Is Cam Morphology Found in Ancient and Medieval Populations in Addition to Modern Populations?

BACKGROUND: Cam morphology is thought to originate near puberty and reflects a response of the peripheral aspect of the proximal femoral physis to increased local load. Participation in particular sports activities has been associated with cam morphology in contemporary patient populations; however, it is unclear whether cam is a recent phenomenon. There are limited data regarding the frequency of its occurrence and the general deviations in femoral anatomy in different historical populations. Such information may help to understand the possible influence of lifestyle and diet on cam morphology. QUESTIONS/PURPOSES: The purpose of this study was to evaluate femoral morphology in three historical populations. We asked: (1) Was cam morphology present in the three study populations, did those populations differ, and were there differences between sexes? (2) Were there differences in neck-shaft angle, version, or inclination between and among the examined populations? METHODS: We examined 204 adult femurs from the Neolithic population from Iran (n = 37, 3000 BC to 1631 BC), medieval population from Poland (n = 135, 10th to 13th centuries), and contemporary Australian aborigines (n = 32, early 20th century), provided by the Open Research Scan Archive, Museum of the First Piasts at Lednica and the University of Wroclaw, respectively. All three human populations represent different chronologic periods and lifestyles. All bones were scanned using CT and then measured on their three-dimensional (3-D) reconstructions in selected planes. Cam impingement was defined as an alpha angle > 55° measured on the inclination view. To evaluate the differences in anatomy between populations, we measured the true neck-shaft angle on the true AP view, apparent neck-shaft angle on the apparent AP view, the version angle on the version view, and the inclination angle on the inclination view. The prevalence of cam morphology and other anatomic parameters were compared among groups using chi-square test, one-way ANOVA with post hoc Tukey test, and paired t-test. RESULTS: Cam morphology was present in 5% of the Neolithic population from Iran, in 7% of the medieval population from Poland, and 3% of the contemporary Australian aborigine femurs (OR Neolithic population from Iran/the medieval population from Poland 0.7 [95% CI 0.2 to 3.4]; p = 0.67; OR Neolithic population from Iran/contemporary Australian aborigines 1.8 [95% CI 0.2 to 20.5]; p = 0.65; OR the medieval population from Poland/contemporary Australian aborigines 2.5 [95% CI 0.3 to 20.1]; p = 0.40). There were differences in the presence of cam morphology between the sexes in the medieval population from Poland with both femurs (females: 1% [1 of 76]; males: 15% [9 of 59]; p = 0.002). There was a difference in true neck-shaft angle between the Neolithic population from Iran (121° ± 6°) and contemporary Australian aborigines (131° ± 5°; mean difference 10° [95% CI 7° to 13°]; p < 0.001) and between the medieval population from Poland (124° ± 5°) and the contemporary Australian aborigines (mean difference 7° [95% CI 5° to 9°]; p < 0.001). Apparent neck-shaft angle differed between the Neolithic population from Iran (126° ± 6°) and the contemporary Australian aborigines (134° ± 5°; mean difference 8° [95% CI 6° to 11°]; p < 0.001), and between the medieval population from Poland (126° ± 6°) and the contemporary Australian aborigines (mean difference 9° [95% CI 7° to 11°]; p < 0.001). Moreover, we observed a difference in the version angle between the Neolithic population from Iran (19° ± 7°) and the medieval population from Poland (12° ± 9°; mean difference 7° [95% CI 4° to 10°]; p < 0.001] and in the inclination angle between aforementioned groups (18° ± 7° versus 11° ± 8°; mean difference 7° [95% CI 5° to 10°]; p < 0.001). CONCLUSION: This study found that cam morphology existed in historical populations at rates comparable with a contemporary population. CLINICAL RELEVANCE: The presence of cam morphology in historical populations suggests that cam morphology can develop outside of the intense sports activity seen in modern adolescents. Further study will help elucidate the etiology of cam morphology, which may be useful in the development of preventive strategies.

Artemisia biennis Willd.: Anti-Nociceptive effects and possible mechanisms of action.

ETHNOPHARMACOLOGICAL RELEVANCE: Artemisia biennis Willd. (Dermane in Persian) has been used as an antinociceptive remedy in Iranian folkloric medicine. OBJECTIVE: The aim of the present study was to evaluate the anti-nociceptive effects of Artemisia biennis Willd. aerial part essential oil (ABAEO) on male Swiss mice. MATERIALS AND METHODS: Nociceptive pain techniques including acetic acid-induced writhing (AAIW), formalin-induced paw licking (FPL), glutamate-induced paw licking (GPL), and tail-flick (TF) models were applied. We assessed opioid and L-arginine-NO-cGMP-KATP pathways to detect the possible anti-nociceptive properties of ABAEO. In addition, neuropathic pain was induced by the cervical spinal cord contusion model. RESULTS: ABAEO (120 mg/kg) had a significant anti-nociceptive activities in comparison to the control animals (p < 0.05) in the AAIW, TF, GPL, and FPL assays. The selective opioid antagonist (naloxonazine) administration in the AAIW test alleviated the anti-nociceptive effect of ABAEO (p < 0.05). L-arginine, methylene blue, and glibenclamide treatment prevented the ABAEO anti-nociceptive effects (p < 0.05); however, sodium nitroprusside could profoundly potentiate the ABAEO-associated antinociception in the FPL (phase II) test (p < 0.05). In nociceptive pain models, Cr (one of the main constituents of ABAEO) showed significant anti-nociceptive effects (p < 0.05). Moreover, the von Frey results indicated that ABAEO could attenuate mechanical allodynia in mice. CONCLUSION: Our observation revealed the anti-nociceptive effects of ABAEO in male mice. These effects could include, at least in part, modulating glutamatergic mechanisms via opioid systems. Our data output also indicates activating the L-arginine-NO-cGMP-KATP system in ABAEO anti-nociceptive activities.

Treatment of women's sexual dysfunction using Apium graveolens L. Fruit (celery seed): A double-blind, randomized, placebo-controlled clinical trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Traditional manuscripts refer to plants such as Apium graveolens L. Fruit (celery seed), which could be used to improve sexual function among women. Since that time, local herbal shops in Iran continue to provide this herb as a natural aphrodisiac product. AIM OF THE STUDY: This study aimed to evaluate the efficacy and safety of celery seed for the treatment of female sexual dysfunction. METHODS AND MATERIALS: In this parallel, randomized, double-blinded clinical trial, 80 women were assigned to receive either 500 mg of celery seed or placebo 3 times a day for a period of 6 weeks (n = 40 per group). The female sexual function index (FSFI) questionnaire was used to evaluate women's sexual function before and after treatment. RESULTS: At the end of the sixth week, an improvement in the total FSFI score was significantly greater in celery seed-treated women than those receiving the placebo (P < 0.001). Increased total FSFI score is mainly contributed by improvement in the sexual desire (p < 0.001), arousal (p < 0.001), lubrication (p < 0.001), and pain (p = 0.033) domains at the endpoint of study. No serious side effects were noticed in both groups during the study period. CONCLUSION: It seems that celery seed improved sexual function in women and could be used as a safe, well-tolerated, and effective herbal medicine in women with sexual dysfunction.

Ethnopharmacological studies of indigenous medicinal plants in the south of Kerman, Iran.

ETHNOPHARMACOLOGICAL RELEVANCE: The aim of this study was to collect and document information concerning the medicinal plants used by indigenous people and traditional healers in the south of Kerman Province, Iran. MATERIALS AND METHODS: Overall, 64 informants between the ages of 30 and 89 were interviewed about the modes of application and consumption of medicinal plants in the region. Quantitative analysis was conducted that included informant consensus factor (ICF), use value (UV), relative frequency of citation (RFC) and cultural importance index (CI). RESULTS AND DISCUSSION: In the current study, a total of 115 medicinal plants in 41 families were reported in the south of the Kerman region. Apiaceae, Asteraceae and Lamiaceae (with 14 species each) were the families with the most medicinal plants. The most frequently used plant parts were leaves at 26.17% and aerial parts (23.49%). Decoction (53%), liniment (23%) and infusion (9%) were the most common preparation methods. The highest UVs were obtained from the following medicinal plants: Amygdalus eburnea Spach, Genista tinctoria L., Calotropis procera (Aiton) Dryand., Fortuynia garcinii (Burm.f.) Shuttlew. and Cerasus mahaleb (L.) Mill. The ICF results indicated that cold-flu and fever were the most common diseases (0.67) in the south of Kerman. CONCLUSION: Based on the current study, the south of Kerman has many potential medicinal plants, and these plants should be the focus of future research.

Physiopathology of Dementia in Iranian Traditional Medicine.

Recently, an article published in this journal by Dr Seifaddini and colleagues. In that article, the authors tried to connect dementia, including Alzheimer's disease, with a condition mentioned in Iranian traditional medical condition, Raoonat and Homgh In this condition, intellectual functions of the brain are disturbed and therefore, learning and decision-making abilities are damaged. This condition is not age limited and affects thinking ability but not memory. On the other hand, there is a condition described in Iranian traditional medicine, which completely matches with Alzheimer's disease. This condition is explained under the title of Nesyan (forgetfulness). Nesyan has 5 subdivisions, one of which is caused by the inclination of the brain normal temperament to more coldness and dryness. By performing animal studies, we have recently shown that this kind of Nesyan is related with Alzheimer's disease. Studies on the traditional recommendations on treatment of this kind of Nesyan can be useful in treatment of Alzheimer's disease.

The ethnic gap in mental health: A population-based study of Russian, Somali and Kurdish origin migrants in Finland.

AIMS: Research demonstrates that migrants are more vulnerable to poor mental health than general populations, but population-based studies with distinct migrant groups are scarce. We aim to (1) assess the prevalence of mental health symptoms in Russian, Somali and Kurdish origin migrants in Finland; (2) compare the prevalence of mental health symptoms in these migrant groups to the Finnish population; (3) determine which socio-demographic factors are associated with mental health symptoms. METHODS: We used data from the Finnish Migrant Health and Wellbeing Study and Health 2011 Survey. Depressive and anxiety symptoms were measured using the Hopkins Symptom Checklist-25 (HSCL-25), and 1.75 was used as cut-off for clinically significant symptoms. Somatization was measured using the Symptom Checklist-90 (SCL-90) somatization scale. The age-adjusted prevalence of mental health symptoms in the studied groups was calculated by gender using predicted margins. Logistic regression analysis was used to determine which socio-demographic factors are associated with mental health symptoms in the studied population groups. RESULTS: The prevalence of depressive and anxiety symptoms was higher in Russian women (24%) and Kurdish men (23%) and women (49%) than in the Finnish population (9-10%). These differences were statistically significant (p<.001). Socioeconomic disadvantage (e.g. unemployment and poor economic situation) and migration-related factors (e.g. poor language proficiency and short time since migration) significantly increased the odds for depressive and anxiety symptoms. CONCLUSIONS: Mental health symptoms are highly prevalent particularly in Kurdish migrants in Finland. Holistic interventions and co-operation between integration and mental health services are acutely needed.

The effect of monthly 50,000 IU or 100,000 IU vitamin D supplements on vitamin D status in premenopausal Middle Eastern women living in Auckland.

BACKGROUND/OBJECTIVES: Middle Eastern female immigrants are at an increased risk of vitamin D deficiency and their response to prescribed vitamin D dosages may not be adequate and affected by other factors. The objectives were to determine vitamin D deficiency and its determinants in Middle Eastern women living in Auckland, New Zealand (Part-I), and to determine serum 25-hydroxyvitamin D (serum-25(OH)D) response to two prescribed vitamin D dosages (Part-II) in this population. PARTICIPANTS/METHODS: Women aged ⩾20 (n=43) participated in a cross-sectional pilot study during winter (Part-I). In Part-II, women aged 20-50 years (n=62) participated in a randomised, double-blind placebo-controlled trial consuming monthly either 50,000, 100,000 IU vitamin D3 or placebo for 6 months (winter to summer). RESULTS: All women in Part-I and 60% women in Part-II had serum-25(OH)D<50 nmol/l. Serum-25(OH)D was higher in prescribed vitamin D users than nonusers (P=0.001) and in Iranians than Arab women (P=0.001; Part-I). Mean (s.d.) serum-25(OH)D increased in all groups (time effect, P<0.001) and differed between groups (time × dosage interaction, P<0.001; 50,000 IU: from 44.0±16.0 to 70.0±15.0 nmol/l; 100,000 IU: 48.0±11.0 to 82.0±17.0 nmol/l; placebo: 45.0±18.0 to 54.0±18.0 nmol/l). Only 32% and 67% achieved serum-25(OH)D⩾75 nmol/l with 50,000 and 100,000 IU/month, respectively. Predictors of 6-month change in serum-25(OH)D were dose (B-coefficient±s.e.; 14.1±2.4, P<0.001), baseline serum-25(OH)D (-0.6±0.1, P<0.001) and body fat percentage (-0.7±0.3, P=0.01). CONCLUSIONS: Vitamin D deficiency/insufficiency is highly prevalent in this population. Monthly 100,000 IU vitamin D for 6 months is more effective than 50,000 IU in achieving serum-25(OH)D ⩾75 nmol/l; however, a third of women still did not achieve these levels.

Personality factors and attitudes toward euthanasia in Iran: implications for end-of-life research and practice.

This article reports on the relationship of personality and euthanasia attitudes. Results from a survey of 165 Iranian students showed that religiosity, honesty-humility, agreeableness, and extraversion were related to negative attitudes toward euthanasia, whereas openness was related to acceptance of euthanasia, with the unconventionality facet driving this relationship. Moreover, openness explained additional variance when added to a multivariate model containing religiosity and HEXACO factors. This study illustrates the possibility of accounting for variation beyond the traditional group level predictors of attitudes toward euthanasia and promoting future cross-cultural studies into personality and end-of-life issues and informing end-of-life conversations at the bedside.

Estudios sobre De Materia Medica de Dioscórides en la era Islámica / Studies on De Materia Medica of Dioscorides in the Islamic era

Pedanius Dioscorides was a Roman army surgeon in the first century A.D. His great work called De Materia Medica is widely accepted as the foremost pharmaceutical source of antiquity. Dioscorides was the originator of materia medica (pharmacology), and he took advantage of his extensive travels to study plants. Dioscorides was considered a major authority on simple drugs for sixteen centuries. De Materia Medica served as a corner stone for both western and eastern pharmaceutical and herbal writing, and was translated into Syriac, Arabic, and Persian, as well as Latin. The particular characteristic of medical therapy in the Medieval Period was the extensive employment of drugs of all kinds. For this reason, Dioscorides’ De Materia Medica was not only studied closely, but it also became a text book that Turk-Islamic scientists frequently referred to in their writings (AU)

Pedanius Dioscórides fue médico cirujano en el ejército romano en el siglo I d.C. Su gran obra llamada De Materia Medica es conocida como la principal fuente de farmacopea de la antigüedad. Dioscórides fue el inventor de la materia medica, y aprovechó sus extensos viajes para dedicarse al estudio de las plantas. Dioscórides fue considerado una eminencia en el tema de las drogas de origen natural a lo largo de dieciséis siglos. De Materia Medica sirvió como piedra angular para los textos farmacéuticos y herbarios tanto en occidente como en oriente y fue traducida al siríaco, árabe y persa, además de al latín. La particular característica de la terapia médica en la época medieval fue el uso extensivo de todo tipo de drogas. Por esta razón, además de estudiarse minuciosamente, De Materia Medica de Dioscórides se convirtió también en un libro de texto al que frecuentemente hacían referencia los científicos turco-islámicos en sus escrituras (AU)

Childbirth at home: a qualitative study exploring perceptions of risk and risk management among Baloch women in Iran.

OBJECTIVE: to explain how women who choose to give birth at home perceive and manage the risks related to childbirth. DESIGN: a qualitative, methodological approach drawing upon the principles of grounded theory. Data were gathered by in-depth interviews with women who had given birth at home. SETTING: the study was conducted in Zahedan, the capital of Sistan and Balochestan province in southeast Iran. PARTICIPANTS: 21 Baloch women aged 13-39 years who had a planned home birth were interviewed. Nine had been attended by university-educated midwives, eight by trained midwives, and four by traditional birth attendants. FINDINGS: concerning perceived risks, women perceived giving birth in hospital to be risky because of medical interventions, routines and ethical considerations. The perceived risks for home birth were acute medical conditions. Women made their decision to give birth at home based on existing verbal, visual, and intuitive information. The following two categories related to risk management were identified: (1) psychological preparation and (2) medical and logistican preparation. All of the women relied on their own intuition, their midwife and the sociopsychological support of their families to transfer them to hospital in the case of complications. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the women who chose to give birth at home accepted that there was a risk of complications, but perceived these to be due to fate. Technical risks were considered to be a consequence of the decision to give birth in hospital, and were perceived to be avoidable. In addition, the women considered ethical issues as risks that are sometimes more important than medical complications. Women's perceptions of risk, and the ways in which they prepare to manage risk, are central issues to help providers and policy makers adjust services to women's expectations in order to respond to the individuality of each woman.

Christchurch earthquakes: how did former refugees cope?

AIM: This study investigated how former refugees now living in Christchurch (Canterbury Province, New Zealand) communities coped after the 4 September 2010 and subsequent earthquakes. METHOD: A systematic sample of one in three former refugees from five ethnic groupings (Afghanistan, Kurdistan, Ethiopia, Somalia and Bhutan) was selected from a list of 317 refugees provided by the Canterbury Refugee Council and invited to participate in the study. Seventy-two out of 105 potential participants completed a 26 item questionnaire regarding the impact of the quakes, their concerns and anxieties, coping strategies and social supports. The methodology was complicated by ongoing aftershocks, particularly that of 22 February 2011. RESULTS: Three-quarters of participants reported that they had coped well, spirituality and religious practice being an important support for many, despite less then 20% receiving support from mainstream agencies. Most participants (72%) had not experienced a traumatic event or natural disaster before. Older participants and married couples with children were more likely to worry about the earthquakes and their impact than single individuals. There was a significant difference in the level of anxiety between males and females. Those who completed the questionnaire after the 22 February 2011 quake were more worried overall than those interviewed before this. CONCLUSION: Overall, the former refugees reported they had coped well despite most of them not experiencing an earthquake before and few receiving support from statutory relief agencies. More engagement from local services is needed in order to build trust and cooperation between the refugee and local communities.

The association between polyunsaturated fatty acids and depression among Iranian postgraduate students in Malaysia.

BACKGROUND: The incidence of depression is expected to increase over the next 20 years, and many people will have to deal with it. It has been reported that up to 40% of university students experience levels of depression. Several negative consequences are associated with depression symptoms, such as memory impairment, suicide, and substance abuse. Recently, researchers have been studying possible associations between depression and polyunsaturated fatty acids (PUFAs), which may modify depression symptoms. The aim of the present study was to find an association between PUFA levels and depression among Iranian postgraduate students in Malaysia. METHODS: This cross-sectional study was conducted in 2011 with 402 Iranian postgraduate students who were studying in Malaysia. The participants included 173 (43%) women and 229 (57%) men, and the mean age of the participants was 32.54 ± 6.22 years. RESULTS: After adjustment for several potential confounders including sex, age, BMI, PUFAs, MUFAs, and SFAs, monthly expenses, close friends, living in campus, smoking, education, and marital status in a logistic regression model, an inverse relationship was found between depression symptoms and the dietary intake of PUFAs. CONCLUSION: We found an inverse association between PUFA intake and depression symptoms in Iranian postgraduate students in Malaysia. We, therefore, concluded that long-term intake of PUFAs may modify or prevent depression symptoms.

The limits of scientific planning: Doxiadis and the Tehran Action Plan.

Tehran after the Second World War experienced a modernization drive and rapid population growth. In 1972, the Greek planner, Constantinos Doxiadis, who had already undertaken major housing and planning projects in Iran, was invited to prepare an action plan for the city, to guide the future investment for easing the city's problems. Doxiadis saw cities as nightmares, but advocated that a holistic scientific analysis and a naturalist approach to urban growth management could address their problems. In applying his ideas to Tehran, however, the limits of his ideas of scientific planning became evident, not only through contextual pressures, such as lack of time and data, but also through the planning consultant's approach, in which commercial considerations and the application of readymade solutions could shape the outcome. Rather than working with the context, Doxiadis followed the modernist tenet of breaking with the past, proposing the creation of West Tehran, an alternative to the city where all future growth should take place on a utopian basis. The radical nature of his proposals, his death, and a turbulent revolution aborted the impact of his action plan on Tehran, while faith in modernist scientific planning was widely being abandoned.

Carrier frequency of SMA by quantitative analysis of the SMN1 deletion in the Iranian population.

BACKGROUND AND PURPOSE: Spinal muscular atrophy (SMA) is a common autosomal recessive neuromuscular disorder. Carrier frequency studies of SMA have been reported for various populations. Although no large-scale population-based studies of SMA have been performed in Iran, previous estimates have indicated that the incidence of autosomal recessive disorder partly because of the high prevalence of consanguineous marriage is much higher in the Iranian population than in other populations. METHODS: In this study, we used a reliable and highly sensitive quantitative real-time PCR assay with SYBR green I dye to detect the copy number of the SMN1 gene to determine the carrier frequency of SMA in 200 healthy unrelated, non-consanguineous couples from different part of Iran. RESULTS: To validate the method in our samples, we determined the relative quantification (RQ) of patients with homozygous deletion (0.00) and hemyzygous carriers (0.29-0.55). The RQ in 10 of 200 normal individuals were within the carrier range of 0.31-0.57, estimating a carrier frequency of 5% in the Iranian population. CONCLUSIONS: Our data show that the SMA carrier frequency in Iran is higher than in the European population and that further programs of population carrier detection and prenatal testing should be implemented.

Use of complementary, non-pharmacological pain reduction methods during childbirth among foreign-born and Swedish-born women.

OBJECTIVE: to investigate the association between country of origin of women and their use of complementary pain reduction methods (i.e. non-pharmacological) during childbirth in Sweden. DESIGN: cross-sectional design. SETTING: a national register-based study. PARTICIPANTS: 215,497 singleton deliveries (including the first birth of each woman during the period) of women aged 18-47 years in Sweden between 1996 and 1998, divided into 12 subgroups of countries or regions. MEASUREMENTS: the use of complementary pain reduction methods during childbirth was analysed by logistic regression, adjusting for parity, level of education, number of antenatal care visits, complications in pregnancy, complications during childbirth, use of any pharmacological methods and use of epidural/spinal analgesia during childbirth. FINDINGS: all subgroups of foreign-born women, except those from Finland, had lower odds of complementary pain reduction methods during childbirth than Swedish-born women. Women from Bosnia, Arab countries, Sub-Saharan Africa, Turkey, Iran and Asia had about 40% lower odds for use of complementary pain reduction methods during childbirth than Swedish-born women. Women who used epidural analgesia had higher odds for use of complementary pain reduction methods during childbirth than women who did not use any pharmacological methods. KEY CONCLUSION: most subgroups of foreign-born women showed lower odds for and a different pattern in the use of complementary pain reduction methods during childbirth than Swedish-born women. These findings raise questions of whether the Swedish health-care system and care providers have sufficient awareness of and insight into the socio-cultural context of giving birth.

First-line anti-tuberculosis drug resistance patterns and trends at the national TB referral center in Iran--eight years of surveillance.

OBJECTIVE: Resistance to anti-tuberculosis (anti-TB) drugs is becoming a major and alarming threat in most regions worldwide. METHODS: This was a descriptive cross-sectional study at a tertiary hospital in Iran, using patient medical records for 2000-2003. The findings were analyzed following the same framework as that used for previous reports from this center. RESULTS: Among 1556 TB patients, drug susceptibility testing (DST) was performed for 548 culture-positive cases. Anti-TB drug resistance to both isoniazid and rifampin was identified in 10 (2.8%) of the new TB cases (multidrug-resistant TB; MDR-TB). Any resistance was detected in 228 (41.6%), showing an increasing trend in both new and retreatment cases. The data analysis revealed that drug-resistant TB had a statistically significant association with Afghan ethnicity, age>65 years, and the type of disease (retreatment vs. new TB case) (p<0.05). Also, assessment of the drug resistance trends showed a significant increase in resistance to any anti-TB agent, to isoniazid, and to streptomycin in new cases, and to all of the first-line anti-TB drugs in retreatment patients. CONCLUSIONS: There has been an increasing trend in drug resistance in recent years, particularly in retreatment cases. Hence, revision of the national TB control program, reevaluation of the role of the World Health Organization category II (CAT II) regimen, as well as the conducting of a nationwide drug resistance survey, are recommended.

Healthcare-seeking behaviors of older Iranian immigrants: health perceptions and definitions.

The purpose of this qualitative study was to explore how cultural differences influence the healthcare-seeking behaviors of older Iranian immigrants in the United States. Cultural differences were examined in a variety of areas, including definitions and perceptions of health, illness, and care. Using a phenomenological methodology, in-depth, semi-structured interviews were conducted with older Iranian immigrants. The findings of this study showed that participants' definitions of health, illness, and care differ significantly from mainstream Western definitions. An understanding of these cultural differences helps explain why older Iranian immigrants may or may not seek healthcare when they need it in the United States. Recommendations for change include cultural training for medical staff and the use of cultural brokers.

Is standardized treatment appropriate for non-XDR multiple drug resistant tuberculosis cases? A clinical descriptive study.

The clinical relevance of second-line drug susceptibility test (DST) results with respect to treatment outcome is unknown in non-XDR MDR patients. This study was carried out in the sole national referral centre for TB in Iran between 2002 and 2006. Multidrug-resistant tuberculosis (MDR-TB) patients who had DST to second-line drugs were included. For all MDR-TB patients the standard second-line regimen was initiated. Outcome of treatment based on DST to second-line drugs was analysed. 53 patients were included. DST for second-line drugs was available for 40 patients. Seven patients returned to Afghanistan during treatment. Among the remainder, 13 (30.4%) cases were Iranian. Mean age was 40.8 + 19.7 y. The relatively small sample size imposes some limitations on this study. However, in this study, there was no difference in resistance to second-line drugs by nationality. No significant correlation was seen between resistance to second-line drugs and outcome of treatment. In conclusion, the treatment outcome according to WHO definitions was appropriate in the study population by the use of standardized treatment regimens. Follow-up studies on a long-term basis are however needed in order to detect possible relapses.

Prevalence and predictors of vitamin D deficiency in five immigrant groups living in Oslo, Norway: the Oslo Immigrant Health Study.

OBJECTIVE: To study the prevalence of vitamin D deficiency and to identify possible predictors of vitamin D deficiency in five main immigrant groups in Oslo. DESIGN: Cross-sectional, population-based. SETTING: City of Oslo. SUBJECTS: In total, 491 men and 509 women with native countries Turkey, Sri Lanka, Iran, Pakistan and Vietnam living in the county of Oslo. RESULTS: Median serum 25(OH)D level (s-25(OH)D) was 28 nmol/l, ranging from 21 nmol/l in women born in Pakistan to 40 nmol/l in men born in Vietnam. Overall prevalence of vitamin D deficiency defined as s-25(OH)D<25 nmol/l was 37.2%, ranging from 8.5% in men born in Vietnam to 64.9% in women born in Pakistan. s-25(OH)D did not vary significantly with age. s-25(OH)D was higher in blood samples drawn in June compared to samples obtained in April, but not significantly for women. Reported use of fatty fish and cod liver oil supplements showed a strong positive association with s-25(OH)D in all groups. Education length was positively associated with s-25(OH)D in women, whereas body mass index (BMI) was inversely associated with s-25(OH)D in women. These two variables were not related to vitamin D deficiency in men. CONCLUSIONS: There is widespread vitamin D deficiency in both men and women born in Turkey, Sri Lanka, Iran, Pakistan and Vietnam residing in Oslo. The prevalence of vitamin D deficiency is higher in women than in men, and it is higher in those born in Pakistan and lower in those born in Vietnam compared to the other ethnic groups. Fatty fish intake and cod liver oil supplements are important determinant factors of vitamin D status in the groups studied. BMI and education length are also important predictors in women.

Iranian migrants' discourses of health and the implications for using standardized health measures with minority groups.

This paper explores the concept of health implied in the SF-36 within a group of Iranians in Australia. Qualitative data were collected from a sample of 21 people--10 females and 11 males. For the first time, the NUD*IST program was used to organize and manage the data in Persian (also known as Farsi), the language spoken by Iranians. Health was defined in terms of holistic, spiritual, social, physical/emotional aspects, and absence-of-disorder dimensions. Among these, physical, absence of disorder, holistic, and spiritual aspects of health were mentioned more frequently than other themes. The findings of the study raise concerns about the extent to which the SF-36 captures the diversity of the concept of health as expressed by the sample of Iranian migrants.