Publications by authors named "Abbas Rahimiforoushani"

13 Publications

  • Page 1 of 1

Risk factors of death from flood: Findings of a systematic review.

J Environ Health Sci Eng 2020 Dec 24;18(2):1643-1653. Epub 2020 Jul 24.

Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Purpose: The number of flood disaster deaths has been on the rise in recent years. The current review investigated and categorized the risk factors of deaths from floods in parallel with preventive and control measures designed to minimize deaths from floods.

Methods: In a systematic review, International electronic databases including PubMed, Scopus, Web of Science, and Google Scholar were investigated for articles published in English language. In addition, Iranian databases including IranMedex, Irandoc, Magiran, and Scientific Information Database (SID) were investigated for studies published in Persian. ProQuest database was also searched for related theses. The studies were selected regardless their methods but based on the inclusion and exclusion criteria. The data were extracted, coded and prepared for further analysis. Finally, descriptive and thematic analyses were conducted.

Results: A total of 114 factors were identified and categorized into the following five category that can influence on flood death.: hazard related factors, and individual, environmental, socio-economic, and managerial categories.

Conclusions: The study identified many factors that affect flood deaths. The variety and the diverse nature of the factors necessitate appropriate interventions for removing or reducing the effects of the identified factors. More quantitative analytical studies are needed to confirm causal relationship between extracted factors and floods death.
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December 2020

Children Food and Nutrition Literacy - a New Challenge in Daily Health and Life, the New Solution: Using Intervention Mapping Model Through a Mixed Methods Protocol.

J Med Life 2020 Apr-Jun;13(2):175-182

Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Food and nutrition literacy is a fundamental and new idiom among health policymakers. Improving children's food and nutrition literacy is a fundamental task, and it requires detailed planning. The aim of this study is to design, implement, and evaluate a food and nutrition literacy promotion intervention in elementary school children based on the Intervention Mapping model. This is a sequential study to design, implement, and evaluate a food and nutrition literacy promotion intervention in elementary school children aged 10-12 years old in Baneh city (Kurdistan, Iran). The study has three sequential phases, six steps based on the Intervention Mapping model, and four sub-studies. The questionnaire was transformed and culturally adapted since it was previously built for the city of Tehran; the results of a population-based cross-sectional survey indicated that the score for understanding food and nutrition information of a sample of 390 students aged 10-12 was mostly moderate and low (90.3% of participants). Therefore, a qualitative study on how to fix existing barriers, and extract facilitators and the best methods of interventions for promoting food and nutrition literacy of participants was conducted. Finally, an interventional study within six months for two intervention and control groups of elementary children 10-12 years old was carried out. The findings of this research will be used to design interventions and strategies based on needs assessment for improving students' skills in food and nutrition literacy in all dimensions of food and nutrition literacy.
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September 2020

Conceptual definition and framework of climate change and dust storm adaptation: a qualitative study.

J Environ Health Sci Eng 2019 Dec 20;17(2):797-810. Epub 2019 Aug 20.

6Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Climate Change Adaptation (CCA) is a complex, multi-disciplinary, and culture-dependent concept. This study aims to explore a conceptual definition, the subjective framework of CCA including its domains, attributes, and consequences. The approach of qualitative conventional content analysis was considered for the explanation of the subjective concept, and at the same time as the collection process, data analysis was performed using Zhang and Wildemuth's method. The interview method was semi-structured and sampling was targeted and with maximum diversity. The interview was conducted with 22 qualified experts. The accuracy and validity of the data were ensured using Guba and Lincoln scientific accuracy criteria. Six main categories including "sustainability, productivity, stability, empowerment, transformation, and flexibility" were conceptualized in the theme of adaptation characteristics. "Sustainable development, life improvement, response coordination and integration, creativity and innovation, resilience promotion, vulnerability reduction, effective management, and independence" were the main categories in the theme of the adaptation consequences. According to the results, the following conceptual-functional definition can be presented for adaptation to climate change: "CCA refers to the ability of system instability, sustainability, empowerment, productivity, flexibility, and transformation to climate change through the optimal use of resources, resistance, and coping, capacity building and opportunity creation". This definition is conceptual, it means that includes the main features of climate-adaptation and is also functional that is, includes adaptation strategies for climate change.
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December 2019

A Comprehensive, Epidemiological and Ecological Descriptive Study on Vitamin D Status in Iran (308005 People, from 2009-2018).

Iran J Public Health 2019 Apr;48(4):644-654

Payvand Teb va Narmafzar Company (PTN), Tehran, Iran.

Background: Vitamin D is an essential substance for absorption of calcium and phosphorus from intestine so it is vital for muscles and skeletal development. Deficiency of this vitamin is pandemic. The vitamin D status depends on the different factors such as UV exposure, diet, and ecological features of living location, age and gender. The aim of this study was to describe the vitamin D level in different provinces of Iran and to investigate the association between vitamin D status and multiple variables.

Methods: We collected the serum 25(OH)D (Vitamin D) level data of 308,005 people referred to different laboratories from 30 provinces of Iran and organized them by each province, year, age, gender, precipitation, latitude and longitude, and humidity over 10 yr (2009-2018). Data were analyzed to find out the correlation between age, gender, longitude and latitude, humidity and sum of precipitation.

Results: West Azerbaijan had the highest level of vitamin D with a mean level of 33.24 and a standard deviation of 32.001, and North Khorasan had the lowest level with a mean level of 14.46 and a standard deviation of 8.980 among 30 provinces of Iran. The correlation between all studied variables (age, and gender, latitude and longitude, humidity, the sum of precipitation) was significant (<0.001).

Conclusion: The average total vitamin D level in Iran is 25.41 ng/ml, which is within the area of deficiency. Vitamin D is associated with age, and gender, latitude and longitude, humidity, the sum of precipitation. So changes in any of these variables can lead to vitamin D alteration.
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April 2019

Knowledge, attitude, and practice about malaria: Socio-demographic implications for malaria control in rural Ghana.

J Public Health Policy 2017 Nov;38(4):445-463

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Despite continuing international attention to malaria prevention, the disease remains a global public health problem. We investigated socio-demographic factors influencing knowledge, attitudes, and practices about malaria in rural Ghana. Our survey looked at 354 households. Mean knowledge score was higher among individuals with a history of volunteers having visited their households to educate them about malaria; families with 4-6 members; and males. Households with at least one under-five-aged child also had significantly higher knowledge scores. Households with at least one pregnant woman evinced a positive attitude towards malaria prevention. National malaria control strategies have achieved positive results in the fight against malaria. Nonetheless, multipronged community-based health strategies that integrate malaria programs and population growth control initiatives may be able to reach by 2030 the sustainable development goal of eliminating malaria.
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November 2017

Interventions for Prevention of Intimate Partner Violence Against Women in Humanitarian Settings: A Protocol for a Systematic Review.

PLoS Curr 2017 Jul 12;9. Epub 2017 Jul 12.

Department of Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.

Introduction: Humanitarian emergencies and the number of people who are adversely affected are increasing. In such emergencies, the vulnerability of women and girls to gender-based violence increases signifi-cantly and they often experience high levels of intimate partner violence (IPV). There are a limited number of interventions to reduce gender-based violence (GBV) and IPV in the contexts of humanitarian emergencies, and there is uncertainty about the effectiveness of these preventive interventions. This is the protocol for a systematic review that will synthesize the evidence on interventions for primary or secondary prevention of IPV in humanitarian settings, and assess the effect of existing types of IPV-related interventions in these settings.

Methods And Design: The PRISMA-P 2015 statement has been used to prepare this report. Studies published from January 2000 to January 2017 will be reviewed with no language limits. Any experimental, quasi-experimental, or controlled trials will be included. A combination of four key concepts, including "IPV" AND "population" AND "humanitarian setting" AND "intervention" will be used in the search and a variety of information sources will be used: (1) bibliographic databases; (2) special databases and grey literature; (3) and the reference lists of eligible studies. Two reviewers will independently screen articles, extract relevant data and assess study quality. Discrepancies will be resolved through consensus. Risk of bias will be assessed using the Cochrane Risk of Bias tool and the quality of evidence will be assessed using the CONSORT checklist. A narrative synthesis will be provided. If a sufficient number of studies are found, their results will be pooled using a random-effects meta-analysis. For dichotomous outcomes, summaries of intervention effects for each study will be provided by calculating risk ratios with 95% confidence interval. Standardized mean differences will be used for continuous outcomes.

Discussion: The review will be useful for IPV management policy and related planning. It will help researchers, policymakers and guideline developers with an interest in reducing violence against women among refugees, internally displaced persons (IDPs), and conflict-affected population.
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July 2017

Sperm Retrieval in Patients with Klinefelter Syndrome: A Skewed Regression Model Analysis.

Int J Fertil Steril 2017 Jul-Sep;11(2):117-122. Epub 2017 Feb 16.

Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

Background: The most common chromosomal abnormality due to non-obstructive azoospermia (NOA) is Klinefelter syndrome (KS) which occurs in 1-1.72 out of 500-1000 male infants. The probability of retrieving sperm as the outcome could be asymmetrically different between patients with and without KS, therefore logistic regression analysis is not a well-qualified test for this type of data. This study has been designed to evaluate skewed regression model analysis for data collected from microsurgical testicular sperm extraction (micro-TESE) among azoospermic patients with and without non-mosaic KS syndrome.

Materials And Methods: This cohort study compared the micro-TESE outcome between 134 men with classic KS and 537 men with NOA and normal karyotype who were referred to Royan Institute between 2009 and 2011. In addition to our main outcome, which was sperm retrieval, we also used logistic and skewed regression analyses to compare the following demographic and hormonal factors: age, level of follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone between the two groups.

Results: A comparison of the micro-TESE between the KS and control groups showed a success rate of 28.4% (38/134) for the KS group and 22.2% (119/537) for the control group. In the KS group, a significantly difference (P<0.001) existed between testosterone levels for the successful sperm retrieval group (3.4 ± 0.48 mg/mL) compared to the unsuccessful sperm retrieval group (2.33 ± 0.23 mg/mL). The index for quasi Akaike information criterion (QAIC) had a goodness of fit of 74 for the skewed model which was lower than logistic regression (QAIC=85).

Conclusion: According to the results, skewed regression is more efficient in estimating sperm retrieval success when the data from patients with KS are analyzed. This finding should be investigated by conducting additional studies with different data structures.
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February 2017

Determination of factors affecting relapse of vaginitis among reproductive-aged women: An experimental study.

Electron Physician 2017 Jan 25;9(1):3499-3507. Epub 2017 Jan 25.

Associated Professor, Department of Health Promotion and Health Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Vaginitis is a common problem for women, especially in reproductive-aged women. It is a worldwide health problem with many side effects but could be prevented by a health-promoting lifestyle related to vagina health. The aim of this study was to determine the factors affecting relapse of vaginitis.

Methods: In this experimental study, 350 reproductive-aged women with vaginitis were selected from 10 health centers in Kermanshah (Iran) during 2015 and were equally included in the intervention and control groups. To collect data, a researcher-created questionnaire, which included sociodemographic and health-promoting lifestyle questions, was used. The educational intervention was performed over 20 sessions, each lasting 25-35 minutes. An intervention group was educated by face-to-face education, pamphlets, phone contacts, text messages, and social media. Another group continued the routine clinic education and treatment without contacting the intervention group. Data were analyzed through chi-square and a logistics regression model using IBM-SPSS version 20.

Results: The results of the study indicated a significant relation between sociodemographic characteristics such as women and their husbands' literacy, job, family size, income, area for each member of family, tendency of pregnancy, body mass index (BMI), and caesarean experience (p<0.001) and vaginitis. In addition, significant relationships between health-promoting lifestyle dimensions and prevention of vaginitis were identified. Relapse after intervention in the intervention group was 27.7% and 72.3% in the control group. According to the logistic regression analysis, chance for relapse of vaginitis in the group that did not receive intervention was more than the same chance in the intervention group (OR=5.14).

Conclusion: Health-promoting lifestyle intervention influences prevention of vaginitis. Health-promoting lifestyle, literacy promotion, prevention of caesarian, and obesity are beneficial to improvement in lifestyle dimensions associated with vagina health could be implemented as a successful prevention method. Therefore, it seems that applying a health-promoting lifestyle is essential for a healthy vagina and prevention of vaginitis.
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January 2017

Standardization as a Tool for Causal Inference in Medical Research.

Arch Iran Med 2016 Sep;19(9):666-70

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, I. R. of Iran.

Traditional standardization methods have been used in medical research for a long time to standardize the effect of interest for one confounder such as age. Model-based standardization extension of these methods is used when we have more than one variable produces an effect which is the population average and has marginal causal interpretation. In this paper, we discuss the most traditional model-based standardization methods that are used to estimate the marginal causal effect of exposure. We applied these methods to data from Tehran Thyroid Study and estimated the standardized effect of exposure on outcome. Based on the simulation studies, covariate standardization is preferred except when 1) we have enough information about the mechanism of exposure or 2) the outcome is rare and exposure is frequent, so propensity score standardization is suggested.
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September 2016

Time Series Analysis of Meteorological Factors Influencing Malaria in South Eastern Iran.

J Arthropod Borne Dis 2016 Jun 5;10(2):222-36. Epub 2016 Jan 5.

Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: The Malaria Early Warning System is defined as the use of prognostic variables for predicting the occurrence of malaria epidemics several months in advance. The principal objective of this study was to provide a malaria prediction model by using meteorological variables and historical malaria morbidity data for malaria-endemic areas in south eastern Iran.

Methods: A total of 2002 locally transmitted microscopically confirmed malaria cases, which occurred in the Minab district of Hormozgan Province in Iran over a period of 6 years from March 2003 to March 2009, were analysed. Meteorological variables (the rainfall, temperature, and relative humidity in this district) were also assessed. Monthly and weekly autocorrelation functions, partial autocorrelation functions, and cross-correlation graphs were examined to explore the relationship between the historical morbidity data and meteorological variables and the number of cases of malaria. Having used univariate auto-regressive integrated moving average or transfer function models, significant predictors among the meteorological variables were selected to predict the number of monthly and weekly malaria cases. Ljung-Box statistics and stationary R-squared were used for model diagnosis and model fit, respectively.

Results: The weekly model had a better fit (R(2)= 0.863) than the monthly model (R(2)= 0.424). However, the Ljung-Box statistic was significant for the weekly model. In addition to autocorrelations, meteorological variables were not significant, except for different orders of maximum and minimum temperatures in the monthly model.

Conclusions: Time-series models can be used to predict malaria incidence with acceptable accuracy in a malaria early-warning system. The applicability of using routine meteorological data in statistical models is seriously limited.
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June 2016

Effect of Nutritional Habits on Dental Caries in Permanent Dentition among Schoolchildren Aged 10-12 Years: A Zero-Inflated Generalized Poisson Regression Model Approach.

Iran J Public Health 2016 Mar;45(3):353-61

Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: The aim of this study was to assess the associations between nutrition and dental caries in permanent dentition among schoolchildren.

Methods: A cross-sectional survey was undertaken on 698 schoolchildren aged 10 to 12 yr from a random sample of primary schools in Kermanshah, western Iran, in 2014. The study was based on the data obtained from the questionnaire containing information on nutritional habits and the outcome of decayed/missing/filled teeth (DMFT) index. The association between predictors and dental caries was modeled using the Zero Inflated Generalized Poisson (ZIGP) regression model.

Results: Fourteen percent of the children were caries free. The model was shown that in female children, the odds of being in a caries susceptible sub-group was 1.23 (95% CI: 1.08-1.51) times more likely than boys (P=0.041). Additionally, mean caries count in children who consumed the fizzy soft beverages and sweet biscuits more than once daily was 1.41 (95% CI: 1.19-1.63) and 1.27 (95% CI: 1.18-1.37) times more than children that were in category of less than 3 times a week or never, respectively.

Conclusions: Girls were at a higher risk of caries than boys were. Since our study showed that nutritional status may have significant effect on caries in permanent teeth, we recommend that health promotion activities in school should be emphasized on healthful eating practices; especially limiting beverages containing sugar to only occasionally between meals.
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March 2016

Role of Hematocrit Concentration on Successful Extubation in Critically Ill Patients in the Intensive Care Units.

Anesth Pain Med 2016 Feb 16;6(1):e32904. Epub 2016 Jan 16.

Division of Respiratory Disease, Department of Internal Medicine, Imam Khomeini Hospital Complex, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Background: Hematocrit (Hct) is an important parameter for optimal oxygenation during discontinuation from ventilator, but there is no consensus about its concentration and effectiveness on successful extubation.

Objectives: The current study aimed to determine the role of Hct concentration on extubation failure in critically ill patients.

Patients And Methods: The current prospective cohort study investigated the effect of age, gender and Hct level on successful extubation of 163 mechanically ventilated patients in Imam Khomeini hospital intensive care units (ICUs), Tehran, Iran. Following successful weaning process, the patients were classified into two groups on the basis of Hct level; 62 with an Hct level of 21% - 27% and the other 101 patients with Hct levels above 27%. The data were analyzed by chi-square test and multiple logistic regressions. A probability value of less than 0.05 was considered significant.

Results: There was no significant association between the level of Hct concentration and extubation failure (8.9% vs. 9.2%, P = 0.507). Gender and age were significantly associated with extubation failure (OR = 9.1, P = 0.034, OR = 12.5, P = 0.014, respectively). Although the differences between, before and after extubation of PaO2 and P/F ratio, were of significant values between the two different groups of Hct (P = 0.001, P = 0.004 respectively), they had no effect on the failure of extubation (P= 0.259, P = 0.403, respectively).

Conclusions: Although some studies showed association between anemia and extubation failure, the current study could not confirm it. The study showed that males, regardless of the Hct level, had a better extubation success rate than those of females.
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February 2016

Brewer's Yeast Improves Blood Pressure in Type 2 Diabetes Mellitus.

Iran J Public Health 2013 1;42(6):602-9. Epub 2013 Jun 1.

International Campus, Tehran University of Medical Sciences, Tehran, Iran.

Background: This study was conducted to investigate the effects of Brewer's yeast supplementation on serum lipoproteins and blood pressure in patients with Type 2 diabetes mellitus.

Methods: In a randomized double blind clinical trial, 90 adults with type 2 diabetes mellitus were recruited, and divided randomly into 2 groups, trial group received brewer's yeast (1800 mg/day) and control group received placebo for 12 weeks. Weight, BMI, food consumption (based on 24 hour food recall), fasting serum lipoproteins (Cholesterol, Triglyceride, LDL-c, HDL-c), systolic and diastolic blood pressures were measured before and after the intervention. Data analyses were performed by Statistical Package for Social Sciences ver. 18.0, and the statistical tests included Independent t-test, Paired t-test, Kolmogorov-Smirnov and analysis of covariance. This trial was registered in Iranian Registry of Clinical Trials (IRCT), No.IRCT138807062513N1.

Results: Eighty-four subjects (21 men and 63 women) aged 46.3±6.1 years completed the study. After 12 weeks supplementation, systolic and diastolic blood pressures were decreased in the group receiving brewer's yeast (4.1±1.5, P=0.007 and 5.7±0.6, P=0.001 respectively). No-significant changes in LDL-c, HDL-c, Triglyceride and Cholesterol were shown.

Conclusion: Supplementation with Brewer's yeast besides the usual treatment of type 2 diabetes mellitus can reduce systolic and diastolic blood pressures in diabetic patients.
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August 2013