Gender Differential in the Association of Body Mass Index and Abdominal Obesity with Prehypertension and Hypertension in Iranian Adults

*Objective:* The aim of this study was to determine the gender differential in the relationship of body mass index (BMI) and abdominal obesity with blood pressure (BP) and prevalence of hypertension (HTN) and prehypertension (Pre-HTN) among the adult population of Iran.

*Design:* A nationwide cross-sectional survey was conducted from December 2004 to February 2005. The selection was conducted by stratified probability cluster sampling through household family members in Iran.

*Subjects and Measurements:* Weight, height, waist circumference (WC), and systolic and diastolic BP of 45,082 men and 44,322 women aged 15-65 (mean 39.2) were measured. 

*Results:* The prevalence of HTN was 25.2% in men and 24.8% in women; and 50.1% of men and 39.1% of women were pre-hypertensive. WC and BMI were strongly associated with BP in both genders. Multivariate analysis revealed that both WC and BMI had the stronger association with HTN and Pre-HTN in men than women. Compared to men and women with normal weight, the multivariate-adjusted odds ratio (OR) (95% confidence interval) of HTN was 5.75 (5.13, 6.44) for men and 4.29 (3.95, 4.66) for women with BMI ≥ 30. The multivariate OR of prevalence HTN in men with abdominal obesity compared with men without was 3.76 (3.41, 4.22) and in women, 2.92 (2.73, 3.13).

*Conclusion:* These data indicate that both BMI and WC had the stronger association with HTN and Pre-HTN in men than women. 
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Hepatitis B vaccination coverage among Iranian children aged 15-26 months in 2006

This study in 2006 estimated the hepatitis B virus (HBV) vaccination coverage in the Islamic Republic of Iran at the national and district levels in urban, rural and remote populations of 41 university health service areas. Of 21 905 children recruited to the study, vaccination coverage based on vaccination card records was 100% in 14, 15 and 10 of the 41 university areas for the 1st, 2nd and 3rd doses of HBV respectively. National levels of HBV1, HBV2 and HBV3 coverage were 98.9%, 98.8% and 98.4% respectively. The lowest HBV vaccination coverage rate was 90.7% (in a remote district). HBV vaccination coverage was at an acceptable level in Iranian children

Innovation and Entrepreneurship Studies: One or Two Fields of Research?

Innovation and industrial dynamics have grown in importance over the last 40-50 years as we have moved towards a more knowledge intensive society. In an effort to understand these developments in society new research fields have emerged such as innovation and entrepreneurship studies. In general, these two research fields are regarded as rather closely interlinked. In this study we elaborate on the question: Should innovation and entrepreneurship be seen as one or two fields of research? We have taken a cognitive approach in which we analyze the knowledge platforms in innovation and entrepreneurship studies. We use a methodology in which we have built a unique database consisting of all references in twelve “state-of-the-art” books in entrepreneurship. The chapters in these “state-of-the-art” books are written by experts within the field, and it can be assumed that the most frequently cited references in these chapters represent “core knowledge” in entrepreneurship research. We have analyzed the references cited in these chapters in order to identify core contributors and core works within entrepreneurship research. In addition, we have compared our results with a similar study conducted by Fagerberg et al. (2012) on the knowledge basis in the field of innovation studies. The study shows that we are talking about two more or less separate fields of research. Despite common roots in Schumpeter and some interrelated works, the two fields seem to have drifted apart over the last decades. However, there seems to be some elements of overlaps, for example, in the interest in the evolutionary approaches, and in the interest in topics such as innovation management (corporate entrepreneurship) and in technology-based ventures

Relationship between occurrence of Guillain-Barre syndrome and mass campaign of measles and rubella immunization in Iranian 5-14 years old children

Background: Case reports and epidemiologic studies have reported a relation between different vaccines including measles, rubella, mumps and Guillain-Barre syndrome (GBS). In this study we investigated relation between receiving measles and/or rubella vaccines and occurrence of GBS after national immunization campaign in 2003 in Iran. Materials and methods: We used the national surveillance system for acute flaccid paralysis from the beginning of 2002 to the end of 2004 and studied the incidence of GBS disease among 5-14-year-old children. The 3-year time span of the study was divided into fifteen 10 weeks intervals and the number of reported and confirmed GBS case reports in each time period was analyzed supposing their distribution was according to Poisson distribution. Results: From 2002 through 2004 there were 370 patients confirmed GBS case reports among persons 5-14 years of age. The annual incidence in this age group remained relatively constant over the 3-year period and ranged from 0.65 per 100,000 population in 2004 to 0.76 in 2003. The estimated average annual incidence of GBS in persons <15 years of age was 1/100,000 (CI 95%: 0.88-1.13), and 0.7/100,000 in persons 5-14 years of age (CI 95%: 0.58-0.83). No obvious seasonal pattern in GBS occurrence was observed. The mean number of GBS patients during each 10 week study interval was 23.8. Twenty-five patients with GBS were reported in the time period which coincided with national immunization campaign. The probability of occurring ≥25 cases of GBS in that time period according to Poison distribution with expected case numbers of 23-8 is equal to 0.43 (p = 0.43). Conclusion: The yearly incidence rate of GBS in this study was similar to other studies. According to our results, there was no increase in GBS Incidence in the 4 weeks national Immunization campaign and 6 weeks after it in comparison to other 10 weeks periods before or after this time period. © 2008 Elsevier Ltd. All rights reserved

Three Essays on Global Linkages for Innovation

Globalization is an important theme in a broad set of conversations, from everyday talks to political and academic debates, both in positive and also negative terms. But what are the positive implications of globalization for the economic development of the countries? Do the effects of globalization on innovation differ between developed and developing economies? This PhD dissertation aims to explore these questions by identifying under which conditions globalization – conceived as a process fostering knowledge flows at a global scale – has played an important role in the innovation process. The contribution of this dissertation is to the field of geography of innovation. Despite recent research on the spatial dimension of sources of innovation, this field still remains focused on the impact of local and global linkages, for firms in the advanced economies. This thesis contributes to this matter, by extending the discussion also to the organizational learning of firms from emerging economies. Theoretically, it builds on contributions from innovation studies, economic geography and international business. Empirically, the focus is on firm level data gathered from emerging economies (BRICS) as well as several European countries. The thesis consists of an introductory chapter followed by a literature review on previous works related to spatial aspects of knowledge sourcing for learning and innovation, three essays at different stages of publication, and finally conclusions. Contextualizing the searching behaviour and the engagement in global collaborations is at the core of all three papers. By using firm level data and conducting comparative studies between advanced (North) and emerging economies (South), the first two papers analyse the impact of global knowledge flows for novelty of innovation. The third paper explores the impact of high level of local embeddedness on firm’s engagement in global sourcing of knowledge; this paper relies on data from Indian firms The first paper investigates the effects of local and global innovation collaborations on the degree of novelty in innovations of small and medium enterprises (SMEs) in the information and communications technology (ICT) sector by considering the country in which these firms are located. The findings of this study show that global linkages do indeed impact on the degree of novelty of innovation. However, this impact is highly positive on the innovativeness of Scandinavian firms, whereas for the Indian SMEs, the regional linkages matter most. The second paper explores the role played by active collaboration with users on the degree of novelty of innovation by focusing on the location of both users and producers. The results indicate that collaborating with international users is positively related to higher degrees of novelty. Furthermore, firms in low- and middle-income countries benefit more from South- South user collaboration than from South-North collaboration. The third paper addresses the relation between high level of local embeddedness and engagement in global linkages for innovations -as a pre-requisite for catching-up- by comparing the engagement of group-affiliated firms, that are expected to present higher degree of internal collaboration, with standalone firms. The results indicate that affiliation to a business group also increases the likelihood of engagement in global linkages for innovation

Surveillance for foodborne disease outbreaks in Iran, 2006-2011

Background: The outbreaks of foodborne diseases is a major health problem and occur daily in all countries, from the most to the least developed. This study is the first report of foodborne outbreaks in Iran that carried out from 2006 to 2011. Methods: A retrospective, longitudinal study carried out using foodborne disease national surveillance system data from 2006-2011, which have been reported by all provincial health centers to the Center for Communicable Disease Control. Collected data were analyzed using SPSS version 18 software. Results: Since 2006 to 2011, a total of 2250 outbreaks were reported in Iran. Analyzed data showed that the outbreak rate has increased from 0.07/100000 in 2006 to 1.38/100000 population in 2011. Khuzestan, Kermanshah and Qazvin were three provinces that reported more outbreaks than nationally expected outbreak incidence rate during 2011. Analysis of epidemiological characteristics of foodborne outbreaks during 2011 indicated that the numbers of outbreaks were highest in warm months, e.g. 17.8 of total outbreaks was just reported in August. Females and age group of 16-30 years old were more affected and 55 of cases occurred in rural area. Among 684 human samples which have been tested, E. coli, Shigella, Hepatitis A and Vibrio cholera were predominant etiologic agents respectively. Conclusion: Increasing the detection rate of foodborne outbreaks imply the expansion of surveillance activities and improved primary health care in Iran in recent years. Foodborne disease surveillance system is a new program in Iran that should be continued and strengthened including diagnostic laboratory capacities

Health care-associated infections, including device-associated infections, and antimicrobial resistance in Iran: The national update for 2018

Introduction. Surveillance of health care-associated infections (HAIs) is an essential part of an efficient healthcare system. This study is an update on incidence and mortality rates of HAIs in Iran in 2018. Methods. Almost all hospitals across the country (940 hospitals) entered the data of HAIs and denominators to the Iranian Nosocomial Infections Surveillance (INIS) software. Statistics were derived from INIS. Results. From 9,607,213 hospitalized patients, 127,953 suffered from HAI, 15.65% of whom died. The incidence rate of HAI was calculated as 4.2 per 1000 patient-days. Considering relative frequencies among HAIs, Pneumonia (29.1%) and UTIs (25.6%) were the most common types of infection. Ventilator-associated pneumonia (VAP) was the most frequent device-associated infection (DAI) 25.66 per 1000 ventilator-days, and had the highest mortality rate (43.08%). Incidence density of other DAIs was 5.43 for catheter-associated UTI and 2.86 for catheter-associated BSI per 1000 device-days. Medical ICUs had the highest incidence and percentage of deaths (15.35% and 37.63%, respectively). The most causative organisms were Escherichia coli, Acinetobacter baumannii, and Klebsiella pneumonia. The rate of methicillin-resistance Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria was about 49%, 57%, and 58% respectively. Conclusion. The findings indicate that HAIs in Iran require special attention, and further studies are needed to evaluate them more accurately, identify risk factors and preventive interventions

Needle and syringe sharing practices of injecting drug users participating in an outreach HIV prevention program in Tehran, Iran: A cross-sectional study

HIV infection rates have reached epidemic proportions amongst injecting drug users (IDUs) in Iran. Although a number of community-based interventions have being implemented in the country, there is little information on the risk behaviors of IDU participants in these programs. This cross-sectional report aimed to compare the risk behaviors of injecting drug users with differential exposure rates to an HIV outreach program in Tehran, Iran. Results indicated that shared use of needle/syringe in the past month was significantly lower among IDUs who received estimated ≥ 7 syringes per week than those who did not [adjusted odds ratio (OR) = 14.36, 95% confidence interval (CI) 2.30–89.56]. While the effectiveness of this outreach program needs further evaluation through a longitudinal investigation, our preliminary findings suggest that the outreach program in Tehran may have been beneficial in reducing direct sharing among those who received more than several needles/syringes from the program

The epidemiology of cholera in the Islamic Republic of Iran, 1965�2014 �pidémiologie du choléra en République Islamique d�Iran (1965-2014)

Background: Cholera is endemic in the Islamic Republic of Iran. According to surveillance system records and historical documents, cholera epidemics have led to thousands of deaths throughout the country in past centuries. Aims: The aim of this study was an overview of cholera disease during the last 5 decades (1965�2014) and the epidemiological features of the most recent large-scale outbreaks. Methods: In this descriptive study, cholera incidence data provided by the National Surveillance Database were extracted and significant fluctuating trends for 1965�2014 were tested using the Cochran�Armitage test. To identify the factors most associated with cholera incidence in the outbreaks, adjusted odds ratios were computed by ordinal logistic regression. Results: Analysis of data has shown a tremendous decrease in incidence trends, from 19.7/100 000 to 0.01/100 000 over the 9 cholera epidemics that occurred at 5�6 year intervals during 1965�2014. Younger age groups (15�44 years) and inhabitants in urban areas have been more vulnerable to cholera in recent epidemics. The virulence of the pathogen and the case fatality rates have not changed during the last 3 epidemics. Conclusion: The burden of cholera in terms of case load has dramatically reduced during 1965�2014. Furthermore, the epidemiological feature of cholera with regard to transmission route, domicile, age, immigration, mortality and antimicrobial resistance has changed considerably in recent epidemics. While the number of epidemic regions has diminished, some areas are still susceptible to cholera outbreaks. © World Health Organization (WHO) 2020