و درمان طی دهه گذشته از سوی سیاست گذاران مورد غفلت واقع شده است. روش: این مطالعه برای اولین بار در پیشینه تحقیق موجود در ایران، تاثیر توسعه مالی روی انتشارCO2 در سه بخش کشاورزی، صنعت و خدمات را با استفاده از داده های پنل دوره 1395-1368 به کمک تخمین زننده های PMG و MG آزمون می نماید. علاوه بر این پتانسیل تاثیرگذاری متغیر اندازه دولت و موجودی سرمایه روی انتشارCO2 نیز آزمون شده است. یافته ها: طبق نتایج تجربی اندازه دولت و موجودی سرمایه تاثیر مثبت، روی انتشار CO2 داشته اند. در حالیکه توسعه مالی باعث کاهش انتشار CO2 می گردد. هر چند نتایج نشان می دهد که این متغیرها تاثیر معناداری بر انتشار CO2 در کوتاه مدت ندارند.  نتیجه گیری: مطالعه دریچه جدیدی پیش روی سیاست گذاران برای کنترل آلودگی های محیط زیست از طریق توسعه مالی باز می کند. آن بیان می کند سیاست گذاران باید ظرفیت هایی که از طریق توسعه مالی می توان انتشار CO2 را کاهش داد را مورد توجه قرار دهند. در این راستا نیاز است که آنها از طریق کاهش هزینه سرمایه گذاری، از طرح های حفاظت محیط زیست  حمایت نمایند 2 Introduction: The national trend indicates that various provinces of Iran have experienced in attaining economic growth exclusive of parallel observing a boost in CO2 emissions. It is clear that the effects of CO2 emissions on health indicators such as death rate, infant mortality, and health expenditures have been ignored by policy makers over the last decade.   Methods: This study for the first time in previous literature in Iran, utilizes 1989-2016 panel data of the three economic sectors (agriculture, industry and services) of Iran to examine the effect of financial development on CO2 emissions using Pooled Mean Group (PMG) and Mean Group (MG) Regression techniques. The potential impact of government size and capital stock on CO2 emissions is also analysed.   Results: According to empirical results, in the long-run, government size and capital stock increase CO2 emissions, while financial development compact it. However, the results show these variables don’t have statistically significant effect on CO2 emissions in short-run.   Conclusion: The study opens up new policy insights to control the Environment from degradation by financial development on economic sectors. It recommends that policy makers should realize the potentiality of the financial development in minimizing the CO2 emissions. Therefore, the policy makers need to facilitate more financing at lower costs for investment in environmental projects. 127 133 2017/12/32018/05/262018/02/102018/02/182018/02/272018/03/22018/04/162018/05/29 1397/3/8 2018/02/172018/05/262018/05/72018/05/72018/05/72018/05/72018/05/72018/05/29 1397/3/8 نغمه قریشی Naghmeh Ghorashi Department of Economics, Kerman Branch, Islamic Azad University, Kerman, Iran Iran n.ghorashi@iauk.ac.ir عباس علوی راد Abbas Alavi Rad Department of Economics, Kerman Branch, Islamic Azad University, Kerman, Iran Iran CO2 Emissions Financial Development Government Size Iran’s Economic Sectors Pooled Mean Group (PMG) Regression انتشارco2 توسعه مالی اندازه دولت بخش های اقتصادی ایران رگرسیون میانگین گروهی انباشته( PMG) 1. Horry HR, Jalaee SA, Jafari S. Examining the impact of financial development and energy consumption on the environmental degradation in Iran in the framework of the environmental kuznets curve hypothesis (EKC). Journal of Iranian Energy Economics. 2013; 2(6): 27-48 [Persian].##2. Ghorashi N, Alavi Rad A. CO2 emissions, health expenditures and economic growth in iran: application of dynamic simultaneous equation models. Journal of Community Health Research. 2017; 6(2): 109-116.##3. Jafari Samimi A, Habibian F. Government size and economic growth: new evidence from some developing countries. Journal of Basic and Applied Scientific Research. 2011; 1(2): 118-123.##4. Copeland BR, Taylor MS. Trade, growth, and the environment. Journal of Economic literature. 2004; 42(1): 7-71.##5. Dasgupta S, Laplante B. Mamingi N. Pollution and capital markets in developing countries. Journal of Environmental Economics and Management. 2001; 42(3): 310-335.##6. Dinda S. Environmental Kuznets curve hypothesis: A survey Ecological Economics. 2004; 49(4): 431-455.##7. Grossman GM, Krueger AB. Economic growth and the environment. The Quarterly Journal of Economics. 1995; 110(2): 353-377.##8. Claessens S. Feijen E. Financial sector development and the millennium development goals. Washington, D.C: World Bank Publications; 2007.##9. Kumbaroğlu G, Karali N, Arıkan Y. CO2, GDP and RET: an aggregate economic equilibrium analysis for Turkey. Energy Policy. 2008; 36(7): 2694-2708.##10. Halicioglu F. An econometric study of CO2 emissions, energy consumption, income and foreign trade in Turkey. Energy Policy. 2009; 37(3): 1156-1164.##11. Tamazian A, Chousa J P. Vadlamannati KC. Does higher economic and financial development lead to environmental degradation: evidence from BRIC countries. Energy Policy. 2009; 37(1): 246-253.##12. Tamazian A, Rao BB. Do economic, financial and institutional developments matter for environmental degradation? evidence from transitional economies. Energy Economics. 2010; 32(1): 137-145.##13. Tadesse SA. Financial development and technology. Turkish Journal of Marketing. 2005; 12(12): 2017-2018.##14. Shahbaz M , Solarin SA, Mahmood H, et al. Does financial development reduce CO2 emissions in Malaysian economy? a time series analysis. Economic Modelling. 2013; 35: 145-152.##15. Shahbaz M, Hye QM A, Tiwari AK, et al. Economic growth, energy consumption, financial development, international trade and CO2 emissions in Indonesia. Renewable and Sustainable Energy Reviews. 2013; 25: 109-121.##16. Boutabba MA. The impact of financial development, income, energy and trade on carbon emissions: Evidence from the Indian economy. Economic Modelling. 2014; 40: 33-41.##17. Abbasi F, Riaz K. CO2 emissions and financial development in an emerging economy: an augmented VAR approach. Energy Policy. 2016; 90: 102-114.##18. Shahzad SJH, Kumar RR, Zakaria M, et al. Carbon emission, energy consumption, trade openness and financial development in Pakistan: a revisit. Renewable and Sustainable Energy Reviews. 2017; 70: 185-192.##19. Salahuddin M, Alam K, Ozturk I, et al. The effects of electricity consumption, economic growth, financial development and foreign direct investment on CO2 emissions in Kuwait. Renewable and Sustainable Energy Reviews. 2018; 81(2): 2002-2010.##20. Xiong L, Tu Z, Ju L. Reconciling regional differences in financial development and carbon emissions: a dynamic panel data approach. Energy Procedia. 2017; 105: 2989-2995.##21. Paramati SR , Mo D. Gupta R. The effects of stock market growth and renewable energy use on CO2 emissions: evidence from G20 countries. Energy Economics. 2017; 66: 360-371.##22. Pesaran MH, Shin Y, Smith RP. Pooled mean group estimation of dynamic heterogeneous panels. Journal of the American Statistical Association. 1999; 94(446): 621-634.##23. Levin A, Lin CF, Chu CS. Unit root tests in panel data: asymptotic and finite-sample properties. Journal of Econometrics. 2002; 108(1): 1-24.##24. Im KS, Pesaran MH, Shin Y. Testing for unit roots in heterogeneous panels. Journal of Econometrics. 2003; 115(1): 53-74.##25. Maddala GS, Wu S. A comparative study of unit root tests with panel data and a new simple test. Oxford Bulletin of Economics and Statistics. 1999; 61(S1): 631-652.## ##