Showing 24 results for Mar
L Manavifar, H Nemati Karimooy , A Nejat Shokuhi , A Sheerdel , M Shakeri , M Mahjoob ,
Volume 5, Issue 2 (9-2009)
Abstract
Background and Objectives: Incidence of neurocognitive and psychologic disorders in elderly seems to become high There are numerous factors affecting neurocognitive functions like vascular factors, Vitamin B12 and folate and homocysteine levels. The aim of this study was to assess the relation between neurocognitive- psychologic markers and homocystein (Hcy), V.B12 (Cobalamin) and folate in serum.
Methods: Two hundred eighty elderly people admitted to Emam Reza Teaching Hospital in Mashahd, Iran. neurocognitive-psychologic disorders was diagnosed by a trained physician. Serum cobalamin, folate and homocystein measured by RIAand ELIZA methods, respectively.
Results: Based on Hcy>15 µmol/l level, cut off point <330 pg/ml for serum cobalamin and <6.5 ng/ml for folate deficiency defined as deficiency. The correlation between cobalamin and folate was statistically significant (p=0.000). Hemocystein correlated inversely to cobalamin (p=0.001) and folate (p=0.044). There were no statistical significant between Cobalamin, Folate and Hcv>15µmol/l and neurocognitive & psychologic markers unless Deep Tendon reflex test (P=0.04). All patients with dementia had hyperhemocysteinemia.
Conclusions: Despite the plausible biochemical mechanism, further diagnostic studies, based on clinical, neuropsychological, laboratory features will be necessary to better understand this fascinating biochemical challenge.
F Rajati, K Kamali, S Parvizy,
Volume 7, Issue 2 (9-2011)
Abstract
Background & Objectives: Custom-orienting is a critical issue for public health service. Peoples with a variety of developmental health care needs and perspectives are health care clients. Health accessibility through “Primary health care” has been approved and emphasized in Alma Ata in 1978. It is important to have a clear and transparent understanding of clients’ health needs and problems that would enable us to address such needs and prevent the negative consequences that might otherwise ensue. The aim of this study was to understand and gain deeper insight into health service customers’ lived experience of public health accessibility.
Methods: This study has been conducted with a phenomenological approach. Max van Manen six steps method of hermeneutic-phenomenology has been used. Nine health care clients were selected purposefully and interviewed semi-structured.
Results: The results of this experiment revealed the following six themes: to encounter with holistic learning chance, custom-oriented communications, qualified health care service, appropriate time-place health services, equality- orienting, and individual participation.
Conclusion: The participants believed that health accessibility is something more than just to have health services. Therefore, health education and social equality will bring about optimum health services. To develop multi-dimensional learning and to promote individual participation will be useful for more community empowerment.
R Rafat, Ar Dorosty, Mr Eshragian, A Rezazadeh,
Volume 7, Issue 3 (12-2011)
Abstract
Background & Objectives: Increasing in prevalence of juvenile myopia in recent decades in eastern and western countries, especially in urban elementary school children, suggests that changing in early life style may play an important role in development of myopia. Our aim was to determine the relationships between myopia and overweight in elementary school children of Eslamshahr a city near Tehran, Iran
Methods: In a case control study, 240 new myopic primary school children (grade 2-4) identified as cases and 240 children without myopia in the same schools enrolled as control group.
Anthropometric information was completed from schools’. Other information about pre-entrancing to school was collected by interviewing their parents. Children having a Body mass index BMI>=85th CDC2000 percentile were identified as overweight. Adjusted odds ratio for overweight was estimated after adjusting other potential risk factors.
Results:
Of total 53.3% were girls. 23.8% of children in case group and 10.1% of them in control group were categorized in overweight group. After adjusting for other potential risk factors (family history, breast milk intake, near works, mother`s job and financial position) being overweight was independently associated to myopia
(OR: 3.10, 95% CI: 1.9-5.03).
Conclusion: It is concluded that overweight in children in preschool age, is independently associated with increased risk of myopia in primary school children. Therefore health promotion programs in order to change of the life style in this group of children should be considered.
M Payab, Ar Dorostymotlagh, Mr Eshraghian, R Rostami, F Siassi, M Ahmadi,
Volume 8, Issue 1 (7-2012)
Abstract
Background & Objectives: Food insecurity has been a global concern. The purpose
of the present study was to examine the relationship between household food
insecurity and depression in mothers with school children in Ray city.
Methods: A cross-sectional survey of 430 mothers of school children was
conducted in 2010 in Ray city. We employed USDA food security questionnaire.
The prevalence of depression in mothers was assessed by Beck Depression
Inventory (DBI).
Results: Household food insecurity was identified approximately in fifty
percent of participants and frequency of depression was 51.4% in mothers.
Depression in ‘food secure' group was 34.6%, and in ‘food insecure with hunger'
group was 77.8%. There was a positive relationship between depression and food
insecurity in mothers having primary school children living in Ray.
Conclusion: The
findings of this study revealed that level of food insecurity among mothers
seems high. This study highlights the need to integrate programs addressing
food insecurity and poor mental health for mothers.
Normal
A Nassi, M Mehrabizade Honarmand, M Shehni Yailagh, S Bassaknejad, A Talebpour,
Volume 8, Issue 3 (12-2012)
Abstract
Background & Objectives: One of the most common anxiety disorders in children is separation anxiety disorder (SAD). The purpose of the present study was to investigate the epidemiology of separation anxiety disorder in Isfahan primary school male student.
Methods: The present study was a descriptive study. The statistical population was all the male students from 7 to 9 years old, studying in second and third grades in primary schools of Isfahan. The sample of study consisted of 1514 male student, who were selected randomly by multi-stage sampling method. The instruments of this study consisted of the Separation Anxiety Disorder Scale, Spence Children's Anxiety Scale and Clinical Interview.
Data obtained were analyzed by using descriptive statistics and chi-square and logistic regression.
Results: The findings showed that the rate of separation anxiety disorder in male (7 to 9 year- old student) was %6/93. SAD were more common in 7 years old (7.4%). Children having record of hospitalization, immigration, single-parent households and close relatives of mortality had a higher rate of separation anxiety disorder.
Conclusion: This study shows that separation anxiety disorder among primary school male students is significantly high. Therefore it is important to consider the potential utility of early anxiety prevention/intervention programs, especially for children at this age group.
M Jahani, J Rezaenoor, E Hadavandi, I Salehi, H Tahsini,
Volume 11, Issue 2 (9-2015)
Abstract
Background & Objectives: In recent years, different decision support systems (DSS) have been used to predict and diagnose diseases. The purpose of this paper was to compare some DSSs and to evaluate their accuracy in predicting diabetes.
Methods: In this research, determination and optimization of the weights of the neural network were undertaken using genetic algorithm and Levenberg-Marquardt (GALM). Traditional and K-Fold Cross Validation were used to verify the models. Finally, the proposed model (i.e. GALM) was compared using logistic regression and genetic algorithm based on area under curve (AUC), and Confusion Matrix.
Results: After evaluating the results, the model based on the GALM algorithm showed better sensitivity and specificity in comparison with models based on the logistic regression (LR) and genetic algorithm (GA). Furthermore, among other models, the proposed model had a high sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and a small negative likelihood.
Conclusion: The results showed that the GALM model with a sensitivity, specificity, PPV, NPV, and AUC of 98.7, 90.01, 91.8, 98.3 and 0.979 respectively was an appropriate model for predicting diabetes in comparison with models of GA and LR.
N Vahabi, F Zayeri, E Fazeli Moghadam , M Safari, F Ebrahimzadeh,
Volume 11, Issue 3 (11-2015)
Abstract
Background and Objectives: Disorders of height and weight growth are the most important health disorders affecting children younger than two in developing societies. Failure to treat these disorders can lead to the increased mortality and mental, emotional or physical disability. The objective of this study was to investigate the growth trends of children and the factors affecting it.
Methods: This retrospective cohort study was conducted on 2030 children younger than two in Khorramabad, Iran who were selected using stratified and cluster sampling. Based on household records, the weight growth trend was recorded as a four-level variable (decline, stagnation, slowness and desirable) and the the height growth trend was recorded as a three-level variable (stagnation, slowness and desirable); finally, the data were modeled using a longitudinal marginal model and the SAS software version 9.2.
Results: The incidence of at least one decline in the weight growth curve and one stagnation in the height growth curve was 14.2% and 10.4%, respectively. The child’s age and the maternal educational level had a significant effect on the growth trends. However, the sex, parity and the exclusive breastfeeding during the first six months had no significant relationship with the growth trends.
Conclusion: Given the results and the relatively high prevalence of growth disorders among children, it seems that increasing the awareness of low literate women about feeding of the children is the most important approach to manage growth disorders. Additionally, health-care professionals should mostly focus on monitoring the growth of children older than 12 months.
S Masoudi, F Pourdanesh, A Biglarian, M Rahgozar,
Volume 11, Issue 4 (3-2016)
Abstract
Background and Objectives: The aim of this study was to analyze the risks of local recurrence, second primary tumor, and metastasis in oral squamous cell carcinoma (OSCC) patients and to present their prognosis after treatment.
Methods: In this retrospective cohort study, 147 patients with oral squamous cell carcinoma (OSCC) who were older than 40 years were included using the data of 1973–2010 Surveillance, Epidemiology, and End Results (SEER) Program in the United States. The variables included gender, race, stage, histologic grade, tumor site, treatment modalities, and dates of diagnosis and death. Markov Multistate model was used for analysis.
Results: At a median follow-up of 33 months, local recurrence, second primary tumor, and distant metastasis rates were 34.01%, 85.03%, and 17.01% respectively and 40.13% of the patients died. Patients with cervical lymph nodes were at risk of second primary tumor 1.37 (1.05-2.05) times higher than early stage patients and were 2.33 (1.29-4.18) times more likely to die. After one year, the risk of death for patients with local recurrence or second primary tumor was almost similar but after 5 years, the risk of death was higher for local recurrence than second primary tumor.
Conclusion: Awareness of the next state and its time with respect to the patient’s clinical status can be one of the appropriate methods for timely diagnosis and treatment to reduce the mortality rate of OSCC patients.
A Bagheri, Hb Razeghi Nasrabad , M Saadati,
Volume 13, Issue 2 (9-2017)
Abstract
Background and Objectives: Changes in ideals and aspirations of childbearing are important factors in fertility behavior. Nowadays, fertility rate reduction below the replacement level and decreased childbearing ideals are the most common fertility challenges in Iran. So, with the decrease in the fertility rate, it is necessary to be aware of the ideal number of children and its determinants in order to adopt suitable population policies contexts. The main objective of this study was to investigate factors affecting the ideal number of children using Poisson regression model.
Methods: In 2012, 389 ever married women aged 15-49 in Semnan Province were selected using two-phase stratified random sampling method and studied through applying a structured questionnaire. To model the ideal number of children by Poisson regression model, marriage duration has taken as offset and the number of children, job status, education level, marriage type, and resident place were considered as predictors. The model was fitted with SPSS software version 22.
Results: All predictors in this study had significant effects on ideal number of children in Semnan (p-value <0.05). Women’s ideal number of children who had 2 or fewer children, were employed, and had university education with consanguineous and rural marriage was higher than those who had 3 and more children, were unemployed, and had elementary and secondary education with inter-family and urban marriage.
Conclusion: To model the ideal number of children, since it is discrete and count, a Poisson regression model is more efficient as compared to linear regression model.
M Parvareh, Gh Moradi, B Nouri, F Farzadfar, N Rezaei,
Volume 13, Issue 3 (12-2017)
Abstract
Background and Objectives:In order to determine the workload of health workers(Behvarz), this research was conducted for work measurement and time assessment in rural health centers(health house).
Methods: This cross sectional study was conducted in 30 health centers during a routine working day in Saghez in 2015 using the “stop watch method”. The time and frequency of the processes were recorded in a checklist. We estimated and compared spent, standard, expected and pessimistic time, and also the mean repetition for each process per day and month as the unit of time.
Results: The mean real working time was about 157.5 minutes (33%) per day, which was mostly (35.5 minutes) spent on the affairs of health volunteers. Care for non-communicable diseases was the most frequent task with an average of 2.4 times per day. In a month, family planning was undertaken more than other processes. The time of most activities like mother care, elderly care, care for communicable and non-communicable disease was significantly lower than the expected and pessimistic times (P<0.05).
Conclusion: The time spent by health workers was low and unscheduled, particularly for important activities of primary health care. It seems that it is necessary to revise the models and methods of service provision in health centers. Efficient use of existing personnel, reducing unnecessary activities and adding more service packages according to the health system priority seem to be important requirements in the first level of health system.
N , , , , H Poustchi, M Yaseri,
Volume 13, Issue 4 (3-2018)
Abstract
One of the traditional methods used for the analysis of survival data is the Cox regression technique. This method calculates the conditional risk ratio. However, when the aim of the study is to estimate the effect of exposure in the total population level, using these conditional methods is not apposite. Furthermore, the hazard ratio has disadvantages of its own such as being non-collapsible, having the risk of structural selection bias and variability in time. Given the limitations, it is recommended to use the marginal hazard ratio, which estimates the average causal effect of exposure in the total population level.
This study introduces the inverse probability treatment weighting (IPTW) as a method of estimating the marginal causal effect. Finally, to illustrate IPTW method, we used Golestan Cohort Study and estimated the marginal causal effect of smoking on time to death due to the upper gastrointestinal cancer (esophageal-gastric).
S Ghorbani Gholiabad , M Sadeghifar, R Ghorbani Gholiabad , O Hamidi,
Volume 14, Issue 1 (6-2018)
Abstract
Background and Objectives: Delivery is one of the most important services in the health systems, and increasing its effectiveness and efficiency are a health priorities. The aim of this study was to forecast the number of deliveries in order to design plans for using all facilities to provide patients with better services.
Methods: The data used in this study were the number of deliveries per month in Hakim Jorjani Hospital, Gorgan, Iran during the years 2010 to 2016. Due to the over-dispersion of the data and non-compliance with a Poisson distribution, the Poisson hidden Markov model was applied to predict the frequency of monthly deliveries. The model parameters were estimated using the maximum likelihood method and expectation maximization algorithm.
Results: The use of the Akaike criteria revealed the frequency of delivery in different months in the hospital followed a Poisson hidden Markov models with three hidden states, and the mean Poisson distribution in each component was 193.74, 236.05, and 272.61 labors, respectively.
Conclusion: The results of this study showed that government’s encouraging policies have had short-term, limited effects on increasing fertility with minimal effects on the results of the two-year forecast.
M Safari, M Sadeghifar, Gh Roshanaei , A Zahiri,
Volume 14, Issue 2 (9-2018)
Abstract
Background and Objectives: Tuberculosis is a chronic bacterial disease and a major cause of morbidity and mortality. It is caused by a Mycobacterium tuberculosis. Awareness of the incidence and number of new cases of the disease is valuable information for revising the implemented programs and development indicators. time series and regression are commonly used models for prediction but these methods require some assumptions. The purpose of this study was to predict new TB cases using the hidden Markov model which does not require many assumption.
Methods: The data used in this study was the monthly number of new TB cases during 2006-2016 identified and recorded in Hamedan Province. Rorecasting the number of new TB cases was done using hidden Markov models using the hidden Markov package in the R software.
Results: According to the AIC and BIC criterion, two states had the best fit to the data, i.e. the data of this study were a mixture of two Poisson distributions with average number of event 5.96 and 10.2 respectively. The results also predicted the number of new cases over the next 24 months based on the hidden Markov model would be between 8 and 9 new cases in each month.
Conclusion: The hidden Markov model is the best model for prediction using the Markov chain. This model, in addition to detection of an appropriate model for the available data, can determine the transition probability matrix, which can help physicians predict the future state of the disease and take preventive measures befor reaching advanced stages.
M Chehrazi, R Omani Samani , E Tehraninejad, H Chehrazi, A Arabipoor,
Volume 14, Issue 4 (3-2019)
Abstract
Background and Objectives: Analysis of ordinal data outcomes could lead to bias estimates and large variance in sparse one. The objective of this study is to compare parameter estimates of an ordinal regression model under maximum likelihood and Bayesian framework with generalized Gibbs sampling. The models were used to analyze ovarian hyperstimulation syndrome data.
Methods: This study used the data from 138 patients of a clinical trial phase III to compare the efficacy of intravenous Albumin and Cabergoline in prevention of ovarian hyperstimulation syndrome. The original study was done between 2010 to 2011 in Royan institute. We compared maximum likelihood and Bayesian estimation with generalized Gibbs sampling for an ordinal regression model based on confidence intervals and standard errors. The model were fit through R 3.3.2 software version.
Results: Markov Chain Monte Carlo results reduced the standard errors for estimates and consequently, narrower confidence intervals. Autocorrelations for generalized Gibbs sampler reached to zero in compare to standard Gibbs sampler for shorter time.
Conclusion: It seems that confidence intervals of an ordinal regression model are shorter for generalized Gibbs sampler in compare to standard Gibbs and maximum likelihood. It suggests doing more studies to warrant the results.
E Ghaderi, M Nasehi, J Hasanzadeh, Ho Barati, Taheri Sh, M Gholami, Mr Bazrafshan, R Taghizadeh Asl , M Shams,
Volume 15, Issue 2 (9-2019)
Abstract
Background and Objectives: Social marketing is a method that acts through identifying the needs and demands of the audience and specifying the components of the behavioral market using the results of developmental research. So far, social marketing has not been used to involve the private sector in the tuberculosis (TB) control program. The aim of this study was to design a Public-Private Mix (PPM) program using social marketing.
Methods: This qualitative study was conducted using focused group discussions (FGD) with six different groups, including tuberculosis coordinator physicians, specialists from different fields in the private section, and managers of selected private laboratories and hospitals in Karaj in 2013 and the components of the PPM program were determined according to the results of the qualitative study.
Results: Most of the participants believed that participation of the private sector in the TB program was associated with significant challenges, including the lack of a well-defined process for communicating with the private sector, lack of a suitable platform, lack of appropriate monitoring tools, private sector’s lack of compliance, private sector’s lack of familiarity with national TB program protocols, lack of appropriate incentive and punitive measures, lack of appropriate feedback to the private sector, and monopoly in laboratories.
Conclusion: To run PPM in the TB program, it is necessary to involve laboratories in the program voluntarily. It is also essential to provide an informational and incentive package containing effective and low-volume tutorials; the package should facilitate feedback and promote respect for the private sector.
E Ghaderi, J Hassanzadeh, A Rezaianzadeh, M Nasehi, H Barati, Mr Bazrafshan , F Mazooji, M Ghorbanian, N Ghavidel, S Razi,
Volume 16, Issue 3 (11-2020)
Abstract
Background and Objectives: A great number of tuberculosis (TB) patients present to the private sector to receive care; therefore, integrating TB control programs into private sector activities can enhance the control of TB. The Public-Private Mix (PPM) program is suggested by the World Health Organization to engage the private sector in TB control programs. In this study, a plan designed for PPM was piloted Karaj, Alborz Province, Iran.
Methods: In this community trial, pre-intervention assessment covered 18 months prior to the study. The intervention was a PPM package that was integrated into the health system by Karaj County Health Center. Then, three-month post-intervention data were collected. Analysis was performed with the SPSS 16 software using chi-square test.
Results: After the intervention, there was an increase of 40.7% in suspected cases of TB per month and an increase of 101.7% in smear positive TB cases diagnosed by Karaj laboratories. The ratio of smear positive cases to all suspected TB patients was 4.57% before and 6.56% after the intervention. The percentage of three sputum sample positive patients was 75.5% and 89.9% before and after the intervention, respectively.
Conclusion: The developed PPM program markedly improved the case detection; therefore, it is suggested to fix the potential defects of the program and implement it in all parts of the country.
Samaneh Dehghani, Masud Yunesian,
Volume 19, Issue 4 (3-2024)
Abstract
Microplastics refer to plastic particles and fragments smaller than 5 millimeters in various forms, derived from the breakdown of larger plastics or initially introduced into the environment from the primary constituent particles of plastic. The exact date of the emergence of microplastics in the environment is not precisely known, but it certainly predates the naming of these particles (2004). These particles can enter the bodies of living organisms, including humans, primarily through ingestion and inhalation. Their effects on the body depend on their size, chemical composition, and the composition of substances that later absorb these particles. In this article, we will first briefly examine the classification of these particles in terms of chemical composition and their origins, and then review some evidence of their presence in biological tissues and fluids. Given the increasing production and use of plastics in human life and the fact that most microplastics in nature derive from the breakdown of larger plastics, sometimes several years after their disposal, it is expected that even if plastic production decreases or stops, we will continue to see an increase in their presence in nature for years and decades, leading to human exposure to these compounds (whose effects and consequences of this exposure are not yet fully understood).
Ali Alami, Hassan Eshaghiyan Farimani, Farnaz Sharifi Mood,
Volume 20, Issue 3 (12-2024)
Abstract
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.
Fatemeh Gorji, Abolghasem Pourreza, Masud Yunesian, Simin Zahra Mohebi, Mahnaz Ashourkhani,
Volume 21, Issue 2 (9-2025)
Abstract
Background and Objectives: Timely use of dental services in early childhood plays an essential role in maintaining the health of primary teeth and preventing complications related to jaw development, nutrition, speech, and mental well-being. Regular dental visits help prevent early childhood caries and its consequences. This study aimed to evaluate factors influencing the use of dental services for primary teeth from parents’ perspectives, based on Andersen’s Behavioral Model.
Methods: This descriptive-analytical cross-sectional study was conducted in 2023 among 395 parents of children under six attending health centers in Semnan, Iran. Participants were selected using simple random sampling. Data were collected online via the Hackey questionnaire and analyzed using SPSS version 26 applying Chi-square tests and logistic regression.
Results: A minority of parents were aware of the appropriate timing for the first dental visit. Forty-five percent sought care only when problems occurred, while 36% attended regular check-ups. Overall, 62% reported moderate to good financial status, and 82% had basic insurance coverage. Key determinants of dental attendance included maternal education, service accessibility, insurance coverage, health information sources, and the characteristics of the healthcare providers as an educator. Larger family size and negative experiences with healthcare staff were associated with reduced utilization.
Conclusion: Interventions at individual and structural levels are needed to promote regular pediatric dental visits. Enhancing parental awareness, involving influential health personnel, expanding dental insurance, and fostering positive provider–parent interactions are recommended.
Parisa Amjadi Zin Hajloo, Mohammad Heidari,
Volume 21, Issue 4 (3-2026)
Abstract
Missing data is a common and unavoidable challenge in medical and epidemiological research, often leading to biased estimates, reduced statistical power, and misleading interpretations when not properly addressed. Despite its importance, accessible and practical educational resources on this topic remain limited in Persian. This educational article provides a clear and structured overview of the fundamental concepts of missing data, including definitions, common patterns (univariate and multivariate), and the three major mechanisms of missingness: MCAR, MAR, and MNAR. A range of widely used approaches for handling missing data is summarized, from basic methods such as case deletion and simple imputation to more advanced techniques including multiple imputation and likelihood-based procedures (EM and MLE). Practical examples and visual illustrations are incorporated to facilitate conceptual understanding. The ultimate goal of this article is to provide a practical framework for researchers and students, enabling them to select the appropriate approach for dealing with missing data in the design and analysis of their research and to prevent analytical errors.
