| 1. Title: Attitudes of healthcare providers towards patients with HIV/AIDS in Bandar Abbas. Author: Aghamolaei T; Tavafian SS; Hasani L; Zare S Source: Archives of Iranian Medicine. 2009 May;12(3):298-301. Abstract: We aimed to investigate the attitudes of healthcare providers towards patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in Bandar Abbas, south of Iran. In this cross-sectional study, a random sample of 250 healthcare providers completed a 20-item questionnaire from January first through February 30th, 2007. There were five domains of attitudes towards patients with HIV. The items measured as a five-point Likert scale ranging from strongly disagree to strongly agree. The mean age of the healthcare providers was 31.3 (SD=7.3) years. Of them 24.4% were males, 42.4% had received Bachelor of Science degree, 19.2% were physicians, 63.2% were nurses, and 17.6% were laboratory technicians. The respondents had fairly positive attitudes towards patients with HIV. Men, older age, more educated participants, and laboratory technicians had more favorable attitude towards HIV (P<0.05). Language: English Keywords: IRAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | HEALTH PERSONNEL | CLIENTS | PERSONS LIVING WITH HIV/AIDS | STAFF ATTITUDE | HIV INFECTIONS | AIDS | LABORATORY PROCEDURES | Middle East | Developing Countries | Research Methodology | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Attitudes | Psychological Factors | Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services Document Number: 342660   |
2. Title: Breastfeeding and obesity among Kuwaiti preschool children. Author: Al-Qaoud N; Prakash P Source: Medical Principles and Practice. 2009;18(2):111-7. Abstract: OBJECTIVES: To determine if breastfeeding and its duration are associated with a reduced risk of obesity among Kuwaiti preschool children. SUBJECTS AND METHODS: The sample consisted of 2,291 (1,092 males and 1,199 females) preschool children (3-6 years of age) and their mothers. The data were collected from September 2003 to June 2004. Height and weight measurements were used for defining weight status while other data were collected by questionnaire. RESULTS: There was no significant association of breastfeeding or its duration with either overweight or obesity among preschool children after adjusting for effects of the confounders. The child's gender, age and birth weight were the significant factors influencing current weight. Girls were at 32% higher risk of becoming obese than boys. Children aged 4-5 years were at nearly 3 times higher risk of overweight and obesity than children of less than 4 years. Children with higher birth weight (>or=4 kg) had double the risk of obesity than those of normal birth weight (>or=2.5 to <4.0 kg). Maternal obesity was a strong predictor of obesity in the children. A child with an obese mother had nearly 2 times higher risk of being overweight (BMI between the 85th the 95th percentiles) and 3 times of being obese (BMI >or=95th percentile) compared to a child born to a mother with a normal body weight. CONCLUSION: Breastfeeding and its duration are not associated with obesity status. However, there is a positive association between child and maternal obesity. Language: English Keywords: KUWAIT | RESEARCH REPORT | PREVALENCE | CHILDREN | BREASTFEEDING | OBESITY | BODY WEIGHT | CHILD HEALTH | Middle East | Developed Countries | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Physiology | Biology Document Number: 341031   |
3. Title: Reducing maternal mortality in Yemen: challenges and lessons learned from baseline assessment. Author: Al Serouri AW; Al Rabee A; Bin Afif M; Al Rukeimi A Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):86-91. Abstract: OBJECTIVE: The Yemen is a signatory of the Millennium Development Goals (MDGs) and one of 10 countries chosen for the UN Millennium Project. However, recent MDG progress reviews show that it is unlikely that the maternal health goal will be reached by 2015 and Yemen still has an unacceptably high maternal mortality of 365 per 100000 live births. Because 82% of deaths happen intrapartum, the purpose of this needs assessment was to identify and prioritize constraints in delivery of emergency obstetric care (EmOC). METHODS: Four district hospitals and 16 health centers in 8 districts were assessed for functional capacity in terms of infrastructure; availability of essential equipment and drugs; EmOC technical competency and training needs; and Health Management Information System. RESULTS: We found poor obstetric services in terms of structure (staffing pattern, equipment, and supplies) and process (knowledge and management skills). CONCLUSION: The data argue for strengthening the 4 interlinked health system elements-human resources, and access to, use, and quality of services. The Government must address each of these elements to meet the Safe Motherhood MDG. Language: English Keywords: YEMEN | RESEARCH REPORT | MOTHERS | SAFE MOTHERHOOD | MATERNAL HEALTH | MATERNAL MORTALITY | PREVENTION AND CONTROL | EMERGENCY SERVICES | OBSTETRICAL SURGERY | Developing Countries | Middle East | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Health | Mortality | Population Dynamics | Demographic Factors | Population | Diseases | Health Services | Delivery of Health Care | Surgery | Treatment | Medical Procedures | Medicine Document Number: 341376   |
4. Peer Reviewed Title: Diarrhoeagenic Escherichia coli are not a significant cause of diarrhoea in hospitalised children in Kuwait. Author: Albert MJ; Rotimi VO; Dhar R; Silpikurian S; Pacsa AS; Molla AM; Szucs G Source: BMC Microbiology. 2009;9:62. Abstract: BACKGROUND: The importance of diarrhoeagenic Escherichia coli (DEC) infections in the Arabian Gulf including Kuwait is not known. The prevalence of DEC (enterotoxigenic [ETEC], enteropathogenic [EPEC], enteroinvasive [EIEC], enterohemorrhagic [EHEC] and enteroaggregative [EAEC]) was studied in 537 children < or = 5 years old hospitalised with acute diarrhoea and 113 matched controls from two hospitals during 2005-07 by PCR assays using E. coli colony pools. RESULTS: The prevalence of DEC varied from 0.75% for EHEC to 8.4% for EPEC (mostly atypical variety) in diarrhoeal children with no significant differences compared to that in control children (P values 0.15 to 1.00). Twenty-seven EPEC isolates studied mostly belonged to non-traditional serotypes and possessed beta and theta intimin subtypes. A total of 54 DEC isolates from diarrhoeal children and 4 from controls studied for antimicrobial susceptibility showed resistance for older antimicrobials, ampicillin (0 to 100%), tetracycline (33 to 100%) and trimethoprim (22.2 to 100%); 43.1% of the isolates were multidrug-resistant (resistant to 3 or more agents). Six (10.4%) DEC isolates produced extended spectrum beta-lactamases and possessed genetic elements (blaCTX-M, blaTEM and ISEcp1) associated with them. CONCLUSION: We speculate that the lack of significant association of DEC with diarrhoea in children in Kuwait compared to countries surrounding the Arabian Gulf Region may be attributable to high environmental and food hygiene due to high disposable income in Kuwait. Language: English Keywords: KUWAIT | RESEARCH REPORT | CONTROL GROUPS | CHILDREN | BACTERIAL AND FUNGAL DISEASES | DIARRHEA | DIARRHEA, INFANTILE | PREVALENCE | ANTIBIOTICS | DRUG RESISTANCE | Middle East | Developed Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Measurement | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341689   |
5. Title: Determination of conversion coefficient to evaluate couple-year of protection (CYP) for tubectomy and vasectomy in urban and rural regions of Iran: IMES Study. Author: Alinejad F; Heidarzade A; Eslami M; Faraji R; Shatti M Source: Journal of Reproduction and Contraception. 2009 Jun;20(2):81-92. Abstract: Objective: To calculate couple-year of protection (CYP) by conversion coefficient (F) of tubectomy and vasectomy in urban and rural regions of Iran. Methods A total of 103 450 married women aged 10-49 years in 2005 across urban and rural regions of Iran were sampled by multi stage cluster sampling. The data were collected by household survey and direct interview and analyzed by STATA8.0 software and survey analysis commands. Results Mean age of the women at the time of tubectomy estimated 31.9 years and conversion coefficient of tubectomy was 17.1 ± 0.1. Mean age of women at the time of her husband vasectomy estimated 31.48 years and its conversion coefficient was 17.5 ± 0.1. Cluster analysis defined different regions of Iran on the basis of evaluated conversion coefficients of tubectomy and vasectomy which both of them presented seven clusters. Literacy of women and total coverage of family planning in a region had a direct relationship with this conversion coefficient (P<0.05). Language: English Keywords: IRAN | RESEARCH REPORT | COUPLES | CONTRACEPTION | FAMILY PLANNING | VASECTOMY | TUBAL LIGATION | PROGRAM EVALUATION | Middle East | Developing Countries | Family Characteristics | Family and Household | Sociocultural Factors | Male Sterilization | Sterilization, Sexual | Female Sterilization | Programs | Organization and Administration Document Number: 339900   |
6. Title: Misoprostol for pregnancy termination in grand multiparous women with three cesarean deliveries. Author: Alsibiani SA Source: International Journal of Gynaecology and Obstetrics. 2009 Apr 3; Abstract: In countries in which women have high parity, pregnancy termination is common in women who have had multiple cesarean deliveries. Although a combination of mifepristone and misoprostol is recommended for late abortion, in Saudi Arabia, mifepristone is not approved or available. There is little information about the safety of misoprostol for the termination of pregnancy or induction of labor in women with scarred uteri and multiple cesarean deliveries. Although there is no recommended dose or mode of administration for misoprostol in patients with scarred uteri and high parity, it is advisable to use a low dose. Misoprostol use in women with scarred uteri can lead to uterine rupture, but few incidences have been reported in the literature. However, caution is advisable. Misoprostol administered orally has a rapid onset of action and increases uterine tone, but contractions are not experienced unless repeated doses are administered. In addition, women usually prefer oral administration. Vaginal administration offers prolonged activity, greatest bioavailability, and a lower incidence of adverse effects. Use of misoprostol for termination of pregnancy in 2 grand multiparous (gravidity N10) women each with 3 previous cesarean deliveries is summarized in Table 1. According to the WHO expert dosage guidelines, the maximum dose was not exceeded in either patient. In patient 1 an intracervical Foley catheter with syntocinon infusion was used to ripen the cervix followed by oral administration of 800 µg of misoprostol. Patient 2 received a single dose of 800 µg of misoprostol vaginally. Favorable results were obtained in both women using a single high dose of misoprostol. The safety of using misoprostol in women with high parity and scarred uteri could not be ascertained from this study. A larger study is needed to confirm the effectiveness and safety of this regimen in patients with high parity who have had more than 2 previous cesarean deliveries. (full-text) Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | SUMMARY REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | CESAREAN SECTION | ABORTION | MULTIPARITY | MISOPROSTOL | UTERUS | RU-486 | ADMINISTRATION AND DOSAGE | Middle East | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Parity | Fertility Measurements | Fertility | Population Dynamics | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Genitalia, Female | Genitalia | Urogenital System | Hormone Antagonists | Hormones | Drugs Document Number: 341466   |
| 7. Title: Knowledge and practice of university students in Lebanon regarding contraception. Author: Barbour B; Salameh P Source: Eastern Mediterranean Health Journal. 2009 Mar-Apr;15(2):387-99. Abstract: We evaluated knowledge and practice of Lebanese university students regarding contraception in a cross-sectional, comparative study on students in public and private universities using an Arabic language self-administered questionnaire. We found low levels of knowledge of contraception. The majority of males (73.3%) and a few females (21.8%) declared previous sexual relations: the majority of males had used a condom (86.1%), but females had generally not used contraceptives (75.6%). Language: English Keywords: LEBANON | RESEARCH REPORT | COMPARATIVE STUDIES | STUDENTS | MEN | UNIVERSITIES | KNOWLEDGE | CONTRACEPTION | CONDOM USE | RISK REDUCTION BEHAVIOR | SEX BEHAVIOR | Middle East | Developing Countries | Studies | Research Methodology | Education | Demographic Factors | Population | Schools | Sociocultural Factors | Family Planning | Behavior Document Number: 341713   |
8. Title: Fetal abnormalities leading to third trimester abortion: nine-year experience from a single medical center. Author: Barel O; Vaknin Z; Smorgick N; Reish O; Mendlovic S; Herman A; Maymon R Source: Prenatal Diagnosis. 2009 Mar;29(3):223-8. Abstract: OBJECTIVE: To assess fetal abnormalities and events leading to third-trimester abortion. METHODS: The study population included all parturient women with singleton pregnancy that underwent termination of pregnancy (TOP) in the third trimester in our institute because of fetal indications between 1998 and 2006. RESULTS: There were 777 cases of TOP due to fetal anomalies in our center during the study period, and 52 terminations were carried out in the third trimester. All cases of third-trimester abortions were due to severe malformations with high probability of perinatal death or severe handicap: 65.3% anomalies were structural, and 58.9% of them involved the central nervous system (CNS). Genetic indications included mostly genetic diseases, unlike aneupluidities in earlier terminations. Routine prenatal care raised suspicion of abnormalities in 22 (42.3%) cases, and diagnosis was established by additional tests. Abnormal findings were either missed in 4 (7.7%) cases or developed later in 11 (21.1%) cases. No routine prenatal screening was performed in the remaining 15 (28.8%) cases. CONCLUSIONS: Third-trimester abortion may be obviated by timely screening and scanning in some cases. The possibility of late TOP should be considered in malformations occurring late in pregnancy and in cases that require meticulous evaluation and follow-up from earlier stages of gestation. Language: English Keywords: ISRAEL | RESEARCH REPORT | FETUS | PREGNANCY, THIRD TRIMESTER | CHROMOSOME ABNORMALITIES | CONGENITAL ABNORMALITIES | SCREENING | ABORTION | Developed Countries | Middle East | Pregnancy | Reproduction | Neonatal Diseases and Abnormalities | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning Document Number: 331172   Notification |
9. Peer Reviewed Title: Maternal mortality in Syria: causes, contributing factors and preventability. Author: Bashour H; Abdulsalam A; Jabr A; Cheikha S; Tabbaa M; Lahham M; Dihman R; Khadra M; Campbell OM Source: Tropical Medicine and International Health. 2009 Sep;14(9):1122-7. Abstract: OBJECTIVES: To describe the biomedical and other causes of maternal death in Syria and to assess their preventability. METHODS: A reproductive age mortality study (RAMOS) design was used to identify pregnancy related deaths. All deaths among women aged 15-49 reported to the national civil register for 2003 were investigated through home interviews. Verbal autopsies were used to ascertain the cause of death among pregnancy related maternal deaths, and causes and preventability of deaths were assessed by a panel of doctors. RESULTS: A total of 129 maternal deaths were identified and reviewed. Direct medical causes accounted for 88%, and haemorrhage was the main cause of death (65%). Sixty nine deaths (54%) occurred during labour or delivery. Poor clinical skills and lack of clinical competency were behind 54% of maternal deaths. Ninety one percent of maternal deaths were preventable. CONCLUSIONS: The causes of maternal death in Syria and their contributing factors reflect serious defects in the quality of maternal care that need to be urgently rectified. Language: English Keywords: SYRIA | RESEARCH REPORT | RECORDS | MATERNAL MORTALITY | CAUSES OF DEATH | PREGNANCY OUTCOMES | MATERNAL HEALTH SERVICES | QUALITY OF HEALTH CARE | Developing Countries | Middle East | Information Processing | Information | Mortality | Population Dynamics | Demographic Factors | Population | Pregnancy | Reproduction | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration Document Number: 342964   |
10. Title: Predictors of Condom Use Among Israeli Soldiers. Author: Ben Natan M; Danilov S; Evdokimovitz Y Source: American Journal of Men's Health. 2009 Jul 14; Abstract: Only a small percentage of young people aged 18 to 20 years use condoms regularly. Thus, the younger population has an increased risk of contracting sexually transmitted diseases. This study examines the underlying determinants of condom use among soldiers based on the theory of planned behavior as well as the influence of soldiers' social circumstances and prior sexual experience. A correlational design using an exploratory survey method was used. Participants were sampled in a convenience sample of 113 male soldiers from the Israel defense forces. A total of 70.1% of soldiers use condoms in their first sexual experience, however, this percentage subsequently decreases. The study indicates that soldiers are not familiar with the risks of frequent oral and anal sex. Behavioral intentions and self-control are significant predictors of condom use. Condom use among soldiers from one-parent families was lower than among soldiers from two-parent families. The theory of planned behavior seems to be a helpful method of predicting condom use among soldiers. Accordingly, efforts should be channeled at attempts to generate changes in soldiers' views of condom use, intensifying normative pressures operated by their social milieu, and increasing their self-control in the use of condoms. Language: English Keywords: ISRAEL | RESEARCH REPORT | SAMPLING STUDIES | MILITARY PERSONNEL | MEN | CONDOM USE | ATTITUDES | BELIEFS | SEX BEHAVIOR | SAFER SEX | PERCEPTION | Developed Countries | Middle East | Studies | Research Methodology | Government | Political Factors | Sociocultural Factors | Demographic Factors | Population | Risk Reduction Behavior | Behavior | Psychological Factors | Culture Document Number: 342123   |
| 11. Title: Risk of mortality in pediatric intensive care unit, assessed by PRISM-III. Author: Bilan N; Galehgolab BA; Emadaddin A; Shiva Sh Source: Pakistan Journal of Biological Sciences. 2009 Mar 15;12(6):480-5. Abstract: This study aimed at evaluating the mortality rate in a PICU applying PRISM-III. Two hundred and twenty one infants and children consecutively admitted to PICU of Tabriz Children's Hospital were studied during a 13 months period of time. Data required for calculating the PRISM-III score were collected during the first 24 h of PICU stay in all patients. The prediction of actual mortality by PRISM-III scoring was evaluated by the Hosmer and Lemeshow goodness-of-fit test. Receiver Operating Characteristic (ROC) curve was constructed, as well. The observed (O) short-term (during hospital stay) mortality rate was compared with the expected (E) figures as the O/E ratio. The mean value of the PRISM-III score was 14.22 +/- 9.57(2-42). ROC analysis indicated a strong predictive power for the PRISM-III (area under the curve = 0.898) and the test was well fit to the designed study (goodness-of-fit p-value = 0.161). The observed short-term mortality rate was 9.05% and the expected mortality rate by the PRISM-III scoring was 9% (O/E ratio = 1.005). The PRISM-III scoring system was highly calibrated in our institute. Language: English Keywords: IRAN | RESEARCH REPORT | EVALUATION | INFANT | CHILDREN | DEATH RATE | RISK FACTORS | Middle East | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Health Document Number: 342232   |
12. Title: Expectant management of pregnancy-related high-velocity uterine arteriovenous shunt diagnosed after abortion. Author: Degani S; Leibovitz Z; Shapiro I; Ohel G Source: International Journal of Gynaecology and Obstetrics. 2009 Jul;106(1):46-9. Abstract: OBJECTIVE: To assess sonographic and clinical outcome in women with pregnancy-related uterine arteriovenous malformations (AVMs) diagnosed after abortion. METHOD: Twelve patients diagnosed as having AVMs after abortion were followed-up until resolution of the lesions. RESULTS: The 9 asymptomatic patients were managed expectantly for 4 to 10 weeks without further complications. None of the 12 required aggressive interventions such as transcatheter arterial embolization, and 6 had uncomplicated pregnancies after resolution of the lesions. CONCLUSION: Expectant management is an option in many women with pregnancy-related uterine AVMs. Language: English Keywords: ISRAEL | RESEARCH REPORT | WOMEN | POSTABORTION | POSTABORTION CARE | UTERINE EFFECTS | MANAGEMENT | ULTRASONICS | Developed Countries | Middle East | Demographic Factors | Population | Reproduction | Health Services | Delivery of Health Care | Health | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Organization and Administration | Medical Procedures | Medicine Document Number: 342604   |
13. Peer Reviewed Title: Ethical Considerations in HIV/AIDS Biobehavioral Surveys That Use Respondent-Driven Sampling: Illustrations From Lebanon. Author: Dejong J; Mahfoud Z; Khoury D; Barbir F; Afifi RA Source: American Journal of Public Health. 2009 Jul 16; Abstract: Respondent-driven sampling is especially useful for reaching hidden populations and is increasingly used internationally in public health research, particularly on HIV. Respondent-driven sampling involves peer recruitment and has a dual-incentive structure: both recruiters and their peer recruits are paid. Recent literature focusing on the ethical dimensions of this method in the US context has identified integral safeguards that protect against ethical violations. We analyzed a study of 3 groups in Lebanon who are at risk for HIV (injection drug users, men who have sex with men, female sex workers) and the ethical issues that arose. More explicit attention should be given to ethical issues involved in research implementing respondent-driven sampling of at-risk populations in developing countries, where ethical review mechanisms may be weak. Language: English Keywords: LEBANON | SUMMARY REPORT | RECRUITMENT ACTIVITIES | RESPONDENTS | IV DRUG USERS | MEN HAVING SEX WITH MEN | SEX WORKERS | PUBLIC HEALTH | HIV INFECTIONS | AIDS | ETHICS | INFORMED CONSENT | Middle East | Developing Countries | Program Activities | Programs | Organization and Administration | Surveys | Sampling Studies | Studies | Research Methodology | Drug Use and Abuse | Behavior | Sex Behavior | Health | Viral Diseases | Diseases | Sociocultural Factors | Health Services | Delivery of Health Care Document Number: 342038   |
14. Title: CD4 validation for the World Health Organization classification and clinical staging of HIV/AIDS in a developing country. Author: Edathodu J; Ali B; Alrajhi AA Source: International Journal of Infectious Diseases. 2009 Mar;13(2):243-6. Abstract: OBJECTIVES: To validate the World Health Organization (WHO) clinical staging and classification of HIV/AIDS using CD4+ T-lymphocyte counts in the setting of a developing country. METHODS: This was a retrospective chart review of HIV-infected adults at the national HIV referral clinic in the Kingdom of Saudi Arabia. Four hundred HIV-infected individuals were reviewed. All individuals under the age of 15 years and those who had received antiretroviral therapy were excluded. WHO clinical stage at presentation was determined by a single reviewer. The first CD4+ T-lymphocyte count within 6 months of diagnosis of HIV infection was then abstracted by a different reviewer. The main outcome measure was the comparison of the WHO clinical stages of HIV/AIDS at the time of diagnosis and the CD4+ T-lymphocyte counts. RESULTS: Data were available for 191 individuals, of whom 123 were men and 68 were women. The mean CD4+ T-lymphocyte count was 281/mm(3) in the men and 425/mm(3) in the women. The distribution of individuals at the WHO clinical stages was 110 at stage I, 10 at stage II, 36 at stage III, and 35 at stage IV. Mean CD4+ T-lymphocyte counts were 457, 337, 188, and 86/mm(3) at the respective stages. The difference between the mean CD4+ T-lymphocyte count in patients at stage IV and at each of the other stages was significant; p<0.0001. The correlation between the stages and the mean CD4+ T-lymphocyte counts was -0.65. CONCLUSION: The WHO clinical staging and classification of HIV/AIDS correlates well with CD4+ T-lymphocyte counts. Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | WHO | VALIDITY | HIV | AIDS | TESTING | IMMUNITY | Middle East | Developing Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Measurement | Research Methodology | HIV Infections | Viral Diseases | Diseases | Immune System | Physiology | Biology Document Number: 341557   |
15. Title: Care-seeking behavior of women with reproductive health problems from low-income areas of Beirut. Author: El-Kak F; Khawaja M; Salem M; Zurayk H Source: International Journal of Gynaecology and Obstetrics. 2009 Jan;104(1):60-3. Abstract: OBJECTIVE: To examine the patterns of care-seeking behavior and provider choice of women with self-reported reproductive health problems from 3 urban communities in Beirut. METHODS: The study was based on a sample of 1869 completed questionnaires from 2051 eligible women (married or had been married, and between 15 and 59 years) obtained during the Urban Health Survey. Associations between community of residence, other background characteristics, and two outcome measures (health care usage and choice of provider) were assessed using logistic regression. RESULTS: Of the 1869 women assessed, 439 (23.5%) reported reproductive health problems; of these, 273 (62%) women sought care for their problems, with the majority (52.5%) using private providers. Younger age, health insurance, and severity and duration of problems were associated with use. Women with higher parity and those with financial problems were significantly more likely to use public and subsidized services. CONCLUSION: The private health sector needs to be more involved in planning, implementing, and offering reproductive health care in low-income communities. Language: English Keywords: LEBANON | RESEARCH REPORT | WOMEN | LOW INCOME POPULATION | UTILIZATION OF HEALTH CARE | HEALTH SERVICES | BEHAVIOR | REPRODUCTIVE HEALTH | NEEDS ASSESSMENT | Middle East | Developing Countries | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Delivery of Health Care | Health | Evaluation Document Number: 331193   |
| 16. Peer Reviewed Title: Trends in infant nutrition in Saudi Arabia: compliance with WHO recommendations. Author: El Mouzan MI; Al Omar AA; Al Salloum AA; Al Herbish AS; Qurachi MM Source: Annals of Saudi Medicine. 2009 Jan-Feb;29(1):20-3. Abstract: BACKGROUND AND OBJECTIVE: The WHO recommends exclusive breastfeeding in the first 6 months of life. Our objective was to evaluate trends in infant nutrition in Saudi Arabia and the degree of compliance with WHO recommendations. SUBJECTS AND METHODS: A nationwide nutritional survey of a sample of Saudi households was selected by the multistage probability sampling procedure. A validated questionnaire was administered to mothers of children less than 3 years of age. RESULTS: Of 5339 children in the sample, 4889 received breast milk at birth indicating a prevalence of initiation of 91.6%. Initiation of breastfeeding was delayed beyond 6 hours after birth in 28.1% of the infants. Bottle feeding was introduced by 1 month of age to 2174/4260 (51.4%) and to 3831/4260 (90%) by 6 months of age. The majority of infants 3870/4787 (80.8%) were introduced to "solid foods" between 4 to 6 months of age and whole milk feedings were given to 40% of children younger than 12 months of age. CONCLUSIONS: The current practice of feeding of Saudi infants is very far from compliance with even the most conservative WHO recommendations of exclusive breastfeeding for 4 to 6 months. The high prevalence of breastfeeding initiation at birth indicates the willingness of Saudi mothers to breastfeed. However, early introduction of complementary feedings reduced the period of exclusive breastfeeding. Research in infant nutrition should be a public health priority to improve the rate of breastfeeding and to minimize other inappropriate practices. Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | NUTRITION SURVEYS | INFANT | HOUSEHOLDS | INFANT NUTRITION | WHO | STANDARDS | BREASTFEEDING, EXCLUSIVE | PREVALENCE | TIME FACTORS | SUPPLEMENTARY FEEDING | AGE FACTORS | BREASTFEEDING | Middle East | Developing Countries | Nutrition | Health | Youth | Population Characteristics | Demographic Factors | Population | Family and Household | Sociocultural Factors | UN | International Agencies | Organizations | Political Factors | Research Methodology | Measurement | Population Dynamics Document Number: 331138   |
17. Title: Prevalence of Chlamydia trachomatis among women attending gynecology and infertility clinics in Gaza, Palestine. Author: El Qouqa IA; Shubair ME; Al Jarousha AM; Sharif FA Source: International Journal of Infectious Diseases. 2009 May;13(3):334-41. Abstract: BACKGROUND: Chlamydia trachomatis is an obligate intracellular bacterium characterized by a biphasic developmental cycle of replication. The organism is recognized as one of the major causes of sexually transmissible human bacterial infection throughout the world. Since there have been no previous studies dealing with chlamydial diagnosis in Palestine, this study was conducted to determine the prevalence of C. trachomatis infection among women attending gynecology and infertility clinics. METHODS: Endocervical swabs were collected from 109 women, aged 18-52 years (median 29 years), attending gynecology and infertility clinics in Gaza. These specimens were processed using molecular (polymerase chain reaction, PCR) and enzyme immunoassay (EIA; IDEIA PCE Chlamydia) techniques. RESULTS: The results obtained show that the overall prevalence rate of C. trachomatis was 20.2%. The sensitivity was 73% for the EIA, 86% for the MOMP (major outer membrane protein gene)-based PCR, and 100% for the plasmid-based PCR. Meanwhile the specificity was 94% for the EIA, 98% for the plasmid-based PCR, and 100% for the MOMP-based PCR. In multivariate analysis, only cervical discharge was significantly associated with positivity for C. trachomatis (adjusted odds ratio 5.6, 95% confidence interval 2.0-15.5; p=0.001). CONCLUSIONS: The study revealed that a significant proportion of Palestinian women expressed evidence of exposure to C. trachomatis. Women with cervicitis are more likely to have been previously infected or exposed to Chlamydia infection. Furthermore, PCR proved to be superior and more efficient in the diagnosis of C. trachomatis than EIA. Language: English Keywords: GAZA | RESEARCH REPORT | CLINICAL RESEARCH | SAMPLING STUDIES | CLIENTS | WOMEN | CHLAMYDIA | PREVALENCE | INFERTILITY | CERVICAL EFFECTS | LABORATORY PROCEDURES | SIGNS AND SYMPTOMS | Middle East | Developing Countries | Research Methodology | Studies | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Reproduction | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342115   |
18. Peer Reviewed Title: Effect of contraceptive pill on the selenium and zinc status of healthy subjects. Author: Fallah S; Sani FV; Firoozrai M Source: Contraception. 2009 Jul;80(1):40-3. Abstract: BACKGROUND: The study was conducted to ascertain the influence of oral contraceptive pill (OCP) uptake on serum zinc and selenium in contraceptive pill users. STUDY DESIGN: The concentration of zinc and selenium was determined by atomic absorption spectrophotometer in 50 healthy women with normal menstrual cycles as a control group and 50 women taking low-dose OCP. RESULTS: The control reference values were 81.61+/-9.44 and 70.35+/-25.57 mcg/dL, which were obtained for zinc and selenium, respectively. Use of OCP resulted in a significant decrease in serum zinc levels (p=.009, t=-3.666) and alteration of selenium levels but not significantly (p=.08, t=0.935). The duration of use beyond 3 months had no effect on the magnitude of the decrease in serum zinc levels. CONCLUSIONS: These findings may be important because selenium is currently believed to offer protective benefits against carcinogenesis. It has been thought that the decrease in serum zinc could be reflected in a reduction of tissue zinc status due to changes in zinc absorption, excretion or tissue turnover. If these changes occur, the dietary zinc requirement would be greater in women using OCP. Language: English Keywords: IRAN | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | ZINC | NUTRITION | Middle East | Developing Countries | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Metals | Vitamins and Minerals | Physiology | Biology | Health Document Number: 341583   |
19. Peer Reviewed Title: HIV/AIDS epidemic features and trends in iran, 1986-2006. Author: Fallahzadeh H; Morowatisharifabad M; Ehrampoosh MH Source: AIDS and Behavior. 2009 Apr;13(2):297-302. Abstract: This study describes the reported HIV/AIDS data for all verified cases in Iran between 1986 and 2006. The cumulative number of the reported cases of HIV/AIDS among Iranians, up to the end of September 2006 was 13,702. Over the 20-year surveillance period, the rate of HIV/AIDS infections diagnosed annually among Iranian citizens gradually increased and, over the period 1997-2004, it reached from 1.38 to 4.6 cases per 100,000 populations per year. Our findings highlight the need for intensified HIV prevention efforts with men who use drugs via injection and strengthened efforts to encourage the individual at risk to get tested for HIV. Language: English Keywords: IRAN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | LONGITUDINAL STUDIES | IV DRUG USERS | PERSONS LIVING WITH HIV/AIDS | MEN | PREVALENCE | HIV INFECTIONS | EPIDEMICS | INCIDENCE | HIV TESTING | Middle East | Developing Countries | Research Methodology | Studies | Drug Use and Abuse | Behavior | Viral Diseases | Diseases | Demographic Factors | Population | Measurement | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 340129   |
| 20. Peer Reviewed Title: Influence of wasting and stunting at the onset of the rainy season on subsequent malaria morbidity among rural preschool children in Senegal. Author: Fillol F; Cournil A; Boulanger D; Cisse B; Sokhna C; Targett G; Trape JF; Simondon F; Greenwood B; Simondon KB Source: American Journal of Tropical Medicine and Hygiene. 2009 Feb;80(2):202-8. Abstract: In sub-Saharan Africa, malaria and malnutrition are major causes of morbidity and mortality in children less than five years of age. To explore the impact of malnutrition on subsequent susceptibility to malaria, a cohort of 874 rural preschool children in Senegal was followed-up during one malaria transmission season from July through December. Data on nutritional status and Plasmodium falciparum parasitemia were collected at baseline. Malaria morbidity was monitored through weekly home visits. Wasted children (weight-for-height z-score < -2) were at lower risk of having at least one subsequent clinical malaria attack (odds ratio = 0.33; 95% confidence interval = 0.13-0.81, P = 0.02), whereas stunting (height-for-age z-score < -2) or being underweight (weight-for-age z-score < -2) was not associated with clinical malaria. Although non-biological explanations such as overprotection of wasted children by their mothers should be considered, immunomodulation according to nutritional status could explain the lower risk of malaria attack among wasted children. Language: English Keywords: IRAN | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | MOTHERS | CHILD CARE | KNOWLEDGE | ATTITUDES | BREASTFEEDING | DEMOGRAPHIC FACTORS | TIME FACTORS | BREASTFEEDING, EXCLUSIVE | SUPPLEMENTARY FEEDING | EDUCATIONAL STATUS | Middle East | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Child Rearing | Behavior | Psychological Factors | Infant Nutrition | Nutrition | Health | Population | Population Dynamics | Socioeconomic Status | Socioeconomic Factors Document Number: 330300   |
21. Title: Birth weight of offspring, maternal pre-pregnancy characteristics, and mortality of mothers: the Jerusalem perinatal study cohort. Author: Friedlander Y; Manor O; Paltiel O; Meiner V; Sharon N; Calderon R; Hochner H; Sagy Y; Avgil M; Harlap S; Siscovick DS Source: Annals of Epidemiology. 2009 Feb;19(2):112-7. Abstract: PURPOSE: To explore the association between birth weight in offspring, a marker of the intrauterine environment, and mortality in their mothers, taking into account maternal pre-pregnancy characteristics, including maternal body mass index (BMI), smoking, and socioeconomic status. Distinguishing the effects of offspring's birth weight and pre-pregnancy characteristics on maternal outcome may provide clues regarding mechanisms underlying the association between birth weight and maternal mortality. METHODS: We studied long-term total mortality (average follow-up period, 29.1 years) in a population-based cohort of 13,185 mothers, aged 15 to 48 years at their offspring's birth, who delivered in West Jerusalem during 1974 through 1976. RESULTS: Univariate and multivariate Cox-proportional hazard models used to estimate the hazard of overall mortality among mothers indicated a nonlinear relationship with birth weight of offspring when introduced into the models as a continuous variable, and a linear positive association with maternal pre-pregnancy BMI. Inclusion of maternal BMI and other pre-pregnancy characteristics in the model did not alter the association between offspring's birth weight and mothers' all-cause mortality. When birth weight was introduced as a categorical variable, higher mortality was observed among mothers who gave birth to babies with birth weight less than 2500 g (hazard ratio [HR] = 1.90; 95% confidence interval [95%CI], 1.23-2.94) as compared to mothers whose offspring had birth weight between 3000 and 3499 g. The HR for mothers who gave birth to babies with birth weight 4000 g or more was 1.30 (95%CI, 0.88-1.91). CONCLUSIONS: Independent of pre-pregnancy maternal BMI and other characteristics, birth weight of offspring was associated with mortality in their mothers, suggesting that intrauterine metabolic events reflected by birth weight and not explained by maternal obesity, smoking, and socioeconomic status have remote consequences for maternal health. These findings underline the need to explore specific genetic and/or environmental mechanisms that account for these associations. Language: English Keywords: ISRAEL | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | COHORT ANALYSIS | LONGITUDINAL STUDIES | MULTIVARIATE ANALYSIS | MATHEMATICAL MODEL | INFANT | PREGNANT WOMEN | BIRTH WEIGHT | MATERNAL MORTALITY | PREGNANCY OUTCOMES | MATERNAL HEALTH | Developed Countries | Middle East | Research Methodology | Studies | Data Analysis | Theoretical Models | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Body Weight | Physiology | Biology | Mortality | Population Dynamics | Pregnancy | Reproduction | Health Document Number: 331228   |
22. Peer Reviewed Title: Pregnancy outcome in women with an intrauterine contraceptive device. Author: Ganer H; Levy A; Ohel I; Sheiner E Source: American Journal of Obstetrics and Gynecology. 2009 Aug 27; Abstract: OBJECTIVE: To investigate pregnancy outcome in patients who conceived with an intrauterine contraceptive device. STUDY DESIGN: A retrospective study comparing the pregnancy outcome of women with retained intrauterine device (n = 98), patients after intrauterine device removal in early pregnancy (n = 194), and pregnancies without an intrauterine device (n = 141,191) was performed. RESULTS: A significant linear association was documented among the 3 groups and adverse outcomes such as preterm delivery (18.4% in the retained intrauterine device, 14.4 % in removed intrauterine device, and 7.3% in the no-intrauterine device group; P < .001) and chorioamnionitis (7.1% in the retained intrauterine device, 4.1% in removed intrauterine device and 0.7% in the no-intrauterine device group; P < .001). The presence of retained or removed intrauterine device was found as an independent risk factor for both preterm delivery and chorioamnionitis in multivariable models. CONCLUSION: Women conceiving with an intrauterine device are at increased risk for adverse obstetric outcomes, whereas the risk is higher for pregnancies with retained intrauterine device compared with early intrauterine device removal. Language: English Keywords: GLOBAL | ISRAEL | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | PREGNANT WOMEN | PREGNANCY OUTCOMES | IUD | PREGNANCY | LOW BIRTH WEIGHT | PREMATURE BIRTH | Developed Countries | Middle East | Studies | Research Methodology | Demographic Factors | Population | Population Characteristics | Reproduction | Contraceptive Methods | Contraception | Family Planning | Birth Weight | Body Weight | Physiology | Biology Document Number: 342708   |
23. Peer Reviewed Title: Epidemiologic study of human immunodeficiency virus (HIV) Infection in the patients referred to health centers in Hamadan province, Iran. Author: Ghannad MS; Arab SM; Mirzaei M; Moinipur A Source: AIDS Research and Human Retroviruses. 2009 Mar;25(3):277-83. Abstract: Acquired immunodeficiency syndrome (AIDS) is one of the most important infectious diseases threatening the world's population today. The main aim of this study was to assess the epidemiologic features of HIV/AIDS from January 1989 to March 2007 in Hamadan province, Iran. In a cross-sectional study, epidemiodemographic characteristics of HIV/AIDS-positive patients during a period of 17 years were collected from health centers in Hamadan province. This study showed that about 1.8% of HIV/AIDS cases in Iran involved people who lived in Hamadan province. Further study is needed to determine the reasons for this. From January 1989 to March 2007, 285 individuals including 275 males and 10 females were infected with HIV in this province. The study showed that 88% of patients lived in urban areas while 12% involved a rural population. Hamadan city had the highest rate of HIV/AIDS infection and death with 191 and 33 individuals, respectively. The main transmission route was intravenous drug use with 78%. From 28 patients who were entered into the AIDS phase, only 10 patients returned to health centers to be covered under definite treatment. The establishment of the Triangular Clinic can be presented as the starting point in the organization of infected people to detect HIV/AIDS. Altogether, efforts in reducing the impact of HIV in this province to date can be considered beneficial. Continuous laboratory diagnostic strategies may lead in time to therapeutic approaches that result in appropriate outcomes. Language: English Keywords: IRAN | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | URBAN POPULATION | IV DRUG USERS | PREVALENCE | HIV INFECTIONS | SEX FACTORS | RISK BEHAVIOR | HIV TESTING | Middle East | Developing Countries | Geographic Factors | Population | Research Methodology | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Drug Use and Abuse | Behavior | Measurement | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 331235   |
24. Title: Disappearance of female genital mutilation from the Bedouin population of Southern Israel. Author: Halila S; Belmaker RH; Abu Rabia Y; Froimovici M; Applebaum J Source: Journal of Sexual Medicine. 2009 Jan;6(1):70-3. Abstract: INTRODUCTION: Recently, clinicians in Southern Israel perceived that the practice of female genital mutilation had disappeared entirely in the Bedouin population. We previously studied the prevalence of this practice in 1995. AIM: We decided to survey again the Bedouin population focusing on those tribes previously reported to perform this practice. METHODS: Eighty percent of the interviews were done by an Arabic-speaking psychiatrist and 20% were done by an Arabic speaking nurse in the gynecologic clinic of a large Bedouin township or the gynecologic clinic of a smaller Bedouin township. Women were asked if they would be willing to answer a few questions about their past and if they were willing to have the gynecologist, with no additional procedure, note whether any operation had been performed on their genitalia. MAIN OUTCOME MEASURES: Physical examination by gynecologist and an oral questionnaire. RESULTS: One hundred and thirty two women were examined. No cases of any scarring of the kind reported in the previous study were found on physical examination. CONCLUSIONS: FGM has apparently disappeared over 15 years in a population in which it was once prevalent. Language: English Keywords: ISRAEL | RESEARCH REPORT | INTERVIEWS | WOMEN | INDIGENOUS POPULATION | FEMALE GENITAL CUTTING | EXAMINATIONS AND DIAGNOSES | Developed Countries | Middle East | Data Collection | Research Methodology | Demographic Factors | Population | Population Characteristics | Harmful Traditional Practices | Traditional Health Practices | Culture | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342101   |
25. Title: In search of health: quality of life among postpartum Palestinian women. Author: Hammoudeh W; Mataria A; Wick L; Giacaman R Source: Expert Review of Pharmacoeconomics and Outcomes Research. 2009 Apr;9(2):123-32. Abstract: OBJECTIVES: The postpartum period is a very important period for the health of the mother and the newborn. Despite its importance, research on this period is limited and tends to be more focused on biomedical aspects of the postpartum period. In the Occupied Palestinian Territory, little is known regarding women's postpartum wellbeing. This study utilizes the Maternal Postpartum Quality-of-Life instrument to assess Palestinian women's postpartum quality of life and the factors associated with variations in their quality-of-life scores. METHODS: A cross-sectional survey utilizing the adapted Maternal Postpartum Quality-of-Life Questionnaire was completed in the Occupied Palestinian Territory with a final sample size of 1020 women. RESULTS: The mean overall quality-of-life score for the sample was 21.53 (maximum = 30), suggesting that women are slightly satisfied with their lives in the postpartum period. Main variations in quality-of-life scores were associated with regional district, refugee status, the loss of a relative due to Israeli occupation violence, standard of living and pregnancy wantedness. CONCLUSION: The results of this study highlight the diversity and complexity of the social context, in particular the region where women live, and the issue of pregnancy wantedness in postpartum quality of life. They also call into question the services currently offered to postpartum women. Language: English Keywords: WEST BANK | GAZA | RESEARCH REPORT | SAMPLING STUDIES | POSTPARTUM WOMEN | FRIENDS AND RELATIVES | QUALITY OF LIFE | QUESTIONNAIRES | CARE AND SUPPORT | STANDARD OF LIVING | SOCIOECONOMIC STATUS | Developing Countries | Middle East | Studies | Research Methodology | Puerperium | Reproduction | Family and Household | Sociocultural Factors | Social Welfare | Economic Factors | Health Services | Delivery of Health Care | Health | Socioeconomic Factors Document Number: 342478   |
26. Title: Domestic violence against women during pregnancy: the case of Palestinian refugees attending an antenatal clinic in Lebanon. Author: Hammoury N; Khawaja M; Mahfoud Z; Afifi RA; Madi H Source: Journal of Women's Health. 2009 Mar;18(3):337-45. Abstract: OBJECTIVES: To determine the factors associated with domestic violence against pregnant Palestinian refugee women residing in Lebanon and currently using the United Nation Relief and Work Agency's (UNRWA) primary healthcare services. METHODS: This was a cross-sectional study conducted at a polyclinic of primary healthcare of the UNRWA in South Lebanon during the years 2005-2006. The sample was 351 pregnant women who were 15-42 years of age and not accompanied by their husbands or relatives. All women were invited by the midwife to participate in the study during their visit to the clinic for their first checkup or during a follow-up visit. The Abuse Assessment Screen instrument was used to screen for past and recent history of physical and emotional abuse among the participants. RESULTS: Domestic violence was significantly associated with education, gestational age, fear of husband or someone else in the house, and unintended pregnancy. The odds of abuse for women with an elementary or lower education were 6.86 (95% CI 1.2-38.1) and for women with an intermediate or secondary education 6.84 (95% CI 1.4-33.3) compared with women with a university education. The odds of abuse during pregnancy for women whose husbands did not desire their pregnancy were 3.80 (95% CI 1.5-9.7) compared with other women. CONCLUSIONS: Domestic violence against women in Lebanon was associated with educational level, gestational age, fear of husband or someone else in the house, and unintended pregnancy. Language: English Keywords: LEBANON | RESEARCH REPORT | PREVALENCE | PREGNANT WOMEN | REFUGEES | ANTENATAL CARE | VIOLENCE AGAINST WOMEN | PHYSICAL ABUSE | SIGNS AND SYMPTOMS | EDUCATIONAL STATUS | FEAR | PREGNANCY, UNPLANNED | Middle East | Developing Countries | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Domestic Violence | Crime | Social Problems | Sociocultural Factors | Violence | Behavior | Diseases | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Emotions | Psychological Factors | Reproductive Behavior | Fertility Document Number: 341353   |
| 27. Title: Iran: migrant smuggling and trafficking in persons. Author: Hosseini-Divkolaye NS Source: Forced Migration Review. 2009 Apr;(32):66-67. Abstract: This article examines two forms of irregular migration in Iran. It discusses differences between trafficking in persons and migrant smuggling, trends in Iran, recent policy initiatives put into place regarding these issues, and the punishment of unauthorized arrivals into the country. Language: English Keywords: IRAN | SUMMARY REPORT | HUMAN TRAFFICKING | SOCIAL PROTECTION | POLICY | LEGISLATION | Middle East | Developing Countries | Crime | Social Problems | Sociocultural Factors | Political Factors Document Number: 340194   |
28. Peer Reviewed Title: HIV seroconversion among injection drug users in detention, Tehran, Iran. Author: Jahani MR; Kheirandish P; Hosseini M; Shirzad H; Seyedalinaghi SA; Karami N; Valiollahi P; Mohraz M; McFarland W Source: AIDS. 2009 Feb 20;23(4):538-40. Abstract: Jails may foster the spread of HIV, particularly among drug users. In 2006, male injection drug users (n = 499) detained in Tehran consented to HIV testing at intake and discharge. HIV prevalence at intake was 24.4%. Nine of those who were HIV negative at intake were positive at discharge (annualized incidence rate 16.8%), including one p24 antigen positive. Jails may be contributing to the rapid spread of HIV in Iran and should be major points for prevention interventions. Language: English Keywords: IRAN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | IV DRUG USERS | MEN | PRISONERS | PREVALENCE | HIV INFECTIONS | Middle East | Developing Countries | Research Methodology | Viral Diseases | Diseases | Drug Use and Abuse | Behavior | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Measurement Document Number: 341164   |
| 29. Title: Seropositivity for Listeria monocytogenes in women with spontaneous abortion: a case-control study in Iran. Author: Jamshidi M; Jahromi AS; Davoodian P; Amirian M; Zangeneh M; Jadcareh F Source: Taiwanese Journal of Obstetrics and Gynecology. 2009 Mar;48(1):46-8. Abstract: OBJECTIVE: There are many studies supporting the role of certain asymptomatic infections such as Listeria monocytogenes (L. monocytogenes) in spontaneous abortion. In some cases, latent listeriosis may complicate the pregnancy, and serologic tests can, therefore, be used to detect the disease. This study was designed to assess the relationship between seropositivity for L. monocytogenes and spontaneous abortion. MATERIALS AND METHODS: A total of 250 women with previous spontaneous abortion and a control group of 200 women with normal full-term deliveries entered the study as case and control groups, respectively. Demographic characteristics were recorded for each subject, and serum samples were obtained from all participants. All serum samples were examined using the indirect immunofluorescence antibody test for L. monocytogenes antibody. Data was analyzed using Chi-squared and t tests. RESULTS: The average age of participants was 25.6 +/- 7.6 years in cases and 25.3 +/- 6.5 years in controls. Eighty-nine (35.6%) of the cases with abortion and 35 (17.5%) of the control group were positive for L. monocytogenes antibody (p = 0.001). No relationship was observed between the number of pregnancies and infection with L. monocytogenes (p = 0.4), or between the number of previous abortions and L. monocytogenes seropositivity (p = 0.2). CONCLUSION: We suggest monitoring L. monocytogenes seroprevalence in pregnant women at high risk of threatened abortion, and further microbiological assessment of symptomatic women for detection of L. monocytogenes and insidious infection. Language: English Keywords: IRAN | RESEARCH REPORT | CASE STUDIES | WOMEN | ABORTION, SPONTANEOUS | PREGNANCY | MONITORING | INFECTIONS | TESTING | Middle East | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Pregnancy Complications | Diseases | Reproduction | Evaluation | Measurement Document Number: 342081   |
30. Peer Reviewed Title: Exploring health stakeholders' perceptions on moving towards comprehensive primary health care to address childhood malnutrition in Iran: a qualitative study. Author: Javanparast S; Coveney J; Saikia U Source: BMC Health Services Research. 2009;9:36. Abstract: BACKGROUND: Due to the multifaceted aspect of child malnutrition, a comprehensive approach, taking social factors into account, has been frequently recommended in health literature. The Alma-Ata declaration explicitly outlined comprehensive primary health care as an approach that addresses the social, economic and political causes of poor health and nutrition. Iran as a signatory country to the Alma Ata Declaration has established primary health care since 1979 with significant progress on many health indicators during the last three decades. However, the primary health care system is still challenged to reduce inequity in conditions such as child malnutrition which trace back to social factors. This study aimed to explore the perceptions of the Iranian health stakeholders with respect to the Iranian primary health care performance and actions to move towards a comprehensive approach in addressing childhood malnutrition. Health stakeholders are defined as those who affect or can be affected by health system, for example health policy-makers, health providers or health service recipients. METHODS: Stakeholder analysis approach was undertaken using a qualitative research method. Different levels of stakeholders, including health policy-makers, health providers and community members were interviewed as either individuals or focus groups. Qualitative content analysis was used to interpret and compare/contrast the viewpoints of the study participants. RESULTS: The results demonstrated that fundamental differences exist in the perceptions of different health stakeholders in the understanding of comprehensive notion and action. Health policy-makers mainly believed in the need for a secure health management environment and the necessity for a whole of the government approach to enhance collaborative action. Community health workers, on the other hand, indicated that staff motivation, advocacy and involvement are the main challenges need to be addressed. Turning to community stakeholders, greater emphasis has been placed on community capabilities, informal link with other social sectors based on trust and local initiatives. CONCLUSION: This research provided a picture of the differences in the perceptions and values of different stakeholders with respect to primary health care concepts. The study suggests that a top-down approach, which still exists among health policy-makers, is a key obstacle that delays, and possibly worse, undermines the implementation of the comprehensive strategy codified by the Alma-Ata Declaration. A need to revitalize primary health care to use its full potential and to combine top-down and bottom-up approaches by narrowing the gap between perceptions of policy makers and those who provide and receive health-related services is crucial. Language: English Keywords: IRAN | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | CHILDREN | POLICYMAKERS | COMMUNITY | COMMUNITY WORKERS | HEALTH PERSONNEL | PRIMARY HEALTH CARE | CHILD NUTRITION | MALNUTRITION | PERCEPTION | HEALTH POLICY | COMMUNITY HEALTH SERVICES | Middle East | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Administrative Personnel | Organization and Administration | Residence Characteristics | Population Distribution | Geographic Factors | Delivery of Health Care | Health | Health Services | Nutrition | Nutrition Disorders | Diseases | Psychological Factors | Behavior | Policy | Political Factors | Sociocultural Factors Document Number: 331083   |
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