Iranian Journal of Epidemiology

Epidemiology of Suicidal Ideation and Some Related Factors in Students of Gonabad University of Medical Sciences in 2023

Farnaz Sharifi Mood

Background and Objectives: Suicide is a major health concern worldwide, and there is a strong association between the presence of suicidal ideation and suicide attempt in the future. This study aimed to determine the epidemiological status of suicidal thoughts among university students and its correlation with some of their personal, family, and social factors.
Methods: An analytic cross-sectional study was conducted on 556 students of Gonabad University of Medical Sciences (GMU) who met the inclusion criteria and were selected by multi-stage sampling in 2023. To collect data, a checklist and the Beck Scale for Suicidal Ideation (BSSI) were used. The collected data were analyzed using independent t-tests, chi-square, Fisher's exact test, and logistic regression.
Results: The prevalence (95% confidence interval) of suicide ideation among students of GMU was estimated at 20.5% (17.2-23.8%), with 11.5% of the students having high-risk (High and very high risk) suicidal thoughts. The prevalence of suicidal ideation was significantly higher among female compared to male students (P=0.016). Moreover, single students had more suicidal thoughts compared to married ones (P=0.019). In contrast, there was no statistically significant association between suicidal ideation and age, native status, place of residence and faculty of study of students.
Conclusion: The prevalence of suicide ideation and high-risk suicide ideation among the students was found to be relatively high. Thus, attention to state of mental health of students, especially female and single students, as well as creating suitable conditions for living and studying for them is recommended.

Personalized Medicine from the Perspective of Rural Family Physician

Parisa Dehghanian

Background and Objectives: Paying attention to future changes and preparing for them is one of the requirements of today's world. Personalized medicine as an emerging and expanding change will bring about changes in medical science. Family physicians as the first line of service delivery and health insurance as factors affecting the provision of services will face this issue. The aim of this study was to draw the space for applying this approach in the field of family physicians and the changes it will bring.
Methods: This study has three stages: preparing a presentation file about personalized medicine and formulating questions, holding a meeting with family physicians, completing the questions form as a group, presenting their opinions, and finally, analyzing and summarizing the views of the doctors by the research team.
Results: Implementing personalized medicine will positively affect each of the family physician's functions, including health management, comprehensiveness of services, continuity of service delivery, coordination, and research. However, like any new change in any field, implementing this approach in this part of the health system will be challenging. There are solutions to face these changes and the resulting challenges from the point of view of family doctors.
Conclusion: As one of the essential parts of facing the changes in the health field, family physicians and health insurance should monitor the issues of this field prospectively and prepare themselves to face them. Providing infrastructures according to possible challenges and considering the principles of change management can be a solution for effectively implementing this approach in this field.

Thirteen Years Incidence of Colorectal Cancer in Shahroud and Meyami Districts: A Report from a Population-Based Cancer Registry

Mohammad Hassan Emamian

Background and Objectives: Colorectal cancer is considered as one of the most common cancers in the world and Iran. Epidemiological studies are necessary to evaluate the trend of this disease in society. This study aimed to describe the incidence and trend of colorectal cancer in 13 years in Shahroud and Meyami districts, Iran.
Methods: The data were obtained from the population-based cancer registry system at Shahroud University of Medical Sciences, including patients in Shahroud and Meyami districts. The standardized incidence rate (ASR) was calculated based on age and gender, and the 13-year trend from 2010 to 2022 was calculated using joinpoint regression along with the percentage of annual changes.
Results: In general, 543 cases of colorectal cancer were recorded from 2010 to 2022, including 280 (51.6%) males and 263 (48.4%) females. The most recorded cases of this cancer were in 2021 with 54 cases. The Age-standardized mean incidence rate of colorectal cancer in this period was 17.6 per 100,000 people. The ASR of colorectal cancer in males and females was 18.4 (95%CI: 16.2 - 20.6) and 16.8 (95% CI: 14.8 - 18.9), respectively. The annual percent change of ASR during the study period was 2.33% (95% CI: 0.13 – 4.87), indicating an increasing trend.
Conclusion: In the Shahroud and Meyami districts, the incidence rate of colorectal cancer was 17.6 per 100,000 people and has increased relatively over the 13-year study period.

Health Indicators in the Eastern Mediterranean Regional Countries: Ranking and Evaluating the Status of Iran

Ghobad Moradi

Background and Objectives: This study aimed to compare the health status of Iran with that of the Eastern Mediterranean Regional Countries in terms of various health indicators.
Methods: The data from 27 health indicators were collected in 2023 from WHO, EMRO, and the World Bank and then grouped into five categories: mortality and morbidity indicators, nutritional risk factor and non-communicable disease indicators, health financing indicators, maternal and immunization indicators, and health workforce indicators. This study used MEREC, a method that analyzes the effects of deleting criteria, to determine the weighting of the indicators. The countries were then ranked using the MARCOS method, one of the new multi-criteria decision-making methods.
Results: Qatar, Saudi Arabia, and the United Arab Emirates were in the best situation. Iran ranked 8^th, 6^th, 7^th, 4^th, and 13^th in the first to fifth categories mentioned in the methods. Iran also ranked 10th among the countries in the region in the overall ranking of all these indicators.
Conclusion: Many researchers and policymakers evaluate the health status in Iran based on the introduced health indicators. Iran needs to intensify its efforts to strengthen its position in the Eastern Mediterranean region, considering its overall circumstances.

Trend of Mortality and Disability-Adjusted Life Years (DALYs) Rates Attributed to Occupational Carcinogens in Hamadan Province from 1990 to 2021

Fatemeh Shahbazi

Background and Objectives: More than 12 types of cancer are caused by contact with environmental factors and occupational carcinogens. Therefore, this study aimed to evaluate the trend of mortality and disability-adjusted life years (DALYs) rates attributed to occupational carcinogens in Hamedan province, Iran, from 1990 to 2021.
Methods: In this ecological study, the Global Burden of Diseases database was used to collect the required data. The trend of changes in the mortality and disability-adjusted life years rates was examined using joinpoint regression analysis and the Join Point Regression software.
Results: The years of life lost (YLLs) due to premature death and disability attributed to occupational carcinogens in Hamadan Province increased from 10.31 per 1,000 population in 1990 to 23.33 per 1,000 population in 2021. The average annual percent change (AAPC) in DALYs was 3.79% for women and 2.57% for men. The all-cause mortality rate attributed to occupational carcinogens rose from 0.31 per 100,000 population in 1990 to 0.74 per 100,000 in 2021 (AAPC = 2.78%; 95% CI: 2.68% to 2.90%).
Conclusion: The trend of mortality and disability-adjusted life years due to occupational carcinogens in Hamadan province had an increasing trend overally. Periodic screenings for workers in high-risk occupations are essential to mitigate the burden of occupational cancers.

Application of Artificial Intelligence and Innovative Technology in Public Health Surveillance and Early Warning of Epidemics

Manoochehr Karami

Artificial intelligence (AI) refers to the process in which computers, rather than human intelligence, perform tasks, such as early warning of an epidemic. This editorial aimed to describe the potential applications of digital health and the challenges faced by the health system of Iran concerning the application of artificial intelligence and innovative technology in public health surveillance and early warning of epidemics. The use of new technologies at national and subnational levels for early warning of public health threats requires a suitable platform within the context of disease surveillance systems. The Iran health system currently utilizes a syndromic approach and event-based surveillance to monitor acute respiratory infections. However, the structure of Iran's national communicable disease surveillance system has faced challenges due to the inability to share and exchange data at the level of primary health care data sources. Accordingly, application and integration of AI should be considered as Iran’s health priority to promote infrastructure and technology requirements, including compatibility, interoperability, and strategies for ethical and responsible use by public health authorities. Since pandemics and epidemics have not been limited to the previous ones, such as COVID-19, influenza, SARS, dengue fever, and similar threats, operations planning is required for the integration of artificial intelligence tools to prepare and respond to biological threats promptly by the Iranian Ministry of Health, stakeholders, and other parties.

Secondhand Smoke and Cardiovascular Disease: A Policy Brief on Prevention and Exposure Reduction

Hosna Janjani

Cardiovascular diseases are recognized as the leading cause of death globally, accounting for a substantial proportion of mortality and disabilities worldwide.
Given that exposure to secondhand smoke is one of the risk factors for cardiovascular diseases, this policy brief presents strategies for reducing exposure to secondhand smoke in the healthy population and cardiovascular patients.
Reducing the burden of cardiovascular diseases caused or aggravated by secondhand smoke exposure and improving health levels requires a multifaceted approach.