Statistical Center Of Iran Research Articles

Estimation of Gender-Specific Lung Cancer Deaths due to Exposure to PM2.5 in 10 Cities of Iran During 2013 - 2016: A Modeling Approach

BackgroundVarious epidemiological studies have related fine particles (PM2.5) to incidence of lung cancer. In addition, particulate air pollution has been classified as Group 1 carcinogen by international agency for research on cancer (IARC) in 2013.ObjectivesThe aim of this study was to quantify the number of gender-specific lung cancer deaths due to exposure to PM2.5 among individuals aged over 30 years using WHO AirQ model in 10 cities of Iran during March 2013-March 2016.MethodsHourly concentrations of PM2.5 were obtained from department of environment (DOE) of Iran and Tehran air quality control company (TAQCC). Demographic information and baseline incidence (BI) were acquired from statistical center of Iran, ministry of health and medical education, respectively. AirQ model was used to quantify the lung cancer deaths among males and females aged over 30 years.ResultsThe highest lung cancer deaths were in Tehran with approximately 407 cases of death during the whole three-year period. The total deaths among men and women in the whole period were 433 and 431 cases, respectively. The sum of lung cancer deaths due to PM2.5 exposure in all the 10 cities during these 3 years were estimated 864 cases. In addition, the attributable proportion of lung cancer due to PM2.5 exposure in each city was estimated. Despite the high number of lung cancer deaths in Tehran, higher AP values were observed in cities such as Isfahan, Ahvaz, Khoram Abad and Arak, reflecting the higher risk of death per unit of population.ConclusionsThe results of this study could be used by authorities for making air pollution reduction strategies and plans. Furthermore, any reduction in attributed mortality and hospitalization reduces financial burden in health organizations.

Urbanization patterns in Iran visualized through spatial auto-correlation analysis

In recent decades urbanization in the world and Iran has changed and evolved based on a variety of patterns. Many factors influence these patterns, including climate conditions, national policies, international developments, and the economic situation. The aim of this study was to investigate changes in spatial autocorrelation pattern of urbanization in Iran. Hence, data has been extracted from the Statistical Center of Iran. At first, patterns of urbanization were calculated and then global Moran index has been used in the analysis of spatial pattern changes. The results showed that central and northern regions of the country, particularly Isfahan and Tehran, in all courses have a positive spatial autocorrelation pattern and its intensity has increased in recent times. This is while the south-eastern half of the country, due to climatic determinism, has a negative spatial autocorrelation pattern.

Inequality in Human Development Index and suicide death in Iran: A National Register–Based Study

Pay attention to the effects of inequality in health outcomes has steadily risen during recent years. It is necessary step to achieve the goal of health for all (HFA) in the coming decades. At the moment, our knowledge about the inequality and suicide is limited. Human Development Index (HDI) is summary measures that we can demonstrate current inequalities regarded to health outcomes. We have reanalyzed the national data by Statistical Centre of Iran for HDI and Iranian Forensic Medicine Organization for suicide to explicate of inequality in suicide death in Iran. Our results showed an inverse correlation between HDI and suicide death, so that deaths from suicide was more occurred in provinces with lower HDI. Therefore, results in current study showed a positive inequality in suicide in relation with HDI in Iran. According to this, we suggested that regional studies will be conducted to detect subgroups with a high suicide risk as well as components of HDI that cause inequality.

Factors Affecting the Utilization of Outpatient Health Services and Importance of Health Insurance

Background: Research on the utilization of health services provides an opportunity to identify and determine the quantity and quality of factors, which can facilitate or debilitate access to services. Policymakers believe that factors affecting the use of health services should be quantified in order to allocate further resources to indicators, which can help reduce inequalities. This study aimed to investigate factors affecting the utilization of outpatient services and to determine the effect of health insurance on financial support for individuals. Methods: The present study included all Iranian households, which had been recruited by the Statistical Center of Iran in 2012 - 2013. The data were analyzed in 2 logit models and divided into urban and rural areas. Results: According to the results, basic and full insurance coverage was the main factor, influencing the utilization of outpatient health services. Furthermore, age composition of households affected their utilization of these services. More precisely, households with more members aged 65 years tended to use outpatient services more frequently. In addition, households with female heads and those from higher decile groups were more likely to use outpatient services. On the contrary, educational level and household size had negative effects on demand for outpatient health services. Conclusions: Based on the results, there was a significant association between social and economic status and utilization of outpatient services. For decreasing the observed inequalities, policymakers should pay particular attention to households with low income and members aged 65 years and provide access to health services for these groups (eg, access to family physicians).

Determinants of financial performance of real estate brokerage industry in Iran

PurposeThe aim of this study is to investigate the factors influencing the financial performance of the real estate brokerage (REB) industry in Iran.Design/methodology/approachThe authors use two surveys concerning REB firms from provinces of Iran which were collected by the Statistical Centre of Iran in 2003 and 2011. The authors apply the pooled ordinary least squares and panel fixed-effects regressions to estimate the relationships between the explanatory variables and performance of REB industry.FindingsThe results indicate that in provinces where REB firms invest more in residential properties, vehicles, computers and business software, REB firms are more active in residential and non-residential property sales, and rent transactions have higher levels of financial performance. In addition, the results show that in provinces where REB firms invest more in non-residential properties and office furniture, REB industry has lower levels of financial performance. The authors also find that Iranian REB industry has significantly benefited from international economic and financial sanctions.Practical implicationsIn terms of managerial implications, the authors findings potentially serve as guidance for Iranian REB firms to allocate resources and adjust their strategy to enhance their financial performance.Originality valuePrevious studies have typically been conducted in countries where REB firms mainly operate as intermediaries in transactions between property buyers and sellers, whereas in Iran, REB firms not only provide services to their clients but also are very active speculators in the property market. Furthermore, while there have been many studies that have investigated the various determinants of performance and efficiency of REB industry in developed economies, there is scant literature around this topic for Middle Eastern countries.

A computable general equilibrium model of international sanctions in Iran

AbstractWe detail recent international sanctions against the Iranian economy and its government imposed by a subset of developed countries. The effects of these sanctions on the Iranian economy in general and upon upper and lower‐income rural and urban Iranian households, as well as the Iranian government, are modelled using a computable general equilibrium (CGE) model. We supplement the Global Trade Analysis Project 8 data set using income and expenditure shares from the Urban and Rural Household Income and Expenditure Survey from the Statistical Centre of Iran (SCI). The model is calibrated to simulate the effects of international sanctions as closely as possible. We use endogenous trade taxes to simulate the effects of sanctions on Iranian oil and petrochemical exports and Iranian imports of petroleum products, metal products and motor vehicles. Our study finds that international sanctions reduced aggregate Iranian welfare by 14%–15%. Rural households in Iran suffered welfare losses which were almost double those experienced by urban households, and the poorest urban and rural households experienced the largest welfare losses, in the order of 5%–10%. But the government of Iran sees a decrease in real revenue of 40%–50%, due to the large negative effect of sanctions on the Iranian oil sector.

Providing an Integrated Method For Ranking the Townships of Ilam Province in Terms of Health Care Services Enjoyment

Introduction: Equitable distribution of health care services is prerequisite of success to the national development programs. This study was conducted to assess the townships of Ilam province in terms of enjoyment of health care services. Materials & methods: This cross-sectional study was carried out in Ilam province using 14 health care services indices. Data were collected by a data collection form made by the researcher using statistical yearbook of Statistical Center of Iran (SCI) in 2011. Ilam townships were assessed with 5 methods using Microsoft Excel 2010 (disharmonious index of Morris; standardized score; Scalogram; Numerical Taxonomy; TOPSIS) and given the different methods did not reach a general consensus, Copeland's method was used. Findings: The findings indicated that there existed unequal distribution of health care services across the townships of Ilam province. According to the Copeland method, Ilam and Malekshahi townships have been ranked the first and last regarding the enjoyment of health care services, respectively. Discussion & conclusions: As a result, health care services have been settled in the provincial center (Ilam Township). The policies leading to the development of health care services in large cities are the major important factors in the unequal distribution of health care services. The results of this study can provide illustration of current situation of enjoyment of the health care services and promote the evidence-informed decision making (in national and local levels) for policymakers.

Geographic distribution indices of general practitioners, midwives, pediatricians, and gynecologists in the public sector of Iran.

BackgroundHealth workforce distribution is so important in access posture, coverage and equity. Following millennium development goals (MDGs), special attention to health workforces in relation with maternal and child health is required.ObjectiveThe aim of the current study was to determine distribution of maternal and child health related workforces in Iran during 2010–2012, using inequality measures.MethodsIn this cross-sectional study, data about the number of physicians and midwives obtained from Ministry of Health reports and demographic statistics were obtained from the Statistical Center of Iran. Gini coefficient and Robin Hood index were calculated in terms of population ratio, need adjusted index for birth (NAIB) and need adjusted index for mortality (NAIM). For calculations, DAD software version 4.6 was used.ResultsGini coefficient was reduced for general physicians (GPs) and pediatricians, and had increasing and decreasing trends for gynecologists. For achieving equality within provinces, the number of transferable health workforces was more than 1 person per 10 health workforces.ConclusionHealth workforce distribution had various trends in Iran. Special attention to deprived provinces is required. Most of the reduction in Gini coefficient is due to the increase in health workforce in developing provinces, and deprived provinces still have serious problems. The health system could achieve better equality by considering deprived provinces and using Gini coefficient and Robin Hood index together.

Demand for Self-Employed Health Insurance

Health insurance provides financial support for health care expenditures. There are two types of health insurance: compulsory and voluntary. Voluntary health insurance can be divided into two categories: self-employed and supplementary. In this study, the main factors that affect the demand for self-employed health insurance in Iran were determined. In this cross-sectional study, data were derived from the 2013 Household Income and Expenditure Survey from the Statistical Center of Iran. Then, a logistic regression model was designed to determine the factors influencing health insurance demand. The age, income, and education level of the head of the household directly correlated with the demand for self-employed health insurance. There was no significant relationship between the demand for health insurance and the gender or marital status of the head of the household. In addition, there were no significant relationships between occupation or house ownership and the demand for health insurance in rural households. To promote voluntary health insurance, it is helpful to identify effective factors that stimulate the health insurance demand.

The impact of mother's literacy on child dental caries: Individual data or aggregate data analysis?

Introduction:To evaluate the impact of mother's literacy on child dental caries based on a national oral health survey in Iran and to investigate the possibility of ecological fallacy in aggregate data analysis.Materials and Methods:Existing data were from second national oral health survey that was carried out in 2004, which including 8725 6 years old participants. The association of mother's literacy with caries occurrence (DMF (Decayed, Missing, Filling) total score >0) of her child was assessed using individual data by logistic regression model. Then the association of the percentages of mother's literacy and the percentages of decayed teeth in each 30 provinces of Iran was assessed using aggregated data retrieved from the data of second national oral health survey of Iran and alternatively from census of “Statistical Center of Iran” using linear regression model. The significance level was set at 0.05 for all analysis.Results:Individual data analysis showed a statistically significant association between mother's literacy and decayed teeth of children (P = 0.02, odds ratio = 0.83). There were not statistical significant association between mother's literacy and child dental caries in aggregate data analysis of oral health survey (P = 0.79, B = 0.03) and census of “Statistical Center of Statistics” (P = 0.60, B = 0.14).Conclusion:Literate mothers have a preventive effect on occurring dental caries of children. According to the high percentage of illiterate parents in Iran, it's logical to consider suitable methods of oral health education which do not need reading or writing. Aggregate data analysis and individual data analysis had completely different results in this study.

Distribution of ophthalmologists and optometrists in Islamic Republic of Iran and their associated factors.

We aimed to determine the distribution of ophthalmic care providers and its correlation with health and socioeconomic status and health system indicators. Data were gathered from the Iran Medical Council and the Iranian Societies of Ophthalmology and Optometry. Concurrent indicators were collected from the Statistical Center of Iran and national studies. A population-adjusted number of combined ophthalmologists and optometrists was used as the main dependent variable. Optometrist/ophthalmologist ratio was 0.9. We had 1 ophthalmologist and 1 optometrist for every 40 000 and 45 000 individuals, respectively. We observed a direct correlation between the number of ophthalmologists, optometrists and life expectancy at the provincial level. Gross provincial income and expenditure and provincial literacy were correlated as well. Provincial unemployment had a negative correlation. Provincial hospital statistics and population density were also significantly correlated. The Islamic Republic of Iran has met the World Health Organization's desired per capita number of ophthalmologists and optometrists, but there is wide variation in their density.

Life Expectancy and its Socioeconomic Determinants in Iran

IntroductionLife expectancy at birth (LEB) is closely associated with the degree of economic and social development in developed and developing countries. This study aimed to examine the socioeconomic factors affecting LEB in Iran from 1985 to 2013.MethodsTime series analysis was used to examine the effects of key explanatory factors (GDP per capita, number of doctors per 10,000 population, degree of urbanization, food availability, CO2 emission, total fertility rate, inflation rate, and literacy rate) on LEB in Iran from 1985 to 2013. Study data were retrieved from the Central Bank of Iran (CBI), Iranian Statistical Center (ISC), and World Bank. Augmented Dickey Fuller (ADF) and Banergy, Dolado, and Master (BDM) tests, Engle Granger approach, and an ordinary least-square (OLS) model were used to achieve the aim of the study. Data analysis was performed by Stata V.12 software.ResultsOur findings indicated that GDP per capita (p=0.003), number of doctors per 10,000 population (p=0.036), literacy rate (p=0.0001), and food availability (p=0.0001) have a positive and significant statistically effect on LEB. The relationship between total fertility rate and LEB was negative and significant (p=0.023). In addition, the effect of degree urbanization (p=0.811), CO2 emission (p=0.185), and inflation rate (p=0.579) on LEB were not significant.ConclusionGDP per capita, number of doctors per 10,000 population, food availability, literacy rate, and total fertility were identified as the main factors affecting life expectancy in Iran. The study, however, suggests that life expectancy in Iran could be improved if attention is given to factors that reside outside of the health sector.

Trend of Inequality in the Distribution of Health Care Resources in Iran

Background: Equity of access to health care services is one of the main goals of health system. Equity in resource distribution in health section constitutes one of the main dimensions of the equity. The aim of the study is determining how doctors, paramedics and hospital beds are distributed in Iran.Materials and Methods: This analytical study was conducted in Iran. Data on 2006-2013 were collected from Statistics Center of Iran and Iran Ministry of Health and Medical Education. After determining the population of 31 provinces and number of physician, paramedics and hospital beds in them, the equal distribution of these facilities and personnel were analyzed using Lorenz curve and Gini coefficient. Stata 12 and DASP2.2 were used for analyzing Gini index. Results: The total number of physicians, paramedics and hospital beds were 37,000, 217,000 and 138,000, respectively in 2013. Tehran as the capital of Iran had the highest percentage of beds among all provinces. The number of physicians, paramedics and hospital beds per 10,000 population of the country were 5.6, 31.3 and 18.5, respectively for 2013. The calculated Gini coefficients for each of them were 0.47, 0.39 and 0.58, respectively.Conclusion: According to Gini coefficients, physicians, paramedics and hospital beds have an unequal distribution throughout the country. However, these distributions are different in different provinces. We recommend creating a comprehensive and continuous monitoring system for equitable allocation of health care resources.[GMJ.2016;5(3):122-130]

Analysis of equality in Iranian household healthcare payments during Iran's fourth development program.

IntroductionToday, the provision of healthcare should be efficient and equitable to achieve the health system’s goals. The aim of this study was to survey equality in healthcare expenditures and its effects on income redistribution.MethodsThis study was a descriptive-analysis, cross-sectional study that was conducted with data obtained from the Statistical Center of Iran (SCI) during 2006 and 2011. The source population and study population were the urban and rural residents of Iran and their households’ income and expenditures on health. The analysis was based on annually aggregated data from all provinces relative to their share of the total population. The data were collected using a pre-tested checklist consisting of two sections. The first section was used to retrieve data about total gross non-food expenditures of households. The second section retrieved out-of-pocket payments for healthcare. The data that were collected were analyzed using a Microsoft Excel spreadsheet. The Kakwani index was used to measure the extent of the deviation from equity. The redistributive effect of healthcare costs was considered as the impact of healthcare payments on households’ income distribution.ResultsThe overall Kakwani index during the fourth development program for urban households was progressive (OKI = 0.013), but it was regressive for rural households (OKI = −0.012). Healthcare payments had a negative effect on income redistribution in urban areas during the entire period of the study, and they had a positive effect in rural areas, except for the years 2010 and 2011, for which the effects were negative and non-existent, respectively.ConclusionBy regarding the regressive Kakwani index and the negative effect of healthcare expenditures on income redistribution in some years, the government can use health grants, such as increasing health facilities and supplementary insurance, to increase the ability of households to deal with the cost of developing a remedy and reducing health inequalities.

Trends of geographic inequalities in the distribution of human resources in healthcare system: the case of Iran.

IntroductionConsidering the scarcity of skilled workers in the health sector, the appropriate distribution of human resources in this sector is very important for improving people’s health. Having information about the degree of equality in the distribution of health human resources and their time trends is necessary for better planning and efficient use of these resources. The aim of this study was to determine the trend of inequality in the allocation of human resources in the health sector in Tehran between 2007 and 2013.MethodsThis cross-sectional study was conducted in Tehran Province in Iran. The inequality in the distribution of human resources (specialists, general practitioners, pharmacists, paramedics, dentists, nurses and community health workers (Behvarz)) in 10 cities in Tehran Province was investigated using the Gini coefficient and the dissimilarity index. The time trend of inequality was examined by regression analysis. The required data were collected from the statistical yearbook of the Iran Statistics Center (ISC).ResultsThe highest value of the Gini coefficient (GC) was related to nurses (GC = 0.291) in 2007. The highest value of the Gini coefficient was related to nurses and Behvarzs in 2008 and 2009, respectively. The distribution of specialists had the highest inequality in 2010 (GC = 0.298), 2011 (GC = 0.300) and 2013 (GC = 0.316). General practitioners had the lowest Gini coefficient for 2007, 2008 and 2012. Nurses for 2009 and Behvarzs for 2010, 2011 and 2013 had the lowest value of Gini coefficient. The dissimilarity indexes for specialists and general practitioners were 26.64 and 8.72 in 2013, respectively. The means of this index for included resources were 31.35, 18.27, 16.91, 22.32, 15.82, 26.74, and 24.33, respectively. The time trend analysis showed that the coefficient of time was positive for all of the human resources, except Behvarzes, and only the coefficient of general practitioners was statistically significant ( p<0.01).ConclusionOver time, inequalities in the distribution of resources in the health sector have been increasing. By developing the private sector and considering the trend of this sector to operate in the more developed regions, health policy makers should continually evaluate the distribution of human resources, and they should arrange a specific plan for the allocation of human resources in the health sector.

Socio-Economic Factors Influencing on Total Fertility Rate in Iran: A Panel Data Analysis for the Period of 2002-2012.

IntroductionOver the last few decades, total fertility rate (TFR) has followed a downward trend in Iran. The consequences of this trend from the perspectives of some are negative. Considering the macro-population policies in recent years, this study aimed to examine the effect of some macro socio-economic variables, including divorce, marriage, urbanization, and unemployment rate on TFR in Iran from 2002 to 2012.MethodsThis time series research was conducted in 2015 using the databases of the National Organization for Civil Registration (NOCR) and the Statistical Center of Iran. The study population was the related data of provinces in the selected variables. The main methods used in the research were the common unit root test, Pedroni Cointegration test, redundant fixed effects tests, correlated random effects-Hausman test, and panel least squares of fixed effects. In order to determine the suitable model for estimating panel data, likelihood ratio and Huasman tests were done using Eviews software, and the fixed effects regression model was chosen as the dominant model.ResultsThe results indicated that the divorce rate had a negative and significant effect on TFR (p < 0.05). A positive and significant relationship between marriage rate and TFR variables also was observed (p < 0.05). Urbanization rate (p = 0.24) and unemployment rate (p = 0.36) had no significant relationship with TFR. According to F statistic, significance of the overall model also was confirmed (p < 0.001).ConclusionDue to the lower effect of the studied factors on the reduction of TFR, it seems that variables other than the ones studied, as well as cultural factors and values, might be fundamental factors for this change in the country.

The disparity in geographical accessibility to healthcare resources in Iran: the comparison of two cross-section

Purpose – Accessing adequate healthcare to all people is one of the main goals of the health sector. The purpose of this paper is to investigate healthcare services access development of the provinces in Iran during 2007 and 2013. Design/methodology/approach – This is a descriptive cross-sectional study. The study population included all the provinces in Iran. The data for 13 variables, including physical and human health resources, was collected from the Ministry of Health and Medical Education and the Statistics Center of Iran. Taxonomy technique was used to determine the degree of healthcare services access development in the provinces. Findings – The findings show that Semnan was the province with the most developed healthcare services access with development score of 0.342 while Sistan Balocehstan province was the least developed with development score of one in 2007. In the year 2013, Chahar-Mahal Bakhtiari and Sistan Baluchestan were the least and most developed provinces with scores of 0.551 and 0.989, respectively. The mean and standard deviation of the development scores in access to healthcare services in 2007 and 2013 were 0.7463±0.1268 and 0.7766±0.1058, respectively. Originality/value – Most previous studies that examined disparities in access to healthcare resources in Iran only considered one resource. This study applied a taxonomy technique to investigate the disparity and changes in access using 13 main healthcare resources. This approach helped the authors to investigate whether the decisions of the policy makers were intended to eliminate the disparities.

Inequalities in the Distribution of Health Care Facilities

Inequality in the distribution of health care facilities is one of the main barriers to health care access. The purpose of this study was to assess the regional differences in health care facilities across the Kohgiluyeh and Boyer-Ahmad (KBA) province in order to reduce the gap between different regions. The study was carried out in the KBA province in the southwest of Iran. Fifteen health indices were selected based on their availability in the 2011 Statistical Centre of Iran (SCI) annual report. Data analysis was conducted through using numerical taxonomy. The findings obtained showed a huge gap between the different counties of the province. Yasouj had the highest (0.73) health indicator level, while Charam (0.982) had the lowest. Our findings can provide a big picture of the inequalities that exist in this province for policy-makers. Consequently, it enables policy-makers to make greater efforts for understanding the present conditions and moving towards a more equal distribution of health care services and facilities.

Longitudinal Analysis of Social Welfare Situation in Iran (1967–2010)

The last few decades have seen increased theoretical and empirical interest in multidimensional measures of social welfare. The objective of this paper is to introduce social welfare index (SWI) and its trend for Iran. In this mix method study, Delphi technique was conducted to evaluate expert opinion on choice of priority social welfare indicators (study variables) for Iran in 2013. Then, we have used OECD methodology of constructing composite indicators to develop SWI. SWI as well as its trend have been measured for 1967–2010 (sample size = 44 years). Data were obtained from the Central Bank of Iran, Statistical Center of Iran, and Social Security Organization of Iran. Data were analyzed using SPSS software ver. 20 and exploratory factor analysis, Kaiser-Meyer-Olkin (KMO), and Bartlett test. Based on KMO (0.710), data was adequate for underlying analysis and result of Bartlett’s test of sphericity (757.75, df = 45, p < 0.001) imply that correlation matrix of variables was not an identity matrix. Furthermore, the first two factors explained 77.58 % of total variances, together. The results showed that SWI generally has been increasing during the study period. Furthermore, the best and worst performances were devoted to 1971 and 1988, respectively. Due to having more and diverse dimensions and indicators, SWI can help as a more realistic measure of social welfare.

Time Trend Analysis of Oral Cancer in Iran from 2005 to 2010.

There is a considerable lack of understanding of oral cancer incidence, especially its time trend in Iran. In this study, the authors aimed to analyze time trend of oral cancer incidence with a focus on differences by gender in a period of six years - from 2005 to 2010. Both population-based cancer registry and national cancer registry (NCR) data based on pathologic reports from 2005 to 2010 were obtained from the Ministry of Health and Medical Education (MOHME). Population data were also received from Statistical Centre of Iran. Age-standardized incidence rates (ASRs) based on the World Standard Population were then calculated. Finally, Negative Binomial regression was run for time trend analysis. The maximum ASR for males was calculated as 2.5 per 100,000 person-years in 2008 and the minimum was observed as 1.9 per 100,000 person-years in 2005 and 2006. Meanwhile, the maximum ASR for females was estimated as 1.8 per 100,000 person-years in 2009 and the minimum was calculated as 1.6 per 100,000 person-years in 2005 and 2006. Additionally, in females, incidence risk ratio (IRR) did not show a clear decreasing or increasing trend during the six years. Nevertheless, in males an increasing trend was observed. The maximum IRR adjusted for age group and province, for females was reported in 2009 (IRR=1.05 95% CI: 0.90-1.23), and for males was estimated in 2010 (IRR=1/2 95% CI: 1.04 - 1.38). Our findings highlight disparities between oral cancer incidence trends in males and females over the six years from 2005 to 2010.