Showing 7 results for Kap
K Holakouie Naeini, A Moradi, F Pourmalek, S.r Majdzadeh,
Volume 1, Issue 1 (12-2005)
Abstract
Background and Objectives: The campaign to eliminate measles and rubella (MR) is one of the most important current health projects in Iran. One of the basic requirements of this program is the creation of an efficient system for collecting data on MR morbidity and mortality, people's knowledge, attitude and practice (KAP) regarding MR prevention, and people's participation in the eradication drive. The present study was done to assess people's knowledge, attitude and practice in relation to the current anti-MR campaign.
Materials and Methods: This cross- sectional study was carried out fur months after the mass (anti-MR campaign (performed in May 2004). The target population included at the people aged 20-25y who lived in areas covered by Tehran University of Medical Sciences and Health Services. The calculated sample size was 384, using a 2-stage sampling procedure. We used X2 tests, odds ratios and confidence intervals to detect relationships between various categorical variables. We also performed Cronbach's alpha test to assess questionnaire reliability, and principal component analysis to ensure construct validity.
Results: Data were collected on 390 individuals. The percentages of people with an acceptable level of knowledge, attitude and practice were 63.3%, 53.6% and 93.1% respectively. After controlling for confounders in a logistic regression model, it became apparent that knowledge concerning the mass immunization campaign was related to the individual's own education and that of his/her mother. Attitude was found to be affected by factors such as education, marital status and the family's main income level. The practice component, on the other hand, was not significantly related to any of the variables included in this study.
Conclusion: The positive achievements of this program should be used in planning any future immunization campaigns. Particular attention should be paid to factors that affect overall coverage. These include human resources, equipment, vaccines and other materials, service uality, the cold chain, information provided to the public, and people's as well as providers' knowledge of the immunization program, the target diseases (s) and the vaccines.
B Moghimi Dehkordi, A Rajaeefard, Hr Tabatabaee, B Zeighami, A Safaee, Z Tabeie,
Volume 3, Issue 1 (9-2007)
Abstract
Background & Objectives: Cancer has been traditionally regarded as a fatal disease it is a major public health problem in many countries throughout the world. In recent years, cancer morbidity and mortality has increased in our country and notably stomach cancer now ranks second or third among all cancers types with regard to morbidity.
Methods: Our study included all gastric cancer patients registered in the cancer registry of Fars province. The patients' survival status was followed using phone calls and death records from hospitals, other medical centers, and the city's cemetery. Data analysis involved the use of the nonparametric Kaplan-Meier and Cox proportional hazards models and was performed with the software package SPSS V.13.
Results: Of the 442 patients with gastric cancer, 303 cases (68.6 percents) were male, and the mean age of patients was 58.41 years (SD=14.46). In univariate analysis with the KM method, a statistically significant association was found between survival rates and the following factors: age at diagnosis (P<0.001), tumor grade (P=0.009), presence of metastases (P<0.001), and type of the initial treatment (P=<0.001). Factors without a significant relationship with the survival rate included sex, ethnicity, weight, BMI, tobacco use, history of cancer in close or distant relatives, place of residence, number of children, marital status, occupation, and income. In Cox regression, only age at diagnosis, tumor grade, and the presence of metastases showed a significant association with survival rates.
Conclusions: Our results imply that early detection of cancer at a lower age and in lower tumor grades could be important for increasing the patients' life expectancy.
H Jamali, N Khanjani, M Fararouei, Z Parisae, M Chorami,
Volume 11, Issue 1 (6-2015)
Abstract
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.
A Afshari Safavi , H Kazemzadeh Gharechobogh , M Rezaei,
Volume 11, Issue 3 (11-2015)
Abstract
Background and Objectives: Missing data is a big challenge in the research. According to the type of the study and of the variables, different ways have been proposed to work with these data. This study compared five popular imputation approaches in addressing missing data in the questionnaires.
Methods: In this study, 500 questionnaires were used for self-medication in diabetic patients. Missing in the observations was artificially generated by random selection of questions and then deleting them. Five imputation ways included: 1) the mean of the questions, 2) the mean of the person, 3) the mode of the person, 4) linear regression, and 5) EM algorithm. For each method, the mean and standard deviation were compared with imputation. The Spearman correlation coefficient, the percentage of incorrectly classified and kappa statistic were also calculated.
Results: A kappa higher than 0.81 represented almost perfect agreement at 10% missingness. The EM algorithm showed the highest level of agreement with the results of actual data with a Kappa of 0.886. With increasing missingness to 30%, the EM algorithm and the mean of the person showed a rather similar agreement with a Kappa of 0.697 and 0.687, respectively.
Conclusion: In this study, the EM algorithm was the most accurate method for handling missing data in all models. The mean of the person method is easy for handling missing data, especially for most non statisticians.
S Kargarian Marvasti , J Abolghasemi, I Heydari , Sh Rimaz,
Volume 13, Issue 2 (9-2017)
Abstract
Background and Objectives: Neuropathy is a common complication of diabetes that can cause disability in diabetic patients. The aim of this study was to determine of effective factors in the Event Time of neuropathy in type 2 diabetic patients using the Cox proportional hazards model.
Methods: This study included 371 patients with type II diabetes without neuropathy who were registered at Fereydunshahr Diabetes Clinic. Subjects were followed up for the development of neuropathy between 2006 until March 2016. The data were analyzed using the R software (ver. 3.2.3). The test was conducted at an error level of 5%.
Results: At the end of 10 years of study, the cumulative incidence and prevalence of neuropathy was 30.7% and 41.6%, respectively. The Kaplan-Meier method showed the mean time to detection of neuropathy was 76.6 ± 5 months after the first diagnosis of diabetes (83.8 ± 8 in men and 72.7 ± 6 in women). The semi-parametric Cox regression model revealed the one-year, two-year, five-year, and eight-year disease-free survival was 0.867, 0.819, 0.647, and 0.527, respectively. Also, four variables of duration of diabetes, sex, family history of diabetes, and HbA1c can be considered as strong determinants of the time of development of neuropathy in the semi-parametric model (COX) (P<0.05).
Conclusion: Optimal glycemic control and regular evaluation of legs in elderly patients, especially women with a positive family history, decrease the occurrence and progression of neuropathy and improve the quality of life in diabetic patients.
A Darvishi, S Emamgholipour Sefiddashti , M Rajabi, Mh Mehrolhassani, V Yazdi Feyzabadi,
Volume 17, Issue 1 (5-2021)
Abstract
Background and Objectives: Fair financial protection against health expenditures is one of the most critical goals of health systems. This study was conducted to investigate the most appropriate threshold for measuring the exposure to catastrophic health expenditure (CHE) in Iran.
Methods: The present study was conducted using 2018 national household income and expenditure data of the Iran statistics center. The occurrence and intensity of the households' exposure to CHE at different thresholds and for economic quintiles was measured using two World Health Organization (WHO) and World Bank (WB) methodologies. The most appropriate threshold for each methodology was also determined using the Kappa statistics adaptation estimation.
Results: The occurrence of households’ exposure to CHE was 3.02% and 8.51% in urban households and 4.66% and 9.22% in rural households, respectively. According to asset quintiles, the highest occurrence was in the first quintile and the lowest in the fifth quintile. In addition, the results of adaptation estimation based on Kappa statistics showed that a threshold of 40% in the WHO methodology and 25% in the WB methodology were the most appropriate thresholds.
Conclusion: The results showed a relatively high rate of exposure to CHE. CHE occurrence was also more in poorer households, and common thresholds were the most appropriate thresholds for estimating CHE.
Sadegh Kargarian-Marvasti , Malihe Hasannezhad , Jamile Abolghasemi,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: This study aimed to investigate the effective factors in the survival/hazard time of Covid-19 patients in three waves of epidemic.
Methods: All 880 Covid-19 patients were included in this prospective cohort study using the census method. Polymerase chain reaction was used to diagnose Covid-19. The survival status of these patients was followed up for 4 months. The analysis of this study was based on the time of infection in three epidemic waves in IRAN. To analyze the data, the Kaplan-Meier nonparametric approach and Cox proportional hazards regression model were used. Survival distributions were compared in three epidemic waves using the R software (version 3.6.2) (P<0.05).
Results: We diagnosed 880 positive case of Covid-19 using PCR test on 2269 susspected people who had respiratory symptomps. At the end of 1-year follow-up, cumulative incidence (risk) of Covid-19 was estimated 7%. Effective factors in the survival time of patients with Covid-19 based on Cox multivariate regression model were: 1- Age 2- Intensity of infection (Hospitalization) 3- Heart disease 4- Epidemic Wave and 5- Transmission mode of the disease (P <0.05). The Kaplan-Meier approach and log rank test (Mantel-Cox) showed a significant difference in the survival rate in three epidemic waves (P = 0.018).
Conclusion: Elderly patients, especially those with a history of heart disease, are at higher risk of death than other groups. In addition to regular screening, these patients will need active monitoring, especially at the time of hospitalization.
