The Effect of Storage Time, Temperature and Type of Packaging on the Release of Phthalate Esters into Packed Acidic Liquids

Kisele tekućine, poput soka od nezrelog voća, limunovog soka i octa često se konzumiraju u Iranu. Različite vrste kiselih sokova pakiraju se u boce od polietilen tereftalata (PET) i polietilena velike gustoće (HDPE). Postoje dokazi koji upućuju na mogućnost otpuštanja ftalata iz PET i HDPE boca. U ovom je radu ispitan utjecaj trajanja skladištenja, temperature i vrste pakiranja na migraciju ftalata u kisele tekućine, čuvane pri različitim uvjetima, i to prije skladištenja, te nakon 2, 4 i 6 mjeseci. Određene su srednje vrijednosti koncentracije ftalata od <0.04 do 0.501 μg/L u sokovima od nezrelog voća, od <0.04 do 0.231 μg/L u limunovom soku i <0.04 do 0.586 μg/L u octu. Najveće koncentracije dietil ftalata (DEP) i dietil heksil ftalata (DEHP) izmjerene su u PET i HDPE bocama. Rezultati prije i naklon skladištenja pokazuju da su se, pri određenim uvjetima skladištenja, koncentracije DEP, DEHP i dibutil ftalata (DBP) povećale u kiselim tekućinama. Rezultati dokazuju da je moguć prijelaz estera ftalne kiseline iz plastičnih pakiranja u sadržaj spremnika.Acidic liquids such as verjuice, lemon juice and vinegar are frequently consumed in Iran. Different kinds of acidic liquids are packaged in polyethylene terephthalate (PET) and high-density polyethylene (HDPE) bottles. There is evidence indicating that phthalates can leach from PET and HDPE bottles into their contents. In this work the effect of storage time, temperature and bottle type on the migration of phthalates from packaging materials into acidic liquids is studied by analyzing the samples stored under different conditions, before storage and after 2, 4 and 6 months of storage. The determined mean phthalate concentrations in μg/L were: <0.04 to 0.501 in verjuice, <0.04 to 0.231 in lemon juice and <0.04 to 0.586 in vinegar. The highest concentrations of diethyl phthalate (DEP) and diethyl hexyl phthalate (DEHP) were found in PET and HDPE bottles, respectively. Results of analyses before and after storage indicate that under some storage conditions, the concentrations of DEP, DEHP and dibutyl phthalate (DBP) increased in acidic liquids. The possible migration of phthalic acid esters from plastic packaging materials into the contents was indicated by the results of the present study

Health impact assessment of air pollution in Shiraz, Iran : a two-part study

We aimed to assess health-impacts of short-term exposure to the air pollutants including PM10, SO2, and NO2 in Shiraz, Iran in a two-part study from 2008 to 2010. In part I, local relative risks (RRs) and baseline incidences (BIs) were calculate using generalized additive models. In part II, we estimated the number of excess hospitalizations (NEHs) due to cardiovascular diseases (CDs), respiratory diseases (RDs), respiratory diseases in elderly group (RDsE-people older than 65 years old), and chronic obstructive pulmonary diseases (COPDs) as a result of exposure to air pollutants using AirQ model, which is proposed approach for air pollution health impact assessment by World Health Organization. In part I, exposure to increase in daily mean concentration of PM10 was associated with hospitalizations due to RDs with a RR of 1.0049 [95% confidence interval (CI), 1.0004 to 1.0110]. In addition, exposure to increase in daily mean concentration of SO2 and NO2 were associated with hospitalizations due to RDsE and COPDs with RRs of 1.0540 [95% CI, 1.0050 to 1.1200], 1.0950 [95% CI, 1.0700 to 1.1100], 1.0280 [95% CI, 1.0110 to 1.0450] and 1.0360 [95% CI, 1.0210 to 1.0510] per 10 μg/m3 rise of these pollutants, respectively. In part II, the maximum NEHs due to CDs because of exposure to PM10 were in 2009-1489 excess cases (ECs). The maximum NEHs due to RDs because of exposure to PM10 were in 2009-1163 ECs. Meanwhile, the maximum NEHs due to RDsE and COPDs because of exposure to SO2 were in 2008, which are 520 and 900 ECs, respectively. In conclusion, elevated morbidity risks were found from acute exposure to air pollutants

Psychological Predictors of Intention to Deliver Vaginally through the Extended Parallel Process Model: A Mixed-Method Approach in Pregnant Iranian Women

Objectives: Despite the fact that cesarean delivery does not offer significant health benefits for either mother or newborn, there has been a noticeable upward trend in elective cesarean births in Iran, over the last two decades. This study aims to examine whether knowledge, perception of health threats, efficacy, and personal beliefs act as psychological predictors towards the intention of women to have a normal vaginal delivery.Methods: The mixed-method approach was used as quantitative and qualitative design. Simultaneously, 290 pregnant women who visited prenatal clinics participated in the study. Quantitative and qualitative data were collected using a structured questionnaire based on Witte’s Extended Parallel Process Model, and four focus groups, respectively.Results: Women perceived lower personal risk but higher levels of efficacy. Perceived self-efficacy, severity, and response efficacy emerged as significant predictors of intention to experience vaginal birth. The participants’ insufficient knowledge and misconceptions about birth methods were prevalent. Major themes were identified and divided into negative and positive beliefs about vaginal birth.Conclusion: This educational model is useful for understanding women’s intention to undergo a vaginal birth, especially when it is combined with a qualitative approach. Maternal care providers should acknowledge their clients’ beliefs and intended childbirth methods prior to offering medical intervention

A framework for exploration and cleaning of environmental data : Tehran air quality data experience

Management and cleaning of large environmental monitored data sets is a specific challenge. In this article, the authors present a novel framework for exploring and cleaning large datasets. As a case study, we applied the method on air quality data of Tehran, Iran from 1996 to 2013. ; The framework consists of data acquisition [here, data of particulate matter with aerodynamic diameter ≤10 µm (PM10)], development of databases, initial descriptive analyses, removing inconsistent data with plausibility range, and detection of missing pattern. Additionally, we developed a novel tool entitled spatiotemporal screening tool (SST), which considers both spatial and temporal nature of data in process of outlier detection. We also evaluated the effect of dust storm in outlier detection phase.; The raw mean concentration of PM10 before implementation of algorithms was 88.96 µg/m3 for 1996-2013 in Tehran. After implementing the algorithms, in total, 5.7% of data points were recognized as unacceptable outliers, from which 69% data points were detected by SST and 1% data points were detected via dust storm algorithm. In addition, 29% of unacceptable outlier values were not in the PR.  The mean concentration of PM10 after implementation of algorithms was 88.41 µg/m3. However, the standard deviation was significantly decreased from 90.86 µg/m3 to 61.64 µg/m3 after implementation of the algorithms. There was no distinguishable significant pattern according to hour, day, month, and year in missing data.; We developed a novel framework for cleaning of large environmental monitored data, which can identify hidden patterns. We also presented a complete picture of PM10 from 1996 to 2013 in Tehran. Finally, we propose implementation of our framework on large spatiotemporal databases, especially in developing countries

A multicenter randomized controlled trial of aftercare services for severe mental illness: study protocol

BACKGROUND: Severe mental illness is responsible for a significant proportion of burden of diseases in Iranian population. People with severe mental illnesses are more likely to have high rates of non-attendance at follow-up visits, and lack of an active follow-up system, particularly in the country’s urban areas that has resulted in the revolving door phenomenon of rehospitalizations. Therefore, there is an increasing need for implementation of effective and cost-effective aftercare services. METHOD/DESIGN: This is a randomized control trial with the primary hypothesis that aftercare services delivered to patients with severe mental illnesses in outpatient department and patient's home by a community care team would be more effective when compared to treatment as usual (TAU) in reducing length of hospital stay and any psychiatric hospitalization. Patients were recruited from three psychiatric hospitals in Iran. After obtaining informed written consent, they were randomly allocated into aftercare intervention and control (TAU) groups. Aftercare services included treatment follow-up (through either home care or telephone follow-up prompts for outpatient attendance), family psychoeducation, and patient social skills training that were provided by community mental health teams. Patients were followed for 12 months after discharge. The primary outcome measures were length of hospital stay and any hospitalization in the 12 month follow-up. Secondary outcome measures included patients' clinical global impression, global functioning, quality of life, and patient's satisfaction. The trial also allowed an assessment of direct cost-effectiveness of the aftercare services. DISCUSSION: This paper presents a protocol for an RCT of aftercare services delivered to patients with severe mental illnesses within patients' home or outpatient department. The findings of this study can influence policy and program planning for people with severe mental illnesses in Iran. TRIAL REGISTRATION: IRCT201009052557N

Microbial Evaluation of Fresh, Minimally-processed Vegetables and Bagged Sprouts from Chain Supermarkets

The aim of this study was to evaluate the bacterial and fungal quality of minimally-processed vegetables (MPV) and sprouts. A total of 116 samples of fresh-cut vegetables, ready-to-eat salads, and mung bean and wheat sprouts were randomly collected and analyzed. The load of aerobic mesophilic bacteria was minimum and maximum in the fresh-cut vegetables and fresh mung bean sprouts respectively, corresponding to populations of 5.3 and 8.5 log CFU/g. E. coli O157:H7 was found to be absent in all samples; however, other E. coli strains were detected in 21 samples (18.1%), and Salmonella spp. were found in one mung bean (3.1%) and one ready-to-eat salad sample (5%). Yeasts were the predominant organisms and were found in 100% of the samples. Geotrichum, Fusarium, and Penicillium spp. were the most prevalent molds in mung sprouts while Cladosporium and Penicillium spp. were most frequently found in ready-to-eat salad samples. According to results from the present study, effective control measures should be implemented to minimize the microbiological contamination of fresh produce sold in Tehran, Iran

National and sub-national environmental burden of disease in Iran from 1990 to 2013-study profile

Development of national evidence-based public health strategies requires a deep understanding of the role of major risk factors (RFs) and the burden of disease (BOD). In this article, we explain the framework for studying the national and sub-national Environmental Burden of Disease (EBD) in Iran as a part of the National and Sub-national Burden of Disease (NASBOD) study.; The distribution of exposures to environmental RFs and their attributable effect size over 1990-2013 will be estimated through comprehensive reviews of either published or unpublished sources. Statistical modeling will be used to impute missing data in the distribution of RFs exposures for each district-year. National and sub-national BOD attributable to these RFs will be estimated in the following metrics: Prevalence, death, years of life lost due to premature death (YLL), years of life lost due to disability (YLD), and disability-adjusted life years lost (DALYs). The BOD attributable to the current distribution of exposures will be compared with a counterfactual exposure distribution scenario-here, the theoretical-minimum-risk exposure distribution. Inequalities in the distribution of exposure to RFs will be analyzed and manifested nationwide using geographic information systems.; The EBD study aims to provide an official report to Iranian Ministry of Health and Medical Education, to publish a series of articles on the exposure trends of the selected environmental RFs, to estimate the BOD attributable to these RFs, and to assess inequalities and its determinants in the distribution of exposure to RFs. Iran's territory is large with diverse population, socioeconomic, and geographic areas. Results of this comparative risk assessment study may pave the way for health policy makers to plan more comprehensive and cost-effective evidence-based strategies

Acute symptoms related to air pollution in urban areas: a study protocol

BACKGROUND: The harmful effects of urban air pollution on general population in terms of annoying symptoms are not adequately evaluated. This is in contrast to the hospital admissions and short term mortality. The present study protocol is designed to assess the association between the level of exposure to certain ambient air pollutants and a wide range of relevant symptoms. Awareness of the impact of pollution on the population at large will make our estimates of the pertinent covert burden imposed on the society more accurate. METHODS/DESIGN: A cross sectional study with spatial analysis for the addresses of the participants was conducted. Data were collected via telephone interviews administered to a representative sample of civilians over age four in the city. Households were selected using random digit dialling procedures and randomization within each household was also performed to select the person to be interviewed. Levels of exposure are quantified by extrapolating the addresses of the study population over the air pollution matrix of the city at the time of the interview and also for different lag times. This information system uses the data from multiple air pollution monitoring stations in conjunction with meteorological data. General linear models are applied for statistical analysis. DISCUSSION: The important limitations of cross-sectional studies on acute effects of air pollution are personal confounders and measurement error for exposure. A wide range of confounders in this study are controlled for in the statistical analysis. Exposure error may be minimised by employing a validated geographical information system that provides accurate estimates and getting detailed information on locations of individual participants during the day. The widespread operation of open air conditioning systems in the target urban area which brings about excellent mixing of the outdoor and indoor air increases the validity of outdoor pollutants levels that are taken as exposure levels

A global survey on changes in the supply, price, and use of illicit drugs and alcohol, and related complications during the 2020 COVID-19 pandemic

Background and Aims : COVID-19 has infected more than 77 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing, and "lockdown" measures have affected drug and alcohol supply chains and subsequently their availability, price, and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic. Design : Cross-sectional survey. Setting : Worldwide. Participants : Starting on April 4, 2020 during a 5-week period, the survey received 185 responses from 77 countries. Measurements : To assess addiction medicine professionals' perceived changes in drug and alcohol supply, price, use pattern, and related complications during the COVID-19 pandemic. Findings : Participants reported (among who answered "decreased" or "increased") a decrease in drug supply (69.0%) and at the same time an increase in price (95.3%) globally. With respect to changes in use patterns, an increase in alcohol (71.7%), cannabis (63.0%), prescription opioids (70.9%), and sedative/hypnotics (84.6%) use was reported, while the use of amphetamines (59.7%), cocaine (67.5%), and opiates (58.2%) was reported to decrease overall. Conclusions : The global report on changes in the availability, use patterns, and complications of alcohol and drugs during the COVID-19 pandemic should be considered in making new policies and in developing mitigating measures and guidelines during the current pandemic (and probable future ones) in order to minimize risks to people with SUD.Publisher PDFPeer reviewe