Demographic and socioeconomic differences in fruit and vegetables consumption, 2007-2009: a province-level study in iran.

High daily intake of fruit and vegetables promotes population health and is inversely associated with morbidity and mortality. Demographic and socioeconomic characteristics are among main predictors of fruit and vegetables consumption. The current study aimed to evaluate these associations using province-level data in Iran during the years 2007-2009

A Comparison of Iran and UK EQ-5D-3L Value Sets Based on Visual Analogue Scale

Background: Preference weights for EQ-5D-3L based on visual analogue scale (VAS) has recently been developed in Iran. The aim of the current study was to compare performance of this value set against the UK VAS-based value set. Methods: The mean scores for all possible 243 health states were compared using Student t test. Absolute agreement and consistency were investigated using concordance correlation coefficient (CCC) and Bland-Altman plot. Health gains for 29 403 possible transitions between pairs of EQ-5D-3L health states were compared. Responsiveness to change and discriminative ability across subgroups of health transitions were assessed. Results: The mean EQ-5D-3L scores were similar for two value sets (mean = 0.31, P = 1.00). For 36% of health states, the absolute differences were greater than 0.10. There were three pairwise logical inconsistencies in the Iranian value set. The Iranian scores were lower (higher) for severe (mild) health states than the United Kingdom. The CCC (95% CI) was 0.85 (0.81 to 0.88) and Bland-Altman plot showed good agreement. The mean health gain for all possible transitions predicted by the Iranian value set was higher (0.22 vs. 0.20, P < .001) and two value sets predicted opposite transitions in 15% of transitions. The responsiveness of these two value sets were similar with lower discriminative ability for Iranian value set. Conclusion: The Iranian value set attribute lower values to most severe health states and higher values to mild health states compared with the UK value set. Such systematic differences might translate into discrepant health gains and cost-effectiveness which should be taking into account for informed decision-making. [ABSTRACT FROM AUTHOR

Cost-utility analysis of adjuvant therapies for breast cancer in iran

Objectives: The aim of this study was to evaluate the cost-utility of Docetaxel with doxorubicin and cyclophosphamide (TAC) and 5-fluorouracil, doxorubicin, cyclophosphamide (FAC) in node-positive breast cancer patients in the south of Iran. Methods: A double blind study was done on a cohort of 100 patients suffering from breast cancer with node-positive over 8 months in the radiotherapy center of Namazi hospital, Shiraz-Iran. Health-related quality of life was assessed using questionnaire (QLQ-C30) from European Organization for Research and Treatment of Cancer (EORTC). QLQ-C30 scale scores were mapped to 15D and EuroQol 5D utilities to measure the quality-adjusted life-years (QALYs). Third party payer point of view was applied to measure and value the cost of treatments. Cost data were extracted from hospital and health insurance organizations. Robustness of the results was checked through a two way sensitivity analysis. Results: TAC was associated with higher deterioration in HRQoL during treatment and higher improvements over 4 months follow-up. On average, the cost of treatment per patient in TAC was 15 times higher than FAC (p < .001). In overall, TA( was resulted in lower QALYs and higher cost over study period.. Conclusions: FAC was a dominant option versus TAC in short-term. The higher improvement in HRQol. over follow-up in TAC may not compensate the more intensive deterioration caused during treatment in short-term. The short time horizon of study may limit the generalizability of our findings and, hence, there is a need to conduct long-term economic evaluation studies whenever data is available to inform decision making

Trend analysis of Air Quality Index criteria pollutants (CO, NO2, SO2, PM10 and O3) concentration changes in Tehran metropolis and its relationship with meteorological data, 2001-2009

Background and Aims: Air pollution is a serious threat to public health and environment. Factors contributing to air pollution have to be identified in order to reduce the corresponding effects. Meteorological data are among the noteworthy factors in determining the severity of air pollution. This study was conducted to investigate the trend of five criteria pollutants in air quality index and to find their correlation with meteorological data in Tehran metropolis during 2001- 2009. Materials and Methods: During this descriptive-analytical study, the required data were obtained from Air Quality Department of Tehran’s Municipality, the Environmental Protection Agency and also from the synoptic stations of Meteorological Organization. SPSS software was used for data analysis. The trends in concentration of studied pollutants including: CO, PM10, SO2, NO2 and O3, as well as meteorological data and their correlation were indeed considered. Results: The current study found that during the studied period, the concentration of O3 shows an increasing trend. Therefore, this pollutant could be a major factor, if not the only one, raising the index of air pollution in recent years. Another important result of this study can be cited to decrease in concentrations of CO, NO2, and SO2 during the years of present study. Conclusion: Our findings revealed that although the air quality in Tehran has improved in term of particulate matter, SO2 and NO2 during the period of study, however the concentration of ozone has increased beyond the standard. It was also possible to draw a meaningful conclusion relating to the impact of some meteorological parameters in airpollution. Keywords: Air pollution, Criteria pollutants, Meteorological data, Tehran metropoli

Quality of life in people with diabetes: a systematic review of studies in Iran.

Evaluation of health-related quality of life (HRQoL) among people with diabetes has been growing in Iran over the last decade. The main aim of the current study was to systematically review the characteristics of these studies and examine quality of their findings. Persian (SID, Magiran) and English (Pubmed, Medline, Web of Science, CINAHL, Scopus, PsycINFO and ERIC) databases were systematically searched using the search terms: "diabetes" AND "quality of life" AND "Iran". The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A total of 46 studies passed the inclusion criteria and were included in the review. The included studies were conducted in 20 out of 30 provinces of the country. Most studies investigated HRQoL among people with type 2 diabetes. The Short Form Health Survey (SF-36) and WHO quality of life instruments (WHOQOL) were the main instruments used in these studies. Studies showed that people with diabetes had lower HRQoL than people without diabetes. Better socioeconomic status and better control of cardiovascular risk factors were associated with better HRQoL among the patients with diabetes. In general, the predictors of HRQoL among Iranian patients were similar to their international counterparts implying that diabetes patients share many common features. The reviewed studies suffer from major methodological and reporting flaws which limit validity and generalizability of their findings

Geographic distribution of need and access to health care in rural population: an ecological study in Iran

Introduction: Equity in access to and utilization of health services is a common goal of policy-makers in most countries. The current study aimed to evaluate the distribution of need and access to health care services among Iran’s rural population between 2006 and 2009. Methods: Census data on population’s characteristics in each province were obtained from the Statistical Centre of Iran and National Organization for civil registration. Data about the Rural Health Houses (RHHs) were obtained from the Ministry of Health. The Health Houses-to-rural population ratio (RHP), crude birth rate (CBR) and crude mortality rate (CMR) in rural population were calculated in order to compare their distribution among the provinces. Lorenz curves of RHHs, CMR and CBR were plotted and their decile ratio, Gini Index and Index of Dissimilarity were calculated. Moreover, Spearman rank-order correlation was used to examine the relation between RHHs and CMR and CBR. Results: There were substantial differences in RHHs, CMR and CBR across the provinces. CMR and CBR experienced changes toward more equal distributions between 2006 and 2009, while inverse trend was seen for RHHs. Excluding three provinces with markedly changes in data between 2006 and 2009 as outliers, did not change observed trends. Moreover; there was a significant positive relationship between CMR and RHP in 2009 and a significant negative association between CBR and RHP in 2006 and 2009. When three provinces with outliers were excluded, these significant associations were disappeared. Conclusion: Results showed that there were significant variations in the distribution of RHHs, CMR and CBR across the country. Moreover, the distribution of RHHs did not reflect the needs for health care in terms of CMR and CBR in the study period

Rheumatoid arthritis as underlying cause of death in 31 countries, 1987-2011: Trend analysis of WHO mortality database

Objective To examine trends in rheumatoid arthritis (RA) as an underlying cause of death (UCD) in 31 countries across the globe during 1987-2011. Methods Data on mortality and population were collected from the World Health Organization mortality database and the United Nations. Age-standardized mortality rates (ASMR) were calculated by means of direct standardization. We applied joinpoint regression analysis for trend analysis. Between-country disparities were examined using between-country variance, and Gini coefficient. Due to low numbers of deaths, we smoothed our ASMR using a three-year moving average. The changes in number of RA deaths between 1987 and 2011 were decomposed using two counterfactual scenarios. Results The absolute number of deaths with RA registered as UCD declined from 9281 (0.12% of all-cause deaths) in 1987 to 8428 in 2011 (0.09% of all-cause deaths). The mean ASMR declined from 7.1/million person-years in 1987-89 to 3.7 in 2009-11 (48.2% reduction). Reduction of 25% or more in ASMR occurred in 21 countries while a corresponding increase was observed in 3 countries. There was a persistent reduction in RA mortality and, on average, the ASMR declined by 3.0% per year. The absolute and relative between-country disparities declined over the study period.CONCLUSION: Mortality rates attributable to RA have declined globally. However, there were substantial between-country disparities in RA mortality, though the disparities decreased over time. Population aging combined with fall in RA mortality may lead to an increase in the economic burden of disease that should be taken into consideration in policy-making. This article is protected by copyright. All rights reserved

تحليل روند تغييرات غلظت پنج آلاينده شاخص كيفيت هوا

Background and Aims:&nbsp;Air pollution is a serious threat to public health and environment. Factors contributing to air pollution have to be identified in order to reduce the corresponding effects. Meteorological data are among the noteworthy factors in determining the severity of air pollution. This study was conducted to investigate the trend of five criteria pollutants in air quality index and to find their correlation with meteorological data in Tehran metropolis during 2001- 2009.Materials and Methods:&nbsp;During this descriptive-analytical study, the required data were obtained from Air Quality Department of Tehran’s Municipality, the Environmental Protection Agency and also from the synoptic stations of Meteorological Organization. SPSS software was used for data analysis. The trends in concentration of studied pollutants including: CO, PM10, SO2, NO2 and O3, as well as meteorological data and their correlation were indeed considered.Results:&nbsp;The current study found that during the studied period, the concentration of O3 shows an increasing trend. Therefore, this pollutant could be a major factor, if not the only one, raising the index of air pollution in recent years. Another important result of this study can be cited to decrease in concentrations of CO, NO2, and SO2 during the years of present study.Conclusion:&nbsp;Our findings revealed that although the air quality in Tehran has improved in term of particulate matter, SO2 and NO2 during the period of study, however the concentration of ozone has increased beyond the standard. It was also possible to draw a meaningful conclusion relating to the impact of some meteorological parameters in airpollution.زمينه و هدف: آلودگي هوا، تهديدي جدي براي سلامت عمومي و محيط زيست است. جهت كاهش اثرات ناشي از آلودگي هوا بايد پارامترهاي موثر در آلودگي هوا را به خوبي بشناسيم، از جمله پارامترهاي مهم در تعيين ميزان آلودگي هوا داده‌هاي هواشناسي است. هدف از اين تحقيق، مطالعه بررسي روند تغييرات پنج آلاينده شاخص آلودگي هوا و ارتباط آن با داده‌هاي هواشناسي در تهران طي سال‌هاي 88-1380 است. مواد و روش‌ها: اين مطالعه از نوع توصيفي‌ تحليلي است. داده‌ها از ايستگاه سينوپتيك سازمان هواشناسي و ايستگاه‌هاي شركت کنترل کيفيت هواي شهرداري و سازمان حفاظت محيط زيست گردآوري شده و چگونگي روند تغييرات غلظت آلاينده‌ها و داده‌هاي هواشناسي و ارتباط آن‌ها با نرم افزار آماريSPSS مورد تحليل قرارگرفت. يافته‌ها: در اين مطالعه مشخص شد که در طي سال‌هاي مورد مطالعه بر مقادير غلظت آلاينده O3 افزوده شده و مي‌توان آلاينده مذکور را آلاينده مسئول افزايش شاخص استاندارد آلودگي هوا در طي سال‌هاي اخير دانست. همچنين از ديگر نتايج مهم اين تحقيق مي‌توان به روند کاهشي آلاينده (CO، NO2، SO2 و PM10) در طي سنوات مورد مطالعه اشاره نمود. نتيجه گيري: طي سال‌هاي فوق کيفيت هواي تهران از نظر آلاينده‌هاي CO، NO2، PM10 و SO2 بهبود يافته، در حالي‌كه غلظت آلاينده O3&nbsp; رو به افزايش بوده و از وضعيت استاندارد فاصله داشته است. با توجه به ارتباط معني دار بين برخي از پارامترهاي هواشناسي و آلاينده‌ها، مشخص گرديد كه متغيرهاي هواشناسي مي‌توانند در ميزان آلايندگي هواي شهر تهران موثر واقع شوند

Health utilities of type 2 diabetes-related complications: a cross-sectional study in sweden.

This study estimates health utilities (HU) in Sweden for a range of type 2 diabetes-related complications using EQ-5D and two alternative tariffs (UK and Swedish) from 1757 patients with type 2 diabetes from the Swedish National Diabetes Register (NDR). Ordinary least squares were used for statistical analysis. Lower HU was found for female gender, younger age at diagnosis, higher BMI, and history of complications. Microvascular and macrovascular complications had the most negative effect on HU among women and men, respectively. The greatest decline in HU was associated with kidney disorders (-0.114) using the UK tariff and stroke (-0.059) using the Swedish tariff. Multiple stroke and non-acute ischaemic heart disease had higher negative effect than a single event. With the UK tariff, each year elapsed since the last microvascular/macrovascular complication was associated with 0.013 and 0.007 units higher HU, respectively. We found important heterogeneities in effects of complications on HU in terms of gender, multiple event, and time. The Swedish tariff gave smaller estimates and so may result in less cost-effective interventions than the UK tariff. These results suggest that incorporating subgroup-specific HU in cost-utility analyses might provide more insight for informed decision-making