Diurnal Temperature Range and Daily Emergency Room Admissions among the Elderly in Beijing,China

In recent years, more attentions have been paid to the association between climate change and human health. Increasing and more variable global surface temperature is one of the key climatic change factors which have been consistently reported about the effect on human health. So far, more researches have revealed that temperature lead not only to direct deaths and illnesses but also to aggravation of cardiovascular and respiratory diseases. Typically, the relationship between temperature and mortality or morbidity is V-, U-, or J- shaped, with optimum temperature corresponding to the lowest point in the temperature mortality curve.     

HIV prevention cascades for injection and sexual risk behaviors among HIV-negative people who inject drug in Iran

BackgroundThe HIV prevention cascade complements the HIV treatment cascade and helps evaluate the access to and use of harm reduction programs among HIV-negative individuals at risk for HIV, including people who inject drugs (PWID). This study aimed to estimate the HIV prevention cascades among PWID in Iran.MethodsUsing data from the 2014 national bio-behavioral surveillance survey, 2,391 PWID were recruited from 31 harm reduction facilities and through outreach efforts across 10 major cities. PWID aged ≥18 years who reported drug injection in the past year were interviewed, and information regarding their demographic characteristics, sexual and drug injection practices, and access to services were gathered. PWID were also tested for HIV infection. We examined the prevention cascade framework among HIV-negative PWID.ResultsThe majority of PWID were male (97.6%) and more than half aged ≥ 35 years old (55.5%). Overall, 2,092 (92.5% [95% CI: 90.8, 93.9]) were HIV-negative; 93% of whom knew illicit drug injection could increase the risk of HIV transmission, 54% had access to free-of-charge sterile needles and syringes, 51% used sterile needles and syringes in their last injection practice, and 33% used sterile needles and syringes in all injection practices in the past month. Also, 87.8% (95% CI: 85.1, 90.0) of HIV-negative PWID had sex with any partner in the past year; 88% of whom knew using condoms could reduce the risk of HIV transmission, 35% had access to free-of-charge condoms, 32% used condoms in their last sexual practice, and 18% used condoms in all of their sexual practices in the past month.ConclusionThe majority of HIV-negative PWID in Iran were at risk for HIV acquisition through unsafe drug injection or sexual practices. Harm reduction programs should improve access to free sterile needles, syringes, and condoms for PWID.     

The risk environments of people who use drugs accessing two harm reduction centers in Tehran,Iran: A qualitative study

BackgroundIran has developed the most robust harm reduction infrastructure in the Middle East, marked by availability of low threshold methadone maintenance treatment (MMT), needle and syringe program (NSPs), and condom distribution services. However, little is known about the socially situated risk factors that make harm reduction clients—specifically those enrolled in MMT—vulnerable to relapse or continued illicit drug use. In this study, we sought to understand the “risk environment” of clients enrolled in harm reduction services in Tehran, Iran.MethodsThrough observation and in-depth interviews with 22 drop-in-center clients and 8 staff members from July to August 2017, we explored the risk environments of clients of two drop in centers (DICs) in Tehran. All interviews were transcribed, coded and analyzed using a qualitative thematic analysis.ResultsWe found that compulsory drug treatment programs, social stigma, police encounters, and difficulties in obtaining governmental identification documents, among other factors, contribute to social marginalization of DIC clients.ConclusionMany interviewed DIC clients continued to use illicit substances (particularly methamphetamine) despite having access to methadone treatment. This study underscores the panoply of social and structural barriers that DIC clients face while attempting to engage in treatment and harm reduction services. Following the “risk environment” framework, it is essential to identify the structural factors shaping individual behaviors that perpetuate experiences of social marginalization and poor health outcomes in this population.     

Application of the microwave digestion-vacuum filtration-automated scanning electron microscopy method for diatom detection in the diagnosis of drowning

The cause of death for the decomposed corpses recovered from water is still a difficult issue in current forensic practice. In this article, we present two cases of bodies recovered from water with no positive findings to indicate the cause of their death. We apply both conventional acid digestion method as well as the microwave digestion-vacuum filtration-automated scanning electron microscopy method (MD-VF-Auto SEM) for diatom detection in different organs of both bodies. Our results indicate that MD-VF-Auto SEM method provide more accurate information and match further police investigation. This novel method would be a useful technique in assessing cause of death for body found in water.     

Estimating the prevalence of autism spectrum disorder in Lebanon

This cross-sectional survey examines the prevalence rate of Autism spectrum disorder (ASD) in 818 children (16–48 months) across all Lebanese regions. Screening was done using the revised form of the Modified-Checklist for Autism in Toddlers. Based on the total score of items failed, children were classified into 3 categories of ASD risk (low, moderate and high). Phone calls follow-up interviews and clinical assessments for diagnosis ascertainment were conducted. Given the caregivers’ reluctance to participate, the prevalence rate was estimated between 49 and 513 per 10,000 with a male predominance. Our prevalence estimation, even under restrictive assumptions, is higher than elsewhere in the Arab region. Anti- stigma interventions adapted to the socio-cultural context are needed prior to future research in the field.     

The impact of diet on disease activity in spondyloarthritis: A systematic literature review

ObjectivesOur study aimed to systematically review the evidence about the effect of diet or dietary supplements on spondyloarthritis (SpA) disease activity.Methodsa systematic literature review (SLR) was conducted in MEDLINE, EMBASE, Cochrane and SCOPUS according to the “PEO” format (Population, Exposure, Outcome). The population was SpA (axial or peripheral, axSpA/pSpA, including Psoriatic Arthritis-PsA); the intervention any kind of diet/dietary supplement; the outcome disease activity. Inclusion criteria were: adult patients, Randomized Controlled Trials (RCTs) and longitudinal studies (so that a pre-and post-intervention assessment were available), papers in English. Risk of bias (RoB) was conducted with different tools according to the design of the study.ResultsLiterature search yielded 1390 publications, of which 15 were finally inlcuded: 12 interventional and 3 observational studies. Among those with the lower RoB: a) 2 RCTs, one at unclear and one at low RoB, failed to show benefit of probiotics in SpA b) Two RCTs at unclear RoB provided evidence that weight loss, but not hypocaloric diet, was associated to MDA achievement in PsA. The remaining interventional studies were at high RoB. Among the observational studies, one study on Mediterranean diet demonstrated an association between diet adherence and a ≥ 20% decrease of ASDAS in axSpA. The other two observational studies were judged of poor quality.Conclusionsweight loss seem to be able to impact disease activity in PsA, while probiotics do not seem useful in SpA; evidence for dietary behaviors is scarce and heterogeneous.     

Estimation of gestational diabetes mellitus and dose–response association of BMI with the occurrence of diabetes mellitus in pregnant women of the west of Iran

Abstract

The authors aim to investigate the GDM and the dose–response association of BMI with it in pregnant women in Kermanshah, Iran. During the 2015–2016?year, the 1010 pregnant women were studied. The restricted cubic spline method was used to evaluate the relationship between BMI and GDM. The risk of GDM was 10.1%. The incidence rate ratio for GDM indicates a non-significant protective effect and, then a significant risk for GDM occurrence along with BMI. BMI can be used as a predictive factor. A healthy diet and recommended levels of physical activity are suggested to prevent overweight and obesity and subsequent GDM.     

Association between Metabolic Syndrome and Carotid Atherosclerosis: A Cross-sectional Study in Northern China

ObjectiveIncreased carotid artery intima-media thickness (CIMT) and carotid plaque as manifestations of carotid atherosclerosis have been used as markers of cardiovascular disease (CVD). The components of metabolic syndrome (MetS) are linked to CVD, but the association between MetS and CVD is controversial.MethodsA total of 8,933 Chinese adults aged 40 years or older from 2010 to 2014 were selected from the Jidong and Kailuan communities. MetS was defined by the International Diabetes Federation criteria. CIMT and carotid plaque were measured using color Doppler ultrasound. Logistic regression models were used to assess the association of MetS with carotid plaque and CIMT.ResultsMetS was found among 3,461 (3,461/8,933) participants. The odds ratio and 95% confidence internal (CI) for carotid plaques in participants with MetS was 1.16 (1.03–1.30). The risk of carotid plaques increased with the number of MetS components. The average CIMT was higher in participants with MetS (β = 0.020, 95% CI, 0.014–0.027) and in participants with more MetS components.ConclusionIndividuals with MetS are at an increased risk for carotid atherosclerosis compared to those without MetS.     

Problematic khat use as a possible risk factor for harmful use of other psychoactive substances: a mixed method study in Ethiopia

Background

Substance use disorders along with neuropsychiatric disorders contributed about 14% of the global burden of disease. Harmful alcohol use, is a known contributor for many harms (accidents, suicide, violence, and complication of other psychiatric and medical disorders). In the Western countries, alcohol and nicotine are gateway drugs to cannabis use, and cannabis use is a risk factor for other illicit drugs such as cocaine and heroin. Khat use is another psychoactive substance which is common in East African and Arabian Peninsula. But there is a knowledge gap regarding the position of khat use or problematic khat use in sequential progression of different psychoactive substances. Therefore, we aimed to understand and investigate the relationship of problematic khat use and other psychoactive substances in Ethiopia.

Methods

Exploratory mixed methods study was employed. Quantitative cross sectional survey was done among 102 khat users, and 4 focus group discussions and 11 in-depth interviews were conducted to understand the pathways between khat use and other psychoactive substances use in 2014. Non random sampling (purposive and snowballing) was employed for both quantitative and qualitative studies. Khat users from khat cafeterias, shops, and from other open markets of khat in Addis Ababa were invited to participate.

Result

Currently significant majorities of khat users (86.3%) used at least one other psychoactive substance after they started khat use. The prevalence of harmful drinking was 53.9% among khat users. Problematic khat use was a significant predictor of harmful drinking (p < 0.05). About one from ten respondents engaged to risky sexual behavior pushed by the effect of khat after chewing.

Conclusion

The proportion of psychoactive substances use especially harmful drinking among khat users was observed higher compared to other cross sectional surveys conducted among general population. In Ethiopia, intervention and policy on harmful alcohol use could consider problematic khat use as one possible risky factor. A rigorous methodology which could test gateway hypothesis of problematic psychoactive substances use could be warranted.

     

Investigation of health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences: health-promoting hospitals

Objectives: The prophecy of health promoting hospitals (HPH) is bringing about a change and transition from treatment-oriented to health-oriented attitudes. In Iran, hospitals usually play the traditional roles. The present study was aimed at the evaluation of the health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences (HUMS).

Methods: This applied study was conducted in two Hamadan specialized hospitals in the Hamadan city. The health promotion status was evaluated using a self-assessment checklist designed by the World Health Organization’s HPH. The evaluation was done in five standards including management policy, patient assessment, patient information and intervention, promotion of a healthy workplace and continuity and cooperation.

Results: The results showed that both the hospitals studied had a poor status in terms of promoting a healthy workplace (average = 31.24%) and management policy standards (average = 35.29%) in comparison with the other relevant standards: patient assessment (53.12%), patient information and intervention (62.5%), continuity and cooperation (65.78%)). The results of the standards and sub-standards status displayed better performance in the cardiovascular hospital (53.67%) compared to the women and parturition hospital (42.64%).

Conclusion: The findings indicated that HPH standards are very low in the studied hospitals. The reason behind this wide gap might be due to the fact that hospitals in Iran are more treatment-oriented and patient-oriented and they do not play an active part in health promoting. It was found that management policy and promoting healthy workplace standards had the worst status and must be improved.