M Eftekhar Ardbili , M Taban, M Hatamizadeh, H Ranjbar,
Volume 15, Issue 2 (9-2019)
Abstract
Background and Objectives: The Problematic Internet Use Questionnaire (PIUQ) is a scale for evaluating the adverse effects of high Internet usage. It was adopted into Persian in a previous study. The factorial structure of the adopted version was different from the original English version. The purpose of this study was to determine the factorial structure of the Persian version of the Problematic Internet Use Questionnaire.
Methods: In this methodologic study, sampling was carried out in students of Iran University of Medical Sciences, University of Tehran, and Sharif University of Science and Technology. A total of 428 students completed the Problematic Internet Use Questionnaire. Exploratory factor analysis was performed using SPSS. Confirmatory factor analysis was carried out using AMOS. The reliability of the Scale was determined using Cronbach’s alpha coefficient (α=0.89).
Results: Exploratory factor analysis showed four factors including online preoccupation, adverse effects, social interactions, and excessive use. The mean ± SD of the domains was 2.12±0.81, 2.01±0.86, 2.18±0.85 and 2.39±0.97 for online preoccupation, adverse effects, social interactions, and excessive use, respectively.
Conclusion: The exploratory and confirmatory factor analysis showed that the Persian version of the Problematic Internet Use Questionnaire had a relatively similar structure with the English version. One dimension of the questionnaire was split to two new dimensions. This questionnaire can be a useful tool for measuring problematic behaviors related to the excessive use of the Internet.
H Tekeh, H Ansari, , N Noori, K Tirgarfakheri, F Zare,
Volume 15, Issue 2 (9-2019)
Abstract
Background and Objectives: Congenital heart disease (CHD) is the most common type of birth defect that accounts for 25% of all congenital anomalies. This study was conducted to identify the risk factors od congenital heart disease in southeast Iran.
Methods: In this case-control study, 353 cases were selected from children aged 0 to 59 months who suffered from congenital heart disease and were referred to the Children’s Heart Clinic of Zahedan. Moreover, 353 controls were selected from healthy children aged 0 to 59 months who presented to health centers in Sistan and Baluchistan Province. The cases and controls were matched for age, sex and place of residence. The data were collected using interviews with children’s mothers and analyzed using independent t-test, chi-square test, and multiple logistic regression models.
Results: This study showed that the lack of folic acid consumption in pregnancy (OR =11.8), mot using multivitamins during pregnancy (OR = 4.1), history of CHD in first-degree relatives of parents (OR=3.4), history of abortion (OR =3.4), presence of telecommunication rig in the vicinity of the house (OR=3) and exposure to secondhand smoke (OR=2.9) significantly increased the chance of a CHD (P <0.05).
Conclusion: Effective planning, emphasis on the use of supplements during pregnancy, and improved awareness of the society, especially high risk women, can be helpful in decreasing CHD in this region. Providing education regarding preventive factors seems to be necessary for health and medical workers to control risk factors and reduce costs associated with CHD.
L Khazaei, S Khodakarim, A Mohammadbeigi , A Alipour,
Volume 15, Issue 2 (9-2019)
Abstract
Background and Objectives: an important problem challenging cesarean section is its extensive use as a common method of delivery. Due to the growing trend of cesarean section in Iran in recent years, the natural delivery promotion program was implemented as one the programs incorporated in the Health System Reform Plan in 2014. In this study, the trend of changes in the percentage of CS delivery in Qom Province following the implementation of this program was evaluated.
Methods: This trend analysis that was performed in all cesarean deliveries in Qom Province from 2005 to 2018 using a joinpoint regression method.
Results: These results showed an annual increase of0.4% in the CS percentage 95% CI: -0.5 to 1.2), which was not statistically significant. A significant decrease was observed in the rate of CS in governmental hospitals. Conversely, in non-governmental hospitals, the percentage of CS increased significantly.
Conclusion: According to the findings of this study, after more than 3 years of implementation of health sector evolution plan, overall implementation of this plan failed to significantly reduce the overall process of cesarean delivery during this period in Qom province and achieve the predetermined goals.
M Enayatrad, Hr Tabatabaee, S Mahdavi, T Valadbeig, K Etemad, Sh Rezaeian , H Yaghoobi , F Zolfizadeh, M Hajipour,
Volume 15, Issue 2 (9-2019)
Abstract
Background and Objectives: One of the causes of neonatal death and death in children under the age of five is premature birth of infants. The purpose of this study was to identify the risk factors associated with preterm infant birth in pregnant women.
Methods: This is a case-control study on mothers referring to comprehensive health centers in the provinces of the country. Descriptive analysis of variables was reported as percentage and frequency. In data analysis, logistic regression analysis was used at a significant level less than 0.05.
Results: In this study, 2463 pregnant women (668 cases as cases and 1795 as controls) were examined. There was a significant relationship between the place of residence (OR=0.702, P=0.002), level of maternal education (OR=1.920, P=0.027), degree of twin (OR=4.953, P=0.001), interval between pregnancies (OR=1.821, P=0.009), specific disease (OR=1.694, P=0.010), nutritional status of the mother (OR=1.420, P=0.024), physical activity (OR=1.591, P=0.001), Sleep patterns (OR=0.634, P=0.008) and history of stillbirth (OR=0.247, P=0.001) associated with the birth of premature infants.
Conclusion: Preterm infant birth is one of the main causes of neonatal death. Therefore, some of the birth defects of the premature baby can be prevented. It is possible to reduce the risk factors for the birth of a premature baby by improving the quality of pregnancy care and changing the lifestyle of the pregnant mother, and by raising awareness and creating a healthy and safe environment for the mother.
F Osmani, E Hajizadeh, Aa Rasekhi, Me Akbari,
Volume 15, Issue 2 (9-2019)
Abstract
Background and Objectives: In many medical situations, people can experience recurrent events with a terminal event. If the terminal event is considered a censor in this type of data, the assumption of independence in the analysis of survival data may be violated. This study was conducted to investigate joint modeling of frequent events and a final event (death) in breast cancer patients using a frailty model.
Methods: In this retrospective cohort study, 443 patients with breast cancer registered at the Hospital of Shohadaye Tajrish Cancer Research Center were studied. The model of Liu (2004) was applied for joint modeling of recurrent events and a terminal event in which a shared frailty with gamma-distribution was used. Data modeling and data analysis were done using the R software.
Results: Four hundred and forty three women with breast cancer were studied. Univariate and multivariate analysis were performed in these patients. Of these, 338 cases (76.3%) had recurrence events, and 105 (23.7%) were censored. The obtained results of joint frailty model indicated that the relative risk of relapse in patients with a positive first-degree family history was 36% higher than that of other people (P<0.05). The relative risk of relapse in patients with stage 3 disease was 19% more than other stages and also the relative risk of relapse in patients with chemotherapy was 2.5 times higher than those without chemotherapy.
Conclusion: In this study, the presented model, in addition to simultaneous modeling capability of the event, could help prevent a higher prevalence of the terminal event (death) and thus reduce the adverse effects of reversible diseases.
Aa Abbasi, Hr Bahrami, B Beygi, E Musa Farkhani, V Vakili, F Rezaee Talab , R Eftekhari Gol , M Talebi,
Volume 15, Issue 2 (9-2019)
Abstract
Background and Objectives: Sleep disorders include problems involving the quality, timing and amount of sleep, which cause decreased functioning and discomfort during the daytime. Considering the importance of sleep in health and quality of life and the probability of the related disorders in the elderly, this study was conducted to investigate sleep disorders and their risk factors in an elderly population covered by Mashhad University of Medical Sciences.
Methods: We conducted one of the largest population-based cross-sectional studies in an elderly population covered by Mashhad University of Medical Sciences in 2016. In this study, a total 8496 elderly people aged 60-90 years old with sleep disorders were compared with 35041 elderly subjects without complaints. Data were extracted from the Sina Electronic Health Record System. Bivariate and multivariate logistic regression analysis were carried out using the STATA ® version 14 to determine associations between independent variables and sleep disorders.
Results: In multivariate analysis, male gender (AOR=0.58; 95% CI: 0.55-0.61), being married (AOR=0.88; 95% CI: 0.83-0.93), overweight and lightweight compared to normal weight (AOR=1.27; 95% CI: 1.21-1.34 and AOR=1.20; 95% CI: 1.04-1.38, respectively), smoking (AOR=2.22; 95% C.I: 2.05-2.40), high blood pressure (AOR=1.44; 95% C.I: 1.37-1.52), diabetes (AOR= 1.49; 95% C.I: 1.40-1.58) and depression (AOR=3.05; 95% C.I: 2.74-3.38) variable remained in the final model after adjusting for confounders.
Conclusion: In this study, gender, marital status, body mass index, smoking, blood pressure, diabetes and depression were the main determinants of sleep disorders. It is necessary to identify the risk factors and perform appropriate interventions to improve the sleep.
M Pourranjbar, H Jamalizadeh, M Mehrtash, K Divsalar,
Volume 15, Issue 2 (9-2019)
Abstract
Background and Objectives: Menopause is one of the most sensitive events in a woman's life. Health improvement in this period can bring women a better quality of life and has many effects. This study was conducted to investigate the relationship between the level of physical activity and the level of health of postmenopausal women in Kerman Province.
Methods: A total of 536 postmenopausal women were selected from Kerman province. The Goldberg’s General Health Questionnaire was used to measure the level of health and the general physical activity questionnaire (GPAQ) was applied to determine the amount of physical activity. The formula for measuring body mass index was used for BMI. Ultimately, the Spearman, Kruskal Wallis, and Bonferroni statistics were used because the data distribution was not normal.
Results: The amount of physical activity in postmenopausal women in Kerman Province was lower than the WHO recommended. There was a significant relationship between physical activity with the level of health (r = 259), (P≤0.001). Moreover, BMI and health level had an inverse relationship (-0.186) (P≤0.001).
Conclusion: Based on the results, a significant relationship was found between physical activity and general health status of postmenopausal women. Considering the effect of physical activity on health, it can be concluded that increased physical activity of postmenopausal women in Kerman Province can improve their health and BMI.
F Amiri , H Sharifi, E Ghorbani , Fs Mirrashidi, M Mirzaee, N Nasiri,
Volume 15, Issue 2 (9-2019)
Abstract
Background and Objectives: Congenital hypothyroidism is one of the reasons for mental retardation and premature death of infants. Since identification of the determinants of hypothyroidism plays a significant role in its prevention, this study was conducted to determine the prevalence of congenital hypothyroidism and to investigate its determinants in newborn infants.
Methods: This study was a secondary analysis of the data of the neonatal congenital hypothyroidism screening program. Hypothyroidism was diagnosed based on the Thyroid Stimulating Hormone (TSH) level in the heel prick blood samples on the third to fifth day of life. The data of infants born in Jiroft hospitals were collected from Jiroft Health Center and analyzed using descriptive statistics and Poisson regression test.
Results: In this study, 4998 newborns (2450, 49.02% female, 2548, 98 / 50% male) were investigated. The study samples were newborns born from March to March 2016. The prevalence of congenital hypothyroidism was 1 in 135 live births. The prevalence of congenital hypothyroidism was higher in babies born by cesarean section (IRR = 2.2, 95% CI =1.1-4.1), newborns admitted to the NICU (IRR = 4.6, 95% CI=2.4-8.9), and babies with high birth weight (IRR = 5.3, 95% CI =3.5-8.1).
Conclusion: The prevalence of hypothyroidism was higher in this study compared to other studies. Its prevalence was higher in males than in females. Genetic and environmental differences may explain this difference. The prevalence of hypothyroidism was higher in infants born through cesarean section and newborns hospitalized in NICU.
Mr Aflatoonian, A Nadim, I Sharifi, M Bamorevat, S Tajik, M Hashemian, R Abasi Rayeni, R Shabanzadeh, B Aflatoonian,
Volume 15, Issue 3 (11-2019)
Abstract
Background and Objectives: Cutaneous leishmaniasis (CL) is one of the health problems in Iran, especially in Kerman Province. The aim of this study was to determine the morbidity rate of CL in two new foci in the east and southeast of Kerman.
Methods: At the end of 2017, demographic data were obtained from the health centers of Kerman. Using cluster sampling, 800 households (40 clusters of 20 households) were studied in Allahabad (southeast) and Sarasiab (east), Keramn. From each subject, data were collected regarding age, sex, number and location of the ulcer(s), scarring, and time and place of infection. The collected data were analyzed using SPSS software.
Results: The prevalence of CL was 9.6 in Allahabad and 42.8 in Sarasiab and the incidence (new cases) was 3.2 and 3.8, respectively. The highest rate of infection was found in Allahabad in the age group under 6 years old and in the Sarasiab was over 40 years old. There was a significant difference in nationality and local transmission between the rwo regions (P <0.001).
Conclusion: The ratio of the prevalence to incidence in two regions showed that the focus in the east of Kerman was almost 12 years old, whilst a new focus is developing in the southeast. It is suggested that the health centers in the city of Kerman provide a regular program including active case- detection and free-of-charge treatment of patients in the aforementioned areas until complete recovery to achieve disease control.
F Behmanesh, Z Taghizadeh, Aa Vedadhir, A Ebadi, A Pourreza, Mj Abbasi Shavazi,
Volume 15, Issue 3 (11-2019)
Abstract
Background and Objectives: Low fertility reduces the workforce and causes population aging. Hence, childbearing and its determinants are important issues in demographic policies. This study was conducted to explain the causes of single child according to women’s views.
Methods: This qualitative study was the second part of a sequential explanatory study carried out using a conventional content analysis approach and inductive reasoning. The research population comprised married women aged 15-49 years old living in Babol who had one child and did not intend to have any pregnancies in the future. The subjects were selected via a target-based sampling method. After receiving written consent, semi-structured interviews were conducted. Data saturation was achieved after 13 interviews.
Results: The findings showed that single child was affected by the media and social patterns associated with their own priorities. Uncertainty about the future and marital conflicts boosted having only one child. In fact, there were issues that forced women to accept "single child” in spite of "single child complaints" and try to a find a meaning for life with only one child.
Conclusion: Apart from economic issues, there are many social issues involved in child-rearing, and demographic policy-makers should consider these issues in order to achieve their desired demographic goals.
E Abdalmaleki, Zh Abdi, M Goharimehr, R Alvandi, S Riazi Esfahani , E Ahmadnezhad,
Volume 15, Issue 3 (11-2019)
Abstract
Background and Objectives: Iran has carried out a series of surveys based on the Global school-based student health survey (GSHS) referred to as the CASPIAN. The aim of this paper was to compare the methodology and tools of CASPIAN surveys and to propose recommendations and suggestions for future implementations.
Methods: The data of this systematic review study were gathered from the World Health Organization (WHO) documentations, international databases including Pubmed, EMBASE, Scopus, GoogleScholar, and ScienceDirect, and national databases including Magiran, SID, and Irandoc. The search was conducted in both English and Persian (for the time period from 2003 to 2018). The time and place of the study, target population, questionnaire(s), sample size, and sampling method were compared between the surveys.
Results: Five rounds of CASPIAN survey were conducted in Iran from 2003 to 2015. The surveys had two sets of questionnaires for students and parents. In all five rounds, sampling methods and questionnaires were similar in the core and differed in some details that were added selectively in each round. The questionnaires were designed based on the GSHS and the WHO stepwise approach to non-communicable disease risk factor surveillance (STEPS) programs.
Conclusion: Considering the small variation in each series and compliance with the global model, it is suggested that the next CASPIAN survey be conducted according to the previous series in accordance with the standards presented in the global model in recent years in a reasonable interval from the 2015 survey.
A Ahmadabadi, H Aghajani, M Khadem Rezaiyan , M Zanganeh, Sh Tavousi, A Hadianfar,
Volume 15, Issue 3 (11-2019)
Abstract
Background and Objectives: Burns are tragic events with considerable mortality rates. This study was conducted to analyze the spatial pattern of burns and identify the factors associated with the burn injuries in Mashhad, Iran.
Methods: This retrospective cross-sectional study was conducted in patients hospitalized in Imam Reza Hospital Burn Center, Mashhad, which is the only referral burn center in the northeast of Iran. Spatial generalized linear models (Poisson and negative binomial) were used to model the association between socio-economic characteristics and the incidence of burn injury.
Results: A total of 1044 acute burn patients (69.9% male, 30.1% female) were reviewed. Most of the burned patients were in the age group 20-29 years (41.4%). The most common cause of burn injury was flame (64.6%). The local test of spatial autocorrelation confirmed that the burns had cluster pattern in the central areas of the city and the worn-out urban texture was at higher risk of burns. The results of model showed that the percentage of worn-out urban texture (IRR =1.007; 95%CI 1.005-1.008), literacy (IRR =0.98; 95% CI 0.95-0.99), percentage of employed women (IRR =0.96; 95%CI 0.92-0.99), unemployment rate (IRR =0.92; 95%CI 0.85-0.99) and percentage of margination (IRR =1.006; 95%CI 1.005-1.008) were associated with burns.
Conclusion: Based on the findings, socio-economic and environmental characteristics are associated with the incidence of burn injuries in different areas. The results of this study could be used to design burn prevention strategies, especially in the high-risk areas and groups.
A Etebarian Khorasgani , A Ghanbari Khanghah , A Paryad, Z Atrkar Roshan ,
Volume 15, Issue 3 (11-2019)
Abstract
Background and Objectives: Lifestyle is a way that a person chooses throughout life and is an indicator that can affect physical and mental health. This study was conducted to determine the lifestyle of people in Rasht and its predictive factors.
Methods: This analytical, cross-sectional study was conducted in 1000 residents of 5 districts of Rasht. Data were collected using a demographic questionnaire and the Behavioral Health Questionnaire. SPSS software version 20 was used to analyze the data. Pearson correlation coefficient, independent t-test and linear regression were applied.
Results: The result showed that 50.3% of the participants were male and 49.7% were female. According to lifestyle, the rate of using alcohol, physical activity, breakfast, red meat, fruits, salt, and ready meal was 13.4%, 54.3%, 95.6%, 87.7%, 98.4%, 59.6%, and 45.9%, respectively. The majority of the research units (70.1%) never smoked. The mean sleep time was 7.45 ± 63/1 hours.
Conclusion: Based on the results, promotion of nutritional knowledge, increased awareness of the disadvantages of smoking, availability of healthy food at a reasonable price, and physical activity are important factors for lifestyle improvement.
Ha Nikbakht, H Ghaem, Hr Tabatabaee, A Mirahmadizadeh, S Hassanipour, S Zahmatkesh, A Hemmati, F Moradi, A Abbasi,
Volume 15, Issue 3 (11-2019)
Abstract
Background and Objectives: Anthropometric indices, especially weight, provide useful information for the care and treatment of newborn infants and can be used to identify infants at risk. Therefore, this study was conducted to examine the mean weight, height and head circumference measurements of infants and some related factors.
Methods: This cross-sectional study was performed to investigate the anthropometric indices (weight, height and head circumference), demographic characteristics, and delivery data of 1484 newborns in 2016 using multi-stage sampling. Moreover, the predictors of these indices were analyzed using a linear regression model.
Results: The mean weight, height and head circumference of the newborn infants was 3185 ± 465 g, 49.92 ± 2.92 cm, and 34.58 ± 2.29 cm respectively, and 7% of newborns were low birth weight. The male newborns weighed 57.29 g more than females on average at birth (p <0.05). Besides, the height and head circumference of the male newborns were 0.15 and 0.10 cm larger than the female newborns respectively but the difference was not statistically significant. In addition to gender, gestational age at birth (week) and type of delivery correlated with all three anthropometric indices in multivariate analysis.
Conclusion: Identifying and controlling largely adjustable risk factors can make it possible to prevent low anthropometric parameters, particularly low birth weight.
H Taherichadorneshin, Mr Esmaeili, M Farahi , M Tavakoli,
Volume 15, Issue 3 (11-2019)
Abstract
Background and Objectives: Nowadays, despite several global initiatives, the use of doping agents has become a problem in athletic societies. Therefore, the aim of the current study was to investigate the prevalence, attitude and tendency toward the use of performance-enhancing supplements among athletes in North Khorasan Province.
Methods: The statistical population of this cross-sectional, descriptive-analytical study was all athletes of North Khorasan Province. Demographic characteristics and data related to doping agents were collected using a researcher-made questionnaire. The validity of the questionnaire was approved by doping experts and its reliability was calculated by Cronbach's alpha. The questionnaires were then distributed using stratified random sampling and 436 questionnaires were collected. Data were analyzed using SPSS software at P<0.05.
Results: The findings showed that 39.2% of the subjects used at least one of the agents for doping. The most common agents were vitamin and protein supplements (36%), minerals (28.7%) and drugs (21.3%). Also, there was a significant negative correlation between the prevalence of using doping agents and age, sport background, and educational level. In addition, attitude and tendency toward the use of doping agents were higher in weightlifters, body builders, and footballers compared to other athletes. Furthermore, knowledge of athletes, awareness about side effects, and the overall awareness of athletes toward performance-enhancing supplements was low.
Conclusion: It is necessary to develop comprehensive educational programs to raise the knowledge and awareness of athletes and coaches toward the use of performance-enhancing supplements in North Khorasan Province.
E Ghaderi, M Salehi Vaziri , E Mostafavi, Gh Moradi, Kh Rahmani, M Zeinali, Mr Shirzadi, H Erfani, Sh Afrasiabian, S Eybpoosh,
Volume 15, Issue 3 (11-2019)
Abstract
Background and Objectives: To provide an overview of the national program of Crimean-Congo hemorrhagic fever surveillance in Iran, its current achievements, and challenges.
Methods: In this mixed method study, the relevant reports, documents, and guidelines, as well as published literature and surveillance data were gathered and critically reviewed. The opinions of the key informants at local and governmental levels were assessed through structured interviews.
Results: The program was integrated into Iran’s primary healthcare (PHC) network in 1999. The involved organizations include CDC, medical universities, Pasteur Institute of Iran (PII), and Veterinary Organization. Case finding is based on standard definitions of suspected, probable, and confirmed cases. Laboratory confirmation is necessary for diagnosis and is provided within 48 hours after receipt of the specimen by the National Reference Laboratory of PII. CCHF treatment is primarily supportive. Antiviral therapy with ribavirin is also considered. Both therapeutic services are free. Education mainly focuses on high-risk groups and healthcare workers. Major achievements of the program include rapid diagnosis and treatment of cases, prevention of nosocomial transmission, identification of high-risk provinces and major transmission routes, improved outbreak preparedness, development of laboratory tests for detection of other arboviruses, and reduction of CCHF case fatality rate.
Conclusion: Program implementation has had a positive impact on early detection and proper control of annual outbreaks. However, some aspects of the program still need improvement, including promotion of the general and high-risk populations’ awareness and regional collaborations (especially among neighboring countries) for infection control in humans, livestock, and vectors.
Kh Rahmani, Gh Moradi, Mb Khadem Erfan , L Faraji, Gh Zamini, B Mohammadian, M Karimi, F Bahrami, A Raeisi,
Volume 15, Issue 4 (1-2020)
Abstract
Background and Objectives: Iran started malaria elimination campaigns many years ago. The purpose of this study was to review the malaria surveillance system in Iran.
Methods: The data of this study were obtained from the surveillance system of the Center for Communicable Disease Control, a review of records, documents, books and published articles, and also interviews with process owners and experts of malaria surveillance in 2017-2019.
Results: The surveillance system of malaria in Iran has a coherent structure, in which all identified cases are reported and monitored from the environmental levels to the center by telephone instantly. Considering that the main goals of the malaria program including disease elimination have been obtained, the surveillance system in Iran is currently aiming at strengthening the elimination phase. In this stage, all new cases are also epidemiologically investigated in addition to examination, treatment and follow-up for categorization of the cases in categories of relapse, indigenous, introduced, and induced.
Conclusion: The successful implementation of the surveillance system for malaria over time has caused indigenous cases of disease to be limited to three southeastern provinces of the country and there are fewer than 300 new cases a year. Despite success, since the goal of malaria surveillance in Iran is now disease elimination, continuous monitoring of correct implementation of all processes and evaluation of the applied strategies are necessary.
F Norouzinezhad, H Erfani, A Norouzinejad, F Kaveh, F Ghaffari,
Volume 15, Issue 4 (1-2020)
Abstract
Background and Objectives: Kurdistan Province has always been one of the areas of interest in national disease control programs due to a high number of human brucellosis cases. This study was conducted to explore some of the epidemiological indexes and the trend of the incidence of human brucellosis in this area from 2009 to 2016.
Methods: The target population of this cross-sectional study included the human brucellosis patients living in Kurdistan Province whose disease was diagnosed between 2009 and 2016. The data of 6918 patients were analyzed. The incidence was calculated in 100,000 at-risk population.
Results: The highest incidence was 103.54 in 100,000 in 2014 and the lowest was 23.86 in 100000 in 2010. According to 8-year analysis, the highest incidence rate was seen in Bijar. Male gender, rural dwellers, farmers, ranchers, housewives, and those aged 24-25 years were at a higher risk of the disease based on the results. Most of the patients reported contact with livestock.
Conclusion: Comprehensive measures should be taken to control the infection transmission from domestic animals and their products to humans; moreover, preventing measures should be devised by health policy-makers, especially for villagers, housewives, and men.
B Damari, M Chegeni, I Esmaili, H Sarrami, H Almadani, H Narenjiha, F Minaee, M Ahmadi Pishkuhi ,
Volume 15, Issue 4 (1-2020)
Abstract
Background and Objectives: Alcohol consumption among various occupations' staff leads to many problems. Therefore, due to the importance of the issue, this comprehensive study was conducted to determine the prevalence of alcohol consumption among industrial workers.
Methods: In this descriptive cross-sectional study, the data were collected using a structured questionnaire through interview based on the workers’ self-reports. The participants included 13,128 workers across the country selected by multi-stage cluster sampling according to the population of labor workers and industrial centers in each province. The data were reported according to the consumption prevalence in the 10 spatial planning zones.
Results: In the optimistic situation, wokers in Ardebil (10.7%), Kermanshah (10.6%) and Guilan (7.1%) reported the highest frequency of alcohol consumption. The country’s mean prevalence of current consumption was 3.2% and the prevalence of alcohol consumption in life was up to 12.4% in the workers.
Conclusion: The data are based on the self-report of the participants. Therefore, the estimated prevalence rate is considered optimistic and below the actual prevalence. In the work environments of the country, especially in provinces with the highest frequency, special policies and interventions are needed to reduce the prevalence of alcohol consumption and minimize the harms caused by it.
M Safari, M Abbasi, F Gohari Ensaf , Z Berangi, Gh Roshanaei,
Volume 15, Issue 4 (1-2020)
Abstract
Background and Objectives: In survival analysis, using the Cox model to determine the effective factors requires the assumptions whose failure of leads to biased results. The aim of this paper was to determine the factors affecting the survival of metastatic gastric cancer patients using the non-parametric method of Randomized Survival Forest (RSF) model and to compare its result with the Cox model.
Methods: In this retrospective cohort study, 201 patients with metastatic gastric cancer were evaluated in Hamadan Province. Patient survival was calculated from diagnosis to death or end of study. Demographic characteristics (such as gender and age) and clinical variables (including stage, tumor size, etc.) were extracted from the patient records. Factors affecting survival were determined using the Cox model and RSF. Data analysis was performed using the R3.4.3 software and RandomForestSRC and survival packages.
Results: The mean (SD) age of patients was 61.5 (12.9) years old. The Cox model showed that chemotherapy (p=0.033) was effective in survival, and the results of fitting the RSF model showed that the most important variables affecting survival were type of surgery, location of metastasis, chemotherapy, age, tumor grade, surgery, number of involved lymph nodes, sex and radiotherapy. Based on the model appropriateness, the RSF model with log-rank split rule had a better performance compared to the Cox model.
Conclusion: If the number of variables is high and there is a relationship between the variables, the RSF method identifies the important and effective variables on survival with high accuracy without requiring restrictive assumptions compared to the Cox model.
