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Background: The lack of an integrated national system prevents the Islamic Republic of Iran from registering and reporting all cases of cutaneous leishmaniasis. Aim: To establish a laboratory network for the improvement of diagnosis and surveillance of cutaneous leishmaniasis in endemic areas of the Islamic Republic of Iran using parasitological and molecular methods. Methods: This descriptive, cross-sectional, pilot study examined 49 laboratories in the 2 endemic areas for cutaneous leishmaniasis in the Islamic Republic of Iran. Samples were taken for identification of the dominant Leishmania species from individuals with cutaneous leishmaniasis referred to the laboratories and had not travelled to other endemic regions. Statistical analysis was conducted using SPSS version 25.0. Using the primary healthcare laboratory network, we established a 3-level surveillance system. We compared misdiagnosis, new cases, clinical relapses, treatment resistance, and treatment failure before and after establishment of the network. Results: Network implementation reduced relapse of cutaneous leishmaniasis. After the laboratory training, the average misdiagnosis rate decreased from 49.3% to 4.2% for positive microscopic slides and from 31.6% to 12% for negative slides. Correct diagnosis was significantly higher in the study areas after the intervention. Conclusion: Implementation of a cutaneous leishmaniasis laboratory network can enhance diagnosis, unify diagnostic methods and improve patient care. [ABSTRACT FROM AUTHOR]

This study is part of broader research aimed to determine the lifetime prevalence and pattern of comorbidity on self-reported suicidal attempts in the general population of Iran. Overall, 25,180 subjects were interviewed, face-to-face, at home; the lifetime prevalence was 1.4% (0.9% males and 2% females). The majority of attempters were 26-55 years of age, married, more highly educated, female, retired, and lived in urban areas. Many of the attempters (45.3%) reported at least one psychiatric disorder during their lifetime; major depressive disorder (22%), panic disorder (6.3%), and obsessive compulsive disorder (6%) was the most common. Because less than half of suicidal attempters reported a psychiatric disorder, the existence of other pathways to suicide may be important foci for prevention. Many of the demographic correlates of suicidal behavior in Iran are very similar to those seen in Western cultures; however, the sociodemographic factors such as few working women and very low levels of divorce is quite different to that of Western populations.

Evidence of rare human helminthiasis in paleoparasitological records is scarce. we report here the finding of Physaloptera spp. eggs in a soil sample collected in the pelvic and sacrum bones area of a skeleton excavated from a grave of Shahr-e Sukhteh archeological site dating back to the Bronze Age. The site is located in southeastern Iran and has attracted the attention of numerous archeological teams owing to its vast expanse and diverse archeological findings since 1997. The spirurid nematodes Physaloptera spp. are rarely the cause of human helminthiasis nowadays, but this infection might not have been so rare in ancient populations such as those in the Shahr-e Sukhteh. Out of 320 skeletons analyzed in this study, only one parasitized individual was detected. This surprising result led us to suspect the role of nematophagous fungi and other taphonomic processes in possible false-negative results. This is the first paleoparasitological study on human remains in this archeological site and the first record of ancient human physalopterosis in the Middle East.

Objective To assess the effects of a comprehensive, integrated community-based lifestyle intervention on diet, physical activity and smoking in two Iranian communities. Methods Within the framework of the Isfahan Healthy Heart Program, a community trial was conducted in two intervention counties (Isfahan and Najaf-Abad) and a control area (Arak). Lifestyle interventions targeted the urban and rural populations in the intervention counties but were not implemented in Arak. In each community, a random sample of adults was selected yearly by multi- stage cluster sampling. Food consumption, physical exercise and smoking behaviours were quantified and scored as 1 (low-risk) or 0 (other) at baseline (year 2000) and annually for 4 years in the intervention areas and for 3 years in the control area. The scores for all behaviours were then added to derive an overall lifestyle score. Findings After 4 years, changes from baseline in mean dietary score differed significantly between the intervention and control areas (+2.1 points versus -1.2 points, respectively; P < 0.01), as did the change in the percentage of individuals following a healthy diet (+14.9% versus -2.0%, respectively; P < 0.001). Daily smoking had decreased by 0.9% in the intervention areas and by 2.6% in the control area at the end of the third year, but the difference was not significant. Analysis by gender revealed a significant decreasing trend in smoking among men (P < 0.05) but not among women. Energy expenditure for total daily physical activities showed a decreasing trend in all areas, but the mean drop from baseline was significantly smaller in the intervention areas than in the control area (-68 metabolic equivalent task (MET) minutes per week versus -114 MET minutes per week, respectively; P < 0.05). Leisure time devoted to physical activities showed an increasing trend in all areas. A significantly different change from baseline was found between the intervention areas and the control area in mean lifestyle score, even after controlling for age, sex and baseline values. Conclusion The results suggest that community-based lifestyle intervention programmes can be effective in a developing country setting. Objectif Evaluer les effets d&apos;une intervention en communaute integree et complete, visant a modifier le mode de vie, sur l&apos;alimentation, l&apos;activite physique et le tabagisme dans deux communautes iraniennes. Methodes Dans le cadre du Programme pour la sante cardiaque d&apos;Isfahan, un essai en communaute a ete mene dan deux regions administratives d&apos;intervention (Isfahan et Najaf-Abad) et dans une zone temoin (Arak). Les interventions pour modifier le mode de vie visaient des populations urbaines et rurales des regions administratives d&apos;intervention et n&apos;ont pas ete mises en oeuvre dans la region d&apos;Arak. Dans chaque communaute, on a selectionne un echantillon aleatoire d&apos;adultes en procedant chaque annee ?un sondage en grappes a plusieurs degres. La consommation d&apos;aliments, l&apos;exercice physique et les habitudes tabagiques ont ete quantifies et affectes d&apos;un score de 1 (risque faible) ou de 0 (autre) pour l&apos;annee de reference (2000) et chaque annee pendant les 4 ans suivants dans les zones d&apos;intervention et pendant les 3 ans suivants dans la zone temoin. On a ensuite ajoute les scores pour l&apos;ensemble des comportements afin de determiner un score global de mode de vie. Resultats Au bout de 4 ans, les evolutions par rapport au score de reference moyen differaient significativement entre zones d&apos;intervention et zone temoin pour le regime alimentaire (+2,1 points contre -1,2 point, respectivement ; p < 0,01), comme pour le pourcentage d&apos;individus suivant un regime alimentaire sain (+14,9 % contre -2,0 %, respectivement ; p < 0,001). A la fin de la troisieme annee, le tabagisme quotidien avait baisse de 0,9 % dans les zones beneficiant de l&apos;intervention et de 2,6 % dans la zone temoin, mais cet ecart n&apos;etait pas significatif. L&apos;analyse selon le sexe a revele une tendance significative a la baisse du tabagisme chez les hommes (p < 0,05), mais pas chez les femmes. La depense energetique correspondant a l&apos;ensemble des activites physiques quotidiennes manifestait une tendance a la baisse dans toutes les zones, mais la diminution moyenne par rapport a la reference etait significativement plus faible dans les zones beneficiant de l&apos;intervention (-68 MET (equivalents metaboliques)-minutes/semaine contre -114 MET-minutes/ semaine, respectivement ; p < 0,05) que dans la zone temoin. Le temps de loisir consacre a des activites physiques presentait une tendance a l&apos;augmentation dans toutes les zones. On a releve une variation statistiquement significative du score de mode de vie entre les zones beneficiant de l&apos;intervention et la zone temoin, meme apres elimination de l&apos;influence de l&apos;age, du sexe et des valeurs de reference. Conclusion Les resultats laissent a penser que les programmes d&apos;intervention en communaute pour modifier le mode de vie peuvent etre efficaces dans un pays en developpement. Objetivo Evaluar los efectos de una intervencion comunitaria integral e integrada sobre el modo de vida centrada en el regimen alimentario, la actividad fisica y el tabaquismo en dos comunidades iranies. Metodos En el marco del Healthy Heart Program (Programa Corazon Sano) de Isfahan, se llevo a cabo un ensayo comunitario en dos distritos de intervencion (Isfahan y Najaf-Abad) y una zona de control (Arak). Las intervenciones sobre el modo de vida se focalizaron en las poblaciones urbanas y rurales en los condados de intervencion pero no se aplicaron en Arak. En cada comunidad, se procedio a seleccionar cada ano una muestra aleatoria de adultos mediante muestreo multietapico por conglomerados. Los comportamientos relacionados con la dieta, el ejercicio fisico y el consumo de tabaco se cuantificaron y calificaron como 1 (de bajo riesgo) o bien 0 (otro caso) al inicio del estudio (ano 2000), y despues de forma anual, durante 4 anos en las areas de intervencion, y durante 3 anos en la zona de control. Por ultimo, se sumaron las puntuaciones correspondientes a cada comportamiento para obtener una puntuacion general del modo de vida. Resultados Al cabo de 4 anos, la variacion de la puntuacion media de la dieta difirio de forma significativa entre las zonas de intervencion y las de control (+2,1 puntos frente a -1,2 puntos, respectivamente; p < 0,01), al igual que la variacion del porcentaje de individuos que seguian una dieta saludable (+14,9% frente a -2,0%, respectivamente; p < 0,001). La costumbre de fumar diariamente habia disminuido en un 0,9% en las zonas de intervencion, y en un 2,6% en la zona de control al final del tercer ano, pero la diferencia no era significativa. El analisis por genero mostro una tendencia significativa a la disminucion del tabaquismo entre los hombres (p < 0,05), pero no asi entre las mujeres. El gasto energetico asociado a la actividad fisica diaria total mostro una tendencia a la baja en todas las zonas, pero la caida media respecto a los valores basales fue significativamente menor en las zonas de intervencion que en la zona de control (-68 minutos de tarea metabolica equivalente (MET) por semana, frente a -114 minutos de MET semanales, respectivamente; p < 0,05). El tiempo de ocio dedicado a actividades fisicas mostro una tendencia al aumento en todas las zonas. Se observo una diferencia significativa en la variacion respecto a los valores iniciales entre las zonas de intervencion y la zona de control en lo relativo a la puntuacion media del modo de vida, incluso despues de controlar los datos en funcion de la edad, el sexo y los valores basales. Conclusion Los resultados parecen indicar que los programas comunitarios de intervenciones sobre el modo de vida pueden ser eficaces en el entorno de los paises en desarrollo., Introduction Non-communicable diseases currently represent 43% of the global burden of disease and are expected to account for 60% of the disease burden and 73% of all deaths in the [...]

In a 1989 Family Planning Study in Iran, 40 percent of the married women of reproductive age reported that their last or current pregnancies were unwanted and unintended. This finding is consistent with the results obtained from a number of studies undertaken in the countries of North Africa and the Middle East. Although the phenomenon of unwanted pregnancy is a significant topic in the population studies, it has received very little attention. This paper shows the differences between two groups: group A, those married women who reported that their last or current pregnancies were wanted, and group B, those married women who reported that their last or current pregnancies were unwanted. The findings of this study clearly show significant differences between these two groups in regard to some key sociodemographic attributes: wife/husband's education, actual and desired fertility, wife's current age, past and present practice of contraceptive methods, and extent of satisfaction with family planning services are among the attributes differentiating these two groups. Our examination of these variables suggests that group B had higher parity, fertility, less desire for more children, less use of contraceptive techniques, and less satisfaction with the efficiency of the contraceptive techniques than group A. The relationship between education and wanted/unwanted pregnancies is mixed. The urban women who wanted pregnancies and were 25 years old or older were more educated than those who did not want pregnancies. On the contrary, the rural women whose pregnancies were not wanted were more educated than those who wanted pregnancies regardless of age, parity, and locality differences. Furthermore, the urban/rural women with different levels of parities who did not want to be pregnant were more educated than the urban/rural women who wanted pregnancies. Finally, the standardized regression coefficients, obtained in logistic regression, reveal that among urban women the desire for more children and parity are the first and second most significant independent variables differentiating between group A and group B. Among rural women, living children and the desire for more children were the first and second most important variables differentiating between group A and group B.

Medical ethics faces several challenges in different aspects of education, research, and treatment in medicine and healthcare practice. Design and implementation of a national strategic plan can pave the way for the development of a roadmap in various countries to strengthen ethics and address these challenges. To create a comprehensive plan compatible with the Iranian healthcare system, a multidisciplinary team of main stakeholders compiled a national strategic plan of medical ethics following several focus group discussion sessions and two workshops (2014-2017). Ultimately, the plan was confirmed by the Supreme Council for the Medical Ethics of the Ministry of Health and Medical Education. The current paper is a national report of the process and the medical ethics strategic plan in Iran. We have also tracked signs of progress and achievements in the country. In conclusion, this valuable effort has led to significant success in the implementation of medical ethics in clinical medicine, medical research, and education by using all the resources in our country. The participation of all the stakeholders, especially healthcare professionals in this way is required. [ABSTRACT FROM AUTHOR]

Abstract Background The medical record is used to document patient's medical history, illnesses and treatment procedures. The information inside is useful when all needed information is documented properly. Medical care providers in Iran have complained of low quality of Medical Records. This study was designed to evaluate the quality of the Medical Records at the university hospital in Tabriz, Iran. Methods In order to get a background of the quality of documentation, 300 Medical Records were randomly selected among all hospitalized patient during September 23, 2003 and September 22, 2004. Documentation of all records was evaluated using checklists. Then, in order to combine objective data with subjective, 10 physicians and 10 nurses who were involved in documentation of Medical Records were randomly selected and interviewed using two semi structured guidelines. Results Almost all 300 Medical Records had problems in terms of quality of documentation. There was no record in which all information was documented correctly and compatible with the official format in Medical Records provided by Ministry of Health and Medical Education. Interviewees believed that poor handwriting, missing of sheets and imperfect documentation are major problems of the Paper-based Medical Records, and the main reason was believed to be high workload of both physicians and nurses. Conclusion The Medical Records are expected to be complete and accurate. Our study has unveiled that the Medical Records are not documented properly in the university hospital where the Medical Records are also used for educational purposes. Such incomplete Medical Records are not reliable resources for medical care too. Some influencing factors external to the structure of the Medical Records (i.e. human factors and work conditions) are involved.

Background: Social determinants of health (SDH) provide a platform in improving health society such as safety. Safety is essential for children because it is directly related to the health and development. The objective of this study was to evaluate the current home safety in the capital city of Iran for children below five years by community-based initiative and its association with common SDH variables. Methods: This is a cross-sectional study, considering community- and family-based initiative. According this five domains checklist which was including physical, kitchen, bath, toys, and first-aid kit, 200 family home safety were evaluated. Moreover, the relation between children safety and social determinants of health was assessed. Furthermore, the research team designed an attractive record card for each child that was distributed among families by community volunteers. Results: The result was extracted into two age groups: less and more than 6 months. We designed an attractive card for each child and distributed among families by volunteers. It showed that children of age above 6 months had higher home safety score. We found a positive association between mother's education and total safety score. Conclusions: This study was a part of MAZDAK project which means friendly environment for children in Persian word. It showed that an effective way for promoting children safety in the community would be community engagement and family cooperation. As the family education can help reduce children injuries, MAZDAK as a model can been run in the other places to check the effects of SDH on home safety for children. This was an experience of improving community knowledge and behavior about home safety by the parents themselves to improve their children safety environment, and it is going to continue the efficacy of Intervention. [ABSTRACT FROM AUTHOR]

Resilience has received increased attention among both practitioners and scholars in recent years. Child resilience has received notable attention in disaster risk reduction (DRR) during the creation of the Sendai Framework 2015-2030 to improve child protection in the event of disasters. As resilience is a subjective concept with a variety of definitions, this study evaluates its different factors and determinates in the existing research to clarify the path for the near future and objective research. A systematic literature review was conducted by searching and selecting the peer-reviewed papers published in four main international electronic databases including PubMed, SCOPUS, WEB OF SCIENCE, and PsycINFO to answer the research question: "What are the criteria, factors or indicators for child resilience in the context of a natural disaster?" The process was based on PRISMA guidelines. In total, 28 papers out of 1838 were selected and evaluated using thematic analysis. The results are shown in two separate tables: one descriptive and the other analytical. Two main themes and five subthemes for criteria for child resilience in a disaster have been found. The factors found cover the following areas: mental health, spiritual health, physical, social behavior, and ecological, and as well as environmental. The majority of the included studies mentioned the scattered criteria about children resilience without any organized category. Although this concept is multifactorial, additional research is needed to develop this study and also observe other kinds of disasters such as human-made disasters. [ABSTRACT FROM AUTHOR]

Background: Child-friendly environment project (MAZDAK) is a community-based project for monitoring the development of children in Iran that was implemented as a pilot study in one of the neighborhoods of Tehran (Eyvanak-e Gharb). This study attempted to engage mothers in monitoring of their children's development and assesses the status of children's development by a community-based participatory approach using the ages and stages questionnaires (ASQ). Methods: This study was a community-based participatory research. Two hundred households residing in Eyvanak-e Gharb with children under 5-year-old were selected as a convenient sample and completed the ASQ. Descriptive measures were used to describe the overall status of children, in each domain. Furthermore, we compared the current sample with other populations, using independent t-test. Results: This study engaged mothers, trained volunteers from the community, and some local institutions in screening and monitoring children development and addressing any poor developmental growth. The mean scores of the different domains (communication, gross motor, fine motor, problem solving, and social-personal) in sampled children in MAZDAK project were higher than corresponding mean scores of the children in a project conducted in Tehran in 2006. Conclusions: Involving mothers and community in monitoring children development based on ASQ was an effective strategy to monitor and foster children development. [ABSTRACT FROM AUTHOR]

Objective: To determine the levels of Polychlorinated biphenyls (PCBs) and Polybrominateddiphenyl ethers (PBDEs) as persistent organic pollutants (POPs) in serum of primiparous women at the third trimester of pregnancy and identify the main determinants of POPs levels such as socio-demographic, lifestyle, and diet in Tehran. Materials and methods: One-hundred eighty five serum samples from two simultaneous case-control studies were collected from September 2013 until August 2015.Ten most abundant PCB congeners (International Union of Pure and Applied Chemistry (IUPAC) congeners 28, 52, 74, 99, 101, 118, 138, 153, 180 and 187) as well as eight PBDE congeners (IUPAC congeners 28, 47, 99, 100, 153, 154, 183 and 209)were analyzed by Gas Chromatography Mass Spectrometry (GC/MS). Multiple linear regression analysis was conducted to explain the relationship between total PCBs and total BPDEs and most detected congeners and some determinants, separately. Results: The mean (SD) age of the participating women was 27.82 ± 5.24 years. The geometric mean (SD) of total PCBs was 2.42 ± 2.26 and total PBDEs was 1.28 ± 1.41 ng/g lipid. Only the PCB 138, PCB 153 and PBDE 153 were detected in 100% of samples. We observed a significant relationship between the time of being indoors and total PBDEs (P = 0.03). Passive smoking was significantly associated with PCB 153 (P = 0.049). The results of the linear regression analysis showed the negative and weak association (P-value < 0.05) between diet (egg and fat and oil consumption) and POPs in this population. Conclusion: It seems the most common route of exposure to PBDEs in our population is indoor pollutants. Meanwhile inhalation of smoke from environment is a route of exposure to PCB 153. Further study is needed to evaluate the effects of socio-demographics and especially dietary intake on POPs level. [ABSTRACT FROM AUTHOR]

Background: Health-related quality of life is affected by electromagnetic field exposure in each person everyday life. However, this is extremely controversial issue. Objective: Investigation of the associations between electromagnetic field exposure and miscarriage among women of Tehran. Materials and Methods: In this longitudinal study, 462 pregnant women with gestational age <12 wks from seven main regions of Tehran city in Iran with similar social and cultural status were participated. Women were interviewed face-to face to collect data. Reproductive information was collected using medical file recorded in those hospitals the subjects had delivery. The measuring device measured electromagnetic waves, Narda safety test solutions with valid calibration date at the entrance door of their houses. Results: A significant likelihood of miscarriage in women who exposed to significant level of electromagnetic wave. However, this association was not confirmed by Wald test. Conclusion: This study may not provide strong or consistent evidence that electromagnetic field exposure is associated or cause miscarriage. This issue may be due to small sample size in this study. [ABSTRACT FROM AUTHOR]

Background: About 80% of deaths in 350 million cases of diabetes in the world occur in low and middle income countries. The aim of this study was to determine the status of diabetes socioeconomic inequality and the share of determinants of inequalities in Kurdistan Province, West of Iran, using two surveys in 2005 and 2009. Methods: Data were collected from non-communicable disease surveillance surveys in Kurdistan in 2005 and 2009. In this study, the socioeconomic status (SES) of the participants was determined based on the residential area and assets using principal component analysis statistical method. We used concentration index and logistic regression to determine inequality. Decomposition analysis was used to determine the share of each determinant of inequality. Results: The prevalence of diabetes expressed by individuals changed from 0.9% (95% CI: 0.6-1.3) in 2005 to 3.1% (95% CI: 2-4) in 2009. Diabetes Concentration Index changed from -0.163 (95% CI: -0.301- -0.024) in 2005 to 0.273 (95% CI: 0.101-0.445) in 2009. The results of decomposition analysis revealed that in 2009, 67% of the inequality was due to low socioeconomic status and 16% to area of residence; i.e., living in rural areas. Conclusion: The prevalence of diabetes significantly increased, and the diabetes inequality shifted from the poor people to groups with better SES. Increased prevalence of diabetes among the high SES individuals may be due to their better responses to diabetes control and awareness programs or due to the type of services they were provided during these years. [ABSTRACT FROM AUTHOR]

Background: An obvious gradient in health outcomes has been implicated in many evidences relating to social and economic factors. Proper data are requested to convince policy-makers calling for intersectoral action for health. Recently, I.R. of Iran has come up with 52 health equity indicators to monitor health equity through the country. Conducting regular surveys on 14 out of 52 national health equity indicators is needed to provide a basis for the health inequality analysis through the country. We aimed to introduce a survey tool and its related protocols on health equity indicators. Methods: This study was conducted through addressing the literature and expertise of health and demographic surveys at the national and international levels. Also, we conducted technical and consultative committee meetings, a final consensus workshop and a pilot study to finalize the survey tool. Results: We defined the study design, sampling method, reliable questionnaires and instructions, data collection and supervision procedure. We also defined the data analysis protocol on health equity indicators, generated from non-routine data. Conclusion: A valid and reliable tool, which could be employed at the national and sub-national levels, was designed to measure health equity in Iran. Policy-makers can use this survey tool to generate useful information and evidence to design appropriate required intervention and reduce health inequality across the country. [ABSTRACT FROM AUTHOR]

Background: Reproductive health problems affect youths in all countries. There is an urgent need to enhance youths reproductive health services to provide a healthy life for this group. In this regard, the present study aimed to evaluate the Reproductive Health Peer Education Program based on the opinion of university students. Methods: This interventional study was conducted in Qazvin University of Medical Sciences through the peer education method. The participants of this study were 24 peer educators who received training in a 40 hour peer educator training course. The peer education program was implemented in the university. In order to evaluate this community-based intervention, 329 students were selected through the stratified sampling method and their opinion was assessed. Descriptive statistical methods were used by SPSS software for data analysis. Results: The results of the study revealed that peer education was accepted by 64.7% (n= 213) of the students, according to their opinion. The educational priorities of the students were as follows: pre-marriage counseling (78%, n= 166); STI/AIDS (17%, n= 36); and contraception (5%, n= 11). The peer education program was recognized as the most required reproductive health service in the university by 55.3% (n= 118) of the students. They believed that the most important duties of the peer educators were: education (33.5%, n= 71); counseling (30.4%, n= 65); referring to a counseling center (21.6%, n= 46) and referring to a therapeutic center (14.5%, n= 31). Also, the students stated that confidentiality (53%, n= 113), suitable communication (26%, n= 55) and sufficient knowledge (21%, n= 45) were desired characteristics for the peer educators. Conclusion: According to the students' opinion, peer education could provide suitable reproductive health services and could also be beneficial for reproductive health promotion and might reinforce positive behaviors in youths. Reproductive health peer-counseling is a sensitive process, and it is best to be conducted under the supervision of specialists. [ABSTRACT FROM AUTHOR]

Background: Planning, organizing, staffing, leading and monitoring are the basic functional component of management. In present article, we aim to define the project monitoring and evaluation in health research system (HRS) considering its success and challenges based on our national experience. Methods: In this study based on the information of annual Medical Science Universities evaluation during the last decade the HRS indicators have been scored in three axes based on HRS functions: Stewardship, capacity building and knowledge production. In this article, we will focus on the results of HRS evaluation from 2002 to 2010, also on its success and challenges. Results: In an overall view, the main results are the experiences of the designing and implantation of such process after pre-project preparation, all parts followed under the whole supervision of the aims of the HRS evaluation. Project management light the way of practical application of knowledge, skills, tools and techniques for better HRS evaluation and management. Conclusions: We concluded that; although monitoring and evaluation as an essential part of HRS Management light the improvement ahead way but we still need to advantage of the new project management advances. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of gender and living area on cardiovascular risk factors in the context of a comprehensive lifestyle intervention program. Design: Data from independent sample surveys before (2000--2001) and after (2007) a community trial, entitled the Isfahan Healthy Heart Program (IHHP) were used to compare differences in the intervention area (IA) and reference area (RA) by gender and living area. Setting: The interventions targeted the population living in Isfahan and Najaf-Abad counties as IA and Arak as RA. Participants: Overall, 12 514 individuals who were more than 19 years of age were studied at baseline, and 9570 were studied in postintervention phase. Interventions: Multiple activities were conducted in connection with each of the four main strategies of healthy nutrition, increasing physical activity, tobacco control, and coping with stress. Main Outcomes: Comparing serum lipids levels, blood pressure, blood glucose and obesity indices changes between IA and RA based on sex and living areas during the study. Results: In IA, while the prevalence of hypertension declined in urban and rural females (P < 0.05). In IA, the prevalence of hypercholesterolemia and hypertriglyceridemia decreased in both females and males of urban and rural areas except for hypercholesterolemia in rural males (P < 0.01). In RA, the significant changes include both decrease in the hypercholesterolemia among rural males (P < 0.001) and hypertriglyceridemia in urban females (P < 0.01), while hypertriglyceridemia was significantly increased in rural females (P < 0.01).Conclusions: This comprehensive community trial was effective in controlling many risk factors in both sexes in urban and rural areas. These findings also reflect the transitional status of rural population in adopting urban lifestyle behaviors. [ABSTRACT FROM AUTHOR]

Background: Community-based participatory research (CBPR) has been applied by health researchers and practitioners to address health disparities and community empowerment for health promotion. Despite the growing popularity of CBPR projects, there has been little effort to synthesize the literature to evaluate CBPR projects. The present review attempts to identify appropriate elements that may contribute to the successful or unsuccessful interventions. Methods: A systematic review was undertaken using evidence identified through searching electronic databases, web sites, and reference list checks. Predefined inclusion and exclusion criteria were assessed by reviewers. Levels of evidence, accounting for methodologic quality, were assessed for 3 types of CBPR approaches, including interventional, observational, and qualitative research design as well as CBPR elements through separate abstraction forms. Each included study was appraised with 2 quality grades, one for the elements of CBPR and one for research design. Results: Of 14,222 identified articles, 403 included in the abstract review. Of these, 70 CBPR studies, that 56 intervention studies had different designs, and finally 8 studies met the inclusion criteria. The findings show that collaboration among community partners, researchers, and organizations led to community-level action to improve the health and wellbeing and to minimize health disparities. It enhanced the capacity of the community in terms of research and leadership skills. The result provided examples of effective CBPR that took place in a variety of communities. However, little has been written about the organizational capacities required to make these efforts successful. Conclusion: Some evidences were found for potentially effective strategies to increase the participant's levels of CBPR activities. Interventions that included community involvement have the potential to make important differences to levels of activities and should be promoted. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to determine association between personal, family, neighborhood, and social network characteristics and perceived intimacy in the neighborhood by the women. Methods: In this cross-sectional study, we applied a two-stage sampling method to choose a representative sample of 150 married women and housewives, aged 15 to 49 years, who had education between six and twelve years and lived in the urban areas of the Khorasan-e-Razavi province of Iran. Association between personal, family, neighborhood, and social network variables, with the perceived neighborhood intimacy, was assessed through univariate and multiple linear regression. Results: Based on the multiple model, there were significant associations between neighborhood intimacy as perceived by the women and their education level (Standardized Beta=-0.190, P=0.019), length of residence (Standardized Beta=0.175, P=0.029), self-rated health status (Standardized Beta=0.177, P=0.029), and their individual social network size (Standardized Beta=0.211, P=0.030). Conclusion: The potential predictors including length of residence, self-rated health, and size of the respondents' personal social networks had a direct association with the women's perceived neighborhood intimacy, while the education level of the respondents had an inverse association with the neighborhood intimacy, as another potential predictor. Neighborhood intimacy could express the social health condition of the community members. [ABSTRACT FROM AUTHOR]

Objective: Evaluating the status of the ECO member countries in relation to HIV/AIDS (goal 6-a) which includes the main targets for global HIV/AIDS control. Materials and methods: In 2009, we have critically reviewed the countries' MDG reports and extracted the data on each MDG's indicator by year to explore the trend. In the next phase, the main stakeholders, from both governmental and international organizations in the country have been visited and interviewed (individually and in group) by the research team as part of the data validation process. Results: The most important issue in ECO countries is lack of accurate data about HIV/AIDS. From all countries four of them are facing concentrated epidemics in IDUs. ECO countries are categorized into three groups; countries in which HIV prevalence had remained less than 0.1 percent during 2001 to 2008 (Only country is within this group) , countries in which prevalence had reached 0.1 percent during 2001 to 2008 (5 countries are in this group) and countries in which prevalence had reached 0.2 percent or more during 2001 to 2008. Three countries are in latter group. There is no valid data about people's awareness, condom usage during last sexual intercourse, and antiretroviral treatment. Existing data indicates inappropriateness of these indicators in all countries of the region. Conclusion: An efficient surveillance system in needed to illustrate an exact picture of HIV/AIDS in all countries. This study shows that though the epidemics has started lately in member countries compared with other parts of the world, no proper intervention has been adopted for controlling the epidemics yet. Moreover, in those countries which AIDS epidemics are concentrated among drug users, harm reduction activities are necessary to control the problem. Increasing the coverage of antiretroviral treatment and awareness of general and high risk population could help countries to achieve HIV/AIDS indicators. [ABSTRACT FROM AUTHOR]

Objective: Evaluating the status of the ECO member countries in relation to goal 5 of 3rd millennium which includes 75% reduction of maternal mortality rate till 2015 in comparison to 1990. Material and Methods: In 2009, we have critically reviewed the countries' MDG reports and extracted the data on each MDGs' indicator by year and cause of mortality, (if possible) resident area (urban/rural) to explore the trend. In the next phase, the main stakeholders, from both governmental and international organizations in the country have been visited and interviewed (individually and in group) by the research team as part of the data validation process. Results: The MMR is very heterogeneous among the ECO countries. Afghanistan with the MMR of 1800 (per 100,000 live births) in 2005 is the worst country in the region/world while Turkey has reached the level of 19.4 maternal deaths per 100,000 live births in 2008. Multiple regression analysis shows that only the index of delivery by skilled health personnel is effective in reduction of maternal mortality. Conclusion: With considering half a decade to the end of predetermined time for achieving the millennium development goals, i.e. 2015, it's optimistically expected that only a few of the ECO countries will reach the target for maternal health [ABSTRACT FROM AUTHOR]