Iranian Journal of

  Background & Objectives: Zagros Mountains, which are between the flatlands of Mesopotamia and the Iranian plateau, surround the western border of the country. This region was the cradle of great civilizations like Mesopotamia and Elam. This study aimed to test the boundary role of the Zagros Mountains in the genetic structure of the region through evaluating the paternal lineages inheritance and patterns of genetic polymorphisms.

  Methods: Two hundred and ninety seven blood samples were collected from unrelated men of the different local areas of the northwest of Iran. Haplogroup frequencies were used to calculate and compare the population genetic parameters as genetic distance and genetic diversity.

  Results : In this research distribution time and entrance of the haplogroup G2-M406 estimated around 8800 years before present, the age of first human residential in the Zagros mountains area, Frequency of central Asian lineages in the eastern side of the mountains observed notable more than west side. While, European paternal lineages in the western side was more than eastern side of the mountains.

  Conclusion : This research emphasized the westward distribution and migration from Iranian plateau to the Europe through Turkey and Caucasus. This research has drown reliable phylogenetic tree of the surrounding population and showed an important geographic barrier role for these mountains to gene flow from neighboring regions and free movements of the local people. Moreover, the important role of the Zagros Mountains as a geographic barrier to gene flow from neighboring regions clearly highlighted in this research

  Background & Objectives : Leishmaniasis is a disease of the skin caused by a variety of protozoa. Leishmaniasis can be seen in any geographic region. This study investigated the role of climate on the prevalence of cutaneous leishmaniasis in the city of Sabzevar between 2003 and 2009.

  Methods : Daily meteorological data (minimum, maximum and mean temperature, sunshine hours, precipitation, and humidity) and city-level data on the prevalence of cutaneous leishmaniasis between 2003 and 2009 were prepared and analyzed using Pearson correlation, time delay, and time series methods.

  Results: The maximum incidence of the disease was observed during the second half of the year, especially in the autumn, in the age group 10 to 20 years. The highest incidence was seen among women and for the wet (rural) type. In addition, the disease showed a weak positive correlation with relative humidity and rainfall, and a weak inverse correlation with sunshine and temperature. It is noteworthy that in the delay analysis, correlations increased with a confidence interval of 95%. In the time delay of three months, the correlation of leishmaniasis incidence and prevalence with relative humidity and rainfall was positive and strong (r=0.82 and P=0.006, r=0.88 and P=0.002, respectively) and the correlation of the disease with temperature and sunshine hours was inverse and strong (r=0.80 and P=0.01, r=0.77 and P=0.01, respectively).

  Conclusion : Considering the significant relationship between climatic factors and leishmaniasis in desert regions, we recommend appropriate measures should be taken to identify and control these factors.

  Background & Objectives : Health risk behaviors in adolescence, such as alcohol consumption and smoking, can affect both short-term and long-term health. The aim of study was to estimate the prevalence of health risk behaviors among high school students of Qazvin.

  Methods : The target population of this descriptive study was all high school students of Qazvin who were enrolled in the 1390-91 academic year. The sample group included 160) 239 girls, 271 boys) students that were selected by randomly multistage sampling. The assessment instrument was the Youth Risk Behaviors Surveillance System (YRBSS) Questionnaire.

  Results: Findings indicated that use of hookah was the most popular in girls and boys (59%) as compared with cigarette smoking (32.7%), drug use (7.3%), and alcohol consumption (16.7%). The prevalence of physical violence in and outside the school in one year, carrying weapons to school in a month, cigarette smoking in the school in one month, smoking hookah, and alcohol and opioid use during one month were more frequently observed in boys than girls. The use of the seat belt was more common among girls than boys, and the total prevalence of using the seat belt was 23.7%.

  Conclusion : Given the high prevalence of high risk behaviors among high school students, it is necessary to develop a high risk behaviors surveillance system and use the obtained information to devise preventive measures at the individual, school, and family levels.

  Sensitive questions about people’s behaviors are often discussed in studies in the fields of human, social, and medical sciences. Obtaining valid answers to these kinds of questions is one of the main challenges in the mentioned studies. The most important risk factors for the validity of these studies are response bias and non-response bias, which occur because of concerns about divulging personal information. Therefore, researchers are to find solutions other than direct questioning to increase the validity of obtained results through reducing these biases.

  In this review article, we discuss the Warner Model, the Unrelated Question Model, the Forced Response Model, the Moors Model, and the Mangat Model that are subsets of the Randomized Response Technique, and also the Triangular Model and Crosswise Model that are subsets of the Non-Randomized Response Technique. The models are all used in answering sensitive binomial questions.

  Background and Objectives : Influenza is an acute, contagious, and zoonotic viral disease. It is caused by a virus of the Orthomyxoviridae family. This very infectious is caused by different subtypes of type A influenza virus in the poultry, turkey, and many other birds. In this study, the serum status of rural domestic poultry was investigated for influenza subtype H9N2.

 Methods: This cross sectional study was done from August to October in 2013 in Iranian villages through sampling domestic poultry. The sampling was accidental and was done based on the GIS 11-digit code. In each village, blood samples were taken from at least 28 birds from different species. Then, ELISA was used for screening followed by the HI test. A total of 397 villages and 11546 birds (10145 chickens, 1413 ducks, 397 turkeys, 10 pigeons, and 175 other species) were sampled.

  Results : Three hindered and forty nine (88%) out of 397 villages were positive on ELISA. In addition, 341 villages (86%) were positive and 56 (14%) were negative on the HI test for antibody titers. Also, among the considered variables, weather was a risk factor and the prevalence was significantly lower in villages near the rivers, lagoons and lakes (up to a radius of 3 Km).

  Conclusion: The high seroprevalence of influenza H9N2 in rural domestic poultry indicates that the disease is becoming endemic. As there is no eradication policy for influenza H9N2 in Iran, using effective vaccines can reduce the infection with influenza virus in domestic and rural poultry.

  Background and Objectives : I In the classification proposed by Holmes and colleague, the stress of divorce has been identified as the greatest one among all types of stresses in the world. This global stress is on the rise in Iran so that Iran is the fourth country in this regard. The purpose of this study was to present a comprehensive and systematic model of the factors affecting divorce in the country.

 Methods: The method used in this study was qualitative and a type of meta-study known as meta-synthesis. The study population consisted of all relevant papers with research topics. In order to perform the research, after designing research questions, a systematic search was carried out based on relevant key words (divorce, spousal conflict, separation) from the databases Science Direct, IEEE, Emerald, ISC, IRANDOC, SID, Civilica, Scopus and also Google Scholar between 1365 to early 1392 .

  Results : By reviewing 61 articles out of 8477 primary ones, both foreign and domestic, researchers identified 15 dimensions and 64 components as the factors affecting divorce. Based on these factors, the final integrated model was presented and validated.

  Conclusion: The results of this study can be used as a basis for planning pre-marriage counseling programs by identifying factors affecting divorce on the basis of all available resources in the years 1365 to 1392.

  Background and Objectives : Awareness of the cancer incidence is essential for cancer prevention and control programs. Capture-recapture methods have been recommended for reducing bias and increasing the accuracy of cancer incidence estimation. This study aimed to estimate the incidence of gastric cancer by the capture-recapture method based on Ardabil population-based cancer registry data.

 Methods: All new cases of gastric cancer reported by three sources, i.e. pathology reports, death certificates, and medical records, reported to Ardabil population-based cancer registry between 2006 and 2008 were enrolled in the study. The duplicate cases based on the similarity of the first name, surname, and father's name were identified among sources. The estimated incidence was calculated by the log-linear method using the Stata 12 software.

  Results : A total 857 new cases of gastric cancer were reported from three sources. After removing duplicates, the reported incidence rate was 35.3 and 32.5 per 100,000 population for the years 2006 and 2008, respectively. The estimated incidence rate calculated by the log-linear method for these years was 96.2 and 90.4 per 100,000 population, respectively.

  Conclusion: The results showed that none of the sources of pathology reports, death certificates, and medical records, individually or collectively, fully covered the incidence of gastric cancer. We can obtain more accurate estimates of the incidence rate using the capture-recapture method.

  Background and Objectives : Breast cancer is the second most common cancer among Iranian women. The peak age of breast cancer in Iran is one decade lower than the global estimates. The aim of this cross-sectional study was to estimate the burden of breast cancer in Iranian women in the country level.

 Methods: In this study, the CANMOD software was used for the calculation of DALYs as the sum of YLL and YLD. The required data was the population of the Iranian women, mortality due to breast cancer, incidence cases of breast cancer, and mean time of the stages of breast cancer that was obtained from the Mortality Registry System, Cancer Registry System, and expert panel views .

  Results : In this study, the total burden of breast cancer in Iranian women was 75811 years in 2009. Moreover, the years of life lost (YLL) was 54938 years while years lived with disability (YLD) was estimated 20873 years. The rate of DALYs per 100000 female population was 220.9 years. The peak age of breast cancer burden was in the age group 45-59 years. The incidence to mortality ratio was 3/2.

  Conclusion: The incidence rate, mortality rate, and the burden of breast cancer in Iranian women increased in 2009 when compared to a previous study in 2003. The findings of this study may provide Iranian health managers with some information on the determinants of the burden of breast cancer in order to design preventive measures as well as screening programs for early detection of breast cancer.

  Background and Objectives : Knowledge transition is an important issue in social epidemiology. Taking into account the importance of knowledge translation network among vulnerable young people in closed environments, this study was conducted to recognize and survey knowledge transition in school lessons. The study aimed at teenagers residing in orphanages in the city of Kerman, using social network analysis.

  Methods: The study samples of this cross-sectional study were all teenagers aged 12-18 years old residing in orphanages. Data was collected via a checklist. In order to study the structural cohesion of social networks and the position of teenagers, density and centrality indices were calculated. Local structure of networks was studied using the triad census method. Finally, the effects of independent variables on indegree index were investigated using a mixed model.

  Results : The mean density in knowledge transition was 0.34 (0.42 and 0.27 in girls and boys, respectively. (P=0.2)). Completely null and completely mutual triads were 17.1% and 11.2% in girls and 33.7% and 0.09% in boys, respectively. Indegree increased with an increase in age (P<0.001), the average of the scores in school exams (P=0.002), and studying non school materials (P=0.04).

  Conclusion: Age, average score of school exams, and studying non school materials were important factors in indegree. In general, density of social network was rather low. The rate of knowledge transition was small. Therefore, activities are required to enhance knowledge sharing and transition.

  Background and Objectives : Failure to gain weight (FTG) is one of the predominant health issues in children. The aim of this study is application of longitudinal transition model in determining the prognostic factors for failure to gain weight in children under two years.

  Methods: In this study, 363 children under 2 years that were visited at the health centers in the east of Tehran were studied. Samples were selected using the two stage clustering method. The study variables were measured repeatedly in 18 consecutive times. Since the data was longitudinal and are dependent, first order transition model was used to determine the risk factors of failure to gain weight. All analyses conducted in R.

  Results : The mean (±sd) birth weight was 3057gr(± 838) and 6.9% of the children weighed less than 2500gr at birth. Moreover, 231 children (63.6 %) had no FTW until 2 years of age while 23 ( 6.3 %) had three or more episodes of FTW. Diarrhea (P<0.001), weaning (P<0.001), catching cold (<0.001), and teething (P<.001) were significant risk factors of failure to gain weight. To measure the association between weight loss and the weight in the previous visit, the logarithm of odds ratios was used that was significant (P=0.039).

  Conclusion: The association between two consecutive measurements showed that any failure in weight would affect weight gain in the next period of time and the effect of weight deficiency remains for at least one month.

  Background and Objectives : Previous studies have reported contradictory results regarding the association of Shift Work (SW) and Blood Cholesterol (BC). In this paper, we studied the relationship between SW and BC.

  Methods: The data of this historical cohort study was extracted from annual observations of the workers of Esfahan’s Mobarakeh Steel Company selected through cluster random sampling between 1996 and 2011. In this research, we assessed the effect of SW on BC with controlling BMI, age, work experience, marital status, smoking, and educational status.

  Results : Five hundered and seventy four male workers participated in this study with a mean (SD) age of 41.89 (7.51) and mean (SD) work experience of 16.75 (7.16) years. In this study, after controlling confounding factors, we found no significant relationship between SW and BC.

  Conclusion: Because our study showed no relationship between SW and BC, we can state that this relationship does not exist with more certainty.

  Background and Objectives : In the current age, due to the increasing growth of knowledge and competition therein, evaluation of scientific products by means of scientometric methods has become a very important and necessary subject. Scientometrics, in simple words, is the science of measuring the knowledge. Scientometric indices are divided into three categories: productivity metrics that measure the productivity of the researchers or research groups, impact metrics that assess the quality (or performance) of journals, researchers, or research groups, and hybrid metrics that are used to summarize both productivity and effect metrics in one index. Scientometric studies help policy makers and managers of universities and heads of research centers in allocating budget, creating a balance between the budget and costs, making appointments, and promoting the researchers and institutes, and results in better recognition of weaknesses and strengths of their affiliated groups by evaluation of priorities, perspectives, and capacities. Meanwhile, this new knowledge can help with systematic evaluation and ranking of universities and research centers. This paper provides a review on scientometric concepts and its applications and discussed scientometric indices.

  Background and Objectives : Health is the most common outcome in health research. In addition to the physician’s examinations as the gold standard, there are many questionnaires to assess objective and subjective health. One of the health indicators is the Self-Rated Health (SRH) which can evaluate health through one question. The use of this indicator is very easy and efficient therefore, it has become very common in health research. In this review, the biases and controversies in the interpretation of the SRH have been elaborated.

  Methods: In this narrative review, Medline and Iran-Med databanks were searched using self-rated or self reported health in the title in December 2013. The titles and abstracts of 1106 article were assessed and 106 articles were recognized as relevant articles. Some of the references of these articles were assessed and 16 articles were added to the list of relevant articles.

  Results: There are different types of the SRH questions five or seven item questions, and comparative or non-comparative ones. However, the findings of these types of questions are similar and none is preferred over the others in the literature. On the other hand, the validity of this indicator is not similar in different socio-economic and ethnic groups. Thus, the estimated health difference between these groups is rated with bias.

  Conclusion: T his question still works in the research and clinical setting evaluations. The main point is paying attention to the socio-economic and cultural status of the study groups in SRH interpretation.

Background and Objectives: Brucellosis is a zoonosis disease that is important in humans and animals. Since the disease is important in ranchers and veterinarians, we conducted this study to estimate the seroprevalence of the infection in these groups in Kerman.

Methods: In this descriptive and analytical cross-sectional study, 187 industrial and semi-industrial dairy personnel and veterinary network staff of Kerman in 2012 were recruited. Rose Bengal, Wright and 2-Mercaptoethanol were done on serum samples. Demographic and occupational characteristics of the participants were recorded. Data was analyzed using descriptive statistics and Poisson regression via the Stata software. Results: The prevalence of brucellosis was 3.2%. In this study, the history of brucellosis in the family, working in the veterinary network, and working in semi-industrial versus industrial dairy farms were the risk factors of the disease.

Conclusion: Although the prevalence of the infection was lower than other studies, it was still considerable in these groups therefore, it is necessary to improve preventive measures in these groups.

  Background and Objectives : Various studies have reported different survival rates of patients with gastric cancer in Iran, and there is no overall estimate of the survival rate. The aim of this study was to conduct a meta-analysis of one, three, and five-year survival rate of patients with gastric cancer in Iran.

  Methods: In this study, all of the national databases including Iran Medex, Magiran, SID, and Medlib and the English databases including Google Scholar and PubMed were searched by using the keywords “stomach cancer”, “survival rate” and other Persian and English synonymous keywords, in the period 1392-1339 . Then, all articles with inclusion criteria and acceptable quality were investigated. Der Simonian and Laird random effects models were used to combine the results of all studies. Other analyses including subgroup analysis, sensitivity analysis, and assessment of publication bias were performed by using the funnel plot, and Beg’s and Egger’s tests. Finally, the data was analyzed using STATA software.

  Results: Of the 235 articles found in the initial search, nine studies were eligible for this study. According to these studies, one, three and five-years survival rate of patients with gastric cancer was 0.57 (95% CI: 0.45-0.70), 0.29 (95% CI: 0.22-0.37), 0.17 (95% CI: 0.13-0.21), respectively.

  Conclusion : Researches conducted in different parts of Iran are limited and there are no exact statistics on the survival rate in other parts of Iran. Therefore, further studies in the whole country are required to obtain more precise estimates of the survival and factors affecting it.

Background & Objectives: In the analysis of mortality trend in the Iran that is basically a sequences of observations sorted by time, there is a point where the statistical properties of the mortality trend change so that the first k₀ observations have a distribution of F₀ and other n-k₀ observations have a distribution of F₁. The point k₀ is unknown and called the change point. The aim of this paper was to detect the location of the change point and estimate it in the real mortality data of the country.

Methods: In this study, X_t indicated the number of mortality in time t (year) and because of the numeric nature of the variable, we considered the Poisson model for the variable X_t.

We assumed in early years (t0), X_t had a Poisson distribution with a mean of ʎ₀ and for later years (t>k₀), X_t had a Poisson distribution with a mean of ʎ₁ .In theory, we used the MIC method, a modification of the SIC method. For detecting more than one change point, we used the binary segmentation process in the mortality trend.

Results: The results showed that the change point occurred in 1993 and 1997.

Conclusion: The finding of this study showed three periods with different rates in the mortality trend of Iran.

Background & Objectives: To adopt appropriate policies and strategies to maintain, preserve, and promote health, accurate information and indicators are required. In this study, the years of life lost due to premature death, which is considered one of the indicators of prioritization of health problems, was calculated and compared with other countries.

Methods: This study was an applied cross-sectional investigation. We use death registry data of the Province of Qazvin and population estimation from the Statistical Center of Iran from 2004- 2008 and a standard life table. We calculated YLL and YLL rates by age, sex and cause of death.

Results: The leading cause of YLL (premature death) in different age groups in the years 2004-2008 (based on ICD10) showed that the most common causes of death in the neonatal period were perinatal disorders, congenital anomalies, and chromosomal disorders. The leading causes of death in the age group 5-14 years were unintentional injuries and in the age group 15-49 years were unintentional injuries and cardiovascular diseases. The main causes of death in the age group 50-64 years were cardiovascular diseases, cancer, and unintentional injuries.

Conclusion: The leading causes of premature death in the Province of Ghazvin were unintentional injuries, cardiovascular diseases, perinatal disorders, and cancers. Several causes are preventable by lifestyle modifications such as reducing the tobacco use, increasing physical activity, and reducing stress.

  Background & Objectives : Children who work or live on the street are one of key populations at risk for HIV and hard to reach for study or providing services. Here, as a methodological paper, we present the methods and steps of a rapid assessment and response (RARE) project conducted among street children in Tehran.

  Methods : We applied a mixture of qualitative (literature review, focus group discussion, in-depth interview) and quantitative (structure interview) methods to collect data from key informants in non-governmental and governmental agencies as well as street children. We applied targeted sampling to recruit key informants and time location sampling to recruit street children.

 Results: The study was conducted in eight steps to recognize the involved stakeholders, define target population (street children) and to guide on how to approach them (steps 1 to 2: Initial Consultation, Study Area Profile), to map the venues and gathering spots and ethnographic findings crucial for further recruitment into surveys (steps 3 to 5: Contextual Assessment, Population and Setting Assessment, Health Issues Assessment), assess the risk behaviors (step 6: Assessment Behavior Risk and Health), evaluate the response (step 7: Intervention Assessment), and develop an operational plan for improving the services (step 8: Developing an Action Plan).

  Conclusion: RARE is a participatory mix research method with sufficient flexibility to study complex health problems such as stigmatized HIV risk behaviors among high risk and hard to reach populations and also to assess the health sector response.

  Background & Objectives : Gastric cancer has a low survival and remains a serious threat to the health of human life, especially in developing countries such as Iran. The present study was performed to estimate the main effective factors in the survival rate of patients with gastric cancer in the Province of Kohgilouyeh & Boyerahmad.

  Methods: All cases of gastric cancer in Kohgiloyeh and Boyerahmad recorded in Provinces of Fars and Kohgiloyeh and Boyerahmad cancer registry were enrolled in this study. The impact of the independent variables on the survival was estimated by single and multivariate Cox regression controlled for the probable confounding variables. Survival analysis was performed using Kaplan Meier curves, the log-rank test, and Wilcoxon test to compare the results. Analysis of the data was performed by SPSS 19, and P-values less than 0.05 were considered significant.

 Results: Among the 348 studied patients, 75.6% were male and the rest (24.4%) were female. In general, in this study, 1, 2, 3, 4, and 5-year survival rate of the patients was 37, 27, 20, 19, and 18%, respectively. By combining these end variables in regression models, three risk groups were identified. In the high risk group, the cumulative survival rate was 0% at the end of the fifth year.

 Conclusion: Execution of the down-staging program through public education, considering the low survival rate in this province seems essential especially for high-risk groups such as farmers, ranchers and regional nomadic populations.

  Background & Objectives: This study examined the prevalence of behavioral disorders in middle and high school students in the Province of Qom.

  Methods: A cross-sectional descriptive design was employed to investigate 762 students (382 middle and 380 high school students) who were selected through a multi-stage cluster sampling method. Data collection was performed suing the Woodworth Personal Data Sheet (WPDS), and the data were analyzed using descriptive statistics and chi-square test.

  Results: The finding showed that the prevalence of behavioral problems in the total sample, and middle and high school students was 19.82, 22.72, and 17.1%, respectively. The prevalence of behavioral problems was higher in boys versus girls, is the middle school versus the high school, and in urban areas versus rural areas. The aggressive disorder and obsessive-compulsive disorder – Psychasthenia had the highest and lowest prevalence in both the middle and high school students, respectively. The educational level of students, parental education, parental divorce, parental death, and family income had significant relationships with behavioral disorders.

  Conclusion: The prevalence of behavioral problems in the Province of Qom was found to be in the middle range in comparison with other studies conducted within and outside the country. However, attention should be paid to mental health policy-making in adolescents to decrease behavioral problems and prevent future issues.