How much self-poisoning attempts are visible in Iran?

Abstract: Background: Stigma of suicide attempt (SA) results in not asking friends and relatives for help. Others’ awareness of an individual’s SA sometimes can solve his/her problems and reduce rates of SA. This study is intended to examine the degree of SA visibility through deliberate self-poisoning (DSP), which is the most common method of SA in Iran. Methods: In order to study visibility, all individuals who had attempted to suicide by DSP and had been referred to the western Iran poisoning center during April-June, 2016 were entered to the study. A female and a male interviewer experienced in role-playing were recruited to interview clients, each with clients of their own gender, in order to increase compliance and information accuracy. Multivariate Poisson Regression was used to identify visibility determinants. Results: Among 100 subjects interviewed, 10 denied SA. Regardless of those denying SA, self-poisoning visibility factor (SVF) was 26.6% (21.7-31.5) which decreased to 23.9% (19.7- 28.1) after considering those individuals who denied SA. The highest values of SVF were observed in subjects poisoned by toxins, alcohol and illegal drugs, respectively. In the multivariate model, the value of SVF increased with an increase in age (IRR=1.03, 95% CI: 1.02-1.04), having history of SA (IRR=1.18, 95% CI: 1.07-1.30), and being married (IRR=1.70, 95% CI: 1.05-1.29). Conclusions: Lower values of SVF of DSP indicate that individuals committing suicide do not ask others for help and saying their SA intents. The higher the degree of visibility, the lower the rates of committing and repeating SAs. To increase the visibility of SA, therefore, the one way is to prevent and reduce SA repetition

Estimating the Annual Risk of Tuberculosis Infection and Disease in Southeast of Iran Using the Bayesian Mixture Method

Background: Tuberculosis is still a public health concern in Iran. The main challenge in monitoring epidemiological status of tuberculosis is to estimate its incidence accurately. Objectives: We used a newly developed approach to estimate the incidence of tuberculosis in Sistan, an endemic area in southeast of Iran in 2012-13. Patients and Methods: This cross-sectional study was conducted on school children aged 6-9 years. We estimated a required sample size of 6350. Study participants were selected using stratified two-stage cluster sampling method and recruited in a tuberculin skin test survey. Indurations were assessed after 72 hours of the injection and their distributions were plotted. Prevalence and annual risk of tuberculosis infection (ARTI) were estimated using the Bayesian mixture model and some traditional methods. The incidence of active disease was calculated using the Markov Chain Monte Carlo technique. Results: We assumed weibull, normal and normal as the best distributions for indurations due to atypical reactions, BCG (Bacillus Calmette–Guérin) reactions and Mycobacterium tuberculosis infection, respectively. The estimated infection prevalence and ARTI were 3.6% (95%CI: 3.1, 4.1) and 0.48%, respectively. These estimates were lower than those obtained from the traditional methods. The incidence of active tuberculosis was estimated as 107 (87-149) per 100000 population with a CDR of 54% (40%-68%). Conclusions: Although the mixture model showed slightly lower estimates than the traditional methods, it seems that this method might generate more accurate results for deep exploration of tuberculosis endemicity. Besides, we found that Sistan is a high endemic area for tuberculosis in Iran with a low case detection rate

Arsenic, Cadmium, Chromium, and Lead in Children’s Products in Iran

Background: Non-standard creativity tools and entertainment products may contain heavy metals. Children are more sensitive than adults to this potentially toxic chemicals. This study aimed at investigating harmful elements in children’s products in Iran. Methods: In this descriptive-analytical study, Iranian samples (13 play dough samples, 6 finger paint, and 1 face paint sample) and 10 imported samples were investigated by atomic absorption spectrophotometry. The statistical analyses were performed using the SPSS statistical package (version 19). Results: The results of this study showed that the lead content of 2 samples of play dough (76%), 10 samples of finger paint (100%) and 3 samples of face paint (100%) was higher than the permissible limits set by the Iranian National Standards Organization. Lead and cadmium contents of 100% of the samples of play dough, along with the face and finger paints exceeded the permissible limits set by the European Union. Conclusion: Research on prolonged exposure to harmful elements and comprehensive risk characterization for toys is recommended

An evaluation of hospital admission respiratory disease attributed to sulfur dioxide ambient concentration in Ahvaz from 2011 through 2013

There is no doubt that air pollutants have adverse impacts on human health. The main objective of this study was to evaluate hospital admission respiratory disease (HARD) attributed to sulfur dioxide levels in Ahvaz during three successive years. Data was taken from Iranian Environmental Protection Agency (EPA). The AirQ2,2,3 model is used to quantify the impact of SO2 on inhabitants of Ahvaz and in terms of hospital admission respiratory diseases. This is a kind of statistical model which is based on some epidemiological indices such as relative risk, baseline incidence, and attributable proportion. Sampling was already performed for 24 h in four stations during 2011–2013. Four stations are good representative for residential, high traffic, industry, and background sites which cover the whole area of the Ahvaz city. Regarding to gravimetric scale, raw data of sulfur dioxide was processed using Excel software. Encoding, filtering, and processing were conducted to prepare input file for the Air Q2,2,3 model. After running model,1 Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 2 Environmental Technologies Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 3 Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran 4 Razi Teaching Hospital, Clinical Research Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 5 Department of Internal Medicine, Division of Pulmonology, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 6 Nutrition&Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 7 Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran 8 Research Center for Environmental Pollutants, Qom University of Medical Sciences, Qom, Iran 9 Department of Environmental Health Engineering, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran 10 The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Research Center, Bushehr University of Medical Sciences, Bushehr, Iran 11 Hyperlipidemia Research Center, Department of Laboratory Sciences School of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR, Iran 12 Environmental Research Institute, Academic Center for Education, Culture and Research (ACECR), Rasht, Iran 13 Department of Anaesthesiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 14 Occupational Hazards Control Research Center and Department of Environmental Health Engineering, School of Public Health Environmental, Shahid Beheshti University of Medical Sciences, Tehran, Iran 15 Faculty of Food Science & Technology, Tehran University, Tehran, Iran 16 Student Research Committee, Department of Environmental Health Engineering, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Environ Sci Pollut Res DOI 10.1007/s11356-016-7447-xoutputs presented in term of hospital admissions respiratory cases. Based on our result, the highest mean and maximum of seasonal and annual levels for sulfur dioxide were observed in 2013. We concluded that obnoxious quality of fuel and some deficiencies in maintenance and operation of industries lead to worse quality of ambient air especially in 2013. Cumulative cases of HARD attributed to sulfur dioxide level at central of relative risk (RR) were estimated 24, 25, and 30 persons for 2011, 2012, and 2013, respectively. The finding of this study showed that total mean of sulfur dioxide was higher than standard concentration. We also noticed that wintertime concentrations of sulfur dioxide during three successive years were higher than of those levels in summer

Modeling for Energy Supply Management in Iran Based on Technical, Economic and Environmental Criteria

These days, achieving an optimal model and defining a comprehensive map for energy supply have become necessary in Iran. Considering a holistic approach and drawing a desired state in the different aspects of sustainability, including technical, economic and environmental criteria, this study introduces an optimal model in order to achieve cost-effective and environment-friendly energy resources under various 100 to 500-year scenarios using a genetic algorithm. Results determined the appropriate portfolio of energy resources in each mentioned period. According to the results, the share of fossil fuels to supply energy is higher than the other resources and the relative impact of financial indicator is more substantial than the environmental indicator in short-run, while this trend is rapidly changing toward renewable energy resources; so that a share of 63 percents of fossil fuels in the 100-year period has changed to the share of 62 percents of renewable energies during the 500-year period. Also estimating the harvest of each of the energy resources from there source capacity over a year showed that, along with increasing the length of various scenarios, the use of renewable and environment-friendly resources is recommended nearly full capacity utilization

Evaluation of Four Multiple Imputation Methods for Handling Missing Binary Outcome Data in the Presence of an Interaction between a Dummy and a Continuous Variable

Multiple imputation by chained equations (MICE) is the most common method for imputing missing data. In the MICE algorithm, imputation can be performed using a variety of parametric and nonparametric methods. The default setting in the implementation of MICE is for imputation models to include variables as linear terms only with no interactions, but omission of interaction terms may lead to biased results. It is investigated, using simulated and real datasets, whether recursive partitioning creates appropriate variability between imputations and unbiased parameter estimates with appropriate confidence intervals. We compared four multiple imputation (MI) methods on a real and a simulated dataset. MI methods included using predictive mean matching with an interaction term in the imputation model in MICE (MICE-interaction), classification and regression tree (CART) for specifying the imputation model in MICE (MICE-CART), the implementation of random forest (RF) in MICE (MICE-RF), and MICE-Stratified method. We first selected secondary data and devised an experimental design that consisted of 40 scenarios (2 × 5 × 4), which differed by the rate of simulated missing data (10%, 20%, 30%, 40%, and 50%), the missing mechanism (MAR and MCAR), and imputation method (MICE-Interaction, MICE-CART, MICE-RF, and MICE-Stratified). First, we randomly drew 700 observations with replacement 300 times, and then the missing data were created. The evaluation was based on raw bias (RB) as well as five other measurements that were averaged over the repetitions. Next, in a simulation study, we generated data 1000 times with a sample size of 700. Then, we created missing data for each dataset once. For all scenarios, the same criteria were used as for real data to evaluate the performance of methods in the simulation study. It is concluded that, when there is an interaction effect between a dummy and a continuous predictor, substantial gains are possible by using recursive partitioning for imputation compared to parametric methods, and also, the MICE-Interaction method is always more efficient and convenient to preserve interaction effects than the other methods

Estimation of the rate and number of underreported deliberate self-poisoning attempts in western Iran in 2015

OBJECTIVES Rates of attempted deliberate self-poisoning (DSP) are subject to undercounting, underreporting, and denial of the suicide attempt. In this study, we estimated the rate of underreported DSP, which is the most common method of attempted suicide in Iran. METHODS We estimated the rate and number of unaccounted individuals who attempted DSP in western Iran in 2015 using a truncated count model. In this method, the number of people who attempted DSP but were not referred to any health care centers, n0, was calculated through integrating hospital and forensic data. The crude and age-adjusted rates of attempted DSP were estimated directly using the average population size of the city of Kermanshah and the World Health Organization (WHO) world standard population with and without accounting for underreporting. The Monte Carlo method was used to determine the confidence level. RESULTS The recorded number of people who attempted DSP was estimated by different methods to be in the range of 46.6 to 53.2% of the actual number of individuals who attempted DSP. The rate of underreported cases was higher among women than men and decreased as age increased. The rate of underreported cases decreased as the potency and intensity of toxic factors increased. The highest underreporting rates of 69.9, 51.2, and 21.5% were observed when oil and detergents (International Classification of Diseases, 10th revision [ICD-10] code: X66), medications (ICD-10 code: X60-X64), and agricultural toxins (ICD-10 codes: X68, X69) were used for poisoning, respectively. Crude rates, with and without accounting for underreporting, were estimated by the mixture method as 167.5 per 100,000 persons and 331.7 per 100,000 persons, respectively, which decreased to 129.8 per 100,000 persons and 253.1 per 100,000 persons after adjusting for age on the basis of the WHO world standard population. CONCLUSIONS Nearly half of individuals who attempted DSP were not referred to a hospital for treatment or denied the suicide attempt for political or sociocultural reasons. Individuals with no access to counseling services are at a higher risk for repeated suicide attempts and fatal suicides

A Study on the variation of Nitrogen dioxide concentration in the city of Shiraz between the years 2010 and 2012

ABSTRACT An oxidant Nitrogen oxide gas, which is one of the most important air pollutants in many citie

Temporal profile of PM10 and associated health effects in one of the most polluted cities of the world (Ahvaz, Iran) between 2009 and 2014

Ahvaz, Iran ranks as the most polluted city of the world in terms of PM10 concentrations that lead to deleterious effects on its inhabitants. This study examines diurnal, weekly, monthly and annual fluctuations of PM10 between 2009 and 2014 in Ahvaz. Health effects of PM10 levels are also assessed using the World Health Organization AirQ software. Over the study period, the mean PM10 level in Ahvaz was 249.5 mu g m(-3), with maximum and minimum values in July (420.5 mu g m(-3)) and January (154.6 mu g m(-3)), respectively. The cumulative diurnal PM10 profile exhibits a dominant peak between 08:00-11:00 (local time) with the lowest levels in the afternoon hours. While weekend PM10 levels are not significantly reduced as compared to weekdays, an anthropogenic signature is instead observed diurnally on weekdays, which exhibit higher PM10 levels between 07:00-17:00 by an average amount of 14.2 mu g m(-3) as compared to weekend days. PMio has shown a steady mean-annual decline between 2009 (315.2 mu g m(-3)) and 2014 (143.5 mu g m(-3)). The AirQ model predicts that mortality was a health outcome for a total of 3777 individuals between 2009 and 2014 (i.e., 630 per year). The results of this study motivate more aggressive strategies in Ahvaz and similarly polluted desert cities to reduce the health effects of the enormous ambient aerosol concentrations. (C) 2016 Elsevier B.V. All rights reserved.National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program, NIH, United States [2 P42 ES04940]Available online 20 August 2016; 24 Month Embargo.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Phytoremediation of pollutants in oil-contaminated soils by Alhagi camelorum: evaluation and modeling

Abstract Phytoremediation is a cost-effective and environmentally friendly method, offering a suitable alternative to chemical and physical approaches for the removal of pollutants from soil. This research explored the phytoremediation potential of Alhagi camelorum, a plant species, for total petroleum hydrocarbons (TPHs) and heavy metals (HMs), specifically lead (Pb), chromium (Cr), nickel (Ni), and cadmium (Cd), in oil-contaminated soil. A field-scale study spanning six months was conducted, involving the cultivation of A. camelorum seeds in a nursery and subsequent transplantation of seedlings onto prepared soil plots. Control plots, devoid of any plants, were also incorporated for comparison. Soil samples were analyzed throughout the study period using inductively coupled plasma-optical emission spectroscopy (ICP‒OES) for HMs and gas chromatography‒mass spectrometry (GC‒MS) for TPHs. The results showed that after six months, the average removal percentage was 53.6 ± 2.8% for TPHs and varying percentages observed for the HMs (Pb: 50 ± 2.1%, Cr: 47.6 ± 2.5%, Ni: 48.1 ± 1.6%, and Cd: 45.4 ± 3.5%). The upward trajectory in the population of heterotrophic bacteria and the level of microbial respiration, in contrast to the control plots, suggests that the presence of the plant plays a significant role in promoting soil microbial growth (P  0.8). These results collectively suggest that phytoremediation employing A. camelorum can effectively reduce pollutants in oil-contaminated soils